HONOLULU — Chronic constipation was found to be associated with gastrointestinal complications among younger patients in a retrospective study presented at ACG 2015.
“Based on the prior literature, chronic constipation has not been well characterized as a risk factor for the development of [colorectal cancer] or other serious organic disorders,” Lauren B. Gerson, MD, FACG, from the California Pacific Medical Center, said during her presentation. “The purpose of this study was to use a very large retrospective database and try to determine whether chronic constipation was in fact associated with a future diagnosis of a serious GI event, which would include any type of GI malignancy, colorectal cancer, ischemic colitis, diverticulitis or inflammatory bowel disease.”
Gerson and colleagues identified and matched patients aged 50 years or younger with and without chronic constipation (each group, n = 12,838) using a large electronic health record database, and estimated hazard ratios for the abovementioned GI events.
They found the chronic constipation cohort had an increased risk for GI events overall (HR = 3.28; 95% CI, 2.19-4.9), as well as ischemic colitis (HR = 7.68; 95% CI, 1.66-35.5), CRC (HR = 6.26; 95% CI, 1.31-30.01), diverticulitis (HR = 5.06; 95% CI, 2.56-10) and GI cancer (including CRC; HR = 5.04; 95% CI, 1.61-15.8). The increased risk for IBD was not significant (HR = 1.59; 95% CI, 0.85-2.95). An estimated one-third of patients reported prior GI bleeding with the exception of those with diverticulitis.
“Chronic constipation disorders may be risk factors for serious outcomes, even in younger patients, and as far as we know this might be novel — there hasn’t been prior literature demonstrating [this] in younger patients,” Gerson concluded. “The magnitude of this risk that we demonstrated was highest for CRC and diverticulitis, and lowest for IBD. There was a threefold increased risk for development of at least one of the pre-specified outcomes, and even in younger patients, clinicians may want to very carefully assess bowel habits, which may [help] diagnose more of these cases.” – by Adam Leitenberger
Gerson LB, et al. Abstract 40. Presented at: ACG 2015; Oct. 19-21, 2015; Honolulu, HI.
Disclosures: Gerson reports she is a consultant for Ironwood Pharmaceuticals and is on the speaker’s bureau for Takeda Pharmaceuticals. Please see the abstract for a full list of all other researchers’ relevant financial disclosures.