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Try one of these related symptoms.

Constipation

Hard stools

Passing fewer than three stools a week

Pain when passing stools

Feeling of incomplete bowel emptying

I want to poop, but cannot

I can't defecate

Feel like I still have to poop after having a bowel movement

Cramping rectal pain

Slow bowel movements

Feeling of incomplete defecation

About the Symptom

Constipation is defined as having fewer than three bowel movements per week, accompanied by hard, dry, or lumpy stools, difficulty or discomfort in passing stools, or a sensation that not all stool has been eliminated.

When to See a Doctor

Seek professional care if you experience any of the following symptoms

Possible Causes

Generally, Constipation can be related to:

Related Serious Diseases

Sometimes, Constipation may be related to these serious diseases:

Doctor's Diagnostic Questions

Your doctor may ask these questions to check for this symptom:

Reviewed By:

Aiko Yoshioka, MD

Aiko Yoshioka, MD (Gastroenterology)

Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.

Unnati Patel, MD, MSc

Unnati Patel, MD, MSc (Family Medicine)

Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.

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Content updated on Jan 30, 2025

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FAQs

Q.

Need Laxatives? Why Your Gut Is Stalling and Medically Approved Next Steps

A.

Laxatives can help constipation, but the right next step depends on why your gut is stalling, with common causes including low fiber, dehydration, inactivity, certain medications, hormonal shifts, and underlying conditions. There are several factors to consider, from doctor-approved first steps like gradual fiber, fluids, movement, and a bathroom routine to choosing the safest laxative type and recognizing red flags that need urgent care. See the complete guidance below for key details that could change your next steps, including risks of overuse and special advice for pregnancy, older adults, and children.

References:

* Ford AC, et al. Management of chronic constipation in adults: an ACG Clinical Guideline. Am J Gastroenterol. 2018 Sep;113(9):1326-1348. doi: 10.1038/s41395-018-0194-6. Epub 2018 Aug 21. PMID: 30134033.

* Quigley EM. The causes of constipation. Med Clin North Am. 2017 Jan;101(1):1-10. doi: 10.1016/j.mcna.2016.08.012. PMID: 27958564.

* Shah A, et al. Pharmacological Treatment of Chronic Constipation. Curr Treat Options Gastroenterol. 2020 Feb;18(1):31-41. doi: 10.1007/s11938-020-00277-2. PMID: 32014798.

* Jantchou P, et al. Chronic constipation in adults: an updated review for general practitioners. Rev Med Interne. 2020 Sep;41(9):603-609. doi: 10.1016/j.revmed.2020.06.002. Epub 2020 Jul 17. PMID: 32677894.

* Bharucha AE, et al. Management of Chronic Constipation: A Review. JAMA. 2023 Feb 14;329(6):499-511. doi: 10.1001/jama.2023.0189. PMID: 36778112.

See more on Doctor's Note

Q.

Still Constipated? How Bisacodyl Works & Medically Approved Next Steps

A.

Bisacodyl is a stimulant laxative that activates colon nerves to increase contractions and move stool, with tablets working in 6 to 12 hours and suppositories in 15 to 60 minutes; it is intended for short-term relief, not routine daily use. If you are still constipated or need it more than once or twice weekly, there are several factors and evidence-based next steps to consider, including gradually increasing fiber and fluids, adding physical activity, trying an osmotic laxative, and setting a regular bathroom routine, with medical evaluation for persistent symptoms or red flags. See below for the complete guidance, including urgent warning signs and special considerations for older adults, pregnancy, and children that could change your next steps.

References:

* Kienzle-Horn S, et al. Efficacy and safety of bisacodyl in the treatment of chronic constipation: an updated review. Ther Adv Gastroenterol. 2018 May;11:1756283718767922.

* Rao SS, et al. Pathophysiology and management of chronic constipation: a review of current concepts. Gut Liver. 2020 Jan 15;14(1):17-31.

