Abstract: Gender Differences in Patients Evaluated for Constipation: Constipation Characteristics, Symptoms, and Bowel and Dietary Habits (WOCN Society 41st Annual Conference (June 6- June 10, 2009))
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3421 Gender Differences in Patients Evaluated for Constipation: Constipation Characteristics, Symptoms, and Bowel and Dietary Habits

Lindsay McCrea, PhD, RN, FNP-BC, CWOCN , California State University, East Bay, Associate Professor, Hayward, CA
Christine Miaskowski, PhD, RN, FAAN , University of California, San Francisco, Professor
Nancy A. Stotts, RN, EdD, FAAN , University of California, San Francisco, Professor, San Francisco, CA
Liz Macera, PhD, RN , University of California, San Francisco, Assistant Professor, CA
Steven M. Paul, PhD , University of California, San Francisco, Principal Statistician & Lecturer
Madhulika G. Varma, MD , University of California, San Francisco, Assistant Professor, San Francisco, CA
While gender differences in the prevalence of constipation are documented, only limited and contradictory information is available on gender differences in the specific characteristics of constipation, its symptoms, and associated bowel habits. 

The purposes of this study were: to evaluate for gender differences in the frequency of various characteristics of constipation, as well as in the frequency of constipation specific symptoms and bowel and dietary habits, and to assess the effects of independent but associated risk factors.

Cross sectional study of 518 patients evaluated for constipation at a tertiary referral center.  Patients completed self-report questionnaires.  Medical conditions that were reported more frequently in women were included in separate multiple logistic regression analyses of gender differences in symptoms and bowel habits. The majority of the patients were female (78.9%), with a mean age of 52.4 years (SD=16.5).  After controlling for conditions that might be associated with constipation, women were still more likely to have infrequent bowel movements (OR 2.97, 95% CI 1.67, 5.28), hard or pellet-like stools (OR 3.08, 95% CI 1.80, 5.28), and a longer duration of constipation symptoms compared with men (OR 2.00, 95% CI 1.05, 3.82). Women were also more likely to report increased frequency of abdominal pain (OR 2.22, 95% CI 1.22, 4.05), bloating (OR 2.65, 95% CI 1.49, 4.70), unsuccessful attempts (OR 1.74, 95% CI 1.01, 3.00) and anal digitations to evacuate stool (OR 3.37, 95% CI 1.15, 9.90). Frequency of incomplete evacuation and need to change positions to evacuate stool were similar in both men and women.

Findings suggest that women are at increased risk for constipation.  Women experience a number of symptoms and abnormal bowel habits more frequently than men.  These findings warrant replication in both population- and specialty clinic-based samples.  In addition, the mechanisms that underlie these gender differences warrant investigation.

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