Presentacin de PowerPoint

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Prevalence of chronic constipation in general
population Dr. Vicente Garrigues Gastroenterology
Unit Hospital Universitario LA FE Valencia
- Spain
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• Gastroenterologist since 1985.
• Working in a 1.500-bed University Hospital.
• Interested in Digestive Functional Disorders and
  in Epidemiology Statistics.
• At present, Head of Education of the Hospital

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Learning objectives

• To know current definitions of chronic
  constipation.
• To find out the prevalence of constipation.
• To know which variables are associated to
  constipation.

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Performance objectives

• To select a sample for a prevalence study.
• To perform statistics in a prevalence study.
• To understand the meaning of likelihood ratios.

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Aims

• Evaluate the prevalence of chronic constipation
  in the general population.
• Assess agreement among several diagnostic
  criteria of constipation

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Aims

• Evaluate the diagnostic accuracy of self-reported
  definition of constipation and of symptoms
  included in Rome II criteria.
• Identify factors associated to chronic
  constipation

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Definition of constipation

• Self-reported by subject
• Rome criteria
• Rome II criteria

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Study subjects.
Selection of population Target population
General population from the town of Aldaya
23.425 inhabitants Elegible population subjects
aged between 18 and 65 years 15.696 subjects
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Study subjects.
Selection of sample. For an expected
prevalence of 20 4 (95 C.I.) 375 subjects
were needed. Sampling procedure.
Systematic, age-stratified sampling was
performed, selecting 506 subjects.
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Questionnaire
A validated questionnaire with 21 items was
mailed up to 6 times- to sampled subjects. Items
allowed diagnosis of constipation and evaluated
associated variables.
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Response
349 subjects (71.5) replied.
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Prevalence of constipation
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Prevalence of constipation
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Prevalence of constipation
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Agreement among criteria
Self-reported
Kappa 0.68 95-IC 0.59- 0.77
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Agreement among criteria
Self-reported
Kappa 0.55 95-IC 0.44- 0.65
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Agreement among criteria
Rome
Kappa 0.71 95-IC 0.61- 0.81
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Diagnostic accuracy of Rome II qualifying symptoms
Gold-standard self-reported
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Accuracy of self-reported and Rome II symptoms
Gold-standard Rome II
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Variables associated with constipation
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Conclusions
Constipation is highly prevalent, especially in
women. Different prevalence rates are observed
using different criteria,although agreement is
acceptable. Anal blockage, straining and hard
stools show the greatest diagnostic accuracy.