Epidemiology of constipation in adults: Why estimates of prevalence differ

Abstract

This review of over 80 articles published in the last 30 years shows that estimates of the prevalence of chronic constipation in community-dwelling adults varied widely from 2.4% to 39.6% in general adult populations and from 4% to 25.8% in older adult populations. Estimates of the prevalence of any constipation (including both chronic and sporadic constipation) also varied widely from 2.6% to 31.0% in general adult populations and from 4.4% to 44.5% in older adult populations. Apart from any country or regional differences, this wide range of estimated prevalence may be attributed to different definitions used for both chronic and any constipation as well as different data collection methods and sampling differences. Sampling issues include sample size, representativeness and age range of populations sampled. Further research is required to examine the impact of different definitions on prevalence estimates to help determine the best definitions for use in future epidemiological studies. If standard definitions can be universally agreed and used, along with appropriate sampling and data collection methods, more precise estimates of constipation prevalence should be attained. This would allow more meaningful comparisons between countries and may also provide the ability to pool results.

Laxative Use in the Community: A Literature Review

“…There are a number of possible explanations for the wide range of results in studies estimating the prevalence of laxative use. Firstly, any differences in prevalence between countries might be explained by the same factors as differences in prevalence of constipation, i.e., differences in culture, diet, environment and genetics may be partly responsible [ 8 ]. For laxatives in particular, socioeconomic differences and differences in healthcare systems may be important considerations as they may impact the availability and affordability of laxative products in different countries.…”

“…For example, various data collection methods have been used in studies, the most common being face-to face (FTF) interviews. Similar to constipation prevalence studies [ 8 ], the research method used may influence survey results. Because of participant embarrassment, FTF interviews may result in lower prevalence rates compared to mail or internet surveys.…”

“…Another aspect of study design relates to the sample. As with constipation prevalence [ 8 ], the sample size may affect the prevalence of laxative use. Study samples have ranged in size from 200 [ 37 ] to 72,000 [ 33 ] participants.…”

“…Nationally representative samples are preferred for estimation of prevalence, along with some evidence of representativeness. Similar to constipation prevalence [ 8 ], the age range of the sample is another important consideration. In most studies of the general adult population, participants sampled were at least 15 or 18 years old with no upper limit but in some studies [ 5 , 21 , 22 , 23 , 31 , 32 , 33 , 39 , 44 ], the age of participants was restricted, therefore not all adults in the community were included.…”

“…Constipation represents a substantial cost in the community [ 6 ], particularly chronic constipation which is usually defined by a set of clinical symptoms known as the Rome criteria [ 7 ]; these criteria have been revised several times since their introduction in 1994 as Rome I criteria. Constipation also includes both chronic and sporadic constipation [ 8 ]. Most adults attempt to self-manage their constipation before consulting a healthcare professional [ 9 ].…”