High Prevalence Of Constipation Research Articles

Constipation-associated factors in outpatients with schizophrenia: A multicenter questionnaire survey.

Constipation is a prevalent gastrointestinal disorder that affects people globally, decreasing their quality of life and life expectancy. Individuals with schizophrenia often suffer from constipation, which could be a result of the illness itself or the side effects of psychotropic medications. However, little research has been conducted on factors contributing to constipation in individuals with schizophrenia. To address this issue, we conducted a survey using self-administered questionnaires and medical records to identify factors associated with constipation in psychiatric outpatients. This study included 399 patients with schizophrenia, resulting in a high prevalence of constipation (43.4%). The analysis suggested that female gender, the doses of antiparkinsonian medications, and benzodiazepine sleeping pills may be associated with constipation.

Improvement of Post-Surgery Constipation in Patients with Fractures by Lactobacillus rhamnosus JYLR-127: A Single-Blind Randomized Controlled Trial.

The high prevalence of constipation after fracture surgery brings intolerable discomfort to patients on the one hand, and affects post-surgery nutrient absorption on the other hand, resulting in poor prognosis. Given the acknowledged probiotic properties of Lactobacillus rhamnosus, 100 fracture patients with post-surgery constipation were centrally enrolled and administered orally with L. rhamnosus JYLR-127 to assess the efficacy of probiotic-adjuvant therapy in alleviating post-fracture constipation symptoms. The results showed that L. rhamnosus JYLR-127 improved fecal properties, promoted gastrointestinal recovery, and relieved constipation symptoms, which were mainly achieved by elevating Firmicutes (p < 0.01) and descending Bacteroidetes (p < 0.001), hence remodeling the disrupted intestinal microecology. In addition, blood routine presented a decrease in C-reactive protein levels (p < 0.05) and an increase in platelet counts (p < 0.05) after probiotic supplementation, prompting the feasibility of L. rhamnosus JYLR-127 in anti-inflammation, anti-infection and hemorrhagic tendency prevention after fracture surgery. Our study to apply probiotics in ameliorating constipation after fracture surgery is expected to bless the bothered patients, and provide broader application scenarios for L. rhamnosus preparations.

Epidemiological investigation of constipation in urban areas of Hangzhou, China

Objective: To determine the prevalence and risk factors of constipation in Hangzhou urban areas by analyzing data from a recent epidemiological survey. Methods: From August 2022 to June 2023, a cross-sectional survey was conducted on 43 communities on eight streets in suburbs of Hangzhou, including Wangjiang, Sijiqing, Puyan, Changhe, Ziyang, Xiaoshanchengxiang, Zhuantang, and Banshan. Written questionnaires were filled out face to face by community doctors. The prevalence of constipation was investigated using a combination of the Bristol stool typing method and the Rome IV criteria. The risk factors for constipation were analyzed using multivariate logistic regression analysis. Results: The study cohort comprised 10,479 participants, 5551 of whom were male (53.0%) and 4928 female (47.0%). The overall prevalence of constipation was 10.6% (1107/10,479). The prevalence was 11.0% (613/5551) for male and 10.0% (494/4928) for female participants; this difference is not statistically significant (P>0.05).There were no significant differences in the prevalence of constipation between different categories of body mass index (P>0.05). The prevalence of constipation was highest in individuals aged 70 years and above, accounting for 15.4% (264/1717) of all cases. There were significant differences in the prevalence of constipation between different occupations, marital statuses, and educational levels (P<0.001). Patients with hypertension or diabetes mellitus had a higher prevalence of constipation than those without these conditions, those who had been taking long-term medication had a higher prevalence of constipation than those who did not, parents of children with constipation had a higher prevalence of constipation than those with children who did not have constipation, and there were other significant differences in various variables (P<0.001). Multivariate logistic regression analysis of modifiable factors revealed that eating less fruit (OR=1.284, 95%CI: 1.061-1.553, P=0.010), liking spicy and salty food (OR=1.234, 95%CI: 1.039-1.466, P=0.016), sleeping for too long (OR=1.644, 95%CI: 1.260-2.144, P<0.001), irregular sleep patterns (OR=1.370, 95%CI: 1.127-1.665, P=0.002) and minimal exercise (OR=1.388, 95% CI: 1.168-1.649, P<0.001) were all risk factors for constipation; whereas mix diets (OR=0.709,95%CI:0.608-0.826, P<0.001), meat diets (OR=0.604,95%CI: 0.495-0.736, P<0.001), moderate alcohol consumption (OR=0.659, 95% CI: 0.534-0.812, P<0.001), less or no drinking (OR=0.523, 95% CI: 0.428-0.638, P<0.001), and non-smoking (OR=0.819, 95%CI:0.674-0.995, P<0.001) protected against constipation. We found no association between dietary preferences and the risk of constipation (refined grains: OR=1.147, 95%CI:0.944-1.393, P=0.167; no specific preference: OR=0.935, 95%CI:0.783-1.117, P=0.459). The rate of agreement between self-evaluation of constipation by the respondents and objective criteria was higher for negatives (95.8%) than for positives (38.0%). Conclusion: The prevalence of constipation is relatively high in the urban population of Hangzhou. A good lifestyle and diet can significantly reduce its incidence. There should be more emphasis on preventive education, promotion of prevention of constipation, and advocacy for a healthy lifestyle.

