Prevalence and risk of developing comorbid conditions in patients with chronic constipation

Abstract

Objective:

To estimate the prevalence of gastrointestinal (GI) and non-GI comorbidities and the risk of incident comorbidities among patients with and without chronic constipation (CC).

Research design and methods:

Adults with CC were identified from a large retrospective US claims database. Each CC patient was matched 1:3 to CC-free patients by birth year, sex, and region of residence.

Main outcome measures:

Prevalence of GI and non-GI comorbidities was measured over a 1-year period. Relative risk of new comorbidities was also estimated among patients who were free of the studied comorbidity prior to the index date.

Results:

Mean age was 61.9 years; 33.3% of patients were male. The 1-year prevalence of GI comorbidities was significantly higher in CC (N = 28,854) vs. CC-free (N = 86,562) patients (all p < 0.05). The risk of developing new GI conditions was also significantly higher in CC patients for all studied conditions except ulcerative colitis: megacolon (hazard ratio [95% confidence interval] HR [CI] = 11.96 [8.16–17.53]), intestinal impaction (10.56 [9.22–12.10]), volvulus (7.12 [5.42–9.35]), other specified functional intestinal disorders (6.67 [5.57–8.00]), and other unspecified functional disorders of intestine (4.60 [3.61–5.87]). Similarly, 1-year prevalence of non-GI comorbidities was higher in CC patients, as was the risk of developing new conditions: depression and mood disorder (HR [CI] = 1.84 [1.77–1.90]), neurological disorders (1.68 [1.62–1.74]), iron deficiency anemia (1.52 [1.47–1.57]), hypothyroidism (1.40 [1.34–1.46]), and peripheral vascular disorders (1.40 [1.34–1.46]).

Limitations:

An algorithm was used to define CC as there is no specific diagnosis code to identify CC.

Conclusions:

CC patients had significantly higher prevalence and were at increased risk of developing new GI and non-GI comorbidities than age-, gender- and region-matched CC-free patients. Future research is warranted to better understand these associations.

Keywords::

• Chronic constipation
• Comorbidities
• Prevalence

Transparency

Declaration of funding

This study was funded by Takeda Pharmaceuticals International Inc., Deerfield, IL, USA.

Declaration of financial/other relationships

R.M., W.Z., and K.L.L. have disclosed that they are employees of Takeda Pharmaceuticals International and own stocks and shares in Takeda Pharmaceuticals International. A.G., B.F., Z.Z. and E.Q.W. have disclosed that they are employees of Analysis Group Inc., which received consulting fees from Takeda Pharmaceuticals International to conduct this research. N.J.T. has disclosed that he is an employee at the University of Newcastle, Callaghan, NSW, Australia, and has received research support from Takeda Pharmaceuticals International.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The authors thank Ana Bozas, an employee of Analysis Group Inc., who contributed to the preparation and editing of the manuscript, funded by Takeda Pharmaceuticals.

Previous presentation: This study was presented at the ACG 2012 Annual Scientific Meeting and Postgraduate Course, Las Vegas, NV, USA, 19–24 October 2012.