Characteristics Of Constipation Research Articles

Meta-analysis: Intestinal ultrasound to evaluate colonic contents and constipation.

Constipation can be diagnosed clinically using the Rome criteria. Ultrasound (US), which lacks the radiation exposure of conventional X-ray, holds promise as a non-invasive tool to evaluate colonic contents and constipation. To examine the role of US in the assessment of constipation. We performed a systematic search of Embase (OVID, 1984), Medline (Ovid, 1946), Cochrane Central, ClinicalTrials.gov and Australia New Zealand Clinical Trials Registry from database inception to 26 January 2024 according to PRISMA guidelines and prospectively registered with PROSPERO. All studies using US to assess constipation or colonic contents in either adults or children were included. Rectal diameter measurements were pooled in meta-analysis. Risk of bias was assessed using the Newcastle Ottawa Scales and Joanna Briggs Institute checklists. Of 12,232 studies screened, 51 articles (6084 patients; 3422 children) describing US to assess symptoms in patients with constipation were included. Most studies used Rome criteria to diagnose constipation. Rectal diameter was associated with clinical constipation in 29 paediatric studies (3331 patients). Meta-analysis showed the mean rectal diameter of constipated patients was significantly higher than controls (mean difference 12 mm, 95% confidence intervals (CI): 6.48, 17.93, p < 0.0001, n = 16 studies). Other features of constipation on US included posterior acoustic shadowing and echogenicity of luminal contents. US is an appealing imaging modality to assess luminal contents and constipation. Further well-designed studies are required to validate US metrics that accurately identify constipation.

Epidemiology of Constipation in Elderly People in Parts of China: A Multicenter Study.

PurposeTo investigate the epidemiological characteristics of constipation in people aged 65 years and older in several regions of China.Patients and MethodsA cross-sectional study based on a cluster sampling design was conducted in four cities of China: Tianjin, Xiamen, Cangzhou and Harbin. A total of 5,222 cases (age ≥ 65 years) were recruited, and the survey was conducted via centralized and household questionnaires that included the following: basic demographic characteristics such as sex, age, education, marital status, living status and occupation; social activities; duration of sleep at night; duration of menstruation and delivery times (in females); and if the participant had constipation symptoms, the severity of constipation. Constipation was diagnosed according to the Rome IV criteria.ResultsOf the 5,222 participants, 919 were diagnosed with constipation. The prevalence of constipation was 17.60% in elderly people ≥65 years old. Prevalence increased with age and was significantly higher in females than males (P < 0.05). Prevalence was lower in the manual compared to the non-manual worker group, and significantly increased with decreasing duration of night sleep (P < 0.05). Older age, female sex and shorter sleep duration at night were risk factors for constipation in elderly people.ConclusionThe prevalence of constipation in the elderly people in four cities of China was 17.60%, and was significantly affected by age, sex and sleep duration at night.

Características da constipação funcional em crianças de zero a doze anos atendidas em um ambulatório de gastroenterologia pediátrica

Justificativa e Objetivo: A caracterização da constipação orienta uma abordagem preventiva. O estudo tem por objetivo conhecer as características da constipação nas crianças atendidas em ambulatório especializado. Métodos: Trata-se de um estudo transversal, quantitativo e descritivo, com aplicação de questionário durante o primeiro atendimento ambulatorial de gastroenterologia pediátrica, entre agosto de 2014 a outubro de 2015. Na seleção dos pacientes utilizou-se os critérios de ROMA IV e relato de hematoquezia e disquezia. Realizou-se um perfil clínico-epidemiológico das crianças, prevalência dos principais sintomas, comorbidades e tratamentos prévios. Na história alimentar incluiu-se questões sobre satisfação dos pais/responsáveis quanto a ingestão de alimentos e líquidos pela criança. A análise e o processamento dos dados foram realizados com o programa Statistical Package for the Social Sciences (SPSS) versão 22.0. Resultados: Queixas de constipação ocorreram em 29% dos novos pacientes. Média de 4,3 anos com início dos sintomas, majoritariamente no primeiro ano de vida (71,0%). A principal comorbidade foi alergia alimentar e 77,6% já realizavam tratamento. Amamentação exclusiva não ocorreu em 19,4%. A média da idade de introdução da fórmula foi 4,89 meses. A introdução de leite de vaca na dieta foi em média aos 9 meses. A ingestão de frutas e legumes, considerada satisfatória em 25,8% e de água em 57%. Conclusão: O estudo mostrou que crianças com constipação intestinal de um ambulatório especializado apresentam elevada prevalência de início já no primeiro ano de vida. O estímulo ao aleitamento materno e adequada orientação alimentar no desmame ainda é considerada a melhor forma de prevenção.

