Chronic constipation imposes a substantial burden on healthcare resources and reduces mental and physical quality of life.[10]Dennison C, Prasad M, Lloyd A, et al. The health-related quality of life and economic burden of constipation. Pharmacoeconomics. 2005;23(5):461-76.
http://www.ncbi.nlm.nih.gov/pubmed/15896098?tool=bestpractice.com
[11]Palsson OS, Whitehead W, Törnblom H, et al. Prevalence of Rome IV functional bowel disorders among adults in the United States, Canada, and the United Kingdom. Gastroenterology. 2020 Apr;158(5):1262-73.e3.
https://www.gastrojournal.org/article/S0016-5085(20)30001-9/fulltext?referrer=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F
http://www.ncbi.nlm.nih.gov/pubmed/31917991?tool=bestpractice.com
Worldwide prevalence of chronic idiopathic constipation in adults is about 10% to 15%, but reported rates vary widely from 0.2% to 30.7%.[12]Barberio B, Judge C, Savarino EV, et al. Global prevalence of functional constipation according to the Rome criteria: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2021 Aug;6(8):638-48.
https://eprints.whiterose.ac.uk/175217
http://www.ncbi.nlm.nih.gov/pubmed/34090581?tool=bestpractice.com
[13]Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. Am J Gastroenterol. 2011 Sep;106(9):1582-91.
http://www.ncbi.nlm.nih.gov/pubmed/21606976?tool=bestpractice.com
In a large multinational survey, the prevalence of Rome IV functional constipation was 7.9% in the US and 8.6% in the UK.[11]Palsson OS, Whitehead W, Törnblom H, et al. Prevalence of Rome IV functional bowel disorders among adults in the United States, Canada, and the United Kingdom. Gastroenterology. 2020 Apr;158(5):1262-73.e3.
https://www.gastrojournal.org/article/S0016-5085(20)30001-9/fulltext?referrer=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F
http://www.ncbi.nlm.nih.gov/pubmed/31917991?tool=bestpractice.com
The natural history of chronic constipation is not well understood; although, in one study, 89% had similar symptoms when surveyed on two separate occasions over 12-20 months and, in another, 45% of people interviewed reported this condition for ≥5 years.[14]Talley NJ, O'Keefe EA, Zinsmeister AR, et al. Prevalence of gastrointestinal symptoms in the elderly: a population-based study. Gastroenterology. 1992 Mar;102(3):895-901.
http://www.ncbi.nlm.nih.gov/pubmed/1537525?tool=bestpractice.com
[15]Stewart WF, Liberman G, Sandler RS, et al. A large U.S. national epidemiological study of constipation gastroenterology. Gastroenterology. 1998;114(suppl 1):A44.
Constipation is about twice as common in women as in men.[11]Palsson OS, Whitehead W, Törnblom H, et al. Prevalence of Rome IV functional bowel disorders among adults in the United States, Canada, and the United Kingdom. Gastroenterology. 2020 Apr;158(5):1262-73.e3.
https://www.gastrojournal.org/article/S0016-5085(20)30001-9/fulltext?referrer=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F
http://www.ncbi.nlm.nih.gov/pubmed/31917991?tool=bestpractice.com
[12]Barberio B, Judge C, Savarino EV, et al. Global prevalence of functional constipation according to the Rome criteria: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2021 Aug;6(8):638-48.
https://eprints.whiterose.ac.uk/175217
http://www.ncbi.nlm.nih.gov/pubmed/34090581?tool=bestpractice.com
[16]Sperber AD, Bangdiwala SI, Drossman DA, et al. Worldwide prevalence and burden of functional Gastrointestinal disorders, results of Rome Foundation Global Study. Gastroenterology. 2021 Jan;160(1):99-114.e3.
https://www.gastrojournal.org/article/S0016-5085(20)30487-X/fulltext?referrer=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F
http://www.ncbi.nlm.nih.gov/pubmed/32294476?tool=bestpractice.com
Data for other demographic and socio-economic associations are less clear.[17]Werth BL, Christopher SA. Potential risk factors for constipation in the community. World J Gastroenterol. 2021 Jun;27(21):2795-817.
https://www.wjgnet.com/1007-9327/full/v27/i21/2795.htm
http://www.ncbi.nlm.nih.gov/pubmed/34135555?tool=bestpractice.com
Prevalence of constipation is thought to increase with advancing age, although some systematic reviews have reported conflicting data or lack of association.[12]Barberio B, Judge C, Savarino EV, et al. Global prevalence of functional constipation according to the Rome criteria: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2021 Aug;6(8):638-48.
https://eprints.whiterose.ac.uk/175217
http://www.ncbi.nlm.nih.gov/pubmed/34090581?tool=bestpractice.com
[13]Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. Am J Gastroenterol. 2011 Sep;106(9):1582-91.
http://www.ncbi.nlm.nih.gov/pubmed/21606976?tool=bestpractice.com
[17]Werth BL, Christopher SA. Potential risk factors for constipation in the community. World J Gastroenterol. 2021 Jun;27(21):2795-817.
https://www.wjgnet.com/1007-9327/full/v27/i21/2795.htm
http://www.ncbi.nlm.nih.gov/pubmed/34135555?tool=bestpractice.com
[18]Serra J, Pohl D, Azpiroz F, et al. European society of neurogastroenterology and motility guidelines on functional constipation in adults. Neurogastroenterol Motil. 2020 Feb;32(2):e13762.
https://onlinelibrary.wiley.com/doi/10.1111/nmo.13762
http://www.ncbi.nlm.nih.gov/pubmed/31756783?tool=bestpractice.com
Other factors that may be associated with constipation include race/ethnicity (some studies report higher prevalence in black people), lower socio-economic status, and rural versus urban residence.[2]Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol. 2004 Apr;99(4):750-9.
http://www.ncbi.nlm.nih.gov/pubmed/15089911?tool=bestpractice.com
[17]Werth BL, Christopher SA. Potential risk factors for constipation in the community. World J Gastroenterol. 2021 Jun;27(21):2795-817.
https://www.wjgnet.com/1007-9327/full/v27/i21/2795.htm
http://www.ncbi.nlm.nih.gov/pubmed/34135555?tool=bestpractice.com
Chronic constipation is frequently associated with other functional gastrointestinal motility disorders, including dyspepsia, GERD, and nausea/vomiting.[17]Werth BL, Christopher SA. Potential risk factors for constipation in the community. World J Gastroenterol. 2021 Jun;27(21):2795-817.
https://www.wjgnet.com/1007-9327/full/v27/i21/2795.htm
http://www.ncbi.nlm.nih.gov/pubmed/34135555?tool=bestpractice.com
[19]Chen Z, Peng Y, Shi Q, et al. Prevalence and risk factors of functional constipation according to the Rome criteria in China: a systematic review and meta-analysis. Front Med (Lausanne). 2022;9:815156.
https://www.frontiersin.org/articles/10.3389/fmed.2022.815156/full
http://www.ncbi.nlm.nih.gov/pubmed/35252254?tool=bestpractice.com
A variety of other conditions have also been associated with constipation, including diabetes, depression and anxiety, and Parkinson's disease.[17]Werth BL, Christopher SA. Potential risk factors for constipation in the community. World J Gastroenterol. 2021 Jun;27(21):2795-817.
https://www.wjgnet.com/1007-9327/full/v27/i21/2795.htm
http://www.ncbi.nlm.nih.gov/pubmed/34135555?tool=bestpractice.com
[19]Chen Z, Peng Y, Shi Q, et al. Prevalence and risk factors of functional constipation according to the Rome criteria in China: a systematic review and meta-analysis. Front Med (Lausanne). 2022;9:815156.
https://www.frontiersin.org/articles/10.3389/fmed.2022.815156/full
http://www.ncbi.nlm.nih.gov/pubmed/35252254?tool=bestpractice.com
Pregnancy is also associated with higher prevalence of constipation (about 20% to 40%).[20]Reijonen JK, Tihtonen KMH, Luukkaala TH, et al. Association of dietary fiber, liquid intake and lifestyle characteristics with gastrointestinal symptoms and pregnancy outcome. Eur J Obstet Gynecol Reprod Biol X. 2022 Dec;16:100168.
https://www.sciencedirect.com/science/article/pii/S2590161322000291?via%3Dihub
http://www.ncbi.nlm.nih.gov/pubmed/36312325?tool=bestpractice.com
[21]Rao SSC, Qureshi WA, Yan Y, et al. Constipation, hemorrhoids, and anorectal disorders in pregnancy. Am J Gastroenterol. 2022 Oct;117(10s):16-25.
https://journals.lww.com/ajg/fulltext/2022/10001/constipation,_hemorrhoids,_and_anorectal_disorders.4.aspx
[22]Kothari S, Afshar Y, Friedman LS, et al. AGA clinical practice update on pregnancy-related gastrointestinal and liver disease: expert review. Gastroenterology. 2024 Oct;167(5):1033-45.
https://www.doi.org/10.1053/j.gastro.2024.06.014
http://www.ncbi.nlm.nih.gov/pubmed/39140906?tool=bestpractice.com