Shared Risk Factors for Constipation, Fecal Incontinence, and Combined Symptoms in Older U.S. Adults

Andy, Uduak U.; Vaughan, Camille P.; Burgio, Kathryn L.; Alli, Foluke; Goode, Patricia S.; Markland, Alayne D.

doi:10.1111/jgs.14521

Cited by 45 publications

(32 citation statements)

References 26 publications

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“…According to Rome III criteria, the prevalence of CC was found to be 4.9% in this study population. This finding is substantially lower compared to the prevalence reported for many elderly female populations in Western countries (12–34%) [1,20–22]. The Rome IV criteria were published in 2016 and are similar to Rome III but further emphasize the subtypes of constipation [23].…”

Section: Discussionmentioning

confidence: 91%

Prevalence and Risk Factors of Chronic Constipation Among Women Aged 50 Years and Older in Shanghai, China

et al. 2017

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BackgroundChronic constipation (CC) is a major public health problem worldwide, especially in elderly women. This study aimed to investigate the prevalence and risk factors of CC among women aged 50 years and older in Shanghai, China.Material/MethodA cross-sectional survey was conducted on 1950 women aged 50 years and older, randomly sampled in Yangpu District of Shanghai from April to October 2015. Information on demographic characteristics, lifestyle habits, medical history, and defecation situation was collected through in-person interviews. CC was defined according to Rome III criteria. The data were analyzed by chi-square test and multiple logistic regression analysis.ResultsThe response rate to the survey was 80.4%. Of the 1568 participants, 77 were diagnosed with CC, with a prevalence of 4.9%. Moreover, the prevalence increased with advancing age. Multiple logistic analyses showed that body mass index (BMI) ≥25.0 kg/m2, non-manual occupation, premenopausal period, no delivery history, poor sleep quality, meat-based diet, and less physical exercise were significant risk factors for CC in the population of women aged 50 years and older.ConclusionsCC was a common health problem among women aged 50 years and older in Shanghai, and the prevalence was positively associated with BMI ≥25.0 kg/m2, non-manual occupation, premenopausal period, no delivery history, poor sleep quality, meat-based diet, and less physical exercise. Further studies are needed to identify the risk factors and potential interventions for CC.

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Section: Discussionmentioning

confidence: 91%

Prevalence and Risk Factors of Chronic Constipation Among Women Aged 50 Years and Older in Shanghai, China

et al. 2017

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“…Women participating in a specialty clinic for constipation had more frequent constipation and abnormal bowel conditions than men and also reported differences in characteristics of constipation, including abdominal pain and bloating, unsuccessful evacuation, hard pellet‐like stools and a longer duration of symptoms . In a US study of older adults , bowel symptoms were common in older men and women but women had a higher prevalence of constipation, whereas men had a higher prevalence of faecal incontinence. In the present study, dietary fibre intake levels were significantly associated with sex, as were rates of constipation; the constipation rate among men was low compared to that in women, indicating a possible protective effect of male sex.…”

Section: Discussionmentioning

confidence: 99%

Lower dietary fibre intake, but not total water consumption, is associated with constipation: a population‐based analysis

