{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T21:53:16Z","timestamp":1769550796715,"version":"3.49.0"},"reference-count":59,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,23]],"date-time":"2023-07-23T00:00:00Z","timestamp":1690070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Education, Research and Innovation, Oman","award":["BFP\/GRG\/HSS\/22\/046"],"award-info":[{"award-number":["BFP\/GRG\/HSS\/22\/046"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objective: Constipation is a prevalent gastrointestinal condition that has a substantial impact on individuals and healthcare systems. This condition adversely affects health-related quality of life and leads to escalated healthcare expenses due to an increase in office visits, referrals to specialists, and hospital admission. This study aimed to evaluate the prevalence, recognition, risk factors, and course of constipation among hospitalized patients in medical wards. Materials and Methods: A prospective study was conducted, including all adult patients admitted to the General Medicine Unit between 1 February 2022 and 31 August 2022. Constipation was identified using the Constipation Assessment Scale (CAS), and relevant factors were extracted from the patients\u2019 medical records. Results: Among the patients who met the inclusion criteria (n = 556), the prevalence of constipation was determined to be 55.6% (95% CI 52.8\u201358.4). Patients with constipation were found to be older (p &lt; 0.01) and had higher frailty scores (p &lt; 0.01). Logistic regression analysis revealed that heart failure (Odds ratio (OR) 2.1; 95% CI 1.2\u20133.7; p = 0.01), frailty score (OR 1.4; 95% CI 1.2\u20131.5; p &lt; 0.01), and dihydropyridines calcium channel blockers (OR 1.8; 95% CI 1.2\u20132.8; p &lt; 0.01) were independent risk factors for constipation. Furthermore, the medical team did not identify constipation in 217 patients (64.01%). Conclusions: Constipation is highly prevalent among medically hospitalized patients. To ensure timely recognition and treatment, it is essential to incorporate a daily constipation assessment scale into each patient\u2019s medical records.<\/jats:p>","DOI":"10.3390\/medicina59071347","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:57:30Z","timestamp":1690160250000},"page":"1347","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prevalence, Recognition, and Risk Factors of Constipation among Medically Hospitalized Patients: A Cohort Prospective Study"],"prefix":"10.3390","volume":"59","author":[{"given":"Jawahar","family":"Al Nou\u2019mani","sequence":"first","affiliation":[{"name":"Internal Medicine Residency Training Program, Oman Medical Specialty Board, Muscat 130, Oman"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2077-7186","authenticated-orcid":false,"given":"Abdullah M.","family":"Al Alawi","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency Training Program, Oman Medical Specialty Board, Muscat 130, Oman"},{"name":"Department of Medicine, Sultan Qaboos University Hospital, Muscat 123, Oman"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juhaina Salim","family":"Al-Maqbali","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Sultan Qaboos University Hospital, Muscat 123, Oman"},{"name":"Department of Pharmacology and Clinical Pharmacy, Sultan Qaboos University, Muscat 123, Oman"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nahid","family":"Al Abri","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Science, Sultan Qaboos University, Muscat 123, Oman"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Al Sabbri","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Science, Sultan Qaboos University, Muscat 123, Oman"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e14050","DOI":"10.1111\/nmo.14050","article-title":"Chronic constipation in adults: Contemporary perspectives and clinical challenges. 1: Epidemiology, diagnosis, clinical associations, pathophysiology and investigation","volume":"33","author":"Scott","year":"2021","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_2","first-page":"937","article-title":"Defecation and the pathophysiology of constipation","volume":"15","author":"Read","year":"1986","journal-title":"Clin. Gastroenterol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/0016-5085(89)91500-X","article-title":"Psychological and physiological characteristics of patients with severe idiopathic constipation","volume":"97","author":"Wald","year":"1989","journal-title":"Gastroenterology"},{"key":"ref_4","first-page":"587","article-title":"Colonic and anorectal dysfunction associated with multiple sclerosis","volume":"84","author":"Hinds","year":"1989","journal-title":"Am. J. Gastroenterol. (Springer Nat.)"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1002\/ca.23561","article-title":"Anatomy, physiology, and updates on the clinical management of constipation","volume":"33","author":"Dupont","year":"2020","journal-title":"Clin. Anat."