* Bharucha AE, Lacy BE, Nee J, et al. ACG Clinical Guideline: Management of Chronic Constipation. Am J Gastroenterol. 2023 Aug 1;118(8):1395-1411.

* Bassotti G, et al. Laxatives in the treatment of chronic constipation. Curr Med Res Opin. 2019 Feb;35(2):227-235.

* Lembo A, et al. Management of refractory constipation. Nat Rev Gastroenterol Hepatol. 2022 Mar;19(4):219-232.

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Q.

Still Constipated? Why Polyethylene Glycol Works & Medically Approved Next Steps

A.

Polyethylene glycol is a first-line osmotic laxative that gently pulls water into the stool to soften it, usually working within 24 to 72 hours and considered safe and effective for many people even with longer use. If you are still constipated, there are several factors to consider, including hydration, consistent daily use, dose adjustments, cautious fiber, short-term stimulants, prescription options, pelvic floor therapy, and red flag symptoms that need urgent care. See the complete details below to decide your next medically approved steps and when to talk to a doctor.

References:

* Ponce J, Gaskins J, Olyaee M. Polyethylene Glycol (PEG) 3350 for the Treatment of Constipation in Children and Adults: A Review. Drugs. 2022 Oct;82(15):1617-1628. doi: 10.1007/s40265-022-01783-6. PMID: 36243916.

* Chang L, Chey WD, Imdad A, Lembo A, Lock B, Moayyedi P, Quigley EMM, Saito YA, Shah ED, Walker M. ACG Clinical Guideline: Management of Chronic Idiopathic Constipation. Am J Gastroenterol. 2021 Oct 1;116(10):1914-1934. doi: 10.14309/ajg.0000000000001440. Epub 2021 Jul 26. PMID: 34310116.

* Trier K, Shiff A. Pharmacologic treatment of chronic constipation. Ther Adv Gastroenterol. 2019 Dec 19;12:1756284819895627. doi: 10.1177/1756284819895627. PMID: 31885567; PMCID: PMC6927357.

* Lee-Robichaud H, Whitehead C, Nelson RL. Efficacy and safety of polyethylene glycol 3350 for chronic constipation in adults: A systematic review and meta-analysis. Am J Gastroenterol. 2019 Apr;114(4):534-547. doi: 10.14309/ajg.0000000000000017. Epub 2018 Sep 18. PMID: 30228393.

* Lembo A, Lacy BE, Bhandari D, Chen X, Northcutt M, Sarocco S, Pimentel M. Approach to the Adult with Chronic Constipation. Dig Dis Sci. 2020 Feb;65(2):401-411. doi: 10.1007/s10620-019-05980-z. Epub 2019 Dec 24. PMID: 31873734.

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Q.

Need a Stool Softener? Why Your Colon is Stalled & Medically Approved Next Steps

A.

Constipation often stems from low fiber or fluids, inactivity, certain medications, or medical conditions, and while a gentle stool softener like docusate can ease hard stools and reduce straining, guidelines recommend starting with gradual fiber increases, better hydration, daily activity, and a consistent bathroom routine first. There are several factors to consider, including when to try other laxatives, red flag symptoms that need prompt medical care, and why long-term use should be supervised. See below for the complete, medically approved next steps to guide your personal plan.

References:

* Camilleri M, et al. American Gastroenterological Association Clinical Guideline: Management of Chronic Constipation. Gastroenterology. 2023 Dec;165(6):1495-1512. doi: 10.1053/j.gastro.2023.08.056. Epub 2023 Oct 12. PMID: 37834515.

* Shin A. Colonic Motility Disorders. Gastroenterol Clin North Am. 2024 Mar 22;53(1):159-173. doi: 10.1016/j.gtc.2023.10.003. Epub ahead of print. PMID: 38520779.

* Rao SS, et al. Pharmacologic Management of Chronic Constipation. Clin Gastroenterol Hepatol. 2019 Dec;17(13):2634-2649.e1. doi: 10.1016/j.cgh.2019.04.053. Epub 2019 May 10. PMID: 31085350.

