Dukas L, Leitzmann M F, Willett W C, Colditz G A, Giovannucci E L
Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA.
Am J Gastroenterol. 2001 Mar;96(3):715-21. doi: 10.1111/j.1572-0241.2001.03611.x.
The authors prospectively examined the association between bowel movement frequency (used as a proxy for intestinal transit), laxative use, and the risk of symptomatic gallstone disease.
A total of 79,829 women, aged 36-61 yr, without a history of symptomatic gallstone disease and free of cancer, responded to a mailed questionnaire in 1982 that assessed bowel movement frequency and use of laxatives. Between 1984 and 1996, 4,443 incident cases of symptomatic gallstone disease were documented. Relative risks (RRs) of symptomatic gallstone disease and 95% confidence intervals (CIs) were calculated using logistic regression.
After controlling for age and established risk factors, the multivariate RRs were, compared to women with daily bowel movements, 0.97 (95% CI 0.86-1.08) for women with bowel movements every third day or less, and 1.00 (95% CI 0.91-11.1) for women with bowel movement more than once daily. No trend was evident. As compared to women who never used laxatives in 1982, a significant modest inverse association was seen for monthly laxative use, with a multivariate RR of 0.84 (95% CI 0.72-0.98), and weekly to daily laxative use was associated with a RR of 0.88 (95% CI 0.78-1.02).
These findings do not support an association between infrequent bowel movements and risk of symptomatic gallstone disease in women, and indicate that simple questions directed at bowel movement frequency are unlikely to enhance our ability to predict risk of symptomatic gallstone disease. The slightly inverse association between use of laxatives and risk of symptomatic gallstone disease may be due to a mechanism that is not related to bowel movement frequency.
作者前瞻性地研究了排便频率（用作肠道转运的替代指标）、泻药使用与有症状胆结石疾病风险之间的关联。
1982年，共有79829名年龄在36 - 61岁、无有症状胆结石病史且无癌症的女性回复了一份邮寄问卷，该问卷评估了排便频率和泻药使用情况。1984年至1996年期间，记录了4443例有症状胆结石疾病的发病病例。使用逻辑回归计算有症状胆结石疾病的相对风险（RRs）和95%置信区间（CIs）。
在控制年龄和已确定的风险因素后，与每天排便的女性相比，每三天或更少排便一次的女性的多变量RRs为0.97（95%CI 0.86 - 1.08），每天排便超过一次的女性的多变量RRs为1.00（95%CI 0.91 - 11.1）。未发现明显趋势。与那些在1982年从未使用过泻药的女性相比，每月使用泻药存在显著的适度负相关，多变量RR为0.84（95%CI 0.72 - 0.98），每周至每天使用泻药的RR为0.88（95%CI 0.78 - 1.02）。
这些发现不支持排便不频繁与女性有症状胆结石疾病风险之间存在关联，并表明针对排便频率的简单问题不太可能提高我们预测有症状胆结石疾病风险的能力。泻药使用与有症状胆结石疾病风险之间的轻微负相关可能是由于一种与排便频率无关的机制。
