Skip to main content

Epidemiology of constipation in the United States

Abstract

In the present study, the epidemiology of constipation in the United States and an assessment of its impact on national health are presented. This analysis was based on four different surveys,i.e., the National Health Interview Survey, the National Hospital Discharge Survey, the National Ambulatory Medical Care Survey, and the Vital Statistics of the United States. These surveys have estimated that over 4 million people in the United States have frequent constipation, corresponding to a prevalence of about 2 percent. Constipation was the most common digestive complaint in the United States, outnumbering all other chronic digestive conditions. Cathartics and laxatives were prescribed to 2 to 3 million patients yearly by general and family practitioners or internists. In 92,000 annual hospitalizations, constipation was listed among the discharge diagnoses. About 900 persons die annually from diseases associated with or related to constipation. Constipation was three times more common in women than men. It showed a marked increase after the age of 65 years. It appeared to affect nonwhites 1.3 times more frequently than whites. In addition, constipation was more frequent in people living in the South than elsewhere in the United States, and in people from families with low income or brief education of the head of family than in people from families with high income or a high educational level of their family head. These data suggest that there are other factors involved in the cause of constipation in addition to dietary fiber content and psychogenic infljences. The frequent occurrence of constipation and its impact on public health stress the need for further studies devoted to the epidemiology and basic pathophysiology of this condition.

This is a preview of subscription content, access via your institution.

References

  1. 1.

    National Center for Health Statistics, Gleeson GA. Interviewing methods in the Health Interview Survey. Vital and Health Statistics. Series 2, No. 48. DHEW Pub. No. (HSM) 72-1048. Health Services and Mental Health Administration. Washington, DC: U.S. Government Printing Office, April 1972.

    Google Scholar 

  2. 2.

    National Center for Health Statistics. Vital Statistics of the United States, Mortality Statistics Branch. Vol. II, Mortality Part A, 1968-1984. Bethesda, MD: Department of Health, Education and Welfare.

    Google Scholar 

  3. 3.

    National Center for Health Statistics. Simmons WR. Development of the design of the NCHS Hospital Discharge Survey. Vital and Health Statistics. Series 2, No. 39. DHEW Pub. No. (HRA) 77-1199. Public Health Service Washington, DC: U.S. Government Printing Office, May 1977.

    Google Scholar 

  4. 4.

    National Center for Health Statistics. Tenney J, White K, Williamson J, Cypress BK. National Ambulatory Medical Care Survey, background and methodology, United States 1967–72. Vital and Health Statistics. Series 2, No. 61. DHEW Pub. No. 74-1335. Health Resources Administration. Washington, DC: U.S. Government Printing Office, December 1978.

    Google Scholar 

  5. 5.

    Drossman DA, Sandler RS, McKee DC, Lovitz AJ. Bowel patterns among subjects not secking health care: use of a questionnaire to identify a population with bowel dysfunction. Gastroenterology 1982;83:529–34.

    PubMed  CAS  Google Scholar 

  6. 6.

    Sandler RS, Drossman DA. Bowel habits in young adults not seeking health care. Dig Dis Sci 1987;32:841–5.

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Rendtorff RC, Kashgarian M. Stool patterns of healthy adult males. Dis Colon Rectum 1967;10:222–8.

    PubMed  CAS  Google Scholar 

  8. 8.

    Mendeloff AI. Epidemiology of functional gastrointestinal disorders. In: Chey WY, ed. Functional disorders of the digestive tract. New York: Raven Press, 1983:13–9.

    Google Scholar 

  9. 9.

    National Center for Health Statistics, Wilson RW. Prevalence of selected chronic digestive conditions, United States, July–December 1968. Vital and Health Statistics. Series 10, No. 83. DHEW Pub. No. (HRA) 74-1510. Public Health Service. Washington, DC: U.S. Government Printing Office, September 1973.

    Google Scholar 

  10. 10.

