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Caetano AC, Costa D, Silva-Mendes S, Correia-Pinto J, Rolanda C. Constipation: Prevalence in the Portuguese community using Rome IV-Associated factors, toilet behaviours and healthcare seeking. United European Gastroenterol J 2022; 10:376-384. [PMID: 35315232 PMCID: PMC9103370 DOI: 10.1002/ueg2.12221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/25/2022] [Indexed: 12/03/2022] Open
Abstract
Background Chronic constipation (CC) is a major public health condition and CC management remains challenging. Objective We aimed to evaluate the CC (and subtypes) prevalence in a Southern Europe Mediterranean country using Rome IV criteria, and to assess related factors, toilet and healthcare seeking behaviours. Methods Cross‐sectional epidemiological survey, conducted in general community and representing the Portuguese population according to sex and age. The questionnaire covered bowel habits, factors potentially associated with CC (demographic, health/lifestyle, toilet behaviours) and data regarding healthcare seeking. Results From the study data of 1950 individuals were analyzed. The answer rate was 68% and 1335 questionnaires were available for calculation. The CC prevalence was 17.8%, with respectively 9.3% of Functional Constipation (FC) and 8.5% of Irritable Bowel Syndrome – subtype constipation (IBS‐C). The likelihood of constipation was significantly higher in younger (OR 1.01; 95% confidence interval [CI], 1.007–1.031), solo (OR 2.48; 95% CI, 1.7–3.47) and low‐income (OR 2.40; 95% CI, 1.77–3.47) individuals. Constipated individuals spent more time at defecation, longer than 5 min (p = 0.001), and had particular toilet behaviours (absence of a morning pattern [p = 0.008], the use of triggers [p = 0.001] and reading/technological material [p = 0.006]) to facilitate the evacuation. Only 39% of affected individuals sought medical advice, mainly IBS‐C patients (p = 0.018). Conclusion Chronic constipation seems to impact 1 in each 5 Portuguese. Constipated patients are younger, solo, less active and with low income. They develop a clear toilet behaviour profile. FC and IBS‐C patients assume particular behaviours.
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Affiliation(s)
- Ana Célia Caetano
- Department of Gastroenterology, Hospital of Braga, Braga, Portugal.,School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal.,ICVS/3B's-PT, Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Dalila Costa
- Department of Gastroenterology, Hospital of Braga, Braga, Portugal.,School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal.,ICVS/3B's-PT, Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Sofia Silva-Mendes
- Department of Gastroenterology, Hospital of Braga, Braga, Portugal.,School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal.,ICVS/3B's-PT, Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Jorge Correia-Pinto
- School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal.,ICVS/3B's-PT, Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Carla Rolanda
- Department of Gastroenterology, Hospital of Braga, Braga, Portugal.,School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal.,ICVS/3B's-PT, Government Associate Laboratory, Braga/Guimarães, Portugal
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Şişik A, Başak F, Hasbahçeci M, Acar A, Kılıç A, Özel Y, Baş G. Recovery from hemorrhoids and anal fissure without surgery. TURKISH JOURNAL OF GASTROENTEROLOGY 2020; 31:289-294. [PMID: 32412899 DOI: 10.5152/tjg.2020.19183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND/AIMS An anal fissure (AF) is a linear tear in the distal anal canal and is one of the most common causes of anal pain. Hemorrhoidal disease (HD) is a symptomatic growth and distal displacement of normal anal cushions. Numerous studies have addressed the contributing factors of these conditions, yet the results remain controversial. In this study, we hypothesize that increasing patients' awareness of hidden risk factors could reduce the rate of HD and AF. MATERIALS AND METHODS A questionnaire-based controlled study was planned. After power analysis, patients with HD (n=60) and AF (n=60) were enrolled consecutively into the study group and compared with the control group (n=60) of healthy individuals. The survey was designed to assess the participants' toilet and dietary habits and anxiety risk. Odds ratios were calculated and a binary logistic regression model was constructed to identify associated factors. RESULTS Hard stools, spending more than 5 minutes in the toilet, frequent straining during defecation, and increased spice intake were more frequent in the patients with HD; and hard fecal consistency, time elapsed in toilet greater than 5 min, straining during defecation, and high anxiety risk were more frequent in the patients with AF as compared to the control group (p<0.05). CONCLUSION Possible associations were identified between habitual factors or conditions (i.e., fecal consistency, the time elapsed in the toilet, straining during defecation) and anxiety and benign anorectal diseases (i.e., HD and AF). Patients should be advised about these hidden threats.
