Inclusion criteria:
Inclusion Criteria : 1-age over 20 years 2. Have at least 2 of the following criteria; - Straining during at least 25 percent of defecations - Lumpy or hard stools in at least 25 percent of defecations -Sensation of incomplete evacuation for at least 25 percent of defecations -Sensation of anorectal obstruction/blockage for at least 25 percent of defecations -Manual maneuvers to facilitate at least 25 percent of defecations -Fewer than three defecations per week 3. during the last month,Without the use of laxatives, rarely have soft stool 4. Patient satisfaction to participate in the study
Exclusion criteria:
Exclousion criterias: 1- Use medications Anti-seizures, Carbamazepine, Phenobarbital, Phenytoin, Anti-neoplastic, Calcium channel blockers: Verapamil, Diuretics: Forzamide, Anti-epileptic drugs, Anti-epileptic drugs, Anti-epileptic drugs. , 5-HT antagonists, NSAIDs: ibuprofen, opioid.
2. History of mechanical and False intestinal obstruction based on previous colonoscopy or radiography or history
3 - Metabolic and endocrine diseases such as Diabetes, Hyperthyroidism and Hypothyroidism, Hypercalcemia, Hypokalemia, Pan-Hypopyothelium, Pheochromocytoma, Porphyria 4. Neurological disease and myopathic amyloidosis, autonomic neuropathy, Chagas disease, dermatomyositis, multiple sclerosis, Parkinson's disease, systemic progressive sclerosis, spinal cord injury based on biography and history 5-Special surgical and special medical conditions such as inability to move, history of Intestine surgery, ...
6. Endoscopy and radiology report in the last 5 years on abnormalities, malignancy, IBD and hemorrhoids 7-Patients with abnormal Hgb, TFT, Ca, and ESR. 8-Patients with HTN or Diabetes 9 -Patients with Asthma and Bronchitis 10.-Patients with Renal failure 11. Pregnant and nursing women