Symptoms and Prevalence of Constipation among Adult Population of Bangladesh.

Constipation is one of the most common gastrointestinal disorders. The prevalence of constipation is rapidly increasing globally. It has adverse effects on the patient's quality of life including productivity and results in a high financial hardship on the healthcare system. The aim of the study was to estimate the symptoms and prevalence of constipation among the adult population of Bangladesh. It was a cross-sectional observational study based on a structured questionnaire and a checklist. In this study, three criteria were used for the diagnosis of chronic constipation (self-reported perception, Rome III criteria, and Bristol's criteria). The study was conducted among 1,550 population between July 2019 and December 2019. The study population consisted of 1,550 respondents, among them 41.61% male and 58.39% female, and the mean age was 32.71 ± 9.72 years. In the study, 12.2% of the population was categorized to have constipation according to self-reported perception, 11.2% according to Rome III, and 10.3% reported to have been suffering from constipation according to Bristol chart.Female gender tends to have a greater prevalence than male. In multivariate analysis for constipation, betel nut chewer, alcohol consumer, diabetes mellitus, hypertension, GI surgery, and bronchial asthma were significantly (p < 0.001) associated with constipation. According to Bristol's criteria, the most common stool form was Type III (sausage-shaped with cracked surface) among the Bangladeshi population in this study. Chronic constipation is a common problem worldwide. The findings of this study suggest that there is a high prevalence of constipation among the general population of Bangladesh. Decreasing modifiable risk factors of constipation can reduce its prevalence and burden of the disease. Bangladesh is markedly deficient in literature citing constipation prevalence and determinants. These findings may commence a call for setting priority as one of the major public health problems and demanding attention for both at the clinical and community levels. Ghosh DK, Sarkar DK, Nath M, et al. Symptoms and Prevalence of Constipation among Adult Population of Bangladesh. Euroasian J Hepato-Gastroenterol 2023;13(2):45-49.

Associations between constipation, overeating, and depression: A survey of Chinese oldest-old and centenarians

ObjectivesDepression is a common disease of elderly population, with a global prevalence of more than 20%. Few studies have involved the associations of constipation and overeating with depression, especially in the elderly population. We aimed to address these associations in Chinese oldest-old and centenarians. MethodsA total of 1863 elderly individuals from 18 regions of Hainan, China, were investigated from July 2014 to December 2016. Health survey, physical examination, and blood analyses were performed through structured questionnaires and standard procedures. The Geriatric Depression Scale (GDS-15) was used to measure depression. ResultsThe proportions of elderly individuals with depression, constipation, and overeating were 20.80% (349), 15.14% (254), and 26.52% (445), respectively. The prevalence of constipation and overeating was significantly higher in the elderly group with depression than in those without depression (P < 0.05, all). In the multiple linear regression analyses, higher prevalence of constipation and overeating had positive and significant associations with the GDS-15 (P < 0.05, all). In the multiple logistic regression analyses, constipation (odds ratio [OR]: 2.328; 95% confidence interval [CI]: 1.540–3.521) and overeating (OR: 2.735; 95% CI: 1.920–3.898) had positive and significant associations with depression (P < 0.05, in all). Conclusions and ImplicationsThis study provides epidemiological evidence that constipation and overeating have positive associations with depression in Chinese oldest-old and centenarians. The interventions for constipation and overeating should be improved to promote prevention and treatment for depression and achieve successful aging and healthy longevity.

