Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Clin Gastroenterol Hepatol. 2012 May;10(5):494-500. doi: 10.1016/j.cgh.2011.12.041. Epub 2012 Jan 28.
BACKGROUND & AIMS: The prevalence of chronic constipation (CC) has been reported to be as high as 20% in the general population, but little is known about its natural history. We estimated the natural history of CC and characterized features of persistent CC and nonpersistent CC, compared with individuals without constipation.
In a prospective cohort study, we analyzed data collected from multiple, validated surveys (minimum of 2) of 2853 randomly selected subjects, over a 20-year period (median, 11.6 years). Based on responses, subjects were characterized as having persistent CC, nonpersistent CC, or no constipation. We assessed the association between constipation status and potential risk factors using logistic regression models, adjusting for age and sex.
Of the respondents, 84 had persistent CC (3%), 605 had nonpersistent CC (21%), and 2164 had no symptoms of constipation (76%). High scores from the somatic symptom checklist (odds ratio [OR] = 2.1; 95% confidence interval [CI], 1.3-3.4) and frequent doctor visits (OR = 2.0; 95% CI, 1.0-3.8) were significantly associated with persistent CC, compared with subjects with no constipation symptoms. The only factor that differed was increased use of laxatives or fiber among subjects with persistent CC (OR = 3.0; 95% CI, 1.9-4.9).
The prevalence of constipation might be exaggerated-the proportion of the population with persistent CC is low (3%). Patients with persistent and nonpersistent CC have similar clinical characteristics, although individuals with persistent CC use more laxatives or fiber. CC therefore appears and disappears among certain patients, but we do not have enough information to identify these individuals in advance.
一般人群中慢性便秘（CC）的患病率高达 20%，但其自然史知之甚少。我们评估了 CC 的自然史，并比较了持续性 CC 和非持续性 CC 与无便秘个体的特征。
在一项前瞻性队列研究中，我们分析了 2853 名随机选择的受试者在 20 年期间（中位数为 11.6 年）多次（至少 2 次）收集的多个经过验证的调查数据。根据回答，将受试者分为持续性 CC、非持续性 CC 或无便秘。我们使用逻辑回归模型评估便秘状态与潜在危险因素之间的关联，同时调整年龄和性别。
在应答者中，84 人有持续性 CC（3%），605 人有非持续性 CC（21%），2164 人没有便秘症状（76%）。躯体症状清单评分较高（比值比[OR] = 2.1；95%置信区间[CI]，1.3-3.4）和频繁就诊（OR = 2.0；95% CI，1.0-3.8）与无便秘症状的受试者相比，与持续性 CC 显著相关。唯一不同的因素是持续性 CC 患者中使用泻药或纤维的频率增加（OR = 3.0；95% CI，1.9-4.9）。
便秘的患病率可能被夸大了-持续性 CC 人群的比例较低（3%）。持续性和非持续性 CC 患者具有相似的临床特征，尽管持续性 CC 患者使用更多的泻药或纤维。因此，CC 在某些患者中出现和消失，但我们没有足够的信息提前识别这些患者。
