Prevalence and risk of developing comorbid conditions in patients with chronic constipation

Abstract

Objective:To estimate the prevalence of gastrointestinal (GI) and non-GI comorbidities and the risk of incident comorbidities among patients with and without chronic constipation (CC).Research design and methods:Adults with CC were identified from a large retrospective US claims database. Each CC patient was matched 1:3 to CC-free patients by birth year, sex, and region of residence.Main outcome measures:Prevalence of GI and non-GI comorbidities was measured over a 1-year period. Relative risk of new comorbidities was also estimated among patients who were free of the studied comorbidity prior to the index date.Results:Mean age was 61.9 years; 33.3% of patients were male. The 1-year prevalence of GI comorbidities was significantly higher in CC (N = 28,854) vs. CC-free (N = 86,562) patients (all p < 0.05). The risk of developing new GI conditions was also significantly higher in CC patients for all studied conditions except ulcerative colitis: megacolon (hazard ratio [95% confidence interval] HR [CI] = 11.96 [8.16–17.53]), intestinal impaction (10.56 [9.22–12.10]), volvulus (7.12 [5.42–9.35]), other specified functional intestinal disorders (6.67 [5.57–8.00]), and other unspecified functional disorders of intestine (4.60 [3.61–5.87]). Similarly, 1-year prevalence of non-GI comorbidities was higher in CC patients, as was the risk of developing new conditions: depression and mood disorder (HR [CI] = 1.84 [1.77–1.90]), neurological disorders (1.68 [1.62–1.74]), iron deficiency anemia (1.52 [1.47–1.57]), hypothyroidism (1.40 [1.34–1.46]), and peripheral vascular disorders (1.40 [1.34–1.46]).Limitations:An algorithm was used to define CC as there is no specific diagnosis code to identify CC.Conclusions:CC patients had significantly higher prevalence and were at increased risk of developing new GI and non-GI comorbidities than age-, gender- and region-matched CC-free patients. Future research is warranted to better understand these associations.