Clinical Profile of Constipation in Children Under 5 Years of Age in Dr. Soetomo General Academic Hospital, Indonesia

Background: Childhood constipation is still common among children under 5 years of age. This study was conducted to determine the clinical profile of childhood constipation under 5 years of age at dr. Soetomo General Hospital, Indonesia. Methods: This retrospective cross-sectional study was performed by reviewing medical record of constipated children under 5 years of age at dr. Soetomo General Hospital Surabaya from January to December 2021. Data regarding age, gender, living place, body anthropometric (weight, height and nutritional status), sign and symptoms, and physical examination were collected for each patient. Nutritional status was determined by using WHO 2006 growth chart. We also assessed the presence of concomitant disease among those children and presented the data on the table. Results: A total of 35 subjects with constipation were included in this study. Mean (±SD) for age, body weight, length/height of these subjects were 27.09±17.71 months, 10.93±6.11 kg, 82.34±18.52 cm, respectively, with the male and female ratio of 1,67: 1. Around 18.2% of subjects presented with wasted, 18.2% with severely wasted, and 18.2% with severely stunted. Hardened stool (80%) was the most prevalent symptom, followed by straining (37.1%) and fecal impaction (22.9%). The most common concomitant diseases of childhood constipation were Hirschsprung’s disease (17.1%), congenital heart disease (11.4%), and hypothyroidism (11.4%). Conclusion: The results of this study showed that boys had a higher prevalence of constipation in children under 5 years of age, with the most prevalent clinical features being hardened stool, straining, and fecal impaction. Meanwhile, Hirschsprung’s disease, hypothyroidism, and congenital heart disease were the most concomitant disease.

Prevalence of Constipation in Elderly and Its Association With Dementia and Mild Cognitive Impairment: A Cross-Sectional Study.

BackgroundConstipation and dementia have similar epidemiological characteristics. Changes in intestinal flora and characteristics of the brain-gut axis play roles in the pathogeneses of the two diseases, suggesting that there may be a close connection between the two. Most of the studies on constipation in dementia patients have focused on the population with α-synucleinopathies [Parkinson’s disease dementia (PDD), dementia with Lewy bodies (DLB)]. Few studies have reported the prevalence of constipation in all-cause dementia and mild cognitive impairment (MCI) populations.ObjectiveTo assess the prevalence of constipation in patients with all-cause dementia and MCI subtypes and to explore the association between constipation with dementia and MCI subtypes.MethodsFrom May 2019 to December 2019, we conducted a population-based cross-sectional survey. A total of 11,743 participants aged 65 or older from nine cities in China were surveyed. Participants underwent a series of clinical examinations and neuropsychological measurements. Constipation, dementia, MCI and MCI subtype were diagnosed according to established criteria through standard diagnostic procedures.ResultsThe overall age- and sex-adjusted prevalence of constipation in individuals aged 65 years and older was 14.8% (95% CI, 14.6–15.0). The prevalence rates of constipation were19.2% (95% CI, 17.3–21.0), 19.1% (95% CI, 16.8–21.5), 14.4% (95% CI, 12.8–15.9), and 13.8% (95% CI, 13.0–14.6) in the dementia, non-amnestic (na)-MCI, amnestic (a)-MCI and normal cognition populations, respectively. Multivariate logistic regression analysis showed that higher prevalence of constipation was associated with dementia (p = 0.0.032, OR = 1.18, 95% CI: 1.02–1.38) and na-MCI (p = 0.003, OR = 1.30, 95% CI: 1.09–1.54).ConclusionThe present study found a high prevalence of constipation in elderly individuals in China, and higher in patients with dementia and na-MCI.

