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World J Gastroenterol. Jun 7, 2021; 27(21): 2795-2817
Published online Jun 7, 2021. doi: 10.3748/wjg.v27.i21.2795
Potential risk factors for constipation in the community
Barry L Werth, Sybele-Anne Christopher
Barry L Werth, Sybele-Anne Christopher, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney 2006, New South Wales, Australia
Author contributions: Werth BL designed the review and wrote the original draft of the manuscript which was reviewed and edited by Christopher SA. Further versions of the manuscript were reviewed and edited by both authors; both authors approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest regarding publication of this review.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Barry L Werth, BPharm, MBA, PhD, Pharmacist, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Building Western Avenue, Sydney 2006, New South Wales, Australia. barrywerth@yahoo.com.au
Received: January 27, 2021
Peer-review started: January 27, 2021
First decision: February 27, 2021
Revised: March 31, 2021
Accepted: April 26, 2021
Article in press: April 26, 2021
Published online: June 7, 2021
Abstract

Constipation is a common community health problem. There are many factors that are widely thought to be associated with constipation but real-world evidence of these associations is difficult to locate. These potential risk factors may be categorised as demographic, lifestyle and health-related factors. This review presents the available evidence for each factor by an assessment of quantitative data from cross-sectional studies of community-dwelling adults published over the last 30 years. It appears that there is evidence of an association between constipation and female gender, residential location, physical activity and some health-related factors such as self-rated health, some surgery, certain medical conditions and certain medications. The available evidence for most other factors is either conflicting or insufficient. Therefore, further research is necessary to determine if each factor is truly associated with constipation and whether it can be regarded as a potential risk factor. It is recommended that studies investigating a broad range of factors are conducted in populations in community settings. Multivariate analyses should be performed to account for all possible confounding factors. In this way, valuable evidence can be accumulated for a better understanding of potential risk factors for constipation in the community.

Keywords: Adults, Constipation, Epidemiology, Factors, Community

Core Tip: Despite widespread beliefs that there are a number of potential risk factors for constipation in the community, this review highlights the paucity of real-world evidence for most factors. It is unclear whether most factors are associated with constipation because, apart from female gender, physical activity, residential location and some health-related factors, there is insufficient evidence or conflicting data available. Further research is required in community-dwelling adult populations to understand the importance of each potential risk factor in constipation. A broad range of factors should be investigated in same population samples using multivariate analysis to determine which factors are truly associated with constipation in the community.