Self-reported Constipation Research Articles

Exercise Habits, Including Exercising With Partners, and the Prevalence of Self-Reported Constipation in Young Japanese People: A Cross-Sectional Study

Exercise Habits, Including Exercising With Partners, and the Prevalence of Self-Reported Constipation in Young Japanese People: A Cross-Sectional Study

Inadequate management of opioid-induced constipation in European cancer pain patients: results of a real-world, multicentre, observational study ("E-StOIC").

The objectives of the study were to determine the prevalence of (uncontrolled) OIC, relevant medications / interventions employed by healthcare professionals, and the additional strategies utilised by patients, amongst European patients with cancer pain. This study was a prospective observational study conducted at 24 research sites in ten European countries. Cancer patients receiving opioid analgesics for at least a week were recruited, and asked to complete a questionnaire including background information, single question (Are you constipated?), Rome IV diagnostic criteria for OIC, Bowel Function Index (BFI), and Patient Assessment of Constipation Quality of Life questionnaire (PAC-QOL). Participants were characterised as having / not having OIC on the basis of the Rome IV diagnostic criteria. 1200 participants completed the study. 59.5% met the Rome IV diagnostic criteria for OIC: only 61.5% that met these criteria self-reported constipation. 72% participants were prescribed a regular conventional laxative / peripherally acting mu-opioid receptor antagonist (PAMORA). However, only 66% took their prescribed laxatives every day. Many participants had utilised other strategies / interventions to manage their OIC. Furthermore, 27% had needed to use suppositories, 26.5% had needed to use an enema, and 8% had had a manual evacuation. The use of PAMORAs, and other novel effective medications, was relatively uncommon. The results of this study suggest that management in Europe is often inadequate, and this undoubtedly relates to a combination of inadequate assessment, inappropriate treatment, and inadequate reassessment.

Relationship Between Colonic Transit Response to Eating With Self-reported Constipation Severity in Constipated Patients According to the Phenotype.

Eating is the major synchronizer of gastrointestinal motility and secretions. The present study aims to evaluate the interplay between self-perceived constipation severity (CS) and colonic response to eating in constipated patients according to the phenotype. We included 387 consecutive outpatients complaining of Rome IV chronic idiopathic constipation. Likert scales for CS, abdominal pain severity, bloating severity, depression and anxiety assessment, total and segmental colonic transit time (CTT), and colonic transit response to eating (CTRE) were performed in all patients. Of the 387 patients included (49.7 ± 16.4 years), 320 (83%) were female, 203 had irritable bowel syndrome with constipation (IBS-C), 184 as functional constipation (FC), and 283 had defecation disorders (DD). The female gender was characterized by increased bloating severity (P = 0.011) and decreased Bristol stool form (P = 0.002). In IBS-C and FC patients, CS was related with bloating severity (P < 0.001 in both groups) and total CTT (P = 0.007 in IBS-constipation, P = 0.040 in FC). In IBS-C patients, CS was also associated with abdominal pain severity (P = 0.003) and Bristol stool form (P = 0.004). In contrast, in FC, CS was only related to left CTRE (P = 0.006), and in patients with DD, CS was associated with total CTT (P < 0.001) and left CTRE (P = 0.002). Colonic transit response to eating was not associated to CS in IBS-C patients, but left CTRE was associated with constipation severity in FC and DD patients.

Efficacy of Bowel Regimen in Decreasing Postoperative Constipation in Bariatric Surgery Patients.

