Obesity linked with chronic diarrhea
Patients with obesity are at greater risk for chronic diarrhea, and the association grew stronger as BMI increased, according to the results of a nationally representative survey.
Sarah Ballou, PhD, of the division of gastroenterology at Beth Israel Deaconess Medical Center, and colleagues wrote that the obesity epidemic has brought on a rise of gastrointestinal conditions, but few studies have explored the connection between obesity and abnormal bowel habits.
“Although these studies have postulated high carbohydrate and fat intake as the underlying etiology for chronic diarrhea in obese individuals, these studies did not present data on dietary carbohydrate or fat intake,” they wrote. “Thus, it is unclear whether the association between obesity and diarrhea is driven primarily by dietary factors.”
Researchers extracted data from the 2009-2010 National Health and Nutrition Examination Survey and included individuals in their analysis if they completed a bowel health questionnaire, were aged at least 20 years and did not have history of inflammatory bowel disease, celiac disease or colon cancer. They compared risk for constipation and diarrhea among five BMI categories; underweight, normal, overweight, obese and severely obese.
Of 5,126 individuals who met the criteria, 70 were in the underweight category (1.4%), 1,350 had normal weight (26.34%), 1,731 had overweight (33.77%), 1.097 had obesity (21.4%) and 878 had severe obesity (17.13%).
Ballou and colleagues found that 8.5% individuals with obesity and 11.5% of individuals with severe obesity had chronic diarrhea compared with 4.5% of individuals with normal weight.
In their analysis, researchers found that patients with obesity were nearly twice as likely (RR = 1.94; 95% CI, 1.29–2.93) and patients with severe obesity were nearly three times as likely (RR = 2.7; 95% CI, 1.99–3.66) to have chronic diarrhea compared with individuals with normal weight. After adjusting for demographics/lifestyle, laxative use, diet and comorbid diabetes, investigators determined that individuals with severe obesity were still nearly twice as likely to have chronic diarrhea (adjusted RR = 1.93; 95% CI, 1.35–2.76).
“The risk of diarrhea increases with severity of obesity,” Ballou and colleagues wrote. “Future studies should explore the underlying physiologic mechanisms of the association between obesity and chronic diarrhea.” – by Alex Young
Disclosures: Ballou reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.