* Bassotti G, et al. Chronic Constipation: Current Perspectives and Future Directions. World J Gastroenterol. 2023 Jul 21;29(27):4255-4273. doi: 10.3748/wjg.v29.i27.4255. PMID: 37576572; PMCID: PMC10411354.

* Ma K, et al. Lifestyle and dietary interventions for chronic constipation: a narrative review. World J Gastroenterol. 2023 Sep 21;29(35):5199-5216. doi: 10.3748/wjg.v29.i35.5199. PMID: 37780076; PMCID: PMC10526715.

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Q.

Still Constipated? Why Lactulose Is Slow & Medically Approved Next Steps

A.

Lactulose often takes 24 to 72 hours to work because it gently draws water into the colon rather than forcing contractions, so consistent dosing, good hydration, and patience are key. There are several factors to consider. Medically approved next steps include optimizing fiber and fluids, discussing polyethylene glycol or a short term stimulant with a clinician, and evaluating for underlying causes or prescription options, with urgent care needed for red flag symptoms; see the complete guidance below for details that can change which next step is right for you.

References:

* Ford AC, et al. Pharmacological Management of Chronic Idiopathic Constipation in Adults. Am J Gastroenterol. 2021 Jan 1;116(1):16-29. doi: 10.14309/ajg.0000000000001031. PMID: 33409477.

* Lacy BE, et al. ACG Clinical Guideline: Management of Chronic Constipation. Am J Gastroenterol. 2021 Jul 1;116(7):1321-1341. doi: 10.14309/ajg.0000000000001309. PMID: 34220037.

* Rao SSC. Management of Chronic Constipation in Adults: An Update. Gastroenterol Clin North Am. 2020 Jun;49(2):207-229. doi: 10.1016/j.gtc.2020.02.001. Epub 2020 Apr 17. PMID: 32414571.

* Camilleri M, et al. Pharmacologic Treatment for Chronic Constipation in Adults. Clin Gastroenterol Hepatol. 2023 Feb;21(2):292-302.e1. doi: 10.1016/j.cgh.2022.09.020. Epub 2022 Sep 27. PMID: 36179979.

* Bharucha AE, Lacy BE. Polyethylene Glycol and Other Osmotic Laxatives in Chronic Constipation. Gastroenterol Clin North Am. 2021 Jun;50(2):279-291. doi: 10.1016/j.gtc.2021.02.003. Epub 2021 May 20. PMID: 34024505.

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Q.

Gut Feeling "Cemented"? Why Your System is Stalling & Clinical Next Steps with Metamucil

A.

Constipation causing a cemented, stuck feeling is often due to low fiber, fluids, or activity, or certain meds or conditions, and Metamucil’s psyllium can help by softening and bulking stool when started low and taken with plenty of water alongside hydration, movement, and a bathroom routine, with improvements in 12 to 72 hours. Seek prompt care for red flags like blood in stool, severe abdominal pain, vomiting, black stools, sudden changes, or persistent symptoms, and know you may need more than fiber if there is no relief after 1 to 2 weeks. There are several factors to consider; see the complete guidance, stepwise options, and an online symptom check below.

References:

* Wald A, Bharucha AE, Cosman BC, et al. ACG Clinical Guideline: Management of Chronic Constipation. Am J Gastroenterol. 2021;116(8):1793-1812.

* McRorie JW Jr, Fahey GC Jr, Nadeau DA, Buddington RK. A Review of the Health Aspects of Psyllium as a Dietary Fiber. J Am Assoc Nurse Pract. 2021;33(8):724-739.

* Zhao T, Zhao L. Gut Microbiota and Fiber-Related Diet in Constipation. Nutrients. 2022;14(21):4498.

* Bharucha AE, Lacy BE. Mechanisms, Evaluation, and Management of Chronic Constipation. Gastroenterology. 2020;158(5):1232-1249.e3.

