Here we are going to see the epidemiology of constipation.
Epidemiology necessarily means how common the disease is in a given community at the particular time defined by various age groups and prevalence and incidence of the disease in a define community. With this data we can determine the cause of disease and public health facilities the management of disease will need. Epidemiology of constipation tries to highlight the points about constipation in society.
“Constipation is defined as a delay or difficulty in defecation present for 2 wk or longer and significant enough to cause distress to the patient.”
For all the practical purpose the definition of constipation was defined and population coming under those criteria is counted as constipated population. Defining constipation is most important step in studying epidemiology of constipation.
As we know constipation is a symptom rather than a disease, it is representative of underlying condition. For many countries above data is still not available as studies were not done in this regard. Constipation is sometimes defined based on weekly stool frequency which generates deferent and incomplete data.
This is the standard definition of the constipation as in many places the constipation was defined differently the studies with uniform definition are lacking till recently. There is pressing need of more studies with uniform definition and defined categories of constipation across different population.
Most commonly studies were done in western world and the real incidence and prevalence of the constipation were determined. The currently available studies give data that gives following information.
Constipation is fairly common in all age groups. The causes of constipation may differ for different age groups. The level of severity may differ according to age. The complications are usually common in chronic constipation and constipation can be manifestation of some common chronic diseases. Among age categories in younger age group in young children commonest cause is functional constipation and rare cause is congenital malformation of anus or gut. Other causes of constipation in this young age group are toilet phobias and improper toilet training. In toddlers and school going children diet lacking in fibers and stool holding habits are the important causes along with consumption of the unhealthy junk food. In adults many factors including psychological factors and stress, unhealthy dietary practices and sedentary lifestyle and drug abuse can be the common causes. In geriatric population age related changes, microscopic and functional changes in gut are the common causes of the constipation. Mental impairment can be cause of constipation among all the age groups.
Constipation acute and chronic is common in both the sexes and some studies have found the constipation is 4 times more common in males than in females.
Constipation is complain present in population across the world. The prevalence of constipation varies widely. Very few studies with enough sample size are currently present with us. The data that represents various regions indicates the prevalence of the constipation varies from 3-26 percent in deferent regions of the world. Many times uniform definition and criteria to include the subjects is lacking and also uniform definition defining the constipation itself and its categories is lacking. But in general in most parts of the world constipation is common problem.
Constipation is more common in all races across the world. It is a more common problem in developed world.
Constipation is more common in people whose diet is lacking of dietary fiber. Readymade food lacking dietary fibers is the main factor that is common in most of the people having constipation. Lack of fruits and green leafy vegetables is common in people suffering from constipation. Inadequate intake of water and fluids in diet is common in people suffering from constipation. Those people with more cow milk in food may suffer from constipation.
Those people with sedentary lifestyle are more prone to constipation. People who have daily physical activities are less prone to constipation. In fact constipation is increase in countries where economic condition is improving in recent years. More the economic condition improves more sedentary people become and more is the food lacking in dietary fibers. Additionally academic pressures have lead to decreased outdoor activities in children with making them prone to constipation.
Some studies have found constipation more commonly affecting people with good socioeconomic status. Indeed those with good socioeconomic status have all other factors that make person prone to constipation. Sedentary lifestyle, less physical activities and unhealthy food make these people more prone for constipation.
Surprisingly unlike other disorders people with more education have more tendancy to suffer from constipation. Some studies have found this correlation though the sample size was not satisfactory the chances of spurious association cannot be rules out.
Many other disorders in people can manifest as constipation. Those people with pelvic floor dysfunction can experience constipation and chronic constipation. Those people with disorders like thyroid disorders may present with constipation. Those people with celiac disease may present with constipation. Congenital anomalies of gut can present with constipation. These all come under the category organic causes of the constipation. People with psychological disorder and mental impairment can present with constipation.
Here we explained about epidemiology of constipation.