人群的排便习惯和对便秘的感知有很大差异。世界范围内成人慢性特发性便秘的患病率约为 14%,[10]Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. Am J Gastroenterol. 2011 Sep;106(9):1582-91.http://www.ncbi.nlm.nih.gov/pubmed/21606976?tool=bestpractice.com 在欧洲,该患病率为 8%-26%。[11]Peppas G, Alexiou VG, Mourtzoukou E, et al. Epidemiology of constipation in Europe and Oceania: a systematic review. BMC Gastroenterol. 2008 Feb 12;8:5.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2258300/http://www.ncbi.nlm.nih.gov/pubmed/18269746?tool=bestpractice.com 在英国,据估计,按照罗马 II 标准所定义便秘的患病率为 8.2%;[12]Probert CS, Emmett PM, Heaton KW. Some determinants of whole-gut transit time: a population-based study. QJM. 1995 May;88(5):311-5.http://www.ncbi.nlm.nih.gov/pubmed/7796084?tool=bestpractice.com 然而,在英国的另一项调查中,39% 的男性和 52% 的女性指出在 4 次排便中会出现 1 次以上排便费力。[13]Heaton KW. TL Cleave and the fibre story. J R Nav Med Serv. 1980 Spring;66(1):5-10.http://www.ncbi.nlm.nih.gov/pubmed/6252318?tool=bestpractice.com 在美国,慢性便秘的患病率为2%-28%。[10]Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. Am J Gastroenterol. 2011 Sep;106(9):1582-91.http://www.ncbi.nlm.nih.gov/pubmed/21606976?tool=bestpractice.com[14]Pare P, Ferrazzi S, Thompson D, et al. An epidemiological survey of constipation in Canada: definitions, rates, demographics, and predictors of health care seeking. Am J Gastroenterol. 2001 Nov;96(11):3130-7.http://www.ncbi.nlm.nih.gov/pubmed/11721760?tool=bestpractice.com[15]Stewart WF, Liberman G, Sandler RS, et al. A large U.S. national epidemiological study of constipation gastroenterology. Gastroenterology. 1998;114(suppl 1):A44.[16]Pare P, Ferrazzi S, Thompson WG. A longitudinal survey of self-reported bowel habits in the United States. Dig Dis Sci. 1989;34:1153-62.[17]Talley NJ, Fleming KC, Evans JM, et al. Constipation in an elderly community: a study of prevalence and potential risk factors. Am J Gastroenterol. 1996 Jan;91(1):19-25.http://www.ncbi.nlm.nih.gov/pubmed/8561137?tool=bestpractice.com[18]Sonnenberg A, Koch TR. Physician visits in the United States for constipation: 1958 to 1986. Dig Dis Sci. 1989 Apr;34(4):606-11.http://www.ncbi.nlm.nih.gov/pubmed/2784759?tool=bestpractice.com
尚不清楚慢性便秘的自然病程,但在一项研究中,在病程第 12 个月到第 20 个月期间选取两个时间点,89% 的患者在这两个时间点有相似的症状。[19]Talley NJ, O'Keefe EA, Zinsmeister AR, et al. Prevalence of gastrointestinal symptoms in the elderly: a population-based study. Gastroenterology. 1992 Mar;102(3):895-901.http://www.ncbi.nlm.nih.gov/pubmed/1537525?tool=bestpractice.com 而在另一项研究中,45% 的受访者报告这种疾病持续时间不少于 5 年。[15]Stewart WF, Liberman G, Sandler RS, et al. A large U.S. national epidemiological study of constipation gastroenterology. Gastroenterology. 1998;114(suppl 1):A44.
女性便秘患病率至少是男性的两倍,估计比值为2.2:1。[2]Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol. 2004;99:750-759.http://www.ncbi.nlm.nih.gov/pubmed/15089911?tool=bestpractice.com[10]Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. Am J Gastroenterol. 2011 Sep;106(9):1582-91.http://www.ncbi.nlm.nih.gov/pubmed/21606976?tool=bestpractice.com[20]Drossman DA, Li Z, Andruzzi E, et al. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci. 1993 Sep;38(9):1569-80.http://www.ncbi.nlm.nih.gov/pubmed/8359066?tool=bestpractice.com[21]Harari D, Gurwitz JH, Avorn J, et al. Bowel habit in relation to age and gender. Findings from the National Health Interview Survey and clinical implications. Arch Intern Med. 1996 Feb 12;156(3):315-20.http://www.ncbi.nlm.nih.gov/pubmed/8572842?tool=bestpractice.com[22]Pekmezaris R, Aversa L, Wolf-Klein G, et al. The cost of chronic constipation. J Am Med Dir Assoc. 2002 Jul-Aug;3(4):224-8.http://www.ncbi.nlm.nih.gov/pubmed/12807642?tool=bestpractice.com 便秘的发病率随着年龄增长而增加,在 65 岁以后尤其如此。[2]Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol. 2004;99:750-759.http://www.ncbi.nlm.nih.gov/pubmed/15089911?tool=bestpractice.com[21]Harari D, Gurwitz JH, Avorn J, et al. Bowel habit in relation to age and gender. Findings from the National Health Interview Survey and clinical implications. Arch Intern Med. 1996 Feb 12;156(3):315-20.http://www.ncbi.nlm.nih.gov/pubmed/8572842?tool=bestpractice.com[22]Pekmezaris R, Aversa L, Wolf-Klein G, et al. The cost of chronic constipation. J Am Med Dir Assoc. 