Even as the same definitions are applied and similar methodologies used, the prevalence of functional constipation varies widely among countries, from less than 1% to more than 30%, according to a study published in The Lancet Gastroenterology and Hepatology.

While constipation is a common bowel disorder, cross-sectional surveys have revealed variability in its prevalence. To estimate the global prevalence of functional constipation, researchers performed a systematic review and meta-analysis of studies by searching MEDLINE, Embase, and Embase Classic databases from January 1, 1990 to December 31, 2020. They identified studies that used comparable methodologies and all iterations of the Rome criteria. Of the 8174 citations evaluated, 45 studies were deemed eligible, representing a total of 80 separate populations and consisting of 275,260 participants.

The researchers found that the pooled prevalence of functional constipation in studies using the Rome I, II, III, and IV criteria were 15.3%, 11.2%, 10.4%, and 10.1%, respectively. The researchers also discovered that the prevalence of functional constipation was higher in women, regardless of which Rome criteria was used (Rome I: odds ratio [OR], 2.40; 95% CI, 2.02-2.86; Rome II: OR, 1.94; 95% CI, 1.46-2.57; Rome III: OR, 2.32; 95% CI, 1.85-2.92). However, no studies using Rome IV criteria reported prevalence by sex.

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Researchers determined there was significant heterogeneity among studies in all of the analyses, which persisted even when the same criteria were applied and similar methodologies were used.

This study was not without limitations. Researchers noted there were a lack of data reporting on the prevalence of constipation from areas such as Africa, Central America, and South America. Additionally, the methods used for data collection varied, potentially leading to differing estimates of prevalence. 

“Our data suggest that functional constipation affects between one in six and one in ten people globally, at any point in time, depending on the definition used,” concluded the authors. They added, “These data provide up-to-date estimates of the burden of this condition and can be used to inform future health-care planning, as well as to underline the importance of the treatment of functional constipation as a research priority.”


Barberio B, Judge C, Savarino EV, Ford AC. Global prevalence of functional constipation according to the Rome criteria: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. Published online June 3, 2021. doi: 10.1016/S2468-1253(21)00111-4

This article originally appeared on Gastroenterology Advisor