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THE CANADIAN POPULATION CONSTIPATION SURVEY: PREVALENCE RATES AND FACTORS PREDICTIVE OF HEALTH CARE SEEKING
P Pare1, S Ferrazzi, WG Thompson, EJ Irvine, L Rance
1CHUQ, Quebec, Quebec
PURPOSE: To estimate the prevalence of Self-reported, Rome I and Rome II definitions of Functional Constipation (FC) and to determine which of the defining criteria best predict health care seeking.
METHODS: A Canada-wide population based survey was conducted using standard random telephone polling. Interviewers recruited household members who were at least 18 years of age. Participants were mailed a survey that included the Rome II questionnaire for functional gastrointestinal disorders, demographics, constipation symptoms and resource utilization. Rome I FC was derived using Rome I algorithms and the Rome II questions.
RESULTS: Of the 1149 participants, 27.2% Self-reported FC within the past 3 months. Prevalence using the Rome I definition was 16.6% and 0% by Rome II . The Rome II rate was 21% if the exclusion of subjects based on a positive answer concerning the occurrence of loose stools in the past 3 months was waived. With all 3 definitions, the prevalence rate for females was close to double that for males. There was no increase with age. Approximately 34% of subjects reported physician visits for constipation. The most bothersome symptoms included straining during a bowel movement (32%), hard lumpy stool (20%) and fewer than 3 bowel movements a week (13%). None of the most bothersome symptoms and neither Rome I or Rome II definitions of FC predicted visiting/seeing a physician. The use of medications to treat constipation (OR 3.41, p<0.01) and Self-reported constipation in the past 3 months (OR 2.47, p<0.01) were associated with health care seeking.
CONCLUSIONS: Functional constipation is a common health problem in the Canadian population. Its prevalence is highly dependent on the definitions used. Health care seeking occurs in 1/3 of the subjects. Rome II FC criteria should be re-evaluated.(Support : Janssen-Ortho Inc., Canada)