Prevalence of constipation in the German population - a representative survey (GECCO).

Variable prevalence rates between 2.4 and 35% have been reported for chronic constipation across different countries worldwide, with a low 5% for Germany. We conducted a computer-assisted telephone interview among 15,002 representative individuals in Germany, asking about health-related problems, including constipation. Those who acknowledged the presence of constipation symptoms during the preceding 12 months were questioned concerning constipation features and sociographic variables. Of 15,002 individuals interviewed, 2,239 (14.9%) acknowledged having experienced constipation during the last 12 months, 864 (5.8%) reported constipation during the last 4 weeks, and 380 (2.5%) had current constipation symptoms; 4.4% had taken medication because of their constipation, and 2.6% had consulted a doctor for constipation. In comparison to non-constipated volunteers, those constipated had a lower health quality of life and poorer health, and lower income and social status. Up to 15% of the general (German) population report symptoms of constipation depending on the definition. This matches pooled constipation rates across 18 countries (14%).

Long-term results following sacral nerve stimulation for chronic constipation.

The long-term outcome of sacral nerve stimulation (SNS) for chronic functional constipation was assessed. Patients who received a definitive SNS implant for chronic functional constipation only (according to the Rome III criteria) and were followed up for at least 3years were included in this study. Slow transit constipation (STC) was distinguished from obstructed defaecation (OD) and mixed/undetermined constipation (MU). Constipation features, Cleveland Clinic Constipation score (CCCS) and SF-36 questionnaire data were collected; physiological tests were performed. Forty-two out of 61 patients suitable for SNS received a definitive implant (14 for STC, 15 for OD, 13 for MU). Following SNS device implantation (mean follow-up 51±15months), the baseline CCCS (17±6) dropped to 9±6 (P<0.001) and 47% of patients had an improvement in the CCCS of more than 50%. Such improvement was more significant in patients with OD. Anal pressures did not change, while threshold and urgency rectal sensation significantly decreased, in particular in patients with OD. All aspects of patients' health status (SF-36) improved significantly following SNS; this was more marked in patients with OD. Data from this study suggest that the clinical efficacy of SNS can be prolonged in constipated patients, but in both the preliminary diagnostic assessment and pathophysiological interpretation every effort should be made to select patients for SNS. Although SNS showed efficacy in a low percentage of patients with STC, patients with OD were more responsive.

Characteristics of Constipation at Acute Phase of Cerebral Stroke

Objectives: The prevalence of constipation is high after stroke. Multiple factors such as long-term bed-ridden status, comorbidity, medical illnesses are combined in this condition. However, the change of bowel movement during the early stage of stroke remains uncertain. Methods: Patients with first stroke who admitted in a single institute from 2008 to 2009 were reviewed retrospectively and 36 patients were enrolled. As a control group, 47 consecutive orthopedic patients needing bed rest without surgery in the same period were enrolled. Data of stroke associated factors, frequency of BM (bowel movement) during 5 weeks, use of gastrointestinal medications, and outcomes were collected from the medical records. Results: The cumulative incidence of decreased ( 3/day) was 38.9% in stroke and 14.9% in control group. In acute stroke, 58% of patient showed severely decreased BM in first week, and the proportion was rapidly decreased below 15% from second week. However, laxative use increased with hospital days. The occurrence of severely decreased BM in stroke patients was associated with National Institutes of Health Stroke Scale (NIHSS; P=0.004). Severely decreased BM was not associated with poor outcomes including death, morbidity, and stroke recurrence. Conclusion: Decreased BM is common in acute stroke. The occurrence of severely decreased BM is associated with NIHSS. However, the severe manifestation occurred mainly in the first week, and considered to be well controlled by laxatives. (Ewha Med J 2015;38(1):22-29) Received October 16, 2014 Accepted October 27, 2014

Surgical methods of treatment of intestinal passage disturbances with the characteristics of constipation in patients with intestinal stoma based on own experience