Prevalence of constipation in adults with obesity class II and III and associated factors

BackgroundConstipation and obesity have common risk factors. However, little is known about the occurrence of constipation in individuals with severe obesity and the associated factors.ObjectiveTo evaluate the prevalence of intestinal constipation and its associated factors in adults with obesity class II and III.MethodThis study analyzed baseline data from a randomized clinical trial with adults aged 18–64 with a Body Mass Index (BMI) ≥ 35 kg/m2, living in the metropolitan region of Goiânia, Brazil. Data were collected using a questionnaire containing sociodemographic, lifestyle, level of obesity, presence of comorbidities, water intake and food consumption variables. The outcome variable was constipation assessed by the Rome III criteria and the Bristol Stool Form Scale. Multiple Poisson regression analysis was used to assess the association between explanatory variables and the outcome.ResultsAmong the 150 participants, the prevalence of constipation was 24.67% (95% CI: 17.69–31.64). After multiple regression analyses constipation was associated with polypharmacy (adjusted PR: 2.99, 95% CI: 1.18–7.57, p = 0.021), younger age group i.e. 18–29 years (adjusted PR: 3.12, 95% CI: 1.21–8.06, p = 0.019) and former smoking (adjusted PR: 3.24, 95% CI: 1.28–9.14, p = 0.014). There was no statistically significant association between constipation and daily consumption of fiber-rich foods, however, the non-consumption of whole grains was borderline significant (adjusted PR: 2.92, 95% CI: 1.00 to 8.49, p = 0.050).ConclusionA high prevalence of constipation was found in adults with obesity class II and III. Constipation was significantly associated with the simultaneous use of five or more medications, younger age group and being a former smoker.

S0482 Incidence and Outcomes of Constipation in Critically Ill, Mechanically Ventilated Patients on Fentanyl Infusions

INTRODUCTION: Gastrointestinal dysfunction is a common adverse outcome in critically-ill patients. Sedated and mechanically ventilated patients are a particularly high-risk group prone to constipation. This study aimed to identify the incidence and associated outcomes of constipation in this high-risk group. METHODS: Data was obtained from the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC) Database v1.4 with the following inclusion criteria: >18 years old, admitted to MICU, and on mechanical ventilation receiving fentanyl infusion for sedation and analgesia. Exclusion criteria entailed intubation for less than 48 hours, intraabdominal surgery during admission, a new or chronic stoma. Patients were stratified by severity of constipation, classically defined as fewer than 3 bowel movements (BMs) in 7 days. Subgroups included: (G1) <1 bowel movements (BM) in 7 days, (G2) 1–2 BMs in 7 days, and (G3) 3+ BMs in 7 days, defined as “non-constipated” patients. Outcome differences identified included in-hospital mortality, hours on a ventilator, and length of stay (LOS). RESULTS: A total of 355 patients met inclusion criteria. The prevalence of overall constipation (fewer than 3 BMs in 7 days) was 74%. Comparison of in-hospital mortality and LOS in non-constipated patients (G1) versus all constipated patients (G2 & G3) showed a higher mortality (45% vs 31%, P = 0.017) but lower LOS (18 days vs 27 days, P < 0.001) in G3. A similar trend was demonstrated comparing G1 with G2 individually with an in-hospital mortality (45% vs 27%, P = 0.006) and lower LOS (18 days vs 23 days, P = 0.009). Comparing G1 with G3 demonstrated significant differences in LOS (18 days vs 30 days, P < 0.001). We found no differences in time spent under mechanical ventilation between the constipated and non-constipated groups. No significant differences were identified in groups comparisons of age, sex, weight, or choice of prophylactic bowel regimen. CONCLUSION: A high prevalence of constipation (74%) was identified in mechanically ventilated patients on fentanyl infusions. Furthermore, constipated patients were found to have a statistically significant difference in LOS compared to non-constipated patients. Findings support constipation as a marker for ICU morbidity and may be amplified by future studies on the effect of prophylactic bowel regimens on outcomes, including LOS and in-hospital mortality.Table 1Table 2Table 3