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Werth, B.L., Williams, K.A., Fisher, M.J., and Pont, L.G. (2019). Defining constipation to estimate its prevalence in the community: Results from a national survey. BMC Gastroenterol., 19.","DOI":"10.1186\/s12876-019-0994-0"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.3109\/00365529709002985","article-title":"Quality of life in patients with different types of functional constipation","volume":"32","author":"Gliav","year":"1997","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1038\/ajg.2013.137","article-title":"Impact of persistent constipation on health-related quality of life and mortality in older community-dwelling women","volume":"108","author":"Koloski","year":"2013","journal-title":"Off. J. Am. Coll. Gastroenterol. ACG"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1038\/ajg.2011.164","article-title":"Prevalence of, and risk factors for, chronic idiopathic constipation in the community: Systematic review and meta-analysis","volume":"106","author":"Suares","year":"2011","journal-title":"Am. J. Gastroenterol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Peppas, G., Alexiou, V.G., Mourtzoukou, E., and Falagas, M.E. (2008). Epidemiology of constipation in Europe and Oceania: A systematic review. BMC Gastroenterol., 8.","DOI":"10.1186\/1471-230X-8-5"},{"key":"ref_11","first-page":"S3","article-title":"Definitions, epidemiology, and impact of chronic constipation","volume":"4","author":"Talley","year":"2004","journal-title":"Rev. Gastroenterol. Disord."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1111\/j.1365-2036.2007.03540.x","article-title":"Cumulative incidence of chronic constipation: A population-based study 1988\u20132003","volume":"26","author":"Choung","year":"2007","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2295","DOI":"10.1111\/jocn.12511","article-title":"Constipation\u2013prevalence and incidence among medical patients acutely admitted to hospital with a medical condition","volume":"23","author":"Noiesen","year":"2014","journal-title":"J. Clin. Nurs."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Konradsen, H., Lundberg, V., Florin, J., and Bostr\u00f6m, A.M. (2022). Prevalence of constipation and use of laxatives, and association with risk factors among older patients during hospitalization: A cross sectional study. BMC Gastroenterol., 22.","DOI":"10.1186\/s12876-022-02195-z"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1097\/WON.0000000000000720","article-title":"Constipation in Hospitalized Patients: A Study of Prevalence and Associated Factors","volume":"48","author":"Junqueira","year":"2021","journal-title":"J. Wound Ostomy Cont. Nurs."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1097\/MEG.0000000000000543","article-title":"Constipation incidence and impact in medical critical care patients: Importance of the definition criterion","volume":"28","author":"Prat","year":"2016","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e423","DOI":"10.5001\/omj.2022.91","article-title":"Incidence and Risk Factors for 28 Days Hospital Readmission: A Retrospective Study from Oman","volume":"37","author":"Yusuf","year":"2022","journal-title":"Oman Med. J."},{"key":"ref_18","first-page":"174","article-title":"Inappropriate Hospital Stay of Patients Admitted Under Care of General Medicine Units: A retrospective study","volume":"1","year":"2022","journal-title":"Sultan Qaboos Univ. Med. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"269","DOI":"10.5144\/0256-4947.2022.269","article-title":"Health outcomes after acute ischemic stroke:retrospective and survival analysis from Oman","volume":"42","author":"Muhanna","year":"2022","journal-title":"Ann. Saudi. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1097\/00002820-198906000-00012","article-title":"Validity and reliability of the Constipation Assessment Scale","volume":"12","author":"McMillan","year":"1989","journal-title":"Cancer Nurs."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1177\/104990910201900616","article-title":"Presence and severity of constipation in hospice patients with advanced cancer","volume":"19","author":"McMillan","year":"2002","journal-title":"Am. J. Hosp. Palliat. Med. \u00ae"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jpainsymman.2019.08.027","article-title":"A Longitudinal Study of Predictors of Constipation Severity in Oncology Outpatients With Unrelieved Pain","volume":"59","author":"Valenta","year":"2020","journal-title":"J. Pain. Symptom. Manag."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/SGA.0000000000000034","article-title":"The measures to evaluate constipation: A review article","volume":"37","author":"Izumi","year":"2014","journal-title":"Gastroenterol. Nurs."