An epidemiological survey of constipation in Canada: Definitions, rates, demographics, and predictors of health care seeking

OBJECTIVES: The prevalence of functional constipation is highly variable am ong, epidemiological surveys and may relate to the definitions applied. We estimated the population prevalence of self-reported, Rome I-defined, and R ome II-defined constipation in Canada and determined the variables that bes t predicted health care seeking. METHODS: A research firm was employed to conduct a random digit dial nation al survey, inviting household members bers at least 18 yr of age to partici pate in a study assessing personal health issues. The sample was stratified to ensure that each region of Canada was represented. Data collection invo lved three stages: 1) recruitment of participants by phone, 2) mailing of t he questionnaire, and 3) data retrieval through a follow-up phone call. The Rome If questionnaire was used to derive the prevalence of functional cons tipation using both Rome I and Rome II criteria. RESULTS: Of the 1149 participants, 27.2% self-reported constipation within the past 3 months, and 16.7% and 14.9% had functional constipation accordin g to Rome I and II, criteria, respectively. For all three definitions, the rate for women was close to twice that for men. Approximately 34% of those with self-reported constipation had visited a physician for it, versus 26.3 % of Rome II subjects. In a regression model, subjects self-reporting in th e past 3 months were more likely to have seen a doctor for their constipati on (odds ratio 2.47, p < 0.01) and significantly more women than men (35.6% vs 19.5%, p < 0.05). CONCLUSIONS: Functional constipation and related health care seeking are co mmon in the Canadian population and are strongly determined by the definiti on used. The Rome II criteria for this disorder seem to be satisfactory, bu t modifications may be considered to allow for constipated subjects taking laxatives and to increase the number of qualifying symptoms. (C) 2001 by Am . Coll. of Gastroenterology.