Constipation is a common and generally mild and short-term complaint for most individuals. However, for a proportion of patients, constipation can be a chronic and sometimes bothersome condition that represents a substantial burden in terms of its effects on quality of life (QoL).1

A review of seven studies has estimated the prevalence of constipation in Europe to be between 5% (in a prospective study using the diagnostic criterion of <3 defaecations per week) and 35% (in an interview questionnaire survey of self-reported constipation).2 Global data suggest a higher rate of chronic constipation among women, older individuals and those with lower socioeconomic status.3

A US survey published in 2007 assessed the frequency, severity and bothersomeness of commonly-reported symptoms of chronic constipation.4  Fifty-four percent of the 557 respondents suffering from chronic constipation considered constipation to be an “extremely”, “very” or “somewhat” severe medical condition and most respondents (76%) rated their constipation as “extremely”, “very” or “somewhat” bothersome. Abdominal bloating, straining and hard stools were ranked as the three most bothersome symptoms, and symptoms were considered more bothersome with increasing duration of this disorder (6 years or more).4

Chronic constipation can impact significantly on QoL. More than half of respondents (52%) in the 2007 US survey reported that constipation affected their QoL “somewhat”, “a lot” or “a great deal”, with a substantial 73% of respondents reporting social or personal impairment as a result of symptoms.4 Data also suggest a higher risk of absenteeism from work as a result of symptoms of chronic constipation.4,5

Many patients with chronic constipation suffer in silence and attempt to self-medicate without seeking medical help.6  Among those who do seek medical help, many remain unsatisfied with available therapies.6 In a 2009 European survey, only 27% of patients were satisfied with their current treatment. Almost half (46%) turned to alternative therapies, such as homeopathy, massage and acupuncture.7,8 One in three respondents were no longer taking any medication and a considerable 87% expressed a high interest in new therapies, reflecting low levels of perceived efficacy and satisfaction with available treatment options.7,8

Similarly, in the 2007 US survey, almost half of respondents (47%) were dissatisfied with their current treatment.4  Reasons for dissatisfaction reported by US survey respondents were largely efficacy related (82%), including “does not work well” (39%) and “inconsistent results” (25%), and safety concerns (16%).4

Further information on the burden of chronic constipation can be sourced from the following reference list:

 

References

1. Wald A, Scarpignato C, Kamm MA, et al. The burden of constipation on quality of life: results of a multinational survey. Aliment Pharmacol Ther 2007;26:227–36.

2. Peppas G, Alexiou VG, Mourtzoukou E, Falagas ME. Epidemiology of constipation in Europe and Oceania: a systematic review. BMC Gastroenterol 2008;8:5.

3. 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.

4. Johanson JF, Kralstein J. Chronic constipation: a survey of the patient perspective. Aliment Pharmacol Ther 2007;25:599–608.

5. Sun SX, Dibonaventura M, Purayidathil FW, Wagner JS, Dabbous O, Mody R. Impact of chronic constipation on health-related quality of life, work productivity, and healthcare resource use: an analysis of the National Health and Wellness Survey. Dig Dis Sci 2011;56:2688–95.

6. Tack J, Müller-Lissner S, Stanghellini V, et al. Diagnosis and treatment of chronic constipation – a European perspective Neurogastroenterol Motil 2011;23:697–710.

7. Tack J, Dubois D, Schenck F, Specht Gryp R. Only 27% of European patients with chronic constipation are satisfied with current treatment options [Abstract]. Gut 2009;58 (Suppl II):A181.

8. Tack J, Dubois D, Schenck F, Specht Gryp R. Only 27% of European patients with chronic constipation are satisfied with current treatment options. United European Gastroenterology Week; London, UK; 21–25 November 2009.