Postoperative constipation after bariatric surgery is a common complaint, decreasing patient quality of life. No literature exists examining the efficacy of a preoperative bowel regimen in reducing postoperative constipation in this cohort. This study aims explore the efficacy of a well-established bowel regimen, polyethylene glycol (PEG), in reducing constipation frequency and severity after bariatric surgery. This was a retrospective study of adult patients undergoing primary and revisional bariatric procedures. The use of PEG bowel prep for bariatric patients was introduced as an institutional quality improvement measure. Patients during the first 3months after PEG implementation were surveyed for postoperative constipation. For the year after implementation, patients were followed for 30-day emergency room visits or hospitalization secondary to constipation. This cohort was compared to historical controls from the previous year. Student t-tests were used for statistical analysis. During the 3-month exploratory phase, 28/49 (57.14%) patients fully completed the bowel regimen. In total, 0/56 (0%) patients reported preoperative constipation, and 5/28 (17.9%) patients reported constipation at the 3-week follow-up. In the 1year post-implementation cohort, 2/234 (0.85%) patients had constipation-related occurrences at 30-day follow-up, compared to 8/219 patients (3.65%) in the historical cohort (p = 0.04). The implementation of a PEG-based bowel regimen did not eliminate self-reported constipation. However, there were significant differences in rates of constipation-related ED visits and hospital readmissions, suggesting that the bowel regimen decreases rates of severe constipation. Finally, patient compliance was limited. Future work should aim towards increasing compliance.

Prevalence and patterns of laxative use in subjects with self-reported constipation: results from a multinational digestive health survey.

Constipation is characterized by symptoms of straining, hard stool, difficult evacuation, and infrequent bowel movements. Online surveys provide valuable information about patients' perspectives, symptoms, management, treatment satisfaction, and risk factors. This survey explored subject experiences involving 20 gastrointestinal (GI) conditions. In total, 20,099 respondents in seven countries with varied cultural and socioeconomic backgrounds participated. Post hoc analysis of 'self-reported constipation' and related symptoms experienced within the past 6 months and the last episode of constipation provided data on prevalence, demographics, frequency and duration of episodes and related symptoms, impact on quality of life (QoL), management with or without laxatives, and resulting treatment satisfaction. In total, 10,425 subjects reported constipation within 6 months and 2637 at the last episode. Prevalence was highest in females and younger adults. Most subjects reported various coexisting GI symptoms. Almost 80% of 6865 episodes reported by 5337 subjects occurred every 2-3 months to every 2-3 weeks. A higher frequency of constipation correlated with a greater impact on QoL. On a 10-point scale, the mean impact was 6.4. More than 90% of respondents had episodes ranging from 1 day to 1 week. More than 90% took action; 16% used laxatives, of whom 80.3% were satisfied. Constipation, a highly prevalent disorder, spans cultures and socioeconomic classes. Its chronic recurrence has a significant impact on QoL, resulting in symptom self-management in >90% of subjects. Significantly higher satisfaction rates in subjects treated with than without laxatives reflect subjects' reports that self-reported constipation can be treated effectively with laxatives.

Constipation preceding depression: a population-based cohort study

Constipation is generally considered a common physical symptom of depression or a side effect of antidepressant treatments. However, according to the gut-brain axis hypothesis, the association between depression and constipation might be bi-directional. This study investigated the association between premorbid constipation and depression. We conducted a retrospective cohort study using data from UK Biobank. Individuals free of depression between 2006 and 2010 were included. Constipation status was determined using diagnostic codes from electronic health records or a baseline questionnaire. Data on covariates, including socio-demographic characteristics, lifestyle factors, health conditions, and regular medication use, were also collected through a baseline questionnaire. The primary outcome is incident depression, which was extracted from hospital inpatient admissions, primary care, self-report, and death data from baseline to 2022. The secondary outcome is depressive symptoms, which was assessed by Patient Health Questionnaire-9 (PHQ-9) from an online survey in 2016. Cox proportional hazard regression models were employed to assess the prospective association between constipation and incident depression. Logistic regression models were used to assess its association with depressive symptoms. Among the 449,459 participants included in the study, 18,596 (4.1%) experienced constipation at baseline, and 18,576 (4.1%) developed depression over a median follow-up period of 12.3 years. Premorbid constipation is associated with a 2.28-fold higher risk of depression. After adjusting the covariates, we found those with constipation still had a 48% higher risk of developing depression (adjusted hazard ratio [aHR] 1.48; 95% CI, 1.41-1.56) than those without constipation. Self-reported and diagnosed constipation were both associated with a higher risk of depression, with the aHR being 1.42 (95% CI: 1.34-1.51) and 1.66 (95% CI: 1.51-1.82), respectively. Participants with constipation were more likely to report depressive symptoms than people without (adjusted odds ratio 2.18; 95% CI, 1.97-2.43). These findings remained consistent in sensitivity analyses. Diagnosed and self-reported constipation are both prospectively associated with an elevated risk of depression. These explorative findings suggest that constipation may be an independent risk factor or a prodromal symptom of depression. Gastroenterologists and primary care physicians should pay more attention to the depressive symptoms of their constipation patients. The Shenzhen Science and Technology Program and the Strategic Priority Research Program of Chinese Academy of Sciences.

