[Guidelines for diagnosis and treatment of constipation in Mexico. A) Epidemiology (meta-analysis of the prevalence), pathophysiology and classification]

Abstract

Background: Constipation is a common problem in the general population and its prevalence is based on the diagnostic criteria, the study population and the research methodology for collecting the data.

Objectives and methods: To establish the clinical gudelines for diagnosis and treatment of chronic constipation in Mexico we have reviewed the epidemiological factors of constipation and have conducted meta-analysis according to the 3 available community-based studies from our country. In addition, evidence-based recommendations have been provided.

Results: The estimated prevalence of functional constipation in Mexico is 14.4% (95% CI: 12.6-16.6%) according to Rome II and Rome III criteria. Although constipation is present in both genders and all age groups, it is more common among young women with a female to male ratio of 3:1. In our population, 43.6% report using laxatives, teas for stimulating bowel movements or fiber supplements, but only 18.0% did so because they considered themselves as constipated. Also, data from a tertiary referral center in Mexico City suggests that patients with prolonged colonic transit time have lower scores in the physical component of the SF-36 compared to those with chronic constipation and a normal colonic transit time.

Conclusions: Functional constipation is a very common problem in Mexico affecting mainly young women. Laxatives and other related agents are frequently used and this disorder seems to have a negative impact on quality of life.