    National Center for Health Statistics. Drury TF, Howie LJ. Prevalence of selected chronic digestive conditions, United States, 1975. Vital and Health Statistics. Series 10, No. 123. DHEW Pub. No. (PHS) 79-1558. Public Health Service. Washington, DC: U.S. Government Printing Office, July 1979.

    Google Scholar 

  11. 11.

    National Center for Health Statistics. Collins JG. Prevalence of selected chronic conditions, United States, 1979–81. Vital and Health Statistics. Series 10, No. 155. DHHS, Pub. No. (PHS) 86-1582. Public Health Service. Washington, DC: U.S. Government Printing Office, July 1986.

    Google Scholar 

  12. 12.

    National Center for Health Statistics. Current estimates from the National Health Interview Survey: United States, 1983. Vital and Health Statistics. Series 10, No. 154. DHHS Pub. No. (PHS) 86-1578. Public Health Service. Washington, DC: U.S. Government Printing Office, September 1985.

    Google Scholar 

  13. 13.

    National Center for Health Statistics. Current estimates from the National Health Interview Survey: United States, 1983. Vital and Health Statistics. Series 10, No. 154. DHHS Pub. No. (PHS) 86-1582. Public Health Service. Washington, DC: U.S. Government Printing Office, June 1986.

    Google Scholar 

  14. 14.

    National Center for Health Statistics. Current estimates from the National Health Interview Survey: United States, 1984. Vital and Health Statistics. Series 10, No. 156. DHHS Pub. No. (PHS) 86-1584. Public Health Service. Washington, DC: U.S. Government Printing Office, July 1986.

    Google Scholar 

  15. 15.

    National Center for Health Statistics. Current estimates from the National Health Interview Survey: United States, 1985. Vital and Health Statistics. Series 10, No. 160. DHHS Pub. No. (PHS) 86-1588. Public Health Service. Washington, DC: U.S. Government Printing Office, September 1986.

    Google Scholar 

  16. 16.

    National Center for Health Statistics, Haupt BJ. Detailed diagnoses and surgical procedures for patients discharged from short-stay hospitals, United States, 1977. DHEW Pub. No. (PHS) 79-1274-1. Public Health Service. Washington, DC: U.S. Government Printing Office, September 1979.

    Google Scholar 

  17. 17.

    National Center for Health Statistics. Haupt BJ. Detailed diagnoses and surgical procedures for patients discharged from short-stay hospitals, United States, 1978. DHHS Pub. No. (PHS) 80-1274-1. Public Health Service. Washington, DC: U.S. Government Printing Office, September 1980.

    Google Scholar 

  18. 18.

    National Center for Health Statistics, Haupt BJ, Graves E. Detailed diagnoses and surgical procedures for patients discharged from short-stay hospitals, United States, 1979. DHHS Pub. No. (PHS) 82-1247-1. Public Health Service. Washington, DC: U.S. Government Printing Office, January 1982.

    Google Scholar 

  19. 19.

    National Center for Health Statistics. Kozak LJ, Moien M. Detailed diagnoses and surgical procedures for patients discharged from short-stay hospitals, United States, 1983. Vital and Health Statistics. Series 13, No. 82. DHHS Pub. No. (PHS) 85-1743, Public Health Service. Washington, DC: U.S. Government Printing Office, March 1985.

    Google Scholar 

  20. 20.

    National Center for Health Statistics. Detailed diagnoses and surgical procedures for patients discharged from short-stay hospitals, United States, 1984. Series 13, No. 86. DHHS Pub. No. (PHS) 86-1747. Public Health Service. Washington, DC: U.S. Government Printing Office, April 1986.

    Google Scholar 

  21. 21.

    National Center for Health Statistics. Detailed diagnoses and surgical procedures for patients discharged from short-stay hospitals, United States, 1985. Series 13, No. 90. DHHS Pub. No. (PHS) 87-1751. Public Health Service. Washington, DC: U.S. Government Printing Office, April 1987.

    Google Scholar 

  22. 22.

