Effect of Body Mass Index and Intra-Abdominal Fat Measured by Computed Tomography on the Risk of Bowel Symptoms

Abstract

BackgroundThis study aims to investigate the association between body mass index (BMI) or intra-abdominal fat measured by computed tomography (CT) and bowel symptoms.MethodA cohort of 958 Japanese adults who underwent colonoscopy and CT and completed questionnaires after excluding colorectal diseases was analyzed. Six symptoms (constipation, diarrhea, loose stools, hard stools, fecal urgency, and incomplete evacuation) using a 7-point Likert scale were evaluated between baseline and second questionnaire for test-retest reliability. Associations between BMI, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and symptom score were analyzed by a rank-ordered logistic model, adjusting for age, sex, smoking, and alcohol consumption, hypertension, diabetes mellitus, and dyslipidemia.ResultsSome bowel symptom scores were significantly (p<0.05) different between the age groups, sexes, smoking, and alcohol consumption. In multivariate analysis, constipation was associated with low BMI (p<0.01), low VAT area (p = 0.01), and low SAT area (p<0.01). Moreover, hard stools was associated with low BMI (p<0.01) and low SAT area (p<0.01). The remaining symptoms were not significantly associated with BMI or intra-abdominal fat. Test-retest reliability of bowel symptom scores with a mean duration of 7.5 months was good (mean kappa, 0.672).ConclusionsBoth low BMI and low abdominal fat accumulation appears to be useful indicators of increased risk for constipation and hard stools. The long-term test-retest reliability of symptom score suggests that bowel symptoms relevant to BMI or visceral fat remain consistent over several months.

The relationship between abdominal obesity and irritable bowel syndrome in adults

“…Computerized tomography was also used in the clinical trial of Nagata et al, evaluating the relation between bowel symptoms and visceral fat tissue. It was determined that the risk of constipation and hard stools was related to low visceral adipose tissue (VAT) and low subcutaneous adipose tissue (SAT), which are criteria for abdominal fat deposition and equally mean abdominal obesity [21]. In our study, complaint of hard stools/constipation and/or being in IBS-C subgroup were not significantly related to the presence of abdominal obesity.…”

Patient dissatisfaction with medical therapy for chronic constipation or irritable bowel syndrome with constipation: analysis of N‐of‐1 prospective trials in 81 patients

“…More unexpectedly, a low BMI was also associated with a less favourable outcome. Previous epidemiological studies established an association between high BMI and diarrhoea, but only in one recent Japanese study low BMI and intra‐abdominal fat were reported to be associated with an increased risk of constipation and hard stools . Moreover, in a recent study comparing individuals with a normal or prolonged balloon expulsion test, the latter group presented a significantly lower BMI .…”

“…Previous epidemiological studies established an association between high BMI and diarrhoea, 30,31 but only in one recent Japanese study low BMI and intra-abdominal fat were reported to be associated with an increased risk of constipation and hard stools. 32 Moreover, in a recent study comparing individuals with a normal or prolonged balloon expulsion test, the latter group presented a significantly lower BMI. 33 It remains to be investigated whether that association is related to differences in behavioural or dietary habits, hormone and neuro-transmitter release, colonic microbiome and colorectal or more widespread altered motor function impairing the maintenance of a normal body weight.…”

The impact of visceral obesity on chronic constipation, inflammation, immune function and cognitive function in patients with inflammatory bowel disease

“…Our study suggested that VAT/SAT ratio is associated with BMI and CD patients with visceral obesity has higher chance of chronic constipation. A previous study of 958 Japanese adults who underwent colonoscopy suggested that BMI is a useful indicator for constipation [ 20 ]. In contrast with this study, we evaluated the association of VAT/SAT with chronic constipation and found positive association.…”