Risk of developing colorectal cancer and benign colorectal neoplasm in patients with chronic constipation

Guérin, Annie; Mody, Reema; Fok, Beverly; Lasch, Karen; Zhou, Zheng–Yi; Wu, Eric Q.; Zhou, Wen; Talley, Nicholas J.

doi:10.1111/apt.12789

Cited by 101 publications

(77 citation statements)

References 33 publications

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“…In contrast to ischemic heart disease, stroke, and severe infection, constipation is not a life-threatening complication in CKD, except in rare cases of colonic bleeding due to stercoral ulcers [5]. However, several cohort studies have shown that constipation is associated with increased mortality in the general population [6], which may be explained by the relationship between constipation and colon cancer [7,8] and cardiovascular disease (CVD) [9][10][11]. Furthermore, a nationwide cohort study from the United States including 3 million veterans reported that constipation was associated with the higher incidence of CKD (hazard ratio, 1.13) and ESKD (hazard ratio, 1.09) [12].…”

Section: Introductionmentioning

confidence: 99%

Constipation in chronic kidney disease: it is time to reconsider

Ikee

Yano

Tsuru³

2019

Ren Replace Ther

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Constipation is highly prevalent in patients with chronic kidney disease (CKD) and is primarily characterized by decreased intestinal motility. This chronic disorder affects the quality of life of patients. However, nephrologist and dialysis clinicians have long had a disproportionately limited understanding of constipation. Accumulating evidence has revealed a relationship between constipation and cardiovascular disease and CKD. The pathogenesis of constipation in CKD patients is multifactorial: decreased physical activity, comorbidities affecting bowel movement, such as diabetes mellitus, cerebrovascular disease, and hyperparathyroidism, a restricted dietary intake of plantbased fiber-rich foods, and multiple medications, including phosphate binders and potassium-binding resins, have all been implicated. CKD is associated with alterations in the composition and function of the gut microbiota, socalled gut dysbiosis. Recent studies showed that CKD-related gut dysbiosis decreased intestinal motility via intestinal inflammation or the increased generation of gut-derived uremic toxins, such as indoxyl sulfate and pcresyl sulfate. Furthermore, the gastrointestinal secretion of mucin was found to be decreased in CKD animal models, which may delay colonic transit by diminished lubrication in the alimentary tract. Thus, CKD-related gut dysbiosis may play a role in constipation, but limited information is currently available. Since constipation is often intractable, particularly in CKD patients, every available means needs to be employed in its treatment. The effects of probiotics, prebiotics, and synbiotics on the composition of the gut microbiota and gut-derived uremic toxins have been increasingly reported. However, their effects on stool consistency or frequency in CKD patients remain unclear. Some laxatives may be beneficial for improving not only bowel habits but also gut dysbiosis. Further studies are required to elucidate the CKD-specific pathogenesis of constipation and develop novel effective treatment options.

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Section: Introductionmentioning

confidence: 99%

Constipation in chronic kidney disease: it is time to reconsider

Ikee

Yano

Tsuru³

2019

Ren Replace Ther

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“…The problem is difficult to talk about because of its intimate nature, and it has been found that patients feel that staff do not pay enough attention to the problem . Further, constipation also increases the risk of comorbidities such as megacolon, intestinal impaction, volvulus, psychological conditions such as depression and mood disorders , and colorectal cancer .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of constipation among persons living in institutional geriatric‐care settings – a cross‐sectional study

Lämås

Karlsson

Nolén

et al. 2016

Scandinavian Caring Sciences

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The results show that constipation is common among residents in institutional geriatric-care settings in Sweden, which is in line with previous studies from other Western countries. Despite being constipated when having prescribed opioid analgesics, a large number did not have prescribed laxatives. The results indicate the urgency of finding strategies and implementing suitable interventions to improve bowel management in residents in institutional geriatric-care settings.

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“…The list of the excluded studies with the exclusion reasons are presented in Supplementary Material S3. Finally, ten cohort studies were included [15,[22][23][24][25][26][27][28][29][30]. The study selection process is presented in Figure 1.…”

Section: Identification and Characteristics Of The Included Studiesmentioning

confidence: 99%

Abnormal bowel movement frequency increases the risk of rectal cancer: evidence from cohort studies with one million people

Shen

et al. 2020

Bioscience Reports

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Correspondence: Zhanzhan Li (liche4006@126.com)Previous studies from case-control studies failed to draw reliable conclusions regarding the relationship between bowel movement frequency and the risk of colorectal cancer. To further examine this relationship, we collect the data from cohort studies that make a more accurate estimation. Several online data were searched from inception to February 29, 2020. Ten cohort studies involving 1,038,598 individuals were included in our study. The pooled results indicated that a bowel movement of less than once per day was not associated with the risk of colorectal cancer (relative risk (RR)= 1.00, 95% confidence interval (CI): 0.87-1.16, P = 0.950) compared with that of once per day. Compared with a bowel movement frequency of once per day, a bowel movement of more than once per day was also not related to elevated risk of colorectal cancer (RR = 1.04, 95% CI: 0.91-1.19, P = 0.570). The subgroup analyses indicated a low or high bowel movement frequency did not increase the risk of colon cancer (RR = 0.91, 95% CI: 0.80-1.03, P = 0.130). However, an increased frequency of bowel movements increased the risk of rectal cancer (RR = 1.34, 95% CI: 1.19-1.52, P < 0.001). The sensitivity analysis still supports the results. No significant publication bias existed. The data from cohort indicated that less bowel movement frequency was not associated with the risk of colorectal cancer. The frequency of bowel movement affects the risk of rectal cancer.

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Risk of developing colorectal cancer and benign colorectal neoplasm in patients with chronic constipation

Abstract: SUMMARY BackgroundChronic constipation (CC) is a highly prevalent health problem, potentially associated with increased risk of colorectal cancer (CRCancer).

Cited by 101 publications

References 33 publications

Constipation in chronic kidney disease: it is time to reconsider

Constipation in chronic kidney disease: it is time to reconsider

Prevalence of constipation among persons living in institutional geriatric‐care settings – a cross‐sectional study

Abnormal bowel movement frequency increases the risk of rectal cancer: evidence from cohort studies with one million people

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