Functional Constipation in the General Population in Cotonou: Prevalence and Associated Socio-Demographic Factors

Abstract

Background: Constipation is considered rare in sub-Saharan Africa because of the high fiber content of the local diet. However, certain factors could intervene in this pathology. The purpose of this study was to assess the prevalence of constipation in the general population in Cotonou and to determine the associated socio-demographic factors. Methods: This was a cross-sectional descriptive and analytical study conducted from July to August 2017 in 7 districts of the township of Cotonou, according to a cluster sampling. We included anyone over the age of 15 living in the city of Cotonou for at least 6 months. Constipation was either self-reported or functional (meeting the Rome IV criteria). Results: A total of 1058 participants were included: 574 men (sex ratio of 1.2), mean age of 29 years [range 15-92]. Self-reported constipation was noted in 512 patients (48.5%). It was functional in 256 cases (24.2%). In the latter category, there was a predominance of women (138, 53.9%), of secondary education (46.5%), of self-employed professionals (50.4%), from the Ouémé-Plateau (41.8%). Were associated with the occurrence of functional constipation (univariate analysis), age ≥ 60 years (p = 0.049), female gender (p = 0.003), and subjects living alone (166, 64.8%) vs. those living in a relationship (90, 35.2%, p = 0.001). Conclusion: Constipation was not as rare in Cotonou. It was more common in women, subjects over 60 years old or living alone.

The relations between constipation and characteristics of intestinal morphologies by colonoscopy

“…A possible contributing factor to the higher rates in females may be higher risk of injury to the pelvic floor muscles and nerves that are required for defecation (22) following childbirth (23). In addition, most epidemiologic studies demonstrated a higher prevalence of constipation in elderly individuals (1,5,24), due in part to intrinsic changes in colonic motility and physiology in the elderly, such as an increase in collagen deposition in the left colon (25), which predisposes individuals to developing constipation (24). Moreover, gastrointestinal disorders such as enteritis may play a part in the onset of constipation (26).…”

“…There are various factors that are associated with constipation. The most frequently cited associated risk factors for constipation are female gender and advanced age (1,(3)(4)(5).…”

Ethnobotanical survey of anti-constipation medicinal plants used in Sikonge District, Tanzania

“…The disorder accounts for 3 -5% of the referral cases to pediatricians, and the records show that about one-third of kids aged 6 to 12 years get constipation at least once per annum (Farnam et al 2009). In Africa, data on the prevalence of the disorder is limited and poorly quantified, but studies in urban health facilities report high frequency (Sehonou et al 2018).…”

“…The disorder is mainly due to low-intake or lack of fibre diet, dehydration or taking inadequate amounts of fluids, especially water, during physical activity or in hot areas, delaying the impulse to have a bowel movement and causing a gradual decrease in colonic motility (Saad et al 2010), travel or changes in routine (Wald et al 2007), pregnancy, aging especially those with greater than 60 years (Sehonou et al 2018), and consumption of some medications including certain antacids, painkillers, diuretics and some treatments for Parkinson's disease (Everhart & Ruhl 2009). The management of constipation includes the use of osmotic and stimulant laxatives, fibrous drugs, fibre-rich diets, stool softeners, and behavioral modification, including diet and lifestyle (Liu 2011).…”