Prevalence, repercussion and factors associated with intestinal constipation in women in Florianópolis

Sacomori, Cinara; Silveira, Camila; Sperandio, Fabiana Flores; Cardoso, Fernando Luiz

doi:10.1016/j.jcol.2014.08.006

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Journal of Coloproctology (Rio de Janeiro)

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Sumário

Original Articles • J. Coloproctol. (Rio J.) 34 (4) • Oct-Dec 2014 • https://doi.org/10.1016/j.jcol.2014.08.006 copy

Prevalence, repercussion and factors associated with intestinal constipation in women in Florianópolis

Prevalência, repercussões e fatores associados à constipação intestinal nas mulheres em Florianópolis

Authorship SCIMAGO INSTITUTIONS RANKINGS

The objective of this study was to determine the prevalence of intestinal constipation and its association with sociodemographic and health-related factors in 605 adult women of metropolitan Florianópolis/SC who underwent screening tests for cervical cancer. This is a cross-sectional study in which intestinal constipation was evaluated by Rome III criteria. We used Poisson regression considering p <0.05.

Results:

The prevalence of intestinal constipation according to Rome III was 25.1%. Approximately 80% of women with constipation reported that the problem caused medium/high interference in their lives. In univariate analysis, constipation was associated with: income per capita lower than 1 minimum wage, a poor health state, body dissatisfaction, physical activity during personal commuting and self-report of hemorrhoids. In multivariate analysis and following a hierarchical model, the association persisted only for self-report of hemorrhoids (PR = 4.45, CI = 3.49-5.68). Coping strategies for intestinal constipation in the health care of women are suggested.

Intestinal constipation; Quality of life; Body image; Physical activitya

Criteria of constipation		n	%
Self-report		148	24.5
Diagnosed according to Rome III		152	25.1
	Sensation of anal block	138	22.8
	Need for digital facilitation	9	1.5
	Sensation of incomplete evacuation	123	20.3
	Passage of hard stools	134	22.1
	Straining necessity	134	22.1
Occurrence of less than three bowel movements/week		119	19.7
	Regular use of laxatives	31	5.1
Hemorrhoids		51	8.4
Interference in everyday life (0–10) ^a a Five women did not respond to this question.
	0 – No interference	458	75.7
	1	1	0.2
	2	5	0.8
	3	8	1.3
	4	10	1.7
	5 – Medium interference	25	4.1
	6	11	1.8
	7	14	2.3
	8	20	3.3
	9	11	1.8
	10 – High interference	37	6.1

		n (%)^a a Valid percentages were used due to some missing data for some variables.		Raw analysis PR (CI)	Adjusted analysis PR (CI)
		Not constipated (n = 453)	Constipated (n = 152)	Raw analysis PR (CI)	Adjusted analysis PR (CI)
Level 1 – sociodemographic variables
Education				p = 0.178	p = 0.269
	Fundamental complete/incomplete	195 (74.7)	66 (25.3)	1.69 (0.92–3.11)	1.66 (0.89–3.10)
	Medium complete/incomplete	200 (73.5)	72 (26.5)	1.77 (0.97–3.25)	1.59 (0.87–5.93)
	Superior complete/incomplete	57 (85.1)	10 (14.9)	1	1
Income per capita				p = 0.045	p = 0.120
	Up to 1 minimum wage	261 (72.1)	101 (27.9)	1.36 (1.01–1.85)^b b Significant at p < 0.05.	1.29 (0.94–1.77)
	More than 1 minimum wage	183 (79.6)	47 (20.4)	1	1
Age group				p = 0.065	p = 0.062
	<44 years	265 (72.2)	102 (27.8)	1.33 (0.98–1.80)	1.36 (0.98–1.88)
	≥45 years	178 (79.1)	47 (20.9)	1	1
Marital status				p = 0.476
	With no partner	133 (76.9)	40 (23.1)	0.89 (0.65–1.22)	^c c Variables not included in multiple Poisson model for not presenting p < 0.25.
	With partner	320 (74.1)	112 (25.9)	1
Ethnicity				p = 0.712
	Caucasian	354 (75.3)	116 (24.7)	0.96 (0.66–1.33)	^c c Variables not included in multiple Poisson model for not presenting p < 0.25.
	Black/mulatto/yellow	81 (73.6)	29 (26.4)	1
Level 2 – health-related variables
State of health				p < 0.001	p = 0.069
	Fair/poor/very poor	170 (67.7)	81 (32.3)	1.66(1.26–2.19)^b b Significant at p < 0.05.	1.34 (0.98–1.83)
	Good/very good	282 (80.6)	68 (19.4)	1	1
Hemorrhoids				p < 0.001	p < 0.001
	Yes	6 (11.8)	45 (88.2)	4.56 (3.75–5.56)^b b Significant at p < 0.05.	4.45 (3.49.5.68)^b b Significant at p < 0.05.
	No	447 (80.7)	107 (19.3)	1	1
Urinary incontinence				p = 0.051	p = 0.660
	Yes	143 (70.1)	61 (29.9)	1.32 (0.99–1.74)	1.07 (0.79–1.46)
	No	310 (77.3)	91 (22.7)	1	1
BMI classification				p = 0.106	p = 0.423
	Excess body weight	209 (72.6)	79 (27.4)	1.27 (0.95–1.71)	1.13 (0.84–1.52)
	Normal weight	215 (78.5)	59 (21.5)	1	1
Abdominal obesity				p = 0.476
	Inappropriate (waist ≥ 80 cm)	201 (79.4)	52 (20.6)	1	^c c Variables not included in multiple Poisson model for not presenting p < 0.25.
	Appropriate (waist < 80 cm)	175 (76.8)	53 (23.2)	1.13 (0.81–1.58)
Body satisfaction				p = 0.013	p = 0.925
	Unsatisfied	114 (67.5)	55 (32.5)	1.54 (1.15–2.06)^b b Significant at p < 0.05.	1.05 (0.73–1.48)
	Neither satisfied nor dissatisfied	44 (71)	18 (29)	1.37 (0.88–2.15)	0.94 (0.57–1.55)
	Satisfied	291 (78.9)	78 (21.1)	1	1
Satisfaction with body image				p = 0.066	p = 0.382
	Satisfied	131 (80.4)	32 (19.6)	1	1
	Unsatisfied	319 (72.8)	119 (27.2)	1.38 (0.98–1.96)	1.19 (0.81–1.75)
Physical activity at work				p = 0.345
	Inactive	251 (76.5)	77 (23.5)	0.87 (0.66–1.15)	^c c Variables not included in multiple Poisson model for not presenting p < 0.25.
	Active	202 (73.2)	74 (26.8)	1
Physical activity personal commuting				p = 0.005	p = 0.124
	Inactive	333 (78)	94 (22)	1	1
	Active	120 (67.4)	58 (32.6)	1.48 (1.12–1.95)^b b Significant at p < 0.05.	1.26 (0.94–1.71)
Domestic physical activity				p = 0.655	^c c Variables not included in multiple Poisson model for not presenting p < 0.25.
	Inactive	39 (72.2)	15 (27.8)	1.11 (0.70–1.75)
	Active	410 (75)	137 (25)	1

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[1] *Corresponding author. E-mail: csacomori@yahoo.com.br (C. Sacomori).