210 Association of epidermal dysfunction and constipation in the elderly

Chronologically aged humans display epidermal dysfunction and high prevalence of constipation. Whether epidermal dysfunction and constipation are associated is unknown. In the present study, we compared the epidermal function in subjects with and without constipation. A total of 577 aged subjects, including 169 males and 408 females, were enrolled in this study. Epidermal biophysical properties, including transdermal water loss (TEWL) rates and stratum corneum hydration, on the flexor forearm, were measured with a Gpskin device, while skin surface pH was measured with a portable pH meter. Our results showed that the stratum corneum hydration levels were 14% lower in subjects with constipation than that without constipation. Moreover, both TEWL rates and skin surface pH were significantly higher in subjects with constipation than that without constipation (p<0.05). Furthermore, permeability barrier recovery was delayed in subjects with constipation in comparison with those without constipation. In contrast, epidermal biophysical properties were comparable in subjects with or without gastric disorders. Interestingly, twice-daily applications of an emollient for 6 months improved epidermal functions, such as stratum corneum hydration, TEWL rates and barrier recovery rates, along with marked reductions in constipation scores. These results suggest that epidermal dysfunction plays a pathogenic role in aging-associated constipation, and improvements in epidermal function can alleviate aging-associated constipation.

The role of dietary fibre and prebiotics in the paediatric diet.

Dietary fibres are resistant to digestion and absorption. Prebiotics are fermentable dietary fibres that confer health benefits through their effects on microbiome composition and activity. The range of physiological benefits from consuming dietary fibres is broad. Encouraging children to eat fibre-rich foods promotes a nutrient-dense diet. Introducing a variety of dietary fibre sources to young children helps establish future dietary choices and a more diverse intestinal microbiota. Low-fibre intake is associated with a higher prevalence of constipation and obesity.

Sodium phosphate is superior to polyethylene glycol in constipated patients undergoing colonoscopy: a systematic review and meta-analysis.

Constipation is an important and highly prevalent predictor of inadequate bowel preparation during colonoscopy. In North America, between 2 and 28% of the general population suffer from constipation. Despite the high prevalence of constipation, to our knowledge, no meta-analysis on the optimal bowel preparation for constipated patients has been performed. We aimed to systematically review the literature to determine the ideal bowel preparation regiment for patients with chronic constipation. A comprehensive search of electronic databases (MEDLINE, EMBASE, SCOPUS, and Web of Science) was performed. We included studies that assessed the quality of bowel preparation in constipated patients receiving different agents prior to colonoscopy. The primary outcome was colon cleanliness. Secondary outcomes included tolerability of the bowel preparation and serious adverse events. Preliminary database search yielded 1581 articles after duplicates were removed. After screening of the titles and abstracts using the exclusion criteria, 358 full-text articles were retained. Full-text articles were reviewed and eight studies meeting the inclusion criteria were included for qualitative synthesis. Three randomized controlled trials identified a total of 1636 constipated patients, of whom 225 were eligible for meta-analysis. Of those, 107 (47.6%) received NaP and 118 (52.4%) received PEG. Patients receiving NaP before colonoscopy had a higher chance of a successful bowel preparation than patients receiving PEG (OR 1.87, CI 1.06 to 3.32, P = 0.003). In the studies comparing PEG to NaP, two found that NaP resulted in greater tolerability of the bowel preparation and one study found that PEG resulted in superior tolerability. In chronically constipated patients undergoing colonoscopy, the use of NaP may result in superior colonic cleanliness when compared to PEG, however, quality of evidence was low. Further high-quality studies are required to delineate the optimal bowel preparation in patients with constipation.

How Does Functional Constipation Affect Growth Status in Children?

