Background: This study aimed to investigate the prevalence, symptoms, and factors associated with chronic constipation among community-dwelling older people in the East Coast region of Peninsular Malaysia. Methods: A cross-sectional study was conducted in four selected health clinics using stratified cluster sampling. A face-to-face interview was carried out among the elderly outpatients, in order to complete a structured questionnaire. Results: A total of 400 participants were included in the study. The mean age was 68.7 ± 6.4 years, and 55% of the cohort were women. The prevalence of chronic constipation was 32.3% among the sample population. The most common symptom was “sensation of incomplete evacuation” (63.6%), and none of the participants reported having “less than three defecations per week,” “straining,” or “lumpy or hard stool.” Educational level (p = 0.005), number of defecations per week, stool form, time spent for defecation, and abdominal bloating were significantly associated with chronic constipation (p < 0.001). Conclusion: Chronic constipation was common in older people and associated with a low educational level. Recognition of symptoms was predominantly based on clinical features of constipation and will require the healthcare providers to consider these factors in their routine assessment of older people.
- Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: Systematic review and meta-analysis. Am J Gastroenterol. 2011;106:1582–91.
- Black CJ, Ford AC. Chronic idiopathic constipation in adults: Epidemiology, pathophysiology, diagnosis and clinical management. Med J Aust. 2018;209:86–91.
- Roque MV, Bouras EP. Epidemiology and management of chronic constipation in elderly patients. Clin Interv Aging. 2015;10:919–30.
- Suyasa IGPD, Paterson JB, Xiao LD, Lynn PA. Prevalence of constipation in community-dwelling older people in Indonesia. J Gastroenterol Hepatol. 2011;26:84.
- Koloski NA, Jones M, Wai R, Gill RS, Byles J, Talley NJ. Impact of persistent constipation on health-related quality of life and mortality in older community-dwelling women. Am J Gastroenterol. 2013;108:1152–58.
- Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006;130:1480–91.
- Mounsey A, Raleigh M, Wilson A. Management of constipation in older adults. Am Fam Physician. 2015;92:500–4.
- Patimah AW, Lee YY, Dariah MY. Frequency patterns of core constipation symptoms among the Asian adults: A systematic review. BMC Gastroenterol. 2017;17.
- Song HJ. Constipation in community-dwelling elders: Prevalence and associated factors. J Wound Ostomy Cont Nurs. 2012;39:640–5.
- Lee TH, Choi SC, Park MI, Park KS, Shin JE, Kim SE, et al. Constipation misperception is associated with gender, marital status, treatment utilization and constipation symptoms experienced. J Neurogastroenterol Motil. 2014;20:379–87.
- Patimah AW, Lee YY, Siti Hawa A, Azidah AK, Dariah MY. Beliefs and behavioural responses to constipation among elderly Malays in north-eastern Peninsular Malaysia. Aust New Zeal Cont J. 2017;23:76–83.
- Zhang M, Yang XJ, Zhu HM, Tang Z, Li BY, Zhao DD. Epidemiological study of elderly constipation in Beijing. World J Gastroenterol. 2015;21:13368–73.
- Kua EH, Ko SM. A questionnaire to screen for cognitive impairment among elderly people in developing countries. Acta Psychiatr Scand. 1992;85:119–22.
- Attaluri A, Donahoe R, Valestin J, Brown K, Rao SSC. Randomised clinical trial: Dried plums (prunes) vs. psyllium for constipation. Aliment Pharmacol Ther. 2011;33:822–28.
- Lee YY, Waid A, Tan HJ, Chua SBA, Whitehead WE. Validity and reliability of the Malay-language translation of the Rome III Diagnostic Questionnaire for irritable bowel syndrome. J Gastroenterol Hepatol. 2012;27:746–50.
- Blekken LE, Nakrem S, Vinsnes AG, Norton C, Morkved S, Salvesen O, et al. Constipation and laxative use among nursing home patients: Prevalence and associations derived from the residents assessment instrument for long-term care facilities (interRAI LTCF). Gastroenterol Res Pract. 2016;2016:1215746.
- Fragakis A, Zhou J, Mannan H, Ho V. Association between drug usage and constipation in the elderly population of Greater Western Sydney Australia. Int J Environ Res Public Health. 2018;15:226.
- Werth BL, Williams KA, Pont LG. Laxative use and self-reported constipation in a community-dwelling elderly population. Gastroenterol Nurs. 2017;40:134–41.
- Gupta SK, Varshney A, Tiwari SC, Shinde M. The investigation of medical and psychosocial problems of geriatric population in the urban area of Madhya Pradesh in India. Open J Intern Med. 2012;2:170–5.
- Yang XJ, Zhang M, Zhu HM, Tang Z, Zhao DD, Li BY, et al. Epidemiological study: Correlation between diet habits and constipation among elderly in Beijing region. World J Gastroenterol. 2016;22:8806–11.
- Fosnes GS, Lydersen S, Farup PG. Drugs and constipation in elderly in nursing homes: What is the relation? Gastroenterol Res Pract. 2012;2012:290231.
- Neri L, Iovino P. The laxatives inadequate relief survey (LIRS) group. Bloating is associated with worse quality of life, treatment satisfaction, and treatment responsiveness among patients with constipation-predominant irritable bowel syndrome and functional constipation. Neurogastroenterol Motil. 2016;28:581–91.
- Enck P, Leinert J, Smid M, Köhler T, Schwille-Kiuntke J. Functional constipation and constipation-predominant irritable bowel syndrome in the general population: Data from the GECCO study. United Eur Gastroenterol J. 2016;4:429–37.
- Zhao Y-F, Ma X-Q, Wang R, Yan X-Y, Li Z-S, Zou DW, et al. Epidemiology of functional constipation and comparison with constipation-predominant irritable bowel syndrome: The systematic investigation of gastrointestinal diseases in China (SILC). Aliment Pharmacol Ther. 2011;34:1020–9.
- Wald A, Scarpignato C, Mueller-Lissner S, Kamm MA, Hinkel U, Helfrich I, et al. A multinational survey of prevalence and patterns of laxative use among adults with self-defined constipation. Aliment Pharmacol Ther. 2008;28:917–30.
- Huang L, Jiang H, Zhu M, Wang B, Tong M, Li H, et al. Prevalence and risk factors of chronic constipation among women aged 50 years and older in Shanghai, China. Med Sci Monit. 2017;23:2660–7.
Wahab PA, Kadir AA, Lee YY, Ali SH, Yusoff DM. Chronic constipation among community-dwelling older people in the East Coast region of Peninsular Malaysia. Makara J Health Res. 2019;23.