Shen

Huang

et al. 2019

J Human Nutrition Diet

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Background Associations between constipation and dietary fibre and water intake, as well as various lifestyle factors, have not been fully evaluated. The present study aimed to investigate associations between fibre and water intake and constipation, as well as other possible risk factors for constipation, in a large adult population. Methods Data obtained from 14 024 adults aged ≥20 years from three cycles of the National Health and Nutrition Examination Survey (NHANES) 2005–2010, who had completed a bowel health questionnaire, were included in this cross‐sectional population‐based study. Variables included demographics, lifestyle and dietary factors, comorbidities and laboratory parameters. Logistic regression analyses were performed to determine associations between potential risk factors and constipation. Results Among 17 132 participants ≥20 years, 2401 (14%) did not complete bowel health questionnaires and were excluded, along with pregnant women (n = 461) and participants without dietary sample weight on day 1 (n = 246), leaving data from 14 024 participants available for analysis. Multivariate analysis revealed that black race/ethnicity [odds ratio (OR) = 1.380, 95% confidence interval (CI) = 1.054–1.809], a lower than 12th grade education (OR = 1.420, 95% CI = 1.154–1.749) or high school education (OR = 1.339, 95% CI = 1.057–1.697), lower income/poverty ratios (1.3–3.49 versus ≥3.5: OR = 1.261, 95% CI = 1.015–1.567), normal weight (OR = 1.913, 95% CI = 1.534–2.386) or overweight (OR = 1.536, 95% CI = 1.207–1.955), depression (OR = 1.610, 95% CI = 1.119–2.315) and poor teeth (OR = 1.441, 95% CI = 1.100–1.888) were associated with an increased risk for constipation. Lower dietary fibre intake was associated with a greater risk of constipation. Total water consumption was significantly associated an with an increased risk of constipation in univariate analysis, but not in multivariate analysis. Conclusions Lower dietary fibre intake, but not poor water consumption, was associated with a greater risk of constipation in US adults.

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“…In the general population older than 50 years, depression appears to be two to five times more frequent in people with faecal incontinence . Data are sparse about the possible association between anal incontinence and depression in the postnatal period.…”

Section: Discussionmentioning

confidence: 99%

“…Anal or faecal incontinence is a disability that has repercussions on health‐related quality of life and mood . Depression is two to five times more frequent in people with faecal incontinence . The main risk factors for anal incontinence are ageing, diarrhoea, anorectal surgery and childbirth.…”

Section: Introductionmentioning

confidence: 99%

Postpartum psychological distress associated with anal incontinence in the EDEN mother–child cohort

Fritel

Gachon

Saurel‐Cubizolles

2020

BJOG

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Objective To estimate the prevalence of flatus‐only and faecal incontinence, to describe their risk factors and to analyse the association between anal incontinence and psychological distress over the first year postpartum. Design Cohort study from pregnancy to 12 months postpartum. Setting Two university hospital maternity wards in France. Population A total of 2002 pregnant women were recruited between 2003 and 2006. Data on anal incontinence were available for the 1632 women who comprise the sample for analysis. Methods Women were enrolled during pregnancy. A postal questionnaire was sent at 4 and 12 months postpartum. Main outcome measures Anal (flatus‐only and faecal) incontinence was assessed at 4 months postpartum. Mental health was assessed at 4 and 12 months postpartum by the Edinburgh Postpartum Depression Scale (EPDS) and use of antidepressant drugs as well as by self‐rated mental health. Results At 4 months postpartum, the prevalence for flatus‐only incontinence was 14.4% and for faecal incontinence 1.7%; multivariate analysis, restricted to women reporting no anal incontinence before the index pregnancy, showed that continuing breastfeeding at 4 months was related to a higher risk of de novo postpartum anal incontinence (OR = 2.23). Women who reported anal incontinence at 4 months were more frequently depressed (EPDS ≥10 or antidepressant use) at 12 months postpartum: 36.0% of those with faecal incontinence were depressed, 23.3% of those with flatus‐only incontinence and only 14.8% of the continent women. Conclusion Postnatal faecal incontinence was rare but associated with poorer maternal mental health. Postnatal screening should be encouraged, and psychological support offered. Tweetable abstract Postnatal faecal incontinence was associated with depression; postnatal screening should be encouraged and psychological support offered.

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Shared Risk Factors for Constipation, Fecal Incontinence, and Combined Symptoms in Older U.S. Adults

Abstract: When defining constipation and FI using validated instruments, women had a much higher prevalence of constipation than men, whereas men had a higher prevalence of FI than constipation. Shared risk factors reflect the negative effect that bowel symptoms have on quality of life.

Cited by 45 publications

References 26 publications

Prevalence and Risk Factors of Chronic Constipation Among Women Aged 50 Years and Older in Shanghai, China

Prevalence and Risk Factors of Chronic Constipation Among Women Aged 50 Years and Older in Shanghai, China

Lower dietary fibre intake, but not total water consumption, is associated with constipation: a population‐based analysis

Postpartum psychological distress associated with anal incontinence in the EDEN mother–child cohort

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