Background: There are some evidences suggesting functional constipation-related growth retardation in children, especially in early childhood. Considering high prevalence of constipation, early diagnosis and treatment of constipated patients may improve the quality of life in these children. In this study, weight and height of Iranian children aged 2 to 12 years with functional constipation was evaluated compared to healthy children. Methods: A total of 130 Iranian children aged 2-12 years, 65 with functional constipation and 65 as healthy children referred to pediatric gastroenterology clinic during Jan to Dec of 2016, were enrolled in this case-control study. Functional constipation was defined as Rome III criteria. The growth status was evaluated using the growth charts, and Z scores of weight and height for age were recorded, with the consent of parents and child willingness. Results: 65 constipated patients (44 boys, 21 girls) with the mean age of 8.28 ± 3.24 years and 65 healthy children (25 boys, 40 girls) with the mean age of 8.32 ± 3.42 years were evaluated. The mean weight of case group was 23.69 ± 4.14 kg and mean height 126.49 ± 10.34 cm. The mean weight of control group with 31.62 ± 4.85 kg and mean height 153.47 ± 13.88 cm, demonstrated significant difference with the case group. The observed mean weight and height were significantly lower in constipated group and the differences of height-for-age and weight-for-age Z scores were statistically meaningful in constipated and healthy children. Conclusions: Functional constipation in children aged 2 to 12 years may retard their weight and height growth, so early diagnosis and treatment of children with constipation is beneficial in their adequate growth status. © 2019, Author(s).

Comparative Epidemiological Investigation of Alzheimer's Disease and Colorectal Cancer: The Possible Role of Gastrointestinal Conditions in the Pathogenesis of AD.

Alzheimer’s disease (AD) is a neurodegenerative disorder that affects approximately 35 million people worldwide, and diet has been reported to influence the prevalence/incidence of AD. Colorectal cancer is among the most common cancers in Western populations, and the correlation between constipation and the occurrence of colorectal cancer has been identified in a number of studies, which show that a Westernized diet is a mutual risk factor. Constipation is a growing health problem, particularly in middle-aged and older adults. As the most common gastrointestinal disorder in adults, constipation affects 2–20% of the world population, and it is associated with several diseases, such as diabetes, Parkinson’s disease, and others. Comparing the epidemiological data on colorectal cancer and AD, we find that colorectal cancer and AD have similar epidemiologic feature, which is both disease correlate with high prevalence of constipation. Therefore, we hypothesized that constipation may influence Alzheimer’s disease in a similar way that it contributes to colorectal cancer. This review aimed to systemically elucidate the evidence that constipation contributes to Alzheimer’s disease progression.

Is Fibre an Effective Strategy to Improve Laxation in Long-Term Care Residents?

The high prevalence of constipation in long-term care (LTC) residents has been a long-standing issue for caregivers, attending health professionals, and the residents themselves. The traditional medical response has been to utilize pharmaceutical laxatives, enemas, and suppositories for treatment. The purpose of this review was to determine if fibre supplementation (including fibre added to foods) is effective in increasing stool frequency, improving stool consistency, and decreasing laxative use in LTC residents. A systematic search was conducted using PubMed and CINAHL databases, inclusive to March 2017. Search terms included: "long-term care" or "nursing home" AND "fiber (fibre)," "bran," "psyllium," "inulin," or "prebiotic." Intervention trials of fibre supplementation with ≥5 LTC residents were included. The search generated 456 articles following removal of duplicates; 8 studies met the inclusion criteria. Three additional trials were identified through a hand search of references of pertinent articles. Current evidence suggests that added fibre may be effective in increasing stool frequency and/or decreasing laxative use in LTC residents and, thus, may lessen the burden of constipation. However, randomized controlled trials are needed to clearly demonstrate the effects of adding fibre to foods, particularly insoluble and less fermentable sources, on constipation in LTC residents.

