An extended assessment of bowel habits in a general population

AIM: Bowel habits are difficult to study, and most data on defecatory behaviour in the general population have been obtained on the basis of recalled interview. The objective assessment of this physiological function and its pathological aspects continues to pose a difficult challenge. The aim of this prospective study was to objectively assess the bowel habits and related aspects in a large sample drawn from the general population. METHODS: Over a two-month period 488 subjects were prospectively recruited from the general population and asked to compile a daily diary on their bowel habits and associated signs and symptoms (the latter according to Rome II criteria). A total of 298 (61%) participants returned a correctly compiled record, so that data for more than 8 000 patient-days were available for statistical analysis. RESULTS: The average defecatory frequency was once per day (range of 0.25-3.25) and was similar between males and females. However, higher frequencies of straining at stool (P=0.001), a feeling of incomplete emptying and/or difficult evacuation (P=0.0001), and manual manoeuvres to facilitate defecation (P=0.046) were reported by females as compared to males. CONCLUSION: This study represents one of the first attempts to objectively and prospectively assess bowel habits in a sample of the general population over a relatively long period of time. The variables we analyzed are coherent with the criteria commonly used for the clinical assessment of functional constipation, and can provide a useful adjunt for a better evaluation of constipated patients.