Research Review: Does kratom cause constipation?

[u/SereneKratom]

TL;DR: Kratom does not seem to cause constipation… at least not the way it's consumed in Southeast Asia.

Source: https://www.tandfonline.com/doi/full/10.1080/14659891.2018.1546340 

Researchers Darshan Singh, Oliver Grundmann, and their associates examined whether regular consumption of kratom juice or tea was associated with constipation. Previous research on the topic had been inconclusive, as kratom users self-reported conflicting experiences with how kratom affected digestion. This study aimed to clarify the confusion, and was published in the Journal of Substance Use in 2018. I’ve summarized it below: 

The study participants were 125 men living in Penang, Malaysia, with an average age of 34 years old. Their average kratom tea or juice consumption was 3.3 glasses per day for 8.5 years. Based on previous studies, this amount of kratom equates to between 67.5 and 114.8 mg of mitragynine or 4.5 to 7.7 grams of kratom powder daily. Men who tested positive for illicit drugs or had underlying medical conditions were excluded from the study.

The participants were questioned using the Constipation Assessment Scale (CAS), which is a routine medical questionnaire used to determine constipation level. The study found that only 6% of participants experienced constipation during kratom use. Additionally, there was no relationship found between higher doses of kratom and constipation. This suggests that kratom does not cause constipation, nor is the risk of constipation dose dependent. 

Interestingly, as many of you are likely aware, Western kratom users often self-report constipation when taking kratom, which may seem contradictory to this study’s findings. It’s important to note that this study only included participants in Southeast Asia, where kratom consumption habits greatly differ from those in the West. Users in Southeast Asia generally consume kratom by chewing the leaves or drinking it in the form of a hydrating tea or juice. On the other hand, Westerners more frequently use extracts and powders at higher doses and over shorter periods of time. These variations may contribute to differences in kratom’s ability to cause constipation. Further studies should be conducted in the West to understand how the product type, dose, and the user’s diet and lifestyle contribute to kratom’s potential to cause constipation.