Constipation in adults with neurofibromatosis type 1

BackgroundNeurofibromatosis type 1 (NF1) is an autosomal-dominant disease characterised by symptoms of the skin, eyes, nervous system and bones. A previous study indicated that constipation, large rectal diameters and prolonged colorectal transit times are common in children with NF1. The aim of the present study was to investigate and compare the prevalence of gastrointestinal symptoms in adult patients with NF1 to their unaffected relatives serving as the control group. Patients with NF1 were recruited from one of two Danish National Centres of Expertise for NF1 and their unaffected relatives were invited to participate as controls. Gastrointestinal symptoms were assessed with a web-based, self-administered, validated, Rome® III diagnostic questionnaire. Logistic regression was used to estimate the prevalence of functional dyspepsia, IBS and functional constipation in each group and the groups were compared using their odds ratios.ResultsThe response rates for patients and controls were 66.4% and 82.4%, respectively. We compared 175 patients, median age 34.2 (IQR = 20.1) and 91 of their unaffected relatives, median age 42.0 (IQR = 12). The overall likelihood of fulfilling the diagnostic criteria for functional constipation, irritable bowel syndrome or functional dyspepsia was 33.1% among patients vs. 14.3% among controls, (odds ratio (OR): 2.97; 95% CI: 1.56–5.66) and after adjustment for age and gender (OR: 3.06; 95% CI: 1.62–5.79). The likelihood of functional constipation was higher among patients (OR: 3.80; 95% CI: 1.27–11.31), and this was still true after adjustment (OR: 3.49; 95% CI: 1.14–10.64). The likelihood of irritable bowel syndrome (OR: 2.29; 95% CI: 0.98–5.33) was evident after adjustment (OR: 2.46; 95% CI: 1.10–5.47), whereas there was no difference in the likelihood of functional dyspepsia (OR: 2.35; 95% CI: 0.67–8.32) after adjustment (OR:2.25; 95% CI: 0.70–7.17).ConclusionsOverall, having symptoms usually attributed to either functional dyspepsia, IBS or functional constipation is more common in adults with NF1 compared to unaffected relatives. Of the three, the likelihood of constipation is markedly higher. The high prevalence of constipation indicates that it is not functional but part of the NF1 disorder.

Dietary intake, physical activity, and time management are associated with constipation in preschool children in Japan.

Constipation is a common complaint in children, which is not fatal but can affect quality of life. Several lifestyle-related risk factors for constipation have been reported, particularly dietary factors, but results have been inconsistent. Here, we examined the relationship of dietary and lifestyle factors with constipation in Japanese preschool children using data of a nationwide study. Subjects were 5,309 children aged 5 to 6 years at 380 nursery schools in 44 of 47 prefectures in Japan. Children having three or fewer bowel movements per week were considered constipated. Dietary intake data was collected using a validated brief-type self-administered diet history questionnaire for Japanese preschool children, and information about general lifestyle was collected using a 4-page questionnaire designed for this study. Multivariateadjusted odds ratios for constipation were calculated by logistic regression. Higher dietary fiber intake was significantly associated with a lower prevalence of constipation (adjusted odds ratio: 0.62, p for trend: 0.005), but higher carbohydrate intake was marginally associated with a higher prevalence of constipation. Intake of potatoes, pulses, vegetables, and fruits intake decreased constipation prevalence, whereas higher rice intake was significantly and independently associated with higher prevalence of constipation. Regarding lifestyle factors, high physical activity and sufficient preparation time for breakfast and dinner for guardians were significantly associated with lower prevalence. Prevalence tended to be negatively associated with a higher educational background of the mother. Several lifestyle factors were associated with a lower prevalence of constipation among Japanese preschool children, including dietary fiber intake.

Healthcare Utilization and Spending for Constipation in Children With Versus Without Complex Chronic Conditions

The aim of the study was to examine the prevalence of diagnosis and treatment for constipation among children receiving Medicaid and to compare healthcare utilization and spending for constipation among children based on number of complex chronic conditions (CCCs). Retrospective cohort study of 4.9 million children ages 1 to 17 years enrolled in Medicaid from 2009 to 2011 in 10 states in the Truven Marketscan Database. Constipation was identified using International Classification of Disease, 9th revision codes for constipation (564.0x), intestinal impaction (560.3x), or encopresis (307.7). Outpatient and inpatient utilization and spending for constipation were assessed. CCC status was identified using validated methodology. A total of 267,188 children (5.4%) were diagnosed with constipation. Total constipation spending was $79.5 million. Outpatient constipation spending was $66.8 million (84.1%) during 406,814 visits, mean spending $120/visit. Among children with constipation, 1363 (0.5%) received inpatient treatment, accounting for $12.2 million (15.4%) of constipation spending, mean spending $7815/hospitalization. Of children hospitalized for constipation, 552 (40.5%) did not have an outpatient visit for constipation before admission. Approximately 6.8% of children in the study had ≥1 CCC; these children accounted for 33.5% of total constipation spending, 70.3% of inpatient constipation spending, and 19.8% of emergency department constipation spending. Constipation prevalence was 11.0% for children with 1 CCC, 16.6% with 2 CCCs, and 27.1% with ≥3 CCCs. Although the majority of pediatric constipation treatment occurs in the outpatient setting, inpatient care accounts for a sizable percentage of spending. Children with CCCs have a higher prevalence of constipation and account for a disproportionate amount of constipation healthcare utilization and spending.

