Higgins Peter D R, Johanson John F
Department of Internal Medicine, University of Michigan Division of Gastroenterology, Ann Arbor, Michigan, USA.
Am J Gastroenterol. 2004 Apr;99(4):750-9. doi: 10.1111/j.1572-0241.2004.04114.x.
The aim of this study was to systematically review the published literature regarding prevalence, risk factors, incidence, natural history, and the effect on quality of life of constipation in North America.
A computer-assisted search of MEDLINE, EMBASE, and Current Contents databases was performed independently by two investigators. Study selection criteria included the following: (1) North American population-based sample of adults with constipation; (2) publication in full manuscript form in English; and (3) report on the prevalence, incidence, and natural history of constipation or impact of constipation on quality of life. Eligible articles were reviewed in a duplicate, independent manner. Data extracted were compiled in tables and presented in descriptive form.
The estimates of the prevalence of constipation in North America ranged from 1.9% to 27.2%, with most estimates from 12% to 19%. Prevalence estimates by gender support a female-to-male ratio of 2.2:1. Constipation appears to increase with increasing age, particularly after age 65. No true population-based incidence studies or natural history studies were identified. In one cohort, 89% of patients with constipation still reported constipation at 14.7 months follow-up. From limited data, quality of life appears to be diminished by constipation, but the clinical significance of this is unclear.
Constipation is very common, as approximately 63 million people in North America meet the Rome II criteria for constipation. Minimal data are available regarding incidence, natural history, and quality of life in patients with constipation. Effort should be expended toward the study of these topics, particularly in the elderly, who are disproportionately affected by this condition.
本研究旨在系统回顾北美地区已发表的关于便秘患病率、危险因素、发病率、自然病史以及对生活质量影响的文献。
两名研究人员独立对MEDLINE、EMBASE和《现刊目次》数据库进行计算机辅助检索。研究选择标准包括：（1）基于北美人群的便秘成年样本；（2）以英文全文形式发表；（3）报告便秘的患病率、发病率和自然病史或便秘对生活质量的影响。符合条件的文章以重复、独立的方式进行评审。提取的数据汇总成表格并以描述性形式呈现。
北美地区便秘患病率的估计范围为1.9%至27.2%，大多数估计值在12%至19%之间。按性别划分的患病率估计显示女性与男性的比例为2.2:1。便秘似乎随着年龄增长而增加，尤其是65岁以后。未发现真正基于人群的发病率研究或自然病史研究。在一个队列中，89%的便秘患者在14.7个月的随访中仍报告有便秘症状。根据有限的数据，便秘似乎会降低生活质量，但其临床意义尚不清楚。
便秘非常常见，北美约有6300万人符合罗马II标准的便秘诊断。关于便秘患者的发病率、自然病史和生活质量的数据极少。应努力开展这些主题的研究，尤其是针对受该疾病影响尤为严重老年人群。
