The changing prevalence of functional constipation: why words matter

The impact of chronic constipation, which can refer to both chronic idiopathic constipation or functional constipation, can be recognised through its economic and social burdens. It is associated with decreased health-related quality of life and increased direct outpatient costs. 1 Nag A Martin SA Mladsi D Olayinka-Amao O Purser M Vekaria RM The humanistic and economic burden of chronic idiopathic constipation in the usa: a systematic literature review. Clin Exp Gastroenterol. 2020; 13: 255-265 Crossref PubMed Scopus (6) Google Scholar In the USA, chronic constipation accounts for about 1 million hospital visits annually. 2 Ma C Congly SE Novak KL et al. Epidemiologic burden and treatment of chronic symptomatic functional bowel disorders in the United States: a nationwide analysis. Gastroenterology. 2021; 160: 88-98 Summary Full Text Full Text PDF PubMed Scopus (11) Google Scholar Functional constipation is defined by the Rome criteria, which were originally developed to establish operational definitions for functional gastrointestinal disorders. 3 Thompson WG The road to Rome. Gastroenterology. 2006; 130: 1552-1556 Summary Full Text Full Text PDF PubMed Scopus (68) Google Scholar Efforts to measure the prevalence of functional constipation using well described criteria enable more confident assessments of its epidemiology. Prevalence of the condition is anticipated to grow over time with an ageing population, because rates of chronic constipation are higher in older individuals. 4 Serra J Pohl D Azpiroz F et al. European Society of Neurogastroenterology and Motility guidelines on functional constipation in adults. Neurogastroenterol Motil. 2020; 32e13762 Crossref PubMed Scopus (32) Google Scholar , 5 Suares NC Ford AC Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. Am J Gastroenterol. 2011; 106: 1582-1591 Crossref PubMed Scopus (447) Google Scholar Global prevalence of functional constipation according to the Rome criteria: a systematic review and meta-analysisEven when uniform symptom-based criteria are used to define the presence of functional constipation, prevalence varies between countries. Thus, environmental, cultural, ethnic, dietary, or genetic factors can influence reporting of symptoms. Future studies should aim to elucidate reasons for this geographical variability. Full-Text PDF