* Jalanka J, Voutila L, Salonius I, et al. Psyllium for the treatment of chronic constipation: a systematic review and meta-analysis. Ann Med. 2022;54(1):285-296.

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Q.

Internal Logjam? Why Your Gut is Stalling & Medical Magnesium Citrate Steps

A.

An internal logjam is usually constipation from slow-moving, dried stool caused by low fiber or fluids, limited activity, certain medicines, or medical conditions; magnesium citrate can offer quick, short term relief by drawing water into the colon when you first confirm it is appropriate for you, follow exact dosing, stay well hydrated, and expect results within hours. There are several factors to consider that could change your next steps, including who should avoid it, risks of overuse, red flag symptoms needing medical care, and longer term fixes like fiber, fluids, movement, and routine; see the complete guidance below for safer use, alternatives, and when to seek help.

References:

* Bharucha, A. E., & Lacy, B. E. (2020). Mechanisms, Evaluation, and Management of Chronic Constipation. *Gastroenterology*, *158*(5), 1239–1252.

* Donnellan, A., et al. (2021). The effects of different magnesium formulations on stool characteristics, gastrointestinal function, and the gut microbiome: a systematic review. *International Journal of Environmental Research and Public Health*, *18*(17), 9034.

* Camilleri, M., et al. (2017). Clinical Guideline: AGA Institute Guideline on the Pharmacological Management of Chronic Idiopathic Constipation. *Clinical Gastroenterology and Hepatology*, *15*(3), 323–333.

* Lindberg, G., Hamid, F. E., & Øresland, T. (2021). Medical treatment of chronic constipation in adults. *Scandinavian Journal of Gastroenterology*, *56*(7), 844–857.

* Bassotti, G., et al. (2020). Chronic Constipation: A Critical Review of New Treatment Options for a Perplexing Disease. *Journal of Clinical Gastroenterology*, *54*(2), 118–124.

See more on Doctor's Note

Q.

Internal Traffic Jam? Why Your Gut Is "Frozen" & Medical Miralax Steps

A.

A "frozen" gut is usually constipation from slowed movement due to low fiber, dehydration, inactivity, medications, or stress; MiraLAX (PEG 3350) draws water into stool and, when taken as 17 grams once daily, typically works in 1 to 3 days. There are several safety steps and red flags that can change your next steps, including not using MiraLAX for more than 7 days without medical advice and seeking care for severe pain, bleeding, vomiting, weight loss, or new constipation after 50; see below for the full plan, lifestyle fixes, and when to call a doctor.

References:

* Bharucha, A. E., & Lacy, B. E. (2023). Chronic constipation: An update for the internist. *Cleveland Clinic Journal of Medicine*, *90*(8), 490-499.

* Basumani, P., & Parkman, H. P. (2023). Osmotic Laxatives. *Current Opinion in Gastroenterology*, *39*(4), 304-310.

* Lacy, B. E., Mearin, F., Chang, L., Chey, W. D., Lembo, A. J., Simren, M., & Spiller, R. (2021). ACG Clinical Guideline: Management of Chronic Constipation. *The American Journal of Gastroenterology*, *116*(10), 2262-2278.

* Diop, P., Galmiche, J. P., & Juchaux, A. (2023). Disorders of gastrointestinal motility: from physiology to treatment. *Therapeutic Advances in Gastroenterology*, *16*, 17562848231201550.

* World Gastroenterology Organisation (WGO). (2023). Management of chronic constipation in adults: an evidence-based clinical practice guideline from the World Gastroenterology Organisation. *Journal of Clinical Gastroenterology*, *57*(10), 918-936.

See more on Doctor's Note

Q.

Internal Traffic Jam? Why Your Poop is Stalled & Next Steps to Relief

A.

If your poop feels stuck or hard, common causes include low fiber and fluids, lack of activity, ignoring the urge, certain medications, hormonal shifts, and pelvic floor or structural issues; relief usually comes from gradually adding fiber and water, moving daily, using a footstool and a regular morning toilet routine, and short term laxatives with guidance. Seek care urgently for red flags like blood, black stool, severe pain, vomiting, weight loss, sudden constipation after 50, pencil thin stool, or inability to pass gas, and if symptoms last 3 months you may need evaluation for chronic constipation; there are several factors to consider, and important details that could change your next steps are explained below.