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1093\/ageing\/afaa089","article-title":"The role of illness acuity on the association between frailty and mortality in emergency department patients referred to internal medicine","volume":"49","author":"Pulok","year":"2020","journal-title":"Age Ageing"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.bpg.2010.12.010","article-title":"Epidemiology of constipation in children and adults: A systematic review","volume":"25","author":"Mugie","year":"2011","journal-title":"Best Pract. Res. Clin. Gastroenterol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Lim, J., Park, H., Lee, H., Lee, E., Lee, D., Jung, H.W., and Jang, I.Y. (2021). Higher frailty burden in older adults with chronic constipation. BMC Gastroenterol., 21.","DOI":"10.1186\/s12876-021-01684-x"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"515","DOI":"10.2165\/00002512-200219070-00005","article-title":"Aging and intestinal motility: A review of factors that affect intestinal motility in the aged","volume":"19","author":"Quigley","year":"2002","journal-title":"Drugs Aging"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.gtc.2009.06.001","article-title":"Chronic constipation in the elderly","volume":"38","author":"Bouras","year":"2009","journal-title":"Gastroenterol. Clin."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Iovino, P., Chiarioni, G., Bilancio, G., Cirillo, M., Mekjavic, I.B., Pisot, R., and Ciacci, C. (2013). New onset of constipation during long-term physical inactivity: A proof-of-concept study on the immobility-induced bowel changes. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0072608"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11894-018-0609-x","article-title":"Constipation in Parkinson\u2019s disease: A nuisance or nuanced answer to the pathophysiological puzzle?","volume":"20","author":"Sharma","year":"2018","journal-title":"Curr. Gastroenterol. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1159\/000517212","article-title":"Functional constipation in older adults: Prevalence, clinical symptoms and subtypes, association with frailty, and impact on quality of life","volume":"68","author":"Arco","year":"2022","journal-title":"Gerontology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1002\/(SICI)1099-0496(199809)26:3<222::AID-PPUL10>3.0.CO;2-2","article-title":"Hypoxia and chest pain due to acute constipation: An underdiagnosed condition?","volume":"26","author":"Luder","year":"1998","journal-title":"Pediatr. Pulmonol."},{"key":"ref_33","first-page":"e14540","article-title":"The influence of constipation on asthma: A real-world, population-based cohort study","volume":"75","author":"Huang","year":"2021","journal-title":"Int. J. Clin. Pr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/S0197-0070(86)80018-3","article-title":"Constipation presenting as respiratory distress","volume":"7","author":"Milanese","year":"1986","journal-title":"J. Adolesc. Health Care"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/S0254-6272(14)60029-7","article-title":"Correlation between lower gastrointestinal tract symptoms and quality of life in patients with stable chronic obstructive pulmonary disease","volume":"33","author":"Sun","year":"2013","journal-title":"J. Tradit. Chin. Med."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"(2009). Aspiration pneumonia. Respirology, 14, S59\u2013S64.","DOI":"10.1111\/j.1440-1843.2009.01578.x"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1002\/ueg2.12169","article-title":"Gastrointestinal transit and contractility in diabetic constipation: A wireless motility capsule study on diabetes patients and healthy controls","volume":"9","author":"Sangnes","year":"2021","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.2169\/internalmedicine.7676-21","article-title":"Constipation Is a Frequent Problem Associated with Vascular Complications in Patients with Type 2 Diabetes: A Cross-sectional Study","volume":"61","author":"Ito","year":"2022","journal-title":"Intern. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1007\/s10157-021-02105-9","article-title":"Constipation and diabetic kidney disease: The Fukuoka Diabetes Registry","volume":"25","author":"Ohkuma","year":"2021","journal-title":"Clin. Exp. Nephrol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1016\/j.jacc.2007.07.016","article-title":"Altered Intestinal Function in Patients With Chronic Heart Failure","volume":"50","author":"Sandek","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1111\/jch.13489","article-title":"Constipation-induced pressor effects as triggers for cardiovascular events","volume":"21","author":"Ishiyama","year":"2019","journal-title":"J. Clin. Hypertens."