Association of bowel movement frequency and use of laxatives with the occurrence of symptomatic gallstone disease in a prospective study of women

OBJECTIVES: The authors prospectively examined the association between bowe l movement Frequency (used as a proxy fur intestinal transit), laxative use , and the risk of symptomatic gallstone disease METHODS: A total of 79,829 women, aged 36-61 yr, without a history of sympt omatic gallstone disease and free of cancer, responded to a mailed question naire in 1982 that assessed bowel movement frequency and use of laxatives. Between 1984 and 1996, 4,443 incident cases of symptomatic gallstone diseas e were documented. Relative risks (RRs) of symptomatic gallstone disease an d 95% confidence intervals (CIs) were calculated using logistic regression. RESULTS: After controlling fur age and established risk factors, the multiv ariate RRs were, compared to women with daily bowel movements, 0.97 (95% CI 0.86-1.08) for women with bowel movements every third day or less, and 1.0 0 (95% CI 0.91-1.11) for women with bowel movement more than once daily. No trend was evident. As compared to women who never used laxatives in 1982, a significant modest inverse association was seen for monthly laxative use, with a multivariate RR of 0.84 (95% CI 0.72-0.98), and weekly to daily lax ative use was associated with a RR of 0.88 (95% CI 0.78-1.02). CONCLUSIONS: These findings do not support an association between infrequen t bowel movements and risk of symptomatic gallstone disease in women, and i ndicate that simple questions directed at bowel movement frequency are unli kely to enhance our ability to predict risk of symptomatic gallstone diseas e. The slightly inverse association between use of laxatives and risk of sy mptomatic gallstone disease may be due to a mechanism that is not related t o bowel movement frequency. (C) 2001 by Am. Cell. of Gastroenterology.