Stoma is an intestinal fistula created in emergency or by elective indications, and it is done to drain out the digestive tract content. In some patients there is a disturbance passage of gastric contents through the stoma, which may take the form of chronic constipation or even periodic subileus that will sooner or later require surgical treatment. The aim of the study was the assessment of the causes and method of treatment of constipation in patients with intestinal stoma. A total of 331 patients with stoma followed by Ostomy and Proctology Outpatient Clinic were included in the study in the years 2011-2014. The study included 146 women and 185 men and the average age was 61.3 ± 12.7 years. Within the entire froup, 273 patients had the end stoma performed whereas in 58 patients the loop stoma was created. The highest percentage of patients were the ones with diverticulosis and colorectal cancer, i.e. 132 and 114 patients respectively. A stoma was created in 35 patients due to inflammatory bowel disease (IBD), in 23 patients because of cancer, in 14 as a result of injuries and in 13 due to rectovaginal fistula. Out of the entire group subject to study (331 patients) 93 patients (28.1%) suffered from constipation. 50 patients with constipation required surgical intervention. The most common indication for surgical treatment was the parastomal hernia (36 patients, 72%), other indications were the narrowing of the stoma (5 patients, 10%), its collapse (6 patients, 12%) or prolapse (3 patients, 6%). Parastomal hernia was responsible for 84% of constipation within the stoma and 86.1% were treated with laparotomy (31 out of 36 patients). Other causes of constipation were the stomal stenoses (5 patients), collapse of the stoma (6 patients) and stomal prolapse (3 patients). All patients were treated surgically with a good final result. Constipation associated with dysfunction of the stoma in most cases should be treated surgically. Parastomal hernia is the most common cause of constipation in the stoma. Treatment should be performed in due time because of the possibility of developing complications, especially dangerous one is a strangulated parastomal hernia and ischemia of stoma.

Clinical Characteristics of Pediatric Constipation in South Jordan

PurposeConstipation is a common pediatric problem worldwide. This study aims to describe the clinical characteristics of pediatric constipation in south Jordan according to gender and age group.MethodsAll patients with constipation managed at our pediatric gastroenterology service between September 2009 and December 2012 were included. Hospital charts were reviewed. Demographic data, clinical characteristics, and final diagnosis were recorded. Data were analyzed according to gender and the following age groups: infants, pre-school, school age, and adolescents.ResultsDuring the study period, 126 patients were enrolled. The number (percentage) of patients according to age were the following infants: 43 (34.1%), pre-school: 55 (43.7%), school age: 25 (19.8%), and adolescents: 3 (2.4%). Males made up 54.8% of the study population. There were no statistical gender differences in any age group. The most common symptom in all age groups was dry, hard stool. Infrequent defecation was found in almost one-half of the patients. Fecal incontinence was more common in school-aged children compared to pre-school-aged children and adolescents. Abdominal pain was seen in almost 40% of the constipated children. Abdominal pain was more prevalent in girls and older children. Fecal mass in the rectum was the most common physical finding, with constipated boys exhibiting higher rates. Functional constipation was the most common etiology.ConclusionClinical characteristics of constipation in children vary according to age group and gender. Older children had less frequent bowel motions, a longer duration of symptoms, and a higher prevalence of long-standing constipation compilations (fecal incontinence and abdominal pain).

Age Differences in Patients Evaluated for Constipation

The purpose of this study was to determine the influence of age on various characteristics of constipation. We also sought to determine if age, comorbid conditions, and specific clinical characteristics such as use of pain medications were associated with an increase in the frequency of constipation-associated symptoms. The sample comprised 518 patients 18 years or older with a primary diagnosis of constipation. Subjects were drawn from the clinical database of all patients (n = 1228) referred from primary care or gastroenterology practices to the University of California, San Francisco Center for Pelvic Physiology between March 2003 and October 2007. Cross-sectional study. Patients completed 2 questionnaires. The clinical questionnaire obtained information on demographic characteristics and previous medical history. A second, investigator-developed questionnaire provided data about characteristics of constipation, symptoms of constipation, as well as various bowel and dietary habits. : Both younger and middle-aged patients were more than twice as likely as older patients to have infrequent bowel movements and abdominal bloating and to use position changes to facilitate bowel evacuations. In addition, younger patients were nearly 3 times as likely to report abdominal pain as older patients. Patients with constipation who present at a younger age report a higher frequency of certain characteristics, symptoms, and bowel habits. Screening of younger patients for this common problem is warranted.

Does constipation predict the quality of bowel preparation during colonoscopy?

BackgroundSuboptimal bowel preparation has several consequences, including reduced polyp detection rate and increased cost of colorectal cancer screening. The presence of constipation is thought to be a feature associated with...

