Prevalence of Constipation in Healthy Population,

an observational cross sectional study

Asma Sikander
House Officer, Neurology Department
Lahore General Hospital, Lahore
INTRODUCTION
• Constipation is a common complaint but a poorly defined clinical constellation. Constipation refers to bowel
movements that are infrequent or hard to pass. The stool is often hard and dry. Other symptoms may
include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement.

• The average prevalence of constipation in adults has been estimated as 16% worldwide (varies between
0.7% and 79%); whereas the prevalence of 33.5% was attributed to adults aged 60 to 110 years (Everhart JE,
Ruhr CE. Burden of digestive diseases in the United States part II: lower gastrointestinal
diseases. Gastroenterology 2009;136:741–54).

• Dross man and Coworkers 3 surveyed 789 students and hospital employees and found that 18.5 percent
strained at stool more than 25 percent of the time. Moreover, 4.2 percent reported two or fewer bowel
movements per week. These figures were slightly higher than Thompson and Heaton 4 reported in an earlier
survey.
METHODOLOGY
• Observational cross sectional study.

• Sample population:778 subjects were included that were employees

and students at PGMI/LGH.

• Questionnaire with four constipation related symptoms

1. Frequency of bowel movements on a scale of 0 – 4
2. Difficulty or painful evacuation effort on a scale of 0-4
3. Assistance required to evacuate
4. Duration of symptoms
INCLUSION/EXCLUSION CRITERIA
INCLUSION CRITERIA
1. Clinically not diagnosed for any chronic
disease like Diabetes, Hypertension,
ischemic heart disease, cerebrovascular
accidents.
2. Both genders were included.
3. Age ranging from 10 – 60 were included.
EXCLUSION CRITERIA
1. Marked abdominal pain or significant
distention or cramping.
2. Any chronic medical condition.
3. Conditions that could give rise to
constipation like Hypothyroidism.
4. Patients taking drugs like
opioids, antacids, calcium channel
blockers, and anticholinergics.
DATA COLLECTION AND ANALYSIS

• Questionnaire data: Age, gender, occupational status

• Data is analyzed by SPSS version 21.

• A subjective constipation score was calculated by asking set of

questions , which include 4 constipation related symptoms,1 -
frequency of bowel movements on a scale of 0 – 4 ,2 -difficulty or
painful evacuation effort on a scale of 0-4 , 3 -Assistance required to
evacuate and 4- Duration of symptoms.
RESULTS
Percentage

11
9
5% 1
3%
8 20%
10%

7
7%

6
8% 2
23%
5
7%
4
3
8%
9%

1 2 3 4 5 6 7 8 9 10 11 12 13 14

• 23% participants reported minimal intensity with a score of 2 out of 14

• 5% participants reported maximal intensity with a score of 11 out of 14
RESULTS

• Overall 14% participants reported constipation of which 66%

participants were female whereas 34% were male

• Age range was between 10 year to 60 year old

• Most of the subjects were above 55 year of age.

DISCUSSION
• A study done in china which reported that only 14% of general population
reported constipation which is exactly the same percentage observed in
Pakistani population.(Epidemiology Characteristics of Constipation for
General Population, Pediatric Population, and Elderly Population in China
Huikuan Chu, Likun Zhong, Hai Li, Xiujing Zhang, Jingzhi Zhang, and Xiaohua
Hou)

• Demographics of our study found that most of 14% are female and above
55 year, which is supported by retrieved studies evaluation where eleven
studies were retrieved;they reveal a prevalence of constipation that varied
from 2.6% to 26.9%. The most frequently cited associated factors were
female gender and advanced age(Lawrence Leung, T. R. (2011).Chronic
Constipation: An Evidence-Based Review. The Journal of the American
Board of Family Medicine)
CONCLUSION
• Constipation is a common complaint in our region that should be
addressed at all levels , people might have some history , genetic
factor or other biological issues . Regardless of factors we should
encourage individuals to have active lifestyle , increase fiber and
liquid intake and judicial use of medications.
• Evaluation and management of chronic constipation represent a
significant burden on patients, and it is important for clinicians to
have a clear understanding of the different pathophysiological
mechanisms associated with constipation, understand the different
testing modalities and treatments that are available including their
appropriateness and limitations, and tailor that knowledge to the
management of individual patients.
 THANK YOU!

Asma Sikander
House Officer, Neurology Department
Lahore General Hospital, Lahore