Health-related factors that may be associated with constipation

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

Searching for relevant published documents was performed using the Ovid interface to the MEDLINE and Embase electronic databases. Articles that met the inclusion criteria were classified as chronic constipation and any type of constipation according to the constipation definition used in the study.

Due to the large number of articles published on these topics, the search was limited to articles published between 1989 and 2019. A final sample of 53 articles was selected for inclusion. overview of this document. Of these, 9 are systematic reviews and 44 are community-based quantitative epidemiological studies of general adult populations.

The following section describes health-related factors that may be associated with constipation in adults in the community setting. Self-assessment of health as fair or poor was significantly associated with increased rates of chronic constipation in two European studies Self-assessment of health and status of constipation:



Medical conditions :
Various medical conditions have been reported potentially associated with constipation in epidemiological studies


Gastrointestinal disorders:
In a review of comorbidities, dyspepsia indigestion, heartburn, gastroesophageal reflux disease (GORD), and nausea/vomiting are often associated with chronic constipation. The association of GORD with constipation has been reported in several epidemiological studies. Other digestive disorders including colorectal cancer and diverticulitis are also associated with any constipation and chronic constipation. Anorectal disorders, especially hemorrhoids, are often associated with constipation. A review of 7 studies conducted through 2009 found a significant association between any constipation and hemorrhoids. Hemorrhoids have also been found to be commonly associated with chronic constipation. Other anorectal disorders found to be associated with any constipation include fistulas, anal fissures, and rectal prolapse Depression, anxiety, and insomnia:
There is evidence that depression Feelings and anxiety are associated with chronic constipation and any cases, and there is little evidence for insomnia. In a review of comorbidities, depression was the most commonly reported psychiatric condition associated with chronic constipation, occurring in 15% to 29% of patients with chronic constipation. In other studies not included in the review, depression and anxiety were found to be significantly associated with either chronic or any constipation; One of these studies also found that insomnia was significantly associated with chronic constipation Neurological diseases:
The prevalence of chronic constipation in multiple sclerosis has been reported to be 5.5 and 2.41 respectively. in two studies; Chronic constipation in Parkinson's disease had an odds ratio of 6.5.
Obesity:
There is conflicting evidence about the association between obesity or body weight with chronic or any constipation. In a review of comorbidities, chronic constipation was commonly associated with obesity (20% to 37% of patients with chronic constipation) and overweight (17% to 40% of patients with chronic constipation). However, other epidemiological studies have not found a clear association between body mass index (BMI) and chronic or self-reported constipation.

In a review of comorbidities, diabetes was frequently associated with chronic constipation (4.7% to 11.8% of chronic constipation patients) in a comorbidity review. Some, but not all, epidemiological studies have also reported this association For chronic constipation, constipation with cardiovascular disease had an odds ratio of 1.5 in one study. In the same study, the odds ratio for constipation in angina was 1.4 and in another study it was 1.86. Stroke was associated with chronic constipation in the Brazilian study. Musculoskeletal complaints have been found to be associated with chronic constipation, including back or joint pain. Urinary tract disorders have also been reported to be associated with constipation. Surgery
Surgery is recently known to be a risk factor for constipation; this may involve medications including general anesthetics and opioid pain relievers as well as being sedentary after surgery. However, the long-term effects of various surgical procedures can contribute to chronic constipation. Gynecological, abdominal, and anorectal surgery were significantly associated with an increased risk of chronic constipation in four epidemiological studies but cholecystectomy and appendectomy were not significant in others. art and constipation.
BDQ: Bowel Pathology Questionnaire (similar to Rome criteria). Medication
Constipation is a common side effect of many classes of drugs but this is not always evident in population-based studies because of very few reports of concomitant drug use. The amount of medication used can be related to chronic or any constipation. In a Norwegian study, the use of one or more medications was found to be associated with chronic constipation. Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), especially ibuprofen, were significantly associated with chronic constipation in this and other studies. Other drug classes including digoxin, glyceryl trinitrate, atorvastatin, furosemide and levo-thyroxine were also found to be significantly associated with chronic constipation

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]