Constipation and clinical outcomes in peritoneal dialysis: Results from Thailand PDOPPS.

Patient-reported outcome measures (PROMs) are widely recognized as valuable predictors of clinical outcomes in peritoneal dialysis (PD). Our study aimed to explore the connections between patient-reported constipation and clinical outcomes. We assessed constipation in patients across 22 facilities participating in the Thailand Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) from 2014 to 2017. Constipation diagnosis utilized objective assessment tools such as the Bristol stool form scale (BSFS) and a self-reported questionnaire known as the constipation severity score (CSS). The BSFS is a 7-level scale that visually inspects feces based on texture and morphology, while the CSS measures constipation duration and severity using a 5-point Likert scale for various factors. We employed Cox proportional hazards model regression to determine the associations between constipation and clinical outcomes, including mortality, hemodialysis (HD) transfer and peritonitis. Among 975 randomly selected PD patients from 22 facilities, 845 provided written informed consent, and 729 completed CSS questionnaire. Constipation was prevalent in the PD population (13%), particularly among older patients, those who were caregiver dependent, had diabetes and poorer nutritional status (indicated by lower time-averaged serum albumin, potassium, creatinine and phosphate concentrations). Twenty-seven percent of which experiencing symptoms of constipation for over a year. Notably, self-reported constipation at baseline was significantly associated with a shorter time to first peritonitis and higher rates of peritonitis and death. However, no significant association was found between constipation and HD transfer after adjusting for various factors, including age, gender, PD vintage, comorbidities, shared frailty by study sites and serum albumin. Patient-reported constipation independently correlated with increased risks of peritonitis and all-cause mortality, though no such correlation was observed with HD transfer. These findings underscore the need for further investigation to identify effective interventions for constipation in PD patients.

Self-assessed medication risk factors as part of comprehensive health screening in home-dwelling older adults.

Poor medication management may negatively impact the health and functional capacity of older adults. This cross-sectional study aimed to identify medication-related risk factors in home-dwelling residents using a validated self-assessment as part of comprehensive health screening. The data were derived from comprehensive health screening (PORI75) for older adults of 75 years living in Western Finland in 2020 and 2021. One of 30 validated measures in health screening focused on identifying medication-related risk factors (LOTTA Checklist). The Checklist items were divided into (1) systemic risk factors (10 items) and (2) potentially drug-induced symptoms (10 items). Polypharmacy was categorized according to the number of used drugs: (1) no polypharmacy (<5 drugs), (2) polypharmacy (≥5 and <10), and (3) excessive polypharmacy (≥10). The linearity across these three polypharmacy groups was evaluated using the Cochran-Armitage test. Altogether, 1024 out of 1094 residents who participated in the health screening consented to this study (n = 569 in 2020 and n = 459 in 2021). The mean number of all drugs in use was 7.0 (range 0-26; SD 4.1), with 71% of the residents using >5 drugs, that is, having polypharmacy. Of the systemic risk factors most common was that the resident had more than one physician responsible for the treatment (48% of the residents), followed by missing drug list (43%), missing regular monitoring (35%), and unclear durations of the medication (35%). The most experienced potentially drug-induced symptoms were self-reported constipation (21%), urinating problems (20%), and unusual tiredness (17%). An increasing number of drugs in use, particularly excessive polypharmacy, was associated with various medication-related risk factors. As a part of comprehensive health screening the LOTTA Checklist provides useful information to prevent medication-related risk factors in home-dwelling older adults. The Checklist could be used to guide planning and implementing health services in the future.