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1111\/jgh.13011","article-title":"Constipation prophylaxis reduces length of stay in elderly hospitalized heart failure patients with home laxative use","volume":"30","author":"Staller","year":"2015","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"14686","DOI":"10.3748\/wjg.v20.i40.14686","article-title":"Gastrointestinal dysfunction in liver cirrhosis","volume":"20","author":"Kalaitzakis","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1097\/00005344-198900134-00003","article-title":"Calcium antagonists in the treatment of essential hypertension: Review of international studies","volume":"13","author":"Clement","year":"1989","journal-title":"J. Cardiovasc. Pharm."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1136\/bmj.299.6704.881","article-title":"Verapamil versus hydrochlorothiazide in the treatment of hypertension: Results of long term double blind comparative trial. Verapamil versus Diuretic (VERDI) Trial Research Group","volume":"299","author":"Holzgreve","year":"1989","journal-title":"BMJ"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2539","DOI":"10.2165\/00003495-200262170-00014","article-title":"Fixed combination trandolapril\/verapamil sustained-release: A review of its use in essential hypertension","volume":"62","author":"Muijsers","year":"2002","journal-title":"Drugs"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e10631","DOI":"10.1097\/MD.0000000000010631","article-title":"Chronic constipation: A review of literature","volume":"97","author":"Forootan","year":"2018","journal-title":"Medicine"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"145","DOI":"10.7888\/juoeh.41.145","article-title":"Relationship Between Constipation and Medication","volume":"41","author":"Ueki","year":"2019","journal-title":"J. Uoeh"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"35","DOI":"10.4065\/83.1.35","article-title":"Improved attainment of blood pressure and cholesterol goals using single-pill amlodipine\/atorvastatin in African Americans: The CAPABLE trial","volume":"83","author":"Flack","year":"2008","journal-title":"Mayo Clin. Proc."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"91","DOI":"10.2165\/00002018-199615020-00002","article-title":"A comparative review of the adverse effects of calcium antagonists","volume":"15","author":"Dougall","year":"1996","journal-title":"Drug Saf."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"757141","DOI":"10.5402\/2011\/757141","article-title":"The effect of amlodipine alone and in combination with atenolol on bowel habit in patients with hypertension: An observation","volume":"2011","author":"Saha","year":"2011","journal-title":"ISRN Gastroenterol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1111\/ijpp.12636","article-title":"Prevalence of drugs with constipation-inducing potential and laxatives in community-dwelling older adults in Bahrain: Therapeutic implications","volume":"28","author":"James","year":"2020","journal-title":"Int. J. Pharm. Pract."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.12968\/bjon.2016.25.10.S4","article-title":"Management of opioid-induced constipation","volume":"25","author":"Prichard","year":"2016","journal-title":"Br. J. Nurs."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"312","DOI":"10.12968\/bjon.2017.26.6.312","article-title":"Assessment and treatment options for patients with constipation","volume":"26","author":"Bardsley","year":"2017","journal-title":"Br. J. Nurs."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/164_2016_111","article-title":"Constipation: Pathophysiology and Current Therapeutic Approaches","volume":"239","author":"Sharma","year":"2017","journal-title":"Handb. Exp. Pharm."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1002\/2327-6924.12079","article-title":"Malabsorption anemia and iron supplement induced constipation in post-Roux-en-Y gastric bypass (RYGB) patients","volume":"25","author":"Sahebzamani","year":"2013","journal-title":"J. Am. Assoc. Nurse Pract."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1007\/s00259-002-0854-x","article-title":"Gastric emptying in patients with vitamin B(12) deficiency","volume":"29","author":"Acar","year":"2002","journal-title":"Eur. J. Nucl. Med. Mol. Imag."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/S0889-8529(18)30171-3","article-title":"Hypocalcemic emergencies","volume":"22","author":"Tohme","year":"1993","journal-title":"Endocrinol. Metab. Clin. North Am."},{"key":"ref_59","unstructured":"Margulies, A., Metman, E., Girard, J., Dorval, E., and Bertrand, J. (1986, January 22). Severe constipation indicative of pseudohypoparathyroidism and resolved after normalization of the blood calcium. Proceedings of the Annales de Gastroenterologie et D\u2019hepatologie, Paris, France."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/7\/1347\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:17:31Z","timestamp":1760127451000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/7\/1347"