Prevalence and clinical presentation of constipation in children with severe generalized cerebral palsy

Our aim was to study the prevalence and characteristics of constipation in children with profound multiple disabilities, as data in this area are scarce. A cross-sectional observational study was performed in specialized day-care centres and schools in the Netherlands. The study included 152 children (81 males, 71 females; mean age 9 y 6 mo, SD 4 y 6 mo). Intellectual disability ranged from moderate (7%) to profound (52%) in all participants who also had severe motor disabilities (83% classified at Gross Motor Function Classification System level V). We collected data on defaecation characteristics, food and fluid intake, and laxative consumption using standardized bowel diaries and interviews. Constipation was defined as (1) scybalous, pebble-like, hard stools in over a quarter of defaecations in combination with a defaecation frequency of less than three times per week during a 2-week study period; (2) large stools palpable on abdominal examination; or (3) laxative use or manual disimpaction of faeces. Of the studied population, 57% were constipated and 55% used laxatives, 27% of whom showed symptoms of constipation. Daily intakes of water and fibre were below the required standards in 87% and 53% of participants respectively, without a proven relation to constipation. Constipation is a common problem in children with severe disabilities. Laxative use is high but dosing is frequently inadequate to prevent symptoms.

Gender differences in self-reported constipation characteristics, symptoms, and bowel and dietary habits among patients attending a specialty clinic for constipation

This study assessed gender differences in the frequency of various characteristics of constipation, constipation-specific symptoms, and bowel and dietary habits, as well as the effects of independent but associated risk factors. A cross-sectional study of patients aged >or=18 years with a primary diagnosis of constipation (ie, constipation, slow-transit constipation, outlet dysfunction constipation) was conducted at a tertiary referral center; patients were excluded if they had a primary diagnosis of fecal incontinence. Patients completed both a clinical questionnaire to obtain information on demographic characteristics and medical history and an unvalidated self-report questionnaire relating to the characteristics and symptoms of constipation as well as various bowel and dietary habits. Likert scales were used to assess 4 characteristics of constipation (frequency of constipation, duration of constipation symptoms of >or=1 month, bowel movement frequency, stool consistency) and the frequency of occurrence of 6 constipation symptoms (abdominal pain, abdominal bloating, incomplete evacuation, unsuccessful attempts at evacuation, pain with evacuation, straining with evacuation). The bowel habits that were evaluated included time spent at each evacuation; frequency of needing to change position to evacuate; use of anal digitation to evacuate; and the use of laxatives, enemas, stool softeners, foods, drinks, or other aids. The dietary habits that were evaluated included use of dietary fiber, use of fiber supplements, and water intake. Of the 518 patients, the majority were female (79.0%), white (76.3%), and employed (62.0%), with a mean (SD) age of 52.4 (16.5) years (range, 18.6-91.5 years). After controlling for a number of related conditions, women were more likely than men to have infrequent bowel movements (adjusted odds ratio [AOR] = 2.97; 95% CI, 1.67-5.28), abnormal stool consistency (ie, hard or pelletlike stools) (AOR = 3.08; 95% CI, 1.80-5.28), and a longer duration of constipation symptoms (AOR = 2.00; 95% CI, 1.05-3.82). In addition, women were more likely to report an increased frequency of occurrence of abdominal pain (AOR = 2.22; 95% CI, 1.22-4.05), bloating (AOR = 2.65; 95% CI, 1.50-4.70), unsuccessful attempts at evacuation (AOR = 1.74; 95% CI, 1.01-3.00), and the use of anal digitation to evacuate stool (AOR = 3.37; 95% CI, 1.15-9.90). The women in this specialty-based clinic study experienced a number of constipation symptoms and abnormal bowel habits more frequently than did men. These findings warrant replication in both population- and specialty clinic-based samples. In addition, the physiologic mechanisms that underlie these gender differences warrant investigation.

The call to stool and its relationship to constipation

Objective To determine the characteristics of the call to stool and to test hypotheses linking constipation to the suppression of the call to stool. Design Cross-sectional survey of apparently healthy adults. Setting Establishments with an occupational health service in or near Bristol, UK. Subjects The study included 400 adults aged from 16–70 years (47% female). Interventions Completion of a questionnaire concerning bowel habit, features of constipation and the call to stool, i.e. timing, location, strength, suppression and time to re-appearance, and morning routine. Main outcome measures Associations between responses to questions concerning the call to stool and bowel habit, including forward stepwise logistic regression analysis. Results In most subjects, the call was described as a hard-to-resist rectal sensation, but it could also be abdominal and could be vague or uncertain. The report of uncertain calls to stool was strongly associated with constipation by three out of four definitions. The call was resisted by most of the subjects, at least occasionally and, in 27%, a resisted call disappeared for at least a few hours. Prolonged disappearance of the call was a feature of subjects with a habit of defecating less often than once daily. The commonest times for a call to be felt were immediately on rising and after breakfast, but it came at no particular time in some subjects. Such subjects tended to have an irregular bowel habit and considered themselves to be constipated and lacked any routine in the early morning. Conclusions The call to stool varies in strength, timing and suppressibility. Constipation is associated with calls which are uncertain, unpredictable and slow to re-appear, and with an irregular morning routine.