Straining at stool and laxative taking in an English population

Area of Science:

• Gastroenterology
• Public Health
• Epidemiology

Background:

• Defecation straining is a common symptom, often associated with constipation.
• Prevalence and contributing factors of straining require further population-based investigation.
• Laxative use patterns and potential misuse, especially in older populations, warrant examination.

Purpose of the Study:

• To investigate the prevalence of straining during defecation in a population-based sample.
• To identify factors associated with straining, including gender, age, and stool form.
• To assess current laxative use patterns and identify potential inappropriate use.

Main Methods:

• A population-based study involving 834 men (40-69 years) and 1058 women (25-29 years).
• Data collection via questionnaire and a three-stool record form.
• Assessment of straining, stool form, bowel habit, and laxative use.

Main Results:

• Straining was common (32% women, 22% men for starting; 15% women, 9% men for finishing) but not universal, and more frequent in women than men.
• Straining was associated with lumpier stool consistency but not age.
• Laxative use was less prevalent than historically, with many constipated individuals not using them; older adults showed increased and sometimes inappropriate use.

Conclusions:

• Straining during defecation is a prevalent issue, influenced by stool characteristics and gender, and may be habitual for some.
• Current laxative use is lower than in the past, and a significant portion of individuals experiencing constipation do not use laxatives.
• Increased laxative use with age necessitates attention to appropriate usage guidelines in the elderly population.