Occasional Constipation: Prevalence and Impact in the Rome IV Global Epidemiology Study

Recently, a Rome working group defined individuals with occasional constipation (OC). We used the Rome Foundation Global Epidemiology Study database to study the global prevalence of OC, its comorbidities, quality of life (QoL) impact, and health care utilization, compared to subjects without constipation symptoms (No Constipation), or with functional constipation (FC).

A total of 54,127 adults (26,578 females; mean age, 43.7 years) from 26 countries completed an internet survey including Rome IV diagnoses, demographics, psychosocial data, QoL, and medical history. OC was defined as ≥1 of 5 constipation symptoms without meeting FC criteria, associated with concerns about bowel function. Respondents with other Rome IV bowel disorders or relevant organic disease were excluded.

The global prevalence of Rome-defined OC was 7.4%, ranging from 4.3% in the Middle East to 15.8% in Eastern Europe. OC was predominant in females (46.1%) compared with No Constipation (40.2%) but not compared with FC (63.9%). Compared with No Constipation, subjects with OC had higher odds of fulfilling Rome IV criteria for upper gastrointestinal disorders, but lower odds in comparison to those with FC. OC was associated with significantly lower QoL (physical 14.5 vs 16.1 and mental 13.5 vs 15.3), and a higher prevalence of anxiety (12.3% vs 5.6%) and depression (12.0% vs 5.6%) compared with No Constipation. Compared with subjects with FC, subjects with OC were more concerned about their bowel function. Health care consumption (doctor visits and medication usage) was higher in OC vs No Constipation.

Rome-defined OC is common on a global scale, associated with psychological distress, reduced QoL, other Rome IV diagnoses, and high health care utilization.