Fosnes Gunvor S, Lydersen Stian, Farup Per G
Department of Medicine, Innlandet Hospital Trust, Gjøvik, Norway.
BMC Clin Pharmacol. 2011 Feb 18;11:2. doi: 10.1186/1472-6904-11-2.
Constipation and diarrhoea are common complaints and often reported as adverse drug reactions. This study aimed at finding associations between drugs and constipation and diarrhoea in a general population.
A selection of inhabitants in Oppland County, Norway participated in a cross-sectional survey. Information about demographics, diseases including gastrointestinal complaints classified according to the Rome II criteria and use of drugs were collected on questionnaires. Constipation was defined as functional constipation and constipation predominant Irritable Bowel Syndrome (IBS), and diarrhoea as functional diarrhoea and diarrhoea predominant IBS. Associations between drugs and constipation and diarrhoea were examined with multivariable logistic regression models. Based on the multivariable model, the changes in prevalence (risk difference) of the abdominal complaints for non-users and users of drugs were calculated.
In total 11078 subjects were invited, 4622 completed the questionnaires, 640 (13.8%) had constipation and 407 (8.8%) had diarrhoea. To start using drugs increased the prevalence of constipation and diarrhoea with 2.5% and 2.3% respectively. Polypharmacy was an additional risk factor for diarrhoea. Use of furosemide, levothyroxine sodium and ibuprofen was associated with constipation, and lithium and carbamazepine with diarrhoea. The excess drug related prevalence varied from 5.3% for the association between ibuprofen and constipation to 27.5% for the association between lithium and diarrhoea.
Use of drugs was associated with constipation and diarrhoea in the general population. The associations are most likely adverse drug reactions and show that drug-induced symptoms need to be considered in subjects with these complaints.
便秘和腹泻是常见的病症，常被报告为药物不良反应。本研究旨在探寻普通人群中药物与便秘和腹泻之间的关联。
挪威奥普兰郡的部分居民参与了一项横断面调查。通过问卷收集了人口统计学信息、包括根据罗马II标准分类的胃肠道病症在内的疾病信息以及药物使用情况。便秘定义为功能性便秘和以便秘为主的肠易激综合征（IBS），腹泻定义为功能性腹泻和以腹泻为主的IBS。使用多变量逻辑回归模型检验药物与便秘和腹泻之间的关联。基于多变量模型，计算了非药物使用者和药物使用者腹部病症患病率的变化（风险差异）。
总共邀请了11078名受试者，4622人完成了问卷，640人（13.8%）患有便秘，407人（8.8%）患有腹泻。开始使用药物分别使便秘和腹泻的患病率增加了2.5%和2.3%。联合用药是腹泻的另一个风险因素。使用呋塞米、左甲状腺素钠和布洛芬与便秘有关，使用锂和卡马西平与腹泻有关。与药物相关的额外患病率从布洛芬与便秘关联的5.3%到锂与腹泻关联的27.5%不等。
在普通人群中，药物使用与便秘和腹泻有关。这些关联很可能是药物不良反应，表明在有这些病症的受试者中需要考虑药物引起的症状。
