1Epidemiology of constipation in children and adults: A systematic review
Introduction
Constipation is a common problem worldwide. Because only a minority of patients suffering from constipation seeks health care, its exact prevalence is difficult to ascertain. As a consequence, reports of its prevalence have varied widely, ranging from 0.7% to 29.6% in children [1] and from 2% to 35% in adults in Europe, Oceania and North America [2], [3]. Constipation accounts for 2.5 million physician visits annually in the United States [4] and it contributes significantly to health care financial burden, with a cost of $2757 for diagnostic work up per patient and $3362 per treated child per year [5], [6]. Higher expenses in paediatrics are mainly due to more expensive outpatient, emergency room and prescription drug costs [6]. Constipation has a significant impact on quality of life, affecting both physical and emotional well-being [7], [8], [9], [10], [11], [12]. Due to the aforementioned factors, constipation should be considered a major public health issue both in the paediatric and adult population and knowledge of its epidemiology is highly relevant to primary care providers, gastroenterologists and health care policy makers.
We performed a systematic review on the worldwide published literature to identify the prevalence of constipation in the general paediatric and adult population in order to summarize its geographic, gender and age distribution, and associated socioeconomic factors.
Section snippets
Methods
A literature search was performed on October 2010 to identify published studies on the subject of epidemiology of constipation in children and adults. The Medline database was searched from 1966 to present, using the following medical subject heading (MeSH) terms ‘Constipation/epidemiology’ [Mesh] OR (‘Constipation’ [Mesh] AND (epidemiology OR questionnaires OR prevalence OR incidence OR natural history OR registry)). The results were limited to human studies and English language publications.
Results
A total of 1209 citations were identified by the Medline database search. After the initial evaluation, 80 were judged potentially eligible. Review of the full manuscripts selected 58 articles that met our inclusion criteria. Ten other candidate articles were identified by reviewing the references of the relevant articles. Thus, a total of 68 articles were included in our review (Table 1) [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30],
Discussion
Based on a systematic review of the literature we found that the prevalence of constipation in the worldwide general population is very variable, ranging from 2.5% to 79% in adults and ranging from 0.7% to 29.6% in children. These rates are consistent with published reviews about the epidemiology of constipation in North America, Europe and Oceania [2], [3]. Our up-to-date and comprehensive review shows that prevalence rates range widely between countries and continents, but that in general,
Conflict of interest
None.
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