Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, USA.
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, USA; Division of Gastroenterology and Hepatology, Complutense University, Madrid, Spain.
United European Gastroenterol J. 2016 Feb;4(1):142-51. doi: 10.1177/2050640614558476. Epub 2015 Nov 11.
Chronic constipation (CC) is common in the community but surprisingly little is known about relevant gastro-intestinal (GI) and non-GI co-morbidities.
The purpose of this study was to assess the epidemiology of CC and in particular provide new insights into the co-morbidities linked to this condition.
In a prospective, population-based nested case-control study, a cohort of randomly selected community residents (n = 8006) were mailed a validated self-report gastrointestinal symptom questionnaire. CC was defined according to Rome III criteria. Medical records of each case and control were abstracted to identify potential CC comorbidities.
Altogether 3831 (48%) subjects returned questionnaires; 307 met criteria for CC. Age-adjusted prevalence in females was 8.7 (95% confidence interval (CI) 7.1-10.3) and 5.1 (3.6-6.7) in males, per 100 persons. CC was not associated with most GI pathology, but the odds for constipation were increased in subjects with anal surgery relative to those without (odds ratio (OR) = 3.3, 95% CI 1.2-9.1). In those with constipation vs those without, neurological diseases including Parkinson's disease (OR = 6.5, 95% CI 2.9-14.4) and multiple sclerosis (OR = 5.5, 95% CI 1.9-15.8) showed significantly increased odds for chronic constipation, adjusting for age and gender. In addition, modestly increased odds for chronic constipation in those with angina (OR = 1.4, 95% CI 1.1-1.9) and myocardial infarction (OR = 1.5, 95% CI 1.0-2.4) were observed.
Neurological and cardiovascular diseases are linked to constipation but in the community constipation is unlikely to account for most lower GI pathology.
慢性便秘（CC）在社区中很常见，但令人惊讶的是，人们对相关的胃肠（GI）和非 GI 合并症知之甚少。
本研究旨在评估 CC 的流行病学，特别是提供与该疾病相关的合并症的新见解。
在一项前瞻性、基于人群的嵌套病例对照研究中，随机选择了一组社区居民（n=8006），向他们邮寄了一份经过验证的胃肠道症状自我报告问卷。根据罗马 III 标准定义 CC。从每个病例和对照的病历中提取信息，以确定潜在的 CC 合并症。
共有 3831 名（48%）参与者返回了问卷；307 名符合 CC 标准。女性的年龄调整患病率为每 100 人 8.7（95%置信区间（CI）7.1-10.3），男性为 5.1（3.6-6.7）。CC 与大多数 GI 病理学无关，但与无肛门手术的患者相比，有肛门手术的患者发生便秘的几率增加（比值比（OR）=3.3，95%CI 1.2-9.1）。与无便秘的患者相比，患有帕金森病（OR=6.5，95%CI 2.9-14.4）和多发性硬化症（OR=5.5，95%CI 1.9-15.8）等神经疾病的患者发生慢性便秘的几率显著增加，调整年龄和性别后。此外，患有心绞痛（OR=1.4，95%CI 1.1-1.9）和心肌梗死（OR=1.5，95%CI 1.0-2.4）的患者发生慢性便秘的几率也略有增加。
神经和心血管疾病与便秘有关，但在社区中，便秘不太可能导致大多数下 GI 病理学。