References:

* Ford, A. C., Moayyedi, P., & Lacy, B. E. (2023). Chronic Idiopathic Constipation in Adults: A Review of the Current Evidence and Practical Management. *The American journal of gastroenterology*, *118*(10), 1735–1745. https://pubmed.ncbi.nlm.nih.gov/37311025/

* Bharucha, A. E., & Lacy, B. E. (2020). Mechanisms, Evaluation, and Management of Chronic Constipation. *Gastroenterology*, *158*(5), 1201–1218.e3. https://pubmed.ncbi.nlm.nih.gov/32041724/

* Chey, W. D., Lacy, B. E., & Shah, B. S. (2021). Current pharmacological management of chronic constipation. *Nature reviews. Gastroenterology & hepatology*, *18*(7), 481–491. https://pubmed.ncbi.nlm.nih.gov/33850383/

* Chang, L., Sultan, S., Lembo, A. J., & Lacy, B. E. (2023). AGA Institute Guideline on the Pharmacological Management of Chronic Idiopathic Constipation. *Gastroenterology*, *165*(2), 346–357. https://pubmed.ncbi.nlm.nih.gov/37197825/

* Sperber, A. D., Drossman, D. A., & Ghoshal, U. C. (2020). Chronic functional constipation: What is new?. *Best practice & research. Clinical gastroenterology*, *44-45*, 101662. https://pubmed.ncbi.nlm.nih.gov/32675003/

See more on Doctor's Note

Q.

Sluggish Gut? Why Your Digestion is Stalled & Medical Castor Oil Steps

A.

A sluggish gut typically means constipation from low fiber, dehydration, inactivity, stress or routine changes, medications, or certain conditions; castor oil can offer short-term relief in 6 to 12 hours by stimulating bowel contractions, but it is not for daily use and has safety limits. There are several factors to consider. See below for the medical castor oil steps, safe dosing and who should avoid it, plus proven long-term fixes like fiber, fluids, movement, bathroom routines, and the red flags that mean you should see a doctor.

References:

* Liu Y, Liu J, Ma H, Zhang Y, Zhang Z, He Z. Slow transit constipation: A clinical review. World J Gastroenterol. 2021 Nov 28;27(44):7612-7629. doi: 10.3748/wjg.v27.i44.7612. PMID: 34903823; PMCID: PMC8650536.

* Oh JH, Kim Y, Kim YS, Ko Y, Kim SW. Current Understanding of Gastrointestinal Motility and Functional Motility Disorders. J Neurogastroenterol Motil. 2022 Jul 30;28(3):364-377. doi: 10.5056/jnm22064. PMID: 35914948; PMCID: PMC9317586.

* Mehedi S, Al-Wabel NA, Almarshad FM, Alshammari HM, Alamri MS, Al-Yahya M, Alharbi M, Alshammari TM, Alshammari SF, Aldosari FA, Alkhamees HM, Al-Dosari MS, Alswilem MH. Ricinoleic Acid: The Key Bioactive Compound of Castor Oil for Its Laxative and Anti-inflammatory Properties. Front Pharmacol. 2023 Apr 21;14:1162804. doi: 10.3389/fphar.2023.1162804. PMID: 37151740; PMCID: PMC10156908.

* Schiller LR. Pharmacology of laxatives. Best Pract Res Clin Gastroenterol. 2019 Jun;40-41:101621. doi: 10.1016/j.bpg.2019.05.004. Epub 2019 May 22. PMID: 31151608.

* Sperber AD, Ghoshal UC, Drossman DA, Quigley EMM, Whorwell PJ. Functional gastrointestinal disorders. Lancet. 2021 Jul 10;398(10294):91-106. doi: 10.1016/S0140-6736(21)00591-9. PMID: 34217140.