Prevalence and Severity of Lower Gastrointestinal Symptoms amongst Non-Dialysis Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis.

Chronic kidney disease (CKD) patients experience a wide range of symptoms that deteriorate their health-related quality of life (HRQoL). We aimed to estimate the prevalence and severity of lower gastrointestinal (GI) symptoms in non-dialysis CKD adult outpatients, and to summarize the relationships between these symptoms and HRQoL, laboratory test results, and clinical data. The protocol of the study was preregistered (PROSPERO CRD42021255122). We searched MEDLINE, Scopus, Web of Science, and grey literature sources from the databases' inception up until 27 November 2021. Wide citation chasing was conducted. Single proportions (prevalence of functional constipation, self-reported constipation, diarrhea, abdominal bloating, fecal incontinence, and abdominal/rectal pain) were pooled using generalized linear mixed models. A total of 37 studies with 12,074 patients were included. We found that lower GI symptoms, especially self-reported abdominal bloating [CKD G1-2: 48.45% (95% CI: 43.5-53.4%; 2 studies); G3: 46.95% (95% CI: 45.0-48.9%; 2 studies), G4-5: 36.1% (95% CI: 25.4-48.5%; 8 studies)] and constipation [CKD G1-2: 31.8% (95% CI: 13.9-54.9%); G3: 29.8% (95% CI: 21.2-40.1%; 4 studies); G4-5: 38.8% (95% CI: 30.9-47.4%); 22 studies)], were common in non-dialysis CKD patients. The severity of the symptoms was limited. Self-reported constipation was most consistently associated with worse HRQoL, whereas hard stool consistency was associated with higher uremic toxins levels. To conclude, since lower GI symptoms are common in CKD, using symptom questionnaires that do not take them into account cannot provide full insight into the patient's experience. Further studies are needed to cover identified knowledge gaps, including the exploration of the pathophysiology of GI symptoms in CKD with multi-omics data.

Bowel Health, Brain Age, Brain Volume and Cognitive Function in the Boston Puerto Rican Health Study

ObjectivesThe gut-brain axis has been shown to play an important role in neurodegeneration. Bowel dysfunction, such as constipation, is a marker of gut dysbiosis, which has been associated with risk of dementia in prior studies. However, no work has been done in Puerto Ricans, who have unique dietary and lifestyle characteristics impacting both gut and brain health. We aimed to study the association between constipation and cognitive outcomes including MRI-derived brain age, brain volume and cognitive function in a cohort of Puerto Ricans. MethodsThis analysis was conducted within the Boston Puerto Rican Health Study (BPRHS), an ongoing longitudinal cohort that enrolled 1502 self-identified Puerto Rican adults residing in the Boston area, aged 45–75 y at baseline through wave-4 (mean 12.7 ± 1.2 y from baseline). Our study was comprised of 179 participants at wave-4 (12.7 y). Brain age was derived from magnetic resonance imaging (MRI) features that included cortical thickness, area, volume, cerebellar-subcortical and cortical summary, using a machine learning model. Brain age deviation score was used to represent the difference of the participants’ brain age from their biological age, with higher scores representing more advanced brain aging. Constipation was estimated from self-reported bowel health and defined as bowel frequency < 1/d. Global cognitive score (GCS) is a composite of executive function, memory and attention factors. Covariate-adjusted linear regression was used to examine the association between bowel health and brain age, brain volume and GCS at wave-4 (12.7 y). ResultsAmong 179 participants with MRI, cognitive function (GCS), and bowel health measures at wave-4 (12.7 y), 45 (25.1%) self-reported constipation, defined as bowel frequency < 1/d (age 66.5 ± 7.8 y; female 75.6%). In covariate adjusted multivariable analyses, we observed that constipation was associated with higher brain age deviation (poorer brain health) (β = 0.377, P = 0.0451). We did not observe an association between constipation and brain volume (P = 0.175) or constipation and cognitive function (P = 0.573). ConclusionsIn this study of older, Boston–Area Puerto Ricans, we observed an association between constipation and brain age, but no association between constipation and brain volume or cognitive function. Funding SourcesNIH

