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Risk and main contributing factors for constipation in patients with gastrointestinal cancer: a multicenter cross-sectional study in China

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Abstract

Background and objectives

The purpose of this study is to determine the risk of constipation and to identify the significant risk factors for constipation in patients with gastrointestinal cancer using the Chinese version of the constipation risk assessment scale (CRAS-C), as well as to explore the complementary constipation risk factors in patients with gastrointestinal cancer, to improve the specificity of the CRAS-C in this population, and finally to provide a theoretical basis for constipation prevention.

Research design and methods

A cross-sectional study involving multiple centers was conducted. A total of 190 patients with gastrointestinal cancer completed surveys that included demographic information, defecation habits, and the CRAS-C. The mean, SD, median, maximum, minimum, frequency, and percentage were used as indicators for the constipation risk and significant risk factors. The t test and Chi-square tests were used to analyze constipation indicators in patients with gastrointestinal cancer.

Results

The mean (SD) age of the 190 participants was 61.68 (12.35) years. The total CRAS-C mean (SD) score was 13.22 (4.69). Fifty-one patients (26.8%) scored lower than 11, who were at the low-risk level of constipation. One hundred thirty-nine patients (73.2%) scored 11 or above, who were at the high-risk level of constipation. The top 10 factors were insufficient liquid intake (81.1%), failure to consume bran products daily (78.9%), insufficient fiber intake (77.9%), antiemetics (74.7%), cytotoxic chemotherapy (52.6%), colorectal/abdominal diseases (42.6%), female (35.3%), opioid analgesics(26.8%), calcium channel blockers (16.3%), and endocrine disorders (14.2%). Chi-square test showed that constipating for most of the past 3 months, ascites and ECOG score were complementary constipation risk factors in gastrointestinal cancer patients.

Conclusion

The findings indicate that most gastrointestinal cancer patients were at a high risk of constipation. There are also several complementary constipation risk factors, and CRAS-C can be further revised in future studies to make it more specific in gastrointestinal cancer patients. Integrating CRAS into the pathway of constipation management, carrying out constipation risk screening for hospitalized cancer patients, and building systematic constipation prevention plan based on risk assessment are important to reduce the incidence of constipation in patients with gastrointestinal cancer and improve the quality of life.

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Data availability

The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

SPSS version 20.0 (IBM Corp., NY, USA), which was downloaded from the Peking University Health Science Library.

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Acknowledgements

We thank Renxiu Guo, Li Liu, and Huijuan Yi for their contributions in the process of data collection.

Funding

This work was supported by the Peking University Cancer Hospital’s Science Foundation [grant number 2021–19] and was supported by Xiaoxiao Ma.

Author information

Authors and Affiliations

  1. Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Interventional Therapy, Peking University Cancer Hospital & Institute, NO.52 Fucheng Road, Haidian District, Beijing, 100142, China

    Xiaoxiao Ma

  2. School of Nursing, Peking University, Beijing, China

    Qian Lu

  3. Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education/Beijing), Nursing Department, Peking University Cancer Hospital & Institute, NO.52 Fucheng Road, Haidian District, Beijing, 100142, China

    Yuhan Lu & Xin Li

Authors
  1. Xiaoxiao Ma
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  2. Qian Lu
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  3. Yuhan Lu
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  4. Xin Li
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Contributions

Xiaoxiao Ma: conceptualization, methodology, investigation, data curation, formal analysis, writing—original draft, project administration, and funding acquisition.

Qian Lu: conceptualization, methodology, and writing—review and editing.

Yuhan Lu: conceptualization, methodology, writing—review and editing, and supervision.

Xin Li: methodology and Investigation.

Corresponding author

Correspondence to Yuhan Lu.

Ethics declarations

Ethics approval

This study was approved by the Ethics Committee of Peking University Cancer Hospital.

Consent to participate

Research assistants explained the study purpose, procedures, and participants’ role in the study to all prospective participants before they started. Patients and family caregivers were informed that the autonomy to participate or withdraw in this study at any time was respected. The written informed consent was obtained.

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N/A

Conflict of interest

The authors declare no competing interests.

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What is already known about the topic?

• The incidence of constipation in patients with gastrointestinal cancer is the highest and most serious among all cancer patients.

• The Chinese version of the constipation risk assessment scale (CRAS-C) demonstrated favorable content validity, predictive validity, and interrater reliability in cancer patients in the previous study and could be used in the identification of cancer patients at risk of constipation. But it hasn’t been used in gastrointestinal cancer patients.

What this paper adds

• The risk of constipation in patients with gastrointestinal cancer is generally high, which needs to be paid attention to.

• There are also several complimentary constipation risk factors, and CRAS-C can be further revised in future studies to make it more specific in gastrointestinal cancer patients.

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Cite this article

Ma, X., Lu, Q., Lu, Y. et al. Risk and main contributing factors for constipation in patients with gastrointestinal cancer: a multicenter cross-sectional study in China. Support Care Cancer 30, 8119–8127 (2022). https://doi.org/10.1007/s00520-022-07255-4

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  • DOI: https://doi.org/10.1007/s00520-022-07255-4

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