Zutshi M, Hull T L, Bast J, Hammel J
Department of Colorectal Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.
Dis Colon Rectum. 2007 Mar;50(3):351-8. doi: 10.1007/s10350-006-0758-0.
There has been minimal research done on normal female bowel habits. Because we do not know what is normal, this affects counseling of patients and research. The aim of this study was to conduct a survey of females with no bowel pathology to obtain a baseline of normal bowel function and examine any normal changes that occur during a woman's lifetime.
Females accompanying patients to our hospital and clinic were invited to fill out an IRB-approved questionnaire after excluding those with current bowel pathology, depression, a stoma, or were wheelchair bound.
Four hundred twenty-five of 528 questionnaires of females who reported they had normal bowel habits were evaluated. The age range was from 18 to 80 years and comparison was according to age, race, and parity. Fifty-one percent had one bowel movement daily while 30 percent reported fewer. Overall, 15 percent reported constipation, which was higher in African-American females (26 percent) vs. Caucasian females (14 percent), P = 0.08. The average time for a bowel movement was 5-6 minutes, which was longer in African-American females (7.7 min) vs. Caucasian (5.0 min), P = 0.002. Younger females had changes in their bowel pattern reported as soft stool usually associated with their menstrual cycle; this was seen mostly in single females. Menopause did not affect bowels. Thirty-six percent of parous females reported occasional stool incontinence. Flatal incontinence was seen occasionally in over 50 percent of females, more frequently in those over 35 years old. Seventy-four percent of parous females reported incontinence to gas. One-third of females read on the toilet, with a majority doing so to relax or to be distracted and with African-American females reading more (54 percent) vs. Caucasian (32 percent), P = 0.004. Interestingly, Caucasian females read to conserve time (26 percent) vs. African-Americans (4 percent), P = 0.02. Fiber as a supplement was taken by only 8 percent. Foods affected bowel function in all age groups, while travel and exercise did not. Stress affected a change in 35 percent in the 18 to 50-year group.
There is a vast diversity in what is considered normal female bowel habits. One daily bowel movement is not the norm. Normal older females and those who have had children report more flatal incontinence. One-third experience some element of fecal incontinence. Foods most commonly caused a change in bowel pattern, followed by menstruation, stress, and childbirth. A vast majority do not take fiber as a supplement.
关于正常女性排便习惯的研究极少。由于我们不清楚何为正常，这影响了对患者的咨询和研究。本研究的目的是对无肠道病变的女性进行调查，以获取正常肠道功能的基线数据，并研究女性一生中出现的任何正常变化。
邀请陪同患者前来我院及诊所的女性填写一份经机构审查委员会批准的问卷，排除当前有肠道病变、抑郁症、造口或需依赖轮椅的女性。
对528份报告有正常排便习惯的女性问卷中的425份进行了评估。年龄范围为18至80岁，并根据年龄、种族和生育情况进行比较。51%的女性每天排便一次，30%的女性排便次数更少。总体而言，15%的女性报告有便秘，非裔美国女性（26%）高于白人女性（14%），P = 0.08。排便的平均时间为5至6分钟，非裔美国女性（7.7分钟）长于白人女性（5.0分钟），P = 0.002。年轻女性的排便模式变化表现为通常与月经周期相关的软便；这在单身女性中最为常见。绝经不影响肠道。36%的经产妇报告偶尔有大便失禁。超过50%的女性偶尔会出现排气失禁，在35岁以上的女性中更为频繁。74%的经产妇报告有排气失禁。三分之一 的女性在厕所阅读，大多数这样做是为了放松或分散注意力，非裔美国女性阅读的比例更高（54%），高于白人女性（32%），P = 0.004。有趣的是，白人女性为了节省时间而阅读的比例（26%）高于非裔美国女性（4%），P = 0.02。只有八分之一 的女性服用纤维补充剂。食物影响所有年龄组的肠道功能，而旅行和运动则无此影响。在18至50岁的年龄组中，35%的女性因压力而排便模式改变。
正常女性排便习惯的差异很大。每天排便一次并非常态。正常的老年女性和已生育的女性报告有更多排气失禁。三分之一 的女性有某种程度的大便失禁。最常导致排便模式改变的是食物，其次是月经、压力和分娩。绝大多数女性不服用纤维补充剂。
