Epidemiology of slow and fast colonic transit using a scale of stool form in a community

Measurement of gastrointestinal transit is commonly performed in the clinic, but data on transit in the community are lacking.

To estimate the prevalence of slow and fast colonic transit using stool form, and potential risk factors.

A validated self-reported gastrointestinal symptom questionnaire was mailed to 4196 randomly selected members of the community (response rate 54%). One question asked the subject to self-report their stool form using the Bristol Stool Scale.

Overall, 18%, 9% and 73% met stool form criteria for slow, fast or normal colonic transit, respectively. Increased odds for slow transit were observed with a higher Somatic Symptom Checklist score (OR = 1.6; 1.3-2.0), while a decreased odds for slow transit was observed in males relative to females (OR = 0.6; 0.5-0.8). An increased odds for fast transit was observed with higher Somatic Symptom Checklist score (OR = 2.3; 1.7-2.9) and a history of cholecystectomy (OR = 1.8; 1.2-2.8). Increasing body mass index (per 5 units) was associated with decreased odds for slow (OR = 0.85; 0.78-0.93), and an increased odds for fast (OR = 1.1; 1.04-1.24) colonic transit.

Based on stool form assessment, nearly one in five community members may have slow colonic transit and one in 12 have accelerated colonic transit.