Constipation epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

The incidence of constipation is approximately 16,666 per 100,000 individuals in general population (one in every six). The prevalence of constipation is approximately 2,000 to 28,000 per 100,000 individuals in general population. It is estimated that 4-56 million people are suffering from constipation in United States. The prevalence of constipation is approximately 1,900 to 27,200 (with an average of 14,800) per 100,000 individuals in North America. The general decline in 10-year survival rate of people with functional constipation is about 12%, comparing to normal population. The incidence of constipation increases with age. The non-White to White ratio of involving in constipation is from 1.13 to 2.89 (Mean 1.68, Median 1.41). Females are more commonly affected by constipation than males. The female to male ratio is approximately 2.2 to 1. Developing countries with lower income show higher prevalence of constipation rather than developed countries with higher income. Educational years in the population show an inverse relationship with prevalence of constipation.

Epidemiology and Demographics

Incidence

  • The incidence of constipation is approximately 16,666 per 100,000 individuals in general population (one in every six).[1]

Prevalence

  • The prevalence of constipation is approximately 2,000 to 28,000 per 100,000 individuals in general population.[2][3]
  • It is estimated that 4-56 million people are suffering from constipation in United States.
  • The prevalence of constipation is approximately 1,900 to 27,200 (with an average of 14,800) per 100,000 individuals in North America.[4]
Year Sample size Diagnosis Prevalence

(per 100,000 individuals)

1964 890,394 Self-report 27,100
1971-1975 15,014 Self-report 12,800
1971-1975 11,024 Self-report 15,800
1983-1987 Not reported Self-report 1,900
1989 42,375 Self-report 3,400
1991 835 Self-report

OR

< 3 defecations per week

17,400
1993 690 Self-report 5,000
ROME I functional constipation (FC) 19,200
ROME I outlet obstruction (OD) 11,000
1993 5,430 ROME I functional constipation (FC) 3,600
ROME I Dyschezia 13,800
1997 10,018 ROME II, FC, OD, or IBS-C (irritable bowel syndrome, constipation type) 14,700
2000 1,149 Self-report 27,200
ROME I 16,700
ROME II 14,900

Case-fatality rate/Mortality rate

  • The case-fatality rate of constipation is very low.
  • Very long-term constipation can cause death in elderly.
  • Persistent and transient constipation can increase the mortality rate up to 2.8% and 2%, respectively, rather than people without constipation.[5]
  • The general decline in 10-year survival rate of people with functional constipation is about 12%, comparing to normal population.[6]

Age

  • Patients of all age groups may develop constipation.
  • The incidence of constipation increases with age.[7]
Type of diagnosis Age group Prevalence

(per 100,000 individuals)

Self-report 30-34 21,200
35-39 21,000
40-44 21,600
45-49 23,400
50-54 26,200
55-59 27,700
60-64 29,700
65-69 32,800
70-74 37,300
75-79 42,600
80-84 48,600
≥85 54,600

Race

  • Constipation usually affects individuals of the non-Caucasian race. Caucasian individuals are less likely to develop constipation.
  • The non-White to White ratio of involving in constipation is from 1.13 to 2.89 (Mean 1.68, Median 1.41).[4][8]

Gender

  • Females are more commonly affected by constipation than males. The female to male ratio is approximately 2.2 to 1.[4]
  • Female to male ratio suffering from constipation in various studies is as the following:
Author Criteria Male Female Female to male ratio
Sandler[9] Self-report 7 18.2 2.6
Johnson[10] Self-report 0.9 2.8 3.11
Pare[11] Self-report 18.4 35.4 1.92
ROME I 12 21 1.75
ROME II 8.3 21.1 2.54
Talley[12] Self-report 2.7 7.3 2.7
ROME I functional constipation (FC) 18.3 20.1 1.01
ROME I outlet obstruction (OD) 5.2 16.5 3.17

Region

  • There is no regional difference in the prevalence of constipation.

Developed and Developing Countries

  • Developing countries with lower income show higher prevalence of constipation rather than developed countries with higher income.
  • Educational years in the population show an inverse relationship with prevalence of constipation.
Author Criteria Income Education
USD per year Prevalence

(per 100,000 individuals)

Status Prevalence

(per 100,000 individuals)