Prebiotic Galacto-Oligosaccharides Impact Stool Frequency and Fecal Microbiota in Self-Reported Constipated Adults: A Randomized Clinical Trial.

Constipation is a major issue for 10–20% of the global population. In a double-blind randomized placebo-controlled clinical trial, we aimed to determine a dose-response effect of galacto-oligosaccharides (GOS) on stool characteristics and fecal microbiota in 132 adults with self-reported constipation according to Rome IV criteria (including less than three bowel movements per week). Subjects (94% females, aged: 18–59 years) received either 11 g or 5.5 g of BiotisTM GOS, or a control product, once daily for three weeks. Validated questionnaires were conducted weekly to study primarily stool frequency and secondary stool consistency. At base- and endline, stool samples were taken to study fecal microbiota. A trend towards an increased stool frequency was observed after the intervention with 11 g of GOS compared to control. While during screening everybody was considered constipated, not all subjects (n = 78) had less than three bowel movements per week at baseline. In total, 11 g of GOS increased stool frequency compared to control in subjects with a low stool frequency at baseline (≤3 bowel movements per week) and in self-reported constipated adults 35 years of age or older. A clear dose-response of GOS was seen on fecal Bifidobacterium, and 11 g of GOS significantly increased Anaerostipes hadrus. In conclusion, GOS seems to be a solution to benefit adults with a low stool frequency and middle-aged adults with self-reported constipation.

Status of Constipation and Its Association with Sarcopenia in Older Adults: A Population-Based Cohort Study.

(1) Background: As the clinical relevance of constipation and sarcopenia is not well studied, we aimed to investigate the association between them in older adults. (2) Methods: A cross-sectional study was conducted on 1278 community-dwelling older adults in South Korea. The Rome IV criteria were used to identify patients with clinically defined constipation, while sarcopenia was defined by the Asian Working Group for Sarcopenia consensus. The cohort was classified into three groups: no constipation, self-reported constipation only, and clinically defined constipation. (3) Results: The presence of constipation was associated with sarcopenia and slow gait speed (p < 0.001). After adjustment for possible covariates, the association with sarcopenia attenuated, while that for slow gait speed persisted. In terms of geriatric parameters, both groups with clinically defined and self-reported constipation had a higher burden of cognitive impairment, IADL disability, and lower QOL scores (p < 0.05) compared with those without constipation. (4) Conclusions: Sarcopenia and slow gait speed associated with constipation in community-dwelling older adults. Individuals with self-reported constipation symptoms alone showed comparable sarcopenic and geriatric burden to those with clinically defined constipation. Clinical suspicion for possible co-existing sarcopenia is warranted in older patients with constipation.

Constipação intestinal e fatores associados em pacientes internados em um hospital universitário

