Lifestyle and behavioral factors associated with constipation

Posted by Master, Doctor Mai Vien Phuong - Department of Examination & Internal Medicine - Vinmec Central Park International General Hospital

One of the most common health problems facing the community is constipation. In general, constipation can be defined as the inability to have a bowel movement, which includes a variety of symptoms and can be chronic or sporadic. Chronic constipation is usually defined by a set of clinical symptoms known as the Rome criteria; The Rome criterion was revised several times after being introduced as the Rome I criterion in 1994.

Any constipation can be defined as constipation including chronic constipation and sporadic constipation; This condition is often self-reported in epidemiological studies. Several factors have been implicated in constipation, however actual evidence for these associations appears to be scant. It is widely accepted that the main risk factors for constipation in the community include low levels of exercise, low fiber intake, and insufficient fluid intake. However, these risk factors have been challenged in the past due to limited clinical evidence. In addition to these factors, there are other health determinants reported in the literature to be associated with constipation. These include lifestyle and demographic factors. Furthermore, medications and medical conditions are considered to be the two main causes of constipation. Because there seems to be questionable factual evidence for various risk factors despite their wide acceptance in the community, this literature review seeks to assess each potential risk factor by review evidence from population-based studies of adult populations living in the community.

A statistical study of 53 articles was selected for inclusion in this review. Of these, 9 are systematic reviews and 44 are community-based quantitative epidemiological studies of general adult populations. Three systematic reviews were international, two related to specific regions - North America and Europe plus Oceania, and two related to specific countries - Iran and China. Two other reviews involved specific factors - comorbidities and hemorrhoids. Epidemiological studies are cross-sectional surveys of adults living in the community. Factors that may be associated with constipation derived from the authors' assessment include demographic factors (age, gender, income, education, work status and geography), lifestyle factors, and lifestyle factors. lifestyle and behavior (physical activity, smoking and fibre, fluids, alcohol and coffee consumption) and many other health-related factors (including medical conditions and medications).

The following section describes lifestyle and behavioral factors that may be associated with constipation in adults in the community setting.
Physical activity There is limited evidence that low levels of physical activity and inactivity are associated with high rates of constipation. Low levels of exercise/physical activity are significantly associated with an increased incidence of chronic disease and any constipation in studies conducted in different countries Physical activity and constipation.

Smoking:
Conflicting data indicate that there is no clear association of smoking with the incidence of chronic disease or constipation. Studies from the United States and Iran have suggested that smoking may be a risk factor for chronic constipation. However, other US studies and studies in Greece and Taiwan did not find significant differences in the prevalence of chronic constipation in smokers and non-smokers. Furthermore, one study in the United States and one in Norway found that smoking is a negative risk factor for chronic and any constipation. Smoking and constipation.

Fiber
There is little evidence that eating less fiber is associated with higher rates of chronic disease or constipation. In one Spanish study, low fiber and high fiber intake were both associated with increased incidence of constipation and in another Spanish study, no significant association was found. with chronic constipation

Drink water every day
There is little evidence that drinking a lot of water is related to the incidence of chronic or any constipation. The only evidence occurred in a Spanish study, where chronic constipation was inversely related to fluid intake, defined as glasses of fluid consumed daily. A US study found no link between coffee and chronic constipation

Alcohol
There is some limited evidence that drinking alcohol may be associated with a reduced incidence of chronic constipation
Several studies have investigated the association between alcohol and chronic constipation. Increased alcohol intake was a negative risk factor for chronic constipation in a US study and also in a Norwegian study. A similar trend was observed in Taiwan and other US studies, but the opposite trend was found in Iran, but no relationship reached significance.

References
Werth BL, Christopher SA. Potential risk factors for constipation in the community. World J Gastroenterol 2021; 27(21): 2795-2817 [DOI: 10.3748/wjg.v27.i21.2795]