Frequency patterns of core constipation symptoms among the Asian adults: a systematic review

Abstract

BackgroundIn clinical practice, assessment of constipation depends on reliability, consistency and frequency of several commonly reported or core symptoms. It is not known if frequency patterns of constipation symptoms in adults are different between the West and the East. This review aimed to describe core constipation symptoms and their frequency patterns among the Asian adults.MethodsArticles published in PubMed, MEDLINE, CINAHL and Science Direct from 2005 to 2015 were searched systematically. Studies were included if constipation satisfied the Rome II and or III criteria. Study populations consisted of Asian adults above 18 years old and with sample size above 50.ResultsOf 2812 articles screened, 11 met the eligibility criteria. Constipation among Asian adults was characterized by three core symptoms of ‘straining’ at 82.8%, ‘lumpy and hard stool’ at 74.2% and ‘sensation of incomplete evacuation’ at 68.1% and the least frequent symptom was ‘manual maneuver to facilitate defecation’ at 23.3%. There was heterogeneity in frequency patterns of core symptoms between different Asian studies but also differences in core symptoms between constipation subtypes of functional constipation and irritable bowel syndrome with constipation.ConclusionsIn general, Asian adults perceive constipation symptoms in a similar but not equivalent manner to the West. Recognition of core symptoms will increase the diagnostic confidence of constipation and its subtypes but more studies of the various specific Asian populations are needed to address their differences.

Chronic constipation among community-dwelling older people in the East Coast region of Peninsular Malaysia

“…The majority of studies have reported that straining, lumpy and hard stools, and a sensation of incomplete evacuation are three core constipation symptoms. 8,[22][23][24] Nevertheless, our findings show that older people perceive chronic constipation based on the less frequent symptoms. This mismatch demonstrates that constipation misperception is common in older people, and thus supports our early study findings.…”

“…7 Internationally, the most frequent symptom was straining and the least was using manual maneuvers to facilitate defecation. 8,9 Nevertheless, several studies have reported that ethnicity and sociodemographic differences may cause misperceptions of constipation. 10,11 An inability to recognize the symptoms of constipation will lead to a poorer quality of life, with particular economic and social effects.…”

Prevalence of Chronic Constipation and Its Associated Factors in Pars Cohort Study: A Study of 9000 Adults in Southern Iran

“…This can be due to different life style in Iranian population. 20 , 23 Iranian diet consists of more fibers (vegetable and fruits). Bread and rice is the main food in Iranian diet.…”

“…This association was confirmed in most previous studies. 13 , 23 , 26 , 32 This may be due to higher rate of co-morbidities in elderly. Diabetes mellitus, hypothyroidism, chronic renal failure, cerebrovascular accident, etc.…”

Usefulness of Personal Bowel Habits as a Predictive Factor for Inadequate Bowel Preparation for Colonoscopy: A Prospective Questionnaire-Based Observational Study

“…Such discrepancy could be due to recalled bias of BSFS based on the tendency to recall more extreme forms than usual bowel habit 19. Furthermore, a meta-analysis have suggested that straining is the most common complaint of constipation rather than hard stool or infrequent bowel movement, especially in Asia (at 82.8%, 74.2% and 59.1%, respectively) 20. Therefore, straining rather than hard stool or infrequent bowel movement might be an important surrogate marker for constipation.…”