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Cited by 424Gastrointestinal motility and disordersPelvic floor disorders treatmentsIntestinal Malrotation and Obstruction Disorders

The DOI matches its Crossref record; 72 of the 74 references it cites were found in a registry or an index.

Global prevalence of functional constipation according to the Rome criteria: a systematic review and meta-analysis

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Barberio, Brigida, Judge, Ciaran, Savarino, Edoardo V, Ford, Alexander C·2021·The Lancet Gastroenterology & Hepatology
DOI 10.1016/s2468-1253(21)00111-4
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Abstract

Background Functional constipation is a common functional bowel disorder in the community, which has a varying prevalence across cross-sectional surveys. We did a contemporaneous systematic review and meta-analysis of studies using comparable methodology and all iterations of the Rome criteria to estimate the global prevalence of functional constipation.Methods In this systematic review and meta-analysis, we searched MEDLINE, Embase, and Embase Classic from Jan 1, 1990, to Dec 31, 2020, to identify population-based cross-sectional studies comprising at least 50 participants that reported the prevalence of functional constipation in adults (age 18 years and older) according to Rome I, II, III, or IV criteria. We excluded studies that reported the prevalence of functional constipation in convenience samples. We extracted prevalence estimates of functional constipation from eligible studies, according to the study criteria used to define it. For each study, we extracted data for country; method of data collection; criteria used to define functional constipation; whether the study used the Rome I, II, III, or IV diagnostic questionnaires or approximated these definitions of the condition using another questionnaire; the total number of participants providing complete data; age; the number of participants with the condition; the number of male and female participants; and the number of male and female participants with the condition. We calculated pooled prevalence, odds ratios (OR), and 95% CIs.Findings Of 8174 citations evaluated, 45 studies fulfilled the eligibility criteria, representing 80 separate populations and comprising 275 260 participants. The pooled prevalence of functional constipation was 15·3% (95% CI 8·1-24·4, I 2=99·4%) in studies using the Rome I criteria, 11·2% (7·9-14·9; I 2=99·6%) in studies that used Rome II criteria, 10·4% (6·5-14·9; I 2=99·8%) in those that used Rome III criteria, and 10·1% (8·7-11·6; I 2=98·2%) when Rome IV criteria were used. Prevalence of functional constipation was higher in women, irrespective of the Rome criteria used (OR 2·40 [95% CI 2·02-2·86] for Rome I, 1·94 [1·46-2·57] for Rome II, and 2·32 [1·85-2·92] for Rome III; no studies using Rome IV criteria reported prevalence by sex). There was significant heterogeneity between studies in all of our analyses, which persisted even when the same criteria were applied and similar methodologies used.Interpretation Even when uniform symptom-based criteria are used to define the presence of functional constipation, prevalence varies between countries. Thus, environmental, cultural, ethnic, dietary, or genetic factors can influence reporting of symptoms. Future studies should aim to elucidate reasons for this geographical variability.Funding None.

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Research works printed but not linked: 4

  1. Drossman, 1990, Identification of sub-groups of functional gastrointestinal disorders, Gastroenterol Intl, 3, 159
  2. Hoch, 2011, Symptom frequency, health care seeking behavior, and satisfaction with therapy among chronic constipation (CC) patients with both constipation and abdominal symptoms: results of a population-based survey, Neurogastroenterol Motil, 23, 29
  3. Leelakusolvong, 2012, Prevalence of lower functional gastrointestinal disorders and the associated factors among Thai healthy subjects, J Gastroenterol Hepatol, 27, 149
  4. Pengiran Musa, 2012, Survey of bowel habits and its relation to physical activity and fiber intake in brunei darussalam, J Gastroenterol Hepatol, 27, 142

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Metadata

Authors
Barberio, B., Judge, C., Savarino, E. V., & Ford, A. C.
Affiliations
  • University of Padua (IT)
  • St. James's Hospital (IE)
  • University of Leeds (GB)
Corresponding author
Ford, Alexander C
ORCID
Venue
The Lancet Gastroenterology & Hepatology
Publisher
Elsevier BV
Published
2021-08
Volume
6
Issue
8
Pages
638-648
ISSN
  • 2468-1156 (ISSN-L)
  • 2468-1253
DOI
10.1016/s2468-1253(21)00111-4
OpenAlex
W3166463621
Cited by
422
References
74
Citations by year
2026: 94 · 2025: 131 · 2024: 94 · 2023: 63 · 2022: 33 · 2021: 5
FWCI
9.39
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet. Gastroenterology & hepatology (publishedVersion)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
  • Health Sciences › Medicine › Surgery › Intestinal Malrotation and Obstruction Disorders
Keywords
functional constipation, Rome criteria, prevalence, functional bowel disorders, Rome IV criteria, sex differences, regional variation, symptom-based diagnosis, adults
MeSH terms
Constipation, Defecation, Humans, Global Health, Prevalence

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