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Affiliation(s)
- Abdullah Şişik
- Department of General Surgery, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Fatih Başak
- Department of General Surgery, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Hasbahçeci
- Department of General Surgery, Medical Park Hospital, Fatih, Istanbul, Turkey
| | - Aylin Acar
- Department of General Surgery, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Ali Kılıç
- Department of General Surgery, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Yahya Özel
- Department of General Surgery, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Gürhan Baş
- Department of General Surgery, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
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Abstract
GOALS The goal of this study was to evaluate the influence of defecation postural modification devices (DPMDs) on normal bowel patterns. BACKGROUND The introduction of DPMDs has brought increased awareness to bowel habits in western populations. MATERIALS AND METHODS A prospective crossover study of volunteers was performed that included real-time collection of data regarding bowel movements (BMs) for 4 weeks (first 2 wk without DPMD and subsequent 2 wk with DPMD). Primary outcomes of interest included BM duration, straining, and bowel emptiness with and without DPMD use. RESULTS In total, 52 participants (mean age, 29 y and 40.1% female) were recruited for this study. At baseline 15 subjects (28.8%) reported incomplete emptying, 23 subjects (44.2%) had increased straining, and 29 subjects (55.8%) noticed blood on their toilet paper in the past year. A total of 1119 BMs were recorded (735 without DPMD and 384 with DPMD). Utilizing the DPMD resulted in increased bowel emptiness (odds ratio, 3.64; 95% confidence interval (CI), 2.78-4.77) and reduced straining patterns (odds ratio, 0.23; 95% CI, 0.18-0.30). Moreover, without the DPMD, participants had an increase in BM duration (fold increase, 1.25; 95% CI, 1.17-1.33). CONCLUSIONS DPMDs positively influenced BM duration, straining patterns, and complete evacuation of bowels in this study.
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The Mexican consensus on chronic constipation. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2018; 83:168-189. [PMID: 29555103 DOI: 10.1016/j.rgmx.2017.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 12/08/2017] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Significant advances have been made in the knowledge and understanding of the epidemiology, pathophysiology, diagnosis, and treatment of chronic constipation, since the publication of the 2011 guidelines on chronic constipation diagnosis and treatment in Mexico from the Asociación Mexicana de Gastroenterología. AIMS To present a consensus review of the current state of knowledge about chronic constipation, providing updated information and integrating the new scientific evidence. METHODS Three general coordinators reviewed the literature published within the time frame of January 2011 and January 2017. From that information, 62 initial statements were formulated and then sent to 12 national experts for their revision. The statements were voted upon, using the Delphi system in 3 voting rounds (2 electronic and one face-to-face). The statements were classified through the GRADE system and those that reached agreement >75% were included in the consensus. RESULTS AND CONCLUSIONS The present consensus is made up of 42 final statements that provide updated knowledge, supplementing the information that had not been included in the previous guidelines. The strength of recommendation and quality (level) of evidence were established for each statement. The current definitions of chronic constipation, functional constipation, and opioid-induced constipation are given, and diagnostic strategies based on the available diagnostic methods are described. The consensus treatment recommendations were established from evidence on the roles of diet and exercise, fiber, laxatives, new drugs (such as prucalopride, lubiprostone, linaclotide, plecanatide), biofeedback therapy, and surgery.
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