Introdução: A constipação é um distúrbio no trato gastrointestinal determinado pela dificuldade e/ou rara eliminação das fezes. Sua etiologia é multifatorial e o hábito alimentar inadequado é fator de risco. Objetivo: Avaliar a prevalência de constipação intestinal e verificar o conhecimento sobre fibras alimentares e os hábitos de vida relacionados em pacientes com constipação e sem constipação segundo o critério Roma III. Metodologia: Estudo transversal e descritivo. Coletaram-se dados socioeconômicos, clínicos e aplicou-se um questionário sobre o consumo alimentar, hábitos de vida e conhecimento sobre prevenção e tratamento da constipação intestinal. A constipação intestinal foi definida de acordo com o consenso de ROMA III. Os resultados foram comparados pelo teste Qui-quadrado, ajustado pela correção de Bonferroni, adotando nível de significância de 5%. Resultados: A prevalência de constipação auto-referida foi de 30% e de 33% pelo critério ROMA III. O uso de recursos caseiros para constipação foi mencionado por 55,3% dos constipados e 29,2% dos não constipados. Indivíduos não constipados apresentaram maior conhecimento sobre alimentos fontes de lactobacillus. Sobre o consumo de água, 13,2% dos constipados e 31,8% dos não constipados ingerem mais que oito copos por dia (p=0,02). Quanto aos medicamentos e recursos dietéticos para o auxílio da constipação, os constipados consistem no grupo que mais os consumiu (p&lt;0,05). Conclusão: Foram observadas diferenças entre os hábitos e o conhecimento sobre alimentação entre constipados e não constipados. Avaliar a prevalência de constipação intestinal e fatores associados é fundamental para auxiliar no tratamento e na prevenção da mesma.

Intake of okara soup for 2 weeks for breakfast improved defecation habits in young Japanese women with self-reported constipation: A randomized, double-blind, placebo-controlled, intervention study.

Okara is a byproduct of soymilk manufacturing and a rich source of protein and dietary fiber. We investigated whether okara intake improves the habit of defecation in young Japanese women (n = 52) with self-reported constipation. Subjects were categorized into placebo and test groups, who ingested soymilk (0.1g fiber/meal) and okara (4.1g fiber/meal) soups, respectively, every day for breakfast, for 2 weeks. Subjects' body composition, bowel movement frequency per week, and constipation assessment scale (CAS) and brief-type self-administered diet history questionnaire scores were assessed at baseline and after the intervention (Analysis 1). Further, subjects' bowel movement frequency per week and CAS scores were assessed during the 2-week follow-up (Analysis 2). There were no significant differences in age, anthropometric characteristics, nutrients intake, frequency of bowel movements per week, and total CAS scores between the placebo and test groups at baseline. After intervention, the total CAS score was significantly lower in the test group than in the placebo group. Moreover, the difference in the total CAS scores between baseline and after intervention was lower in the test group than in the placebo group, although not significant. The weekly frequency of bowel movement significantly increased for both placebo and test groups. The test group reported reduced abdominal bloating 2 weeks after the intervention, but the placebo group did not. The findings suggest that okara is effective in increasing the frequency of bowel movements and improving defecation habit in young women with self-reported constipation. PRACTICAL APPLICATION: Okara is an effective food to increase the frequency of bowel movements and to improve defecation habits in young women with self-reported constipation.

Prevalence of constipation and lifestyle risk factors related to constipation in an adult population of South Tangerang

Background: Constipation is a common bowel complaint in a general population that can negatively impact a quality of life. Unhealthy lifestyles play major roles in causing the constipation. Objective: This study was aimed to estimate prevalence of the constipation and identify lifestyle risk factors related to constipation in a general adult population. Methods: A cross-sectional survey was conducted on 227 adults aged =20 years, who lived in East Ciputat, South Tangerang. Information about demographic characteristics, lifestyle habits, and bowel habits was collected through in-person interviews. Chi-square test and logistic regression were used for data analysis. Results: The prevalence of self-reported constipation in the general adult population was 21.6%. The common symptoms included defecation time =5 minutes (39.6%), sensations of incomplete evacuation (37.9%), and frequency of defecation <1/day (34.4%). Married status was related to a decreased risk of constipation (odds ratio= 0.31; 95% confidence interval= 0.11-0.89). Lifestyle factors of smoking, sedentary job, body mass index, and physical activity were less related to the risk of constipation. Conclusion: The prevalence of constipation was relatively high in the general adult population in South Tangerang. Further studies are needed to explore the relationships between lifestyle risk factors and constipation in other populations.

