medwireNews: Australian researchers highlight the widespread impact of constipation on both quality of life (QoL) and longevity, finding the majority of women experience symptoms in later life.
"In light of the enormous economic costs associated with constipation, it is a problem that needs to be further understood and better managed," the team says in the American Journal of Gastroenterology.
Over five surveys conducted at 3-year intervals, responses from 5107 women aged 70-75 years at baseline showed that 20.9% of women reported persistent constipation on at least four surveys and 54.1% reported transient constipation on up to three surveys.
Just 25.0% of women rarely or never had symptoms of constipation over the 15-year period of the Australian Longitudinal Study on Women's Health, write Nicholas Talley (University of Newcastle, New South Wales) and co-authors.
Of concern, patients with transient or persistent constipation had significantly poorer QoL scores on the eight domains of the Short Form-36 assessment compared with women without constipation, after adjusting for chronic illness and fluid intake.
Women with transient or persistent depression also had significantly higher rates of self-reported depression than those without no symptoms, although significance was lost for patients with transient symptoms after adjustment for confounders.
Compared with transient symptoms, persistent constipation was also associated with significantly poorer QoL, except for the role-emotional domain, and greater self-reported depression, the researchers report.
Moreover, women with persistent or transient constipation had significantly higher mortality rates than women without symptoms (11.0 and 10.2 vs 8.2%, respectively). The odds ratios for increased mortality risk with persistent and transient constipation versus no symptoms had only borderline significance, however, after taking into consideration diabetes, heart disease, malignancy, and Alzheimer's disease (odds ratios=1.32 and 1.21, respectively).
Talley et al therefore conclude: "Our data suggest that elderly people with persistent constipation need better monitoring and management by physicians in clinical practice, including modification of cardiovascular risk factors, but more work is needed to understand the now recognized association with poorer outcomes."
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