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
- ↑ 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. doi:10.1111/j.1365-2036.2007.03540.x. PMID 17919271.
- ↑ Johanson JF, Sonnenberg A, Koch TR (1989). "Clinical epidemiology of chronic constipation". J. Clin. Gastroenterol. 11 (5): 525–36. PMID 2551954.
- ↑ 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. doi:10.1111/j.1572-0241.1999.01642.x. PMID 10606315.
- ↑ 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. doi:10.1111/j.1572-0241.2004.04114.x. PMID 15089911.
- ↑ 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. doi:10.1038/ajg.2013.137. PMID 23670115.
- ↑ 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. doi:10.1038/ajg.2010.40. PMC 2887253. PMID 20160713.
- ↑ 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 1254627. PMID 14117648.
- ↑ 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.
- ↑ 9.0 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 1404600. PMID 2297063.
- ↑ 10.0 10.1 Johanson JF (1998). "Geographic distribution of constipation in the United States". Am. J. Gastroenterol. 93 (2): 188–91. doi:10.1111/j.1572-0241.1998.00188.x. PMID 9468239.
- ↑ 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. doi:10.1111/j.1572-0241.2001.05259.x. PMID 11721760.
- ↑ 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.