Constipation screening in people taking clozapine: A diagnostic accuracy study

ObjectiveClozapine is the favoured antipsychotic for treatment-refractory schizophrenia but its safe use requires careful adverse-effect management. Clozapine-induced gastrointestinal hypomotility (CIGH or ‘slow-gut’) is one of the most common and serious of clozapine's adverse effects. CIGH can lead to paralytic ileus, bowel obstruction, gastrointestinal ischaemia, toxic megacolon, and death. Enquiring about constipation is a simple and commonly used screening method for CIGH but its diagnostic accuracy has not previously been assessed. MethodsFirst, we examined the reliability of asking about constipation compared with asking about Rome constipation criteria in inpatients treated with clozapine (n = 69). Second, we examined the diagnostic accuracy of (1) self-reported constipation and (2) the Rome criteria, compared with the reference standard of gastrointestinal motility studies. ResultsAfter 30 motility tests, it was clear constipation screening had very poor diagnostic properties in this inpatient group and the study was terminated. Although 73% of participants had objective CIGH on motility testing, only 26% of participants self-reported constipation, with sensitivity of 18% (95% CI: 5–40%). Specificity and positive predictive values were higher (95% CI: 63–100% and 40–100%, respectively). Adding in Rome criteria improved sensitivity to 50% (95% CI: 28.2–71.8%), but half the cases were still missed, making this no more accurate than tossing a coin. ConclusionsCIGH is often silent, with self-reported constipation having low sensitivity in its diagnosis. Treating CIGH based on self-reported symptoms questions will miss most cases. However, universal bowel motility studies are impractical. In the interests of patient safety, prophylactic laxatives are suggested for people taking clozapine.

Prevalence and impact of self-reported painful and non-painful constipation in the general population.

Chronic constipation, defined by the Rome IV criteria, is a highly prevalent functional bowel disorder with major overlap with other bowel disorders. Therefore, a pooled-analysis to evaluate the presence of self-reported constipation in the general population was conducted. Further, its association with other bowel symptoms and its health-economic impact was analyzed. Collection of information on bowel symptoms' prevalence and their impact was done through an Internet survey (Medistrat Internet panel). The analysis focused on patients who reported constipation symptoms over the last 12months. Firstly, participants who with or without constipation were compared. Secondly, subjects reporting constipation with (PC) or without abdominal pain (NPC) were studied. KEYRESULTS: A total of 1012 subjects (45.2±0.5years old, 62% females), of whom 217 (21%) reported constipation, completed the survey. Women were significantly more represented in the group reporting constipation compared to those with other bowel symptoms (81.57% vs 56.60%, P<.0001). Subjects reporting constipation experienced more additional bowel symptoms than those who did not report constipation [3(2-6) vs 2(1-4), P<.0001]. Of those with constipation, 134 patients reported NPC compared to 83 patients with PC. The presence of PC was associated with higher prevalence of diarrhea symptoms, alternating bowel movements, bloating, cramps, gas, and altered stool frequency and consistency (all P<.01). Out of 83 PC patients, 38 (45.24%) fulfilled the Rome IV IBS criteria. Self-reported constipation, often associated with other bowel symptoms, is a highly prevalent condition in the Belgian general population. Especially when abdominal pain is present, this generates major healthcare costs.

More opioids, more constipation? Evaluation of longitudinal total oral opioid consumption and self-reported constipation in patients with cancer.