Sandler[9] Self-report < 7,000 18,600 0-6 years 21,700
7,000-9,999 13,300 7-11 years 15,300
10,000-14,999 11,600 12 years 12,200
≥ 15,000 8,600 More than 13 years 11,200
Johnson[10] Self-report 0-9,999 3,690 - -
10,000-19,999 2,290
20,000-34,999 1,470
≥ 35,000 1,080
Pare[11] Self-report <20,000 33,800 Grade school 28,700
20,000-39,999 23,700 Some high school 35,100
High school 24,600
40,000-59,999 24,300 High school diploma 29,400
Technician school 20,500
60,000-79,999 28,000 Some College 25,400
College 31,500
≥ 80,000 21,800 Graduate school 19,600
ROME I functional constipation (FC) <20,000 18,500 Grade school 14,300
20,000-39,999 16,300 Some high school 23,800
High school 18,800
40,000-59,999 17,600 High school diploma 22,100
Technician school 15,000
60,000-79,999 13,100 Some College 9,900
College 17,200
≥ 80,000 12,100 Graduate school 11,300
ROME II <20,000 15,300 Grade school 4,300
20,000-39,999 14,300 Some high school 21,700
High school 18,600
40,000-59,999 13,900 High school diploma 18,400
Technician school 12,000
60,000-79,999 14,500 Some College 8,600
College 16,500
≥ 80,000 8,300 Graduate school 10,000
Talley[12] ROME I functional constipation (FC) - - Less than high school graduated 23,300
High school graduated 18,400
More than high school graduated 18,000
ROME I outlet obstruction (OD) - - Less than high school graduated 16,300
High school graduated 8,700
More than high school graduated 12,000

References

  1. Choung RS, Locke GR, Schleck CD, Zinsmeister AR, Talley NJ (2007). "Cumulative incidence of chronic constipation: a population-based study 1988-2003". Aliment. Pharmacol. Ther. 26 (11-12): 1521–8. PMID 17919271. doi:10.1111/j.1365-2036.2007.03540.x. 
  2. Johanson JF, Sonnenberg A, Koch TR (1989). "Clinical epidemiology of chronic constipation". J. Clin. Gastroenterol. 11 (5): 525–36. PMID 2551954. 
  3. Stewart WF, Liberman JN, Sandler RS, Woods MS, Stemhagen A, Chee E, Lipton RB, Farup CE (1999). "Epidemiology of constipation (EPOC) study in the United States: relation of clinical subtypes to sociodemographic features". Am. J. Gastroenterol. 94 (12): 3530–40. PMID 10606315. doi:10.1111/j.1572-0241.1999.01642.x. 
  4. 4.0 4.1 4.2 Higgins PD, Johanson JF (2004). "Epidemiology of constipation in North America: a systematic review". Am. J. Gastroenterol. 99 (4): 750–9. PMID 15089911. doi:10.1111/j.1572-0241.2004.04114.x. 
  5. Koloski NA, Jones M, Wai R, Gill RS, Byles J, Talley NJ (2013). "Impact of persistent constipation on health-related quality of life and mortality in older community-dwelling women". Am. J. Gastroenterol. 108 (7): 1152–8. PMID 23670115. doi:10.1038/ajg.2013.137. 
  6. Chang JY, Locke GR, McNally MA, Halder SL, Schleck CD, Zinsmeister AR, Talley NJ (2010). "Impact of functional gastrointestinal disorders on survival in the community". Am. J. Gastroenterol. 105 (4): 822–32. PMC 2887253Freely accessible. PMID 20160713. doi:10.1038/ajg.2010.40. 
  7. HAMMOND EC (1964). "SOME PRELIMINARY FINDINGS ON PHYSICAL COMPLAINTS FROM A PROSPECTIVE STUDY OF 1,064,004 MEN AND WOMEN.". Am J Public Health Nations Health. 54: 11–23. PMC 1254627Freely accessible. PMID 14117648. 
  8. Everhart JE, Go VL, Johannes RS, Fitzsimmons SC, Roth HP, White LR (1989). "A longitudinal survey of self-reported bowel habits in the United States". Dig. Dis. Sci. 34 (8): 1153–62. PMID 2787735. 
  9. 9.0 9.1 Sandler RS, Jordan MC, Shelton BJ (1990). "Demographic and dietary determinants of constipation in the US population". Am J Public Health. 80 (2): 185–9. PMC 1404600Freely accessible. PMID 2297063. 
  10. 10.0 10.1 Johanson JF (1998). "Geographic distribution of constipation in the United States". Am. J. Gastroenterol. 93 (2): 188–91. PMID 9468239. doi:10.1111/j.1572-0241.1998.00188.x. 
  11. 11.0 11.1 Pare P, Ferrazzi S, Thompson WG, Irvine EJ, Rance L (2001). "An epidemiological survey of constipation in canada: definitions, rates, demographics, and predictors of health care seeking". Am. J. Gastroenterol. 96 (11): 3130–7. PMID 11721760. doi:10.1111/j.1572-0241.2001.05259.x. 
  12. 12.0 12.1 Talley NJ, Weaver AL, Zinsmeister AR, Melton LJ (1993). "Functional constipation and outlet delay: a population-based study". Gastroenterology. 105 (3): 781–90. PMID 8359649. 



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