2002 Jul-Aug;3(4):224-8.http://www.ncbi.nlm.nih.gov/pubmed/12807642?tool=bestpractice.com 黑种人的患病率为其他人群的 2 倍,[2]Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol. 2004;99:750-759.http://www.ncbi.nlm.nih.gov/pubmed/15089911?tool=bestpractice.com[17]Talley NJ, Fleming KC, Evans JM, et al. Constipation in an elderly community: a study of prevalence and potential risk factors. Am J Gastroenterol. 1996 Jan;91(1):19-25.http://www.ncbi.nlm.nih.gov/pubmed/8561137?tool=bestpractice.com 社会经济地位较低的群体[2]Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol. 2004;99:750-759.http://www.ncbi.nlm.nih.gov/pubmed/15089911?tool=bestpractice.com[10]Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. Am J Gastroenterol. 2011 Sep;106(9):1582-91.http://www.ncbi.nlm.nih.gov/pubmed/21606976?tool=bestpractice.com[14]Pare P, Ferrazzi S, Thompson D, et al. An epidemiological survey of constipation in Canada: definitions, rates, demographics, and predictors of health care seeking. Am J Gastroenterol. 2001 Nov;96(11):3130-7.http://www.ncbi.nlm.nih.gov/pubmed/11721760?tool=bestpractice.com[17]Talley NJ, Fleming KC, Evans JM, et al. Constipation in an elderly community: a study of prevalence and potential risk factors. Am J Gastroenterol. 1996 Jan;91(1):19-25.http://www.ncbi.nlm.nih.gov/pubmed/8561137?tool=bestpractice.com 和在养老院的人群的患病率为(其他人群)的2倍。[2]Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol. 2004;99:750-759.http://www.ncbi.nlm.nih.gov/pubmed/15089911?tool=bestpractice.com[3]Rao SS, Tuteja AK, Vellema T, et al. Dyssynergic defecation: demographics, symptoms, stool patterns, and quality of life. J Clin Gastroenterol. 2004;38:680-685.http://www.ncbi.nlm.nih.gov/pubmed/15319652?tool=bestpractice.com[23]Chang L, Toner BB, Fukudo S, et al. Gender, age, society, culture, and the patient's perspective in the functional gastrointestinal disorders. Gastroenterology. 2006 Apr;130(5):1435-46.http://www.ncbi.nlm.nih.gov/pubmed/16678557?tool=bestpractice.com 妊娠也与便秘患病率升高有关。[24]Derbyshire E, Davies J, Costarelli V, et al. Diet, physical inactivity and the prevalence of constipation throughout and after pregnancy. Matern Child Nutr. 2006 Jul;2(3):127-34.http://www.ncbi.nlm.nih.gov/pubmed/16881925?tool=bestpractice.com 慢性便秘常与其他功能性胃肠动力障碍疾病相关,包括胸痛、[25]Mudipalli RS, Remes-Troche J, Andersen L, et al. Functional chest pain: esophageal or overlapping functional disorder. J Clin Gastroenterol. 2007 Mar;41(3):264-9.http://www.ncbi.nlm.nih.gov/pubmed/17426464?tool=bestpractice.com 胃食管反流病 (gastro-oesophageal reflux disease,GORD)、[26]Talley NJ, Waever AL, Zinsmeister AR, et al. Onset and disappearance of gastrointestinal symptoms and functional gastrointestinal disorders. Am J Epidemiol. 1992 Jul 15;136(2):165-77.http://www.ncbi.nlm.nih.gov/pubmed/1415139?tool=bestpractice.com[27]Locke GR 3rd, Zinsmeister AR, Fett SL, et al. Overlap of gastrointestinal symptom complexes in a US community. Neurogastroenterol Motil. 2005 Feb;17(1):29-34.http://www.ncbi.nlm.nih.gov/pubmed/15670261?tool=bestpractice.com 肠易激综合征(IBS)和功能性消化不良。[26]Talley NJ, Waever AL, Zinsmeister AR, et al. Onset and disappearance of gastrointestinal symptoms and functional gastrointestinal disorders. Am J Epidemiol. 1992 Jul 15;136(2):165-77.http://www.ncbi.nlm.nih.gov/pubmed/1415139?tool=bestpractice.com[27]Locke GR 3rd, Zinsmeister AR, Fett SL, et al. Overlap of gastrointestinal symptom complexes in a US community. Neurogastroenterol Motil. 2005 Feb;17(1):29-34.http://www.ncbi.nlm.nih.gov/pubmed/15670261?tool=bestpractice.com[28]Talley NJ, Dennis EH, Schettler-Duncan VA, et al. Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome patients with constipation or diarrhea. Am J Gastroenterol. 2003 Nov;98(11):2454-9.http://www.ncbi.nlm.nih.gov/pubmed/14638348?tool=bestpractice.com 慢性便秘对医疗资源造成了巨大的负担。[29]Dennison C, Prasad M, Lloyd A, et al. The health-related quality of life and economic burden of constipation. Pharmacoeconomics. 2005;23(5):461-76.http://www.ncbi.nlm.nih.gov/pubmed/15896098?tool=bestpractice.com 2002年美国有8.21亿美元用于支付缓泻药。[30]Rao SS. Constipation: evaluation and treatment. Gastroenterol Clin North Am. 2003 Jun;32(2):659-83.http://www.ncbi.nlm.nih.gov/pubmed/12858610?tool=bestpractice.com 每年约有570万人因便秘至内科门诊就诊。[31]Martin BC, Barghout V, Cerulli A. Direct medical costs of constipation in the United States. Manag Care Interface. 2006 Dec;19(12):43-9.http://www.ncbi.nlm.nih.gov/pubmed/17274481?tool=bestpractice.com