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Exclusion criteria included end-stage illness, dialysis, renal transplantation, severe pancreatic disorders, bowel obstruction or major surgery of the intestines before cohort entry, the diagnosis of drug misuse within one year of cohort entry, and the diagnosis of diseases (e.g., inflammatory bowel disease, neoplasms, or hernias) that could cause constipation or intestinal obstruction within 90 days of cohort entry