Shared Risk Factors for Constipation, Fecal Incontinence, and Combined Symptoms in Older U.S. Adults.

To estimate the prevalence of constipation, fecal incontinence (FI), and combined symptoms and to identify shared factors associated with bowel symptoms in older U.S. men and women DESIGN: Population-based cross-sectional study. National Health and Nutrition Examination Survey (2005-2010). Women and men aged 50 and older. Constipation was defined as hard stool consistency on the validated Bristol Stool Form Scale or stool frequency of fewer than three bowel movements per week. FI was defined as at least monthly loss of solid, liquid, or mucus stool. Combined symptoms was defined as constipation and FI. Multinomial multivarible models adjusted for age, race, socioeconomic status, education, self-rated health, depression, impairments in activities of daily living, and number of comorbidities. Women (n = 3,078) reported higher prevalence of bowel symptoms than men (constipation 11.8% vs 4.7%%, FI 11.2% vs 8.6%, combined symptoms 1.4% vs 0.4%). In adjusted models, women had greater odds of having constipation (odds ratio (OR) = 3.0, 95% confidence interval (CI) = 2.3-3.8), FI (OR = 1.4, 95% CI = 1.1-1.8), and combined symptoms (OR = 4.6, 95% CI = 2.0-10.2) than men. Shared risk factors included poor self-rated health and depression symptoms (constipation: OR = 1.8, 95% CI = 1.4-2.4 and OR = 1.8, 95% CI = 1.0-3.2; FI: OR = 1.6, 95% CI = 1.2-2.2 and OR = 2.3 95% CI = 1.4-3.6; combined symptoms: OR = 2.6 95% CI = 1.5-4.8 and OR = 4.6, 95% CI = 1.3-16.4). When defining constipation and FI using validated instruments, women had a much higher prevalence of constipation than men, whereas men had a higher prevalence of FI than constipation. Shared risk factors reflect the negative effect that bowel symptoms have on quality of life.

High prevalence of constipation and reduced quality of life in opioid-dependent patients treated with opioid substitution treatments

ABSTRACTObjectives To evaluate prevalence and severity of constipation and quality of life (QoL) in a cohort of opioid-addicted patients treated with opioid substitution treatments (OST).Methods: A total of 1057 heroin-dependent patients treated with methadone or buprenorphine were enrolled in a multicenter observational study. Constipation was assessed by Wexner Constipation Scoring System (Wexner CSS), QoL by General Health Questionnaire (GHQ-12).Results: 38.5% patients reported mild constipation, 33.3% reported moderate constipation, 14.8% severe constipation and 5.1% very severe constipation. Mean Wexner CSS score was 6.6 ± 4.8. 44.9% patients showed a GHQ-12 score ≥14; of these 18.3% patients showed a GHQ-12 score ≥20. Mean GHQ score was 13.8 ± 6.5. Mean Wexner CSS score was significantly higher in methadone patients (p = 0.004), in those taking psychoactive drugs (p = 0.0001) and in female (p < 0.0001) with respect to counterparts. Similarly, GHQ-12 mean scores were higher methadone group (p = 0.003), in those taking psychoactive drugs (p < 0.0001), and in female (p = 0.039) with respect to counterparts. ANOVA and ANCOVA showed a significant influence of methadone and female gender on Wexner CSS score while psychoactive drugs significantly influenced both tests.Conclusions: The present study shows that patients affected by opioid-dependence in OST with methadone and buprenorphine have a high prevalence of constipation and reduced QoL.