Abstract
To investigate possible etiologic inluences on the development of constipation, the present study examines the concordant occurrence of constipation with other diseases. Using 8.8 million Medicare patients hospitalized in the United States during 1987, the frequency distribution of all three-digit International Classification of Diseases (ICD) codes was compared in constipated patients and patients without constipation. Most associations and the closest associations were observed between constipation and neurologic diseases, the majority of which resulted from damage to the central nervous system. Associations between constipation and disorders of the spine also involved neuronal damage. The influence of potential confounding factors such as immobility or pain on the development of constipation was assessed and found to be minimal. The frequent association of constipation with disorders involving neuronal malfunction suggests that disruption of the neural modulation of colonic motility may play an important role in the development of constipation.
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References
Burkitt DP, Walker ARP, Painter NS: Effect of dietary fibre on stools and transit-times, and its role in the causation of disease. Lancet 2:1408–1411, 1972
Burkitt DP: Varicose veins, deep vein thrombosis, and haemorrhoids: epidemiology and suggested aetiology. Br Med J 2:556–561, 1972
Burkitt DP, Walker ARP, Painter NS: Dietary fiber and disease. JAMA 229:1068–1074, 1974
Müller-Lissner S: Effect of wheat bran on weight of stool and gastrointestinal transit time: A meta-analysis. Br Med J 296:615–617, 1988
Everhart JE, Go VLW, Johannes RS, Fitzsimmons SC, Roth HP, White LR: A longitudinal survey of self-reported bowel habits in the United States. Dig Dis Sci 34:1153–1162, 1989
Johanson JF, Sonnenberg A, Koch TR: Clinical epidemiology of chronic constipation. J Clin Gastroenterol 11:525–536, 1989
Bingham SA, Cummings JH: Effect of exercise and physical fitness on large intestinal function. Gastroenterology 97:1389–1399, 1989
Devroede G, Soffié M: Colonic absorption in idiopathic constipation. Gastroenterology 64:552–561, 1973
Biscop G: Über pathologische Veränderungen am Auerbachschen Plexus bei Megacolon. Z Zellforsch 34:141–159, 1948
Dyer NH, Dawson AM, Smith BF, Todd IP: Obstruction of the bowel due to a lesion in the myenteric plexus. Br Med J 1:686–689, 1969
Krishnamurthy S, Schuffler MD, Rohrmann CA, Pope CE: Severe idiopathic constipation is associated with a distinctive abnormality of the colonic myenteric plexus. Gastroenterology 88:26–34, 1985
Riemann JF, Schmidt H: Ultrastructural changes in the gut autonomic nervous system following laxative abuse and in other conditions.In Basic Science in Gastroenterology: Structure of the Gut. JM Polak, SR Bloom, NA Wright, MJ Daly (eds). Ware, Herts, UK, Page Brothers (Norwich), 1982, pp 289–302
Koch TR, Carney A, Go L, Go VLW: Idiopathic chronic constipation is associated with decreased colonic vasoactive intestinal peptide. Gastroenterology 94:300–310, 1988
Kahn HA:In An Introduction to Epidemiologic Methods, New York, Oxford University Press, 1983, pp 46–48
Abdel-Rahman M, Toppercer A, Duguay C, Watier A, Tetreault L, Arhan P, Deveroede G, Elhilali M: Urorectodynamics in patients with colonic inertia. Urology 18:428–432, 1981
Bannister JJ, Lawrence WT, Smith A, Thomas DG, Read NW: Urologic abnormalities in young women with severe constipation. Gut 29:17–20, 1988
Kubota M, Ito Y, Ikeda K: Membrane properties and innervation of smooth muscle cells in Hirschsprung's disease. Am J Physiol 244:G406-G415, 1983
Köberle F: Quantitative Pathologie des vegetativen Nervensystems. Wiener Klin Wochenschr 74:144–151, 1962
Gonella J, Bouvier M, Blanquet F: Extrinsic nervous control of motility of small and large intestines and related sphincters. Physiol Rev 67:902–961, 1987
Walsh TN, Lane D: Pseudoobstruction of the colon associated with varicella-zoster infection. Ir J Med Sci 151:318–319, 1982
Caccese WJ, Bronzo RL, Wadler G, McKinley MJ: Ogilvie's syndrome associated with herpes zoster infection. J Clin Gastroenterol 7:309–313, 1985
Stevens JG, Wagner EK, Devi-Rao GB, Cook ML, Feldman LT: RNA complementary to a herpesvirus α gene mRNA is prominent in latently infected neurons. Science 235:1056–1059, 1987
Devroede G, Lamarche J: Functional importance of extrinsic parasympathetic innervation to the distal colon and rectum in man. Gastroenterology 66:273–280, 1974
Fukai K, Fukuda H: The intramural pelvic nerves in the colon of dogs. J Physiol (London) 354:89–98, 1984
Watkins GL, Oliver GA: Giant megacolon in the insane. Gastroenterology 48:718–727, 1965.
Kraft E, Finby N, Egidio PT, Glen JS: The megasigmoid syndrome in psychotic patients. JAMA 195:1099–1101, 1966
Warnes H, Lehmann HE, Ban TA: Adynamic ileus during psychoactive medication. Can Med Assoc J 96:1112–1113, 1967
Milner G, Hills NF: Adynamic ileus and nortriptyline. Br Med J 1:841–842, 1966
Milner G: Gastro-intestinal side effects and psychotropic drugs. Med J Austr 153–155, 1969
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The study was supported in parts by VA Medical Research Funds.
Data previously published in abstract form: Gastroenterology 98:A362, 1990.
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Johanson, J.F., Sonnenberg, A., Koch, T.R. et al. Association of constipation with neurologic diseases. Digest Dis Sci 37, 179–186 (1992). https://doi.org/10.1007/BF01308169
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DOI: https://doi.org/10.1007/BF01308169