Epidemiology of constipation in São Paulo, Brazil: a population-based study

Abstract

Objective:

Epidemiologic data on constipation in South America are limited. The main objective of this study was to assess the prevalence of self-reported symptoms of constipation in Brazil.

Methods:

Telephone and personal surveys were conducted among community-dwelling adults in homes with land-based telephones in São Paulo. Data were weighted by numbers of adults, total residents, and telephones in each household. To account for potential nonresponse and noncoverage bias, results were further adjusted according to Brazilian census data.

Results:

Among 4570 households contacted, 3050 adults (66.7%) participated. Respondents (mean [SE] age: 42.6 [2.7] years) were primarily women (53.1%). A minority of all respondents reported symptoms consistent with constipation, including a perception of incomplete voiding in 8.0%; expending efforts to defecate in 7.6%; ≤2 stools weekly in 9.0%; and hard stools in 12.7%. Prevalences of these symptoms and efforts to manage them were more frequent in women (P ≤ 0.004), but most were not significantly associated with advancing age. With increasing age, proportions of respondents with ≤2 stools per week declined (P = 0.001), whereas use of bowel enemas (P = 0.026) and digital maneuvers to disimpact stool increased (P < 0.001). Despite frequent constipation symptoms, the vast majority of respondents did not report using prescription medications, but some used natural remedies (29.5%) and/or laxatives (13.4%).

Conclusions:

Symptoms of constipation are prevalent in São Paulo, particularly among women. On the other hand, most survey respondents did not use medications or other remedies that manage this condition. These findings may point to an unmet gastrointestinal treatment need. Future research is needed to corroborate our findings in rural settings and to further evaluate potential predictors and consequences of constipation in South America.

Keywords: :

• Age
• Constipation
• Epidemiology
• Gender
• Prevalence
• South America
• Survey

Transparency

Declaration of funding

The present study and this communication were supported by Janssen-Cilag Farmacêutica Ltda., São Paulo, Brazil.

Author contributions: Category 1 – Study design and data acquisition: all authors participated in study design, and M.R.D.O.L. and A.M.d.S. fielded the survey. Analysis and interpretation of data: all authors. Category 2 – (a) Drafting the article: D.C., M.R.D.O.L. and A.M.d.S., with assistance from Stephen W. Gutkin. (b) Revising it for intellectual content: all authors. Category 3 – Approval of the final manuscript: all authors. D.C. had access to all data and takes full responsibility for the integrity of both the analysis and this report (study guarantor).

Declaration of financial/other relationships

D.C. has disclosed that he has served as a paid consultant to, and has been a recipient of honoraria, lecture payments (service on speakers’ bureaus) and travel support from, Janssen-Cilag. He has received lecture payments and/or served on speakers’ bureaus for AstraZeneca (with whom he has also consulted) and Takeda. He is also a board member for Takeda and Reckitt Benckiser. T.R.P.D.-B. and A.M.d.S. have disclosed that they are employees of Janssen-Cilag. J.N.E. has disclosed that he has received grants from Janssen-Cilag and is a board member for Takeda. M.R.D.O.L. has received fees from Janssen-Cilag for participating in review activities such as data monitoring boards, statistical analysis, and endpoint committees.

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

Acknowledgment

Assistance in manuscript preparation was provided by Stephen W. Gutkin, Rete Biomedical Communications Corp. (Wyckoff, NJ, USA), with support from Janssen-Cilag Farmacêutica Ltda.