    National Center for Health Statistics. Cypress BK. Patterns of ambulatory care in general and family practice, National Ambulatory Medical Care Survey, United States, January 1980–December 1981. Vital and Health Statistics. Series 13, No. 73. DHHS Pub. No. 83-1734. Public Health Service. Washington, DC: U.S. Government Printing Office, September 1983.

    Google Scholar 

  23. 23.

    National Center for Health Statistics. Cypress BK. Patterns of ambulatory care in internal medicine, National Ambulatory Medical Care Survey, United States, January 1980–December 1981. Vital and Health Statistics. Series 13. No. 80. DHHS Pub. No. 84-1741. Public Health Service. Washington, DC: U.S. Government Printing Office, September 1984.

    Google Scholar 

  24. 24.

    Connell AM, Hilton C, Irvine G, Lennard-Jones JE, Misiewicz JJ. Variation of bowel habit in two population samples. Br Med J 1965;2:1095–9.

    PubMed  CAS  Google Scholar 

  25. 25.

    Milne JS, Williamson J. Bowel habit in older people. Geront Clin 1972;14:56–60.

    PubMed  CAS  Article  Google Scholar 

  26. 26.

    Thompson WG, Heaton KW. Functional bowel disorders in apparently healthy people. Gastroenterology 1980;79:283–8.

    PubMed  CAS  Google Scholar 

  27. 27.

    Burkitt DP, Walker ARP, Painter NS. Effect of dietary fibre on stools and transit-times, and its role in the causation of disease. Lancet 1972;2:1408–12.

    PubMed  Article  CAS  Google Scholar 

  28. 28.

    Cummings JH. Constipation, dietary fibre and control of large bowel function. Postgrad Med J 1984;60:811–9.

    PubMed  CAS  Article  Google Scholar 

  29. 29.

    Gear JSS, Brodribb AM, Ware L, Mann JI. Fibre and bowel transit times. Br J Nutr 1981;45:77–82.

    PubMed  Article  CAS  Google Scholar 

  30. 30.

    Tucker DM, Sandstead HH, Logan GM, et al. Dietary fiber and personality factors as determinants of stool output. Gastroenterology 1981;81:879–83.

    PubMed  CAS  Google Scholar 

  31. 31.

    Almy TP. Experimental studies on the irritable colon. Am J Med 1951;10:60–72.

    PubMed  Article  CAS  Google Scholar 

  32. 32.

    Whitehead WE, Engel BT, Schuster MM. Irritable bowel syndrome: physiological and psychological differences between diarrhea predominant and constipation predominant patients. Dig Dis Sci 1980;25:404–13.

    PubMed  Article  CAS  Google Scholar 

  33. 33.

    Rees DW, Rhodes J. Altered bowel habit and menstruation. Lancet 1976;2:475.

    Article  Google Scholar 

  34. 34.

    Wald A, Van Thiel DR, Hoechstetter L, et al. Gastrointestinal transit: the effect of the menstrual cycle. Gastroenterology 1981;80:1497–1500.

    PubMed  CAS  Google Scholar 

  35. 35.

    Lawson M, Kern F, Everson GT: Gastrointestinal transit time in human pregnancy: prolongation in the second and third trimester followed by postpartum normalization. Gastroenterology 1985;89:996–9.

    PubMed  CAS  Google Scholar 

  36. 36.

    Koch TR, Go VLW, Szurszewski JH. Changes in some electrophysiological properties of circular muscle from normal sigmoid colon of the aging patient (Abstract). Gastroenterology 1986;90: 1497.

    Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Amnon Sonnenberg M.D..

Additional information

Supported by grant So 172/1-1 from the Deutsche Forschungsgemeinschaft.

About this article

Cite this article

Sonnenberg, A., Koch, T.R. Epidemiology of constipation in the United States. Dis Colon Rectum 32, 1 (1989). https://doi.org/10.1007/BF02554713

Download citation

Key words

  • Constipation
  • Functional digestive disorders
  • Human colon
  • Megacolon