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Q.

Stuck & Heavy? Why Your Gut Is "Frozen" + Medically Approved Next Steps

A.

Constipation that feels “frozen” usually means colon movement has slowed so stool sits longer, dries, and hardens; most often this is tied to low fiber, dehydration, inactivity, medication side effects, or conditions like hypothyroidism, diabetes, IBS, or pelvic floor dysfunction. Medically approved next steps include adding fiber gradually, hydrating consistently, moving daily, setting a post-meal bathroom routine, and short term use of bulk forming or osmotic laxatives, with urgent care for red flags like bleeding, unexplained weight loss, severe pain, vomiting, black stools, or sudden pencil thin stools; there are several factors to consider, so see the complete guidance below to choose the safest next steps for you.

References:

* Camilleri, M. (2021). Gastroparesis and functional dyspepsia: recent advances in diagnosis and treatment. *Gut*, *70*(1), 198-208.

* Talley, N. J., & Ford, A. C. (2022). Functional gastrointestinal disorders. *The Lancet*, *399*(10332), 1334-1344.

* Bassotti, G., Villanacci, V., & Antonelli, M. (2020). Pathology of gut dysmotility: a critical review. *Gut*, *69*(1), 185-195.

* Bharucha, A. E., & Lacy, B. E. (2020). Mechanisms, Evaluation, and Management of Chronic Constipation. *Gastroenterology*, *158*(5), 1202-1216.e4.

* Park, S. Y., & Im, S. J. (2021). Gut Microbiota and Functional Gastrointestinal Disorders: Current Perspectives and Future Directions. *Journal of Neurogastroenterology and Motility*, *27*(4), 481-497.

See more on Doctor's Note

Q.

Is it safe to use laxatives every day?

A.

Using laxatives every day can be safe in certain situations, but it's important to choose the right type and follow medical advice. See below to understand more.

References:

de Azevedo RP, Freitas FG, Ferreira EM, Pontes de Azevedo LC, & Machado FR. (2015). Daily laxative therapy reduces organ dysfunction in .... Critical care (London, England), 26373705.

https://pubmed.ncbi.nlm.nih.gov/26373705/

Tack J, van Outryve M, Beyens G, Kerstens R, & Vandeplassche L. (2009). Prucalopride (Resolor) in the treatment of severe chronic .... Gut, 18987031.

https://pubmed.ncbi.nlm.nih.gov/18987031/

Tuteja AK, & Rao SS. (2008). Lubiprostone for constipation and irritable bowel syndrome .... Expert review of gastroenterology & hepatology, 19090733.

https://pubmed.ncbi.nlm.nih.gov/19090733/

See more on Doctor's Note

Q.

When should I start worrying about constipation?

A.

If you haven't had a bowel movement for more than 5-7 days and also have pain, nausea or even vomiting, please seek further medical attention.

References:

Dorfman L, El-Chammas K, Mansi S, Kaul A. Gastrocolonic Response. Curr Gastroenterol Rep. 2022 Nov;24(11):137-144. doi: 10.1007/s11894-022-00849-2. Epub 2022 Nov 3. PMID: 36324042.

Burr RL, Jarrett ME, Cain KC, Jun SE, Heitkemper MM. Catecholamine and cortisol levels during sleep in women with irritable bowel syndrome. Neurogastroenterol Motil. 2009 Nov;21(11):1148-e97. doi: 10.1111/j.1365-2982.2009.01351.x. Epub 2009 Jul 1. PMID: 19573081; PMCID: PMC2820403.

Burr RL, Jarrett ME, Cain KC, Jun SE, Heitkemper MM. Catecholamine and cortisol levels during sleep in women with irritable bowel syndrome. Neurogastroenterol Motil. 2009 Nov;21(11):1148-e97. doi: 10.1111/j.1365-2982.2009.01351.x. Epub 2009 Jul 1. PMID: 19573081; PMCID: PMC2820403.

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References