Opioid-induced constipation (OIC) is a distressing physical symptom for patients with cancer taking opioids. Total opioid consumption may contribute to developing worsening OIC-related symptoms. We completed a retrospective analysis examining the association of total daily opioid consumption on self-reported constipation in patients with cancer. In over 5 clinic visits, we collected self-reported constipation scores and 24-h oral morphine equivalents (OME). We examined the association between OME and the presence of constipation (i.e., score >3) and the relationship of OME between patients with or without constipation. Of 297 patients with cancer, we observed 57.8% with constipation and 42.4% without constipation at the first clinic visit. Age was similar in both groups (54.2 ± 14.5 vs. 56.4 ± 14.8years [mean ± SD]) and the majority of patients were women (63.7% vs. 61.1%). The most common cancer type in patients with constipation was non-colorectal gastrointestinal (n = 25, 14.6%), while in patients without constipation was colorectal gastrointestinal (n = 25; 19.8%). Across visits, we observed weak or no association between OME and self-reported constipation (r = 0.01-0.27). At the first visit, higher mean OME was seen in patients who self-reported constipation (133.4 vs 76; p < 0.05). Age, sex, metastatic disease, and stimulant laxative use were not associated with constipation. We observed weak to no association between OME and constipation in patients with cancer. These results suggest a lack of a clear association between total opioid consumption and self-reported constipation.

Clinical features and treatment options among Chinese adults with self-reported constipation: An internet-based survey.

We aimed to investigate the clinical features, precipitating factors, bowel habits, bothersome symptoms and treatment strategies of individuals in China with self-reported constipation. An internet-based survey was conducted in China. The participants had self-reported chronic constipation (≥1 symptoms including straining, hard stools, time-consuming defecation, sensations of incomplete evacuation and anorectal blockage, using manual assistance, and fewer than three defecations per week, for over 6 months). Data on their sex, age and occupation, precipitating factors, bowel habit, main symptoms and treatment options were collected. Overall, 6318 participants fulfilled the inclusion criteria for chronic constipation. More women (54.6%, n = 3450) than men reported constipation. The most common age group for constipation was 31 to 40 years (40.0%, n = 2520) and the most common occupation was office workers (43.6%, n = 2754). Disordered eating routines, consuming spicy food, and failure to defecate in time were the most common factors associated with constipation. Overall, 76.0% (n = 4804) participants did not defecate in the morning; 56.2% (n = 3548) spent 6 to 15 minutes in defecating. The most prevalent symptom was straining (39.4%, n = 2489). For preferred treatment options, 81.7% (n = 5160) selected changes in their lifestyle and diet, 51.1% (n = 3229) selected using traditional Chinese medicine, and 25.2% (n = 1590) selected using laxatives. Constipation rates were higher in women, people aged 31 to 40 years old, and those working in offices. Having eating disorders, eating spicy food and withholding stools were the most common precipitating factors. Straining was the most prevalent symptom. Lifestyle changes were the most common action taken for managing constipation.

Defining constipation to estimate its prevalence in the community: results from a national survey

BackgroundDifferent definitions of constipation have been used to estimate its prevalence in the community but this creates difficulties when comparing results from various studies. This study explores the impact of different definitions on prevalence estimates in the same population and compares the performance of simple definitions with the Rome III criteria.MethodsThe prevalence of constipation in a large nationally representative sample of community-dwelling adults was estimated using five simple definitions of constipation and compared with definitions based on the Rome III criteria. The sensitivity, specificity, and positive and negative predictive values, were calculated for each definition using the Rome III criteria as the gold standards for chronic and sub-chronic constipation.ResultsPrevalence estimates for the five simple definitions ranged from 9.4 to 58.9%, while the prevalence estimates using the Rome III criteria were 24.0% (95%CI: 22.1, 25.9) for chronic constipation and 39.6% (95%CI: 37.5, 41.7) for sub-chronic constipation. None of the simple definitions were adequate compared to the Rome III criteria. Self-reported constipation over the past 12 months had the highest sensitivity (91.1%, 95%CI: 88.8, 93.4) and negative predictive value (94.5%, 95%CI: 93.1, 96.1) compared to the Rome III criteria for chronic constipation but an unacceptably low specificity (51.3%, 95%CI: 48.8, 53.8) and positive predictive value (37.1%, 95%CI: 34.4, 39.9).ConclusionsThe definition used to identify constipation within a population has a considerable impact on the prevalence estimate obtained. Simple definitions, commonly used in research, performed poorly compared with the Rome III criteria. Studies estimating population prevalence of constipation should use definitions based on the Rome criteria where possible.