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Digestive Diseases and Sciences

, Volume 34, Issue 8, pp 1153–1162 | Cite as

A longitudinal survey of self-reported bowel habits in the United States

  • James E. Everhart
  • Vay Liang W. Go
  • Richard S. Johannes
  • Stacey C. Fitzsimmons
  • Harold P. Roth
  • Lon R. White
Original Articles

Abstract

Information concerning bowel habits was gathered from a representative sample of 14,407 United States adults in the first National Health and Nutrition Examination Survey in 1971–1975 and approximately 10 years later among the same individuals. The prevalence of self-reported constipation, diarrhea, infrequent defecation (three or fewer bowel movements per week), and frequent defecation (two or more bowel movements per day) increased with aging. Women were more likely than men (P<0.05) to report constipation (20.8% compared to 8.0%) and infrequent defecation (9.1% compared to 3.2%). Blacks were more likely than whites to report infrequent defecation (P<0.05). Older respondents reporting constipation were more likely to use laxatives or stool softeners than younger respondents reporting constipation, but they were also less likely to have infrequent defecation. To evaluate factors predictive of impaired bowel function, case definitions were created using information concerning complaint of constipation, laxative use, frequency of defecation, and stool consistency. Female gender, black race, fewer years of education, low physical activity, and symptoms of depression were independent risk factors for impaired bowel function. This study provides national estimates of bowel complaints and their natural history and examines possible risk factors for constipation.

Key words

constipation diarrhea aging epidemiology prevalence laxatives 

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References

  1. 1.
    Read NW, Timms JM: Defecation and the pathophysiology of constipation. Clin Gastroenterol 15(4):937–965, 1986PubMedGoogle Scholar
  2. 2.
    Devroede G: Constipation.In Gastrointestinal Disease: Pathophysiology, Diagnosis, Management, 4th ed. MH Sleisenger, JS Fordtran (eds). Philadelphia, WB Saunders, 1989, pp 331–368Google Scholar
  3. 3.
    Miller HW: Plan and operation of the health and nutrition examination survey, United States 1971–1973, part A— development, plan, and operation.In Vital and Health Statistics, Series 1, No. 10a. DHEW publication No. (HRA) 76-1310. Rockville, Maryland, National Center for Health Statistics, 1973, pp 1–46Google Scholar
  4. 4.
    Shah BV: SESUDAAN: Standard errors program for computing of standardized rates from sample survey data. Research Triangle Park, North Carolina, Research Triangle Institute, 1981, pp 1–33, RTI/5250/00-01SGoogle Scholar
  5. 5.
    Madans JH, Kleinman JC, Cox CS, Barbano H, Feldman JJ, Cohen B, Finucane FF, Lorroni-Huntley J: 10 years after NHANES I: Report of initial follow-up, 1982–84. Public Health Rep 101:465–473, 1986Google Scholar
  6. 6.
    Lanza E, Butrum R: A critical review of food fiber analysis and data. J Am Diet Assoc 86:732–740, 1986PubMedGoogle Scholar
  7. 7.
    Devins GM, Orme CM: Center for epidemiologic studies depression scale.In Test Critiques, Vol 2. DJ Keyser, RC Sweetland (eds). Kansas City, Montana, 1985, pp 144–160Google Scholar
  8. 8.
    Landis JR, Lepkowski JM, Eklund SA, Stenhouwer SA: A statistical methodology for analyzing data from a complex survey: The first national health and nutrition examination survey.In Vital and health statistics, Series 2, No. 92. DHHS publication No. (PHS)82-1366. Hyattsville, Maryland, National Center for Health Statistics, 1982, pp 1–52.Google Scholar
  9. 9.
    Knowler WC, Bennett PH, Hamman RF, Miller M: Diabetes incidence and prevalence in Pima Indians: A 19-fold greater incidence than in Rochester, Minnesota. Am J Epidemiol 108:497–505, 1978PubMedGoogle Scholar
  10. 10.
    SAS Institute Inc: SAS User's Guide: Statistics, Version 5 Edition. The FREQ procedure. Cary, North Carolina, SAS Institute Inc., 1985, pp 403–432Google Scholar
  11. 11.
    SAS Institute Inc: SUGI Supplemental Library User's Guide, Version 5 Edition. The LOGIST Procedure. Cary, North Carolina, SAS Institute Inc., 1986, pp 269–294Google Scholar
  12. 12.
    Sandler RS, Drossman DA: Bowel habits in young adults not seeking health care. Dig Dis Sci 32:841–845, 1987PubMedGoogle Scholar
  13. 13.
    Walker ARP, Walker BF, Bhamjee D, Walker EJ, Ncongwane J, Segal I: Defecation frequencies in Black, Indian, Coloured, and White populations—what do they signify? S Afr Med J 62:195–199, 1982PubMedGoogle Scholar
  14. 14.
    Wald A, Van Thiel DH, Hoechstetter L, Gavaler JS, Egler KM, Verm R, Scott L, Lester R: Gastrointestinal transit: The effect of the menstrual cycle. Gastroenterology 80:1497–1500, 1981PubMedGoogle Scholar
  15. 15.
    Preston DM, Lennard-Jones JE: Severe chronic constipation of young women: “Idiopathic slow transit constipation.” Gut 27:41–48, 1986PubMedGoogle Scholar
  16. 16.
    Milne JS, Williamson J: Bowel habit in older people. Gerontol Clin 14:56–60, 1972Google Scholar
  17. 17.
    Manning AP, Wyman JB, Heaton KW: How trustworthy are bowel histories? Comparison of recalled and recorded information. Br Med J 2:213–214, 1976PubMedGoogle Scholar
  18. 18.
    Hammond EC: Some preliminary findings on physical complaints from a prospective study of 1,064,004 men and women. Am J Public Health 54:11–23, 1964Google Scholar
  19. 19.
    Donald IP, Smith RG, Cruikshank JG, Elton RA, Stoddart ME: A study of constipation in the elderly living at home. Gerontology 31:112–118, 1985PubMedGoogle Scholar
  20. 20.
    Farmer ME, Locke BZ, Moscicki EK, Dannenberg AL, Larson DB, Radloff LS: Physical activity and depressive symptoms: The NHANES I epidemiologic follow-up study. Am J Epidemiol 128:1340–1351, 1988PubMedGoogle Scholar
  21. 21.
    Sandler RS, Jordan MC, Shelton BJ: Demographic and dietary determinants of constipation in the US population. Gastroenterology 94:A398, 1988Google Scholar
  22. 22.
    Verduron A, Devroede G, Bouchocha M, Arhan P, Schang J, Poisson J, Hémond M, Hébert M. Megarectum. Dig Dis Sci 33:1164–1174, 1988PubMedGoogle Scholar
  23. 23.
    Ekwueme O: Bowel habits in Ugandan villagers. Trop Geogr Med 30;247–251, 1978PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1989

Authors and Affiliations

  • James E. Everhart
    • 1
    • 2
    • 3
  • Vay Liang W. Go
    • 1
    • 2
    • 3
  • Richard S. Johannes
    • 1
    • 2
    • 3
  • Stacey C. Fitzsimmons
    • 1
    • 2
    • 3
  • Harold P. Roth
    • 1
    • 2
    • 3
  • Lon R. White
    • 1
    • 2
    • 3
  1. 1.Epidemiology and Data Systems Program, Division of Digestive Diseases and NutritionNational Institute of Diabetes and Digestive and Kidney DiseasesUSA
  2. 2.University of California at Los AngelesUSA
  3. 3.National Institute on AgingUSA

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