Constipation: Prevalence and Associated Factors in Adults Living in Londrina, Southern Brazil

Abstract

The aims of this study were to estimate the prevalence of constipation and identify associated factors among adults living in an urban area in Londrina, Brazil. This was a secondary analysis of an epidemiological, population-based study on bowel habit performed in 2008 with 2,162 individuals selected through cluster sampling. Interviews were administered using a sociodemographic questionnaire and the adapted and validated Brazilian version of the "Bowel Function in the Community" tool. Variables from the original database were used to determine the prevalence of constipation (according to the Rome Criteria III) and associated factors. The chi-square test and multivariate logistic regression were used for data analysis. The overall prevalence of constipation (14.6%; n = 315) was higher among women than among men (21.9% vs. 5.3%), increased with age among men, and was inversely related to family income. Overall, female gender, low socioeconomic status, history of anal fissure, anorectal surgery, stroke, nervous system disease, fistulae, and hemorrhoids were factors significantly associated with constipation. The variables low social economic status, stroke, anal fissure history, and anorectal surgery were statistically significant in all three tested statistical models.

Potential risk factors for constipation in the community

“…Only one study has shown a greater prevalence in males where the F/M ratio was 0.84[ 50 ]. Odds ratios for chronic constipation in females were reported as 2.22 in a global systematic review[ 36 ] and ranged from 1.0 to 4.8 in epidemiological studies[ 46 , 47 , 51 , 53 , 54 , 60 , 64 - 66 ].…”

“…For chronic constipation, a Canadian study showed evidence of an inverse relationship[ 45 ] but this was not the case in a United States study[ 68 ]. In Iran and Brazil, there was significantly higher prevalence in those with lower income[ 52 , 66 ] but there was no inverse relationship in South Korea[ 58 ] and Hong Kong[ 57 ]. An inverse relationship was also reported in an Australian study[ 82 ].…”

“…A review of 7 studies conducted up to 2009[ 43 ] found a significant association between any constipation and haemorrhoids. Haemorrhoids also have been found to be commonly associated with chronic constipation[ 41 , 66 ]. Other anorectal disorders found to be associated with any constipation include fistulas, anal fissures and rectal prolapse[ 43 , 66 ].…”

Epidemiology of constipation in adults: Why estimates of prevalence differ

“…A systematic review of 10 studies conducted in Iranian adult populations showed that the prevalence of any constipation ranged from 1.4% to 37% and the prevalence of chronic constipation based on either Rome II or Rome III criteria ranged from 2.4% to 11.2%. [61] 4.1.5 South America Four studies, [24,53,62,63] have estimated prevalence in Brazil, Argentina and Colombia (see Table 2). In Brazil, prevalence ranged from 9.7% [62] when defined as <3BM/week to 14.6% [63] when using modified Rome III criteria to 16.7% for self-reported constipation.…”

“…[61] 4.1.5 South America Four studies, [24,53,62,63] have estimated prevalence in Brazil, Argentina and Colombia (see Table 2). In Brazil, prevalence ranged from 9.7% [62] when defined as <3BM/week to 14.6% [63] when using modified Rome III criteria to 16.7% for self-reported constipation. [24] 4.1.6 Australia Australia exemplifies the problem where a number of different studies in the same country have produced a wide range of prevalence estimates so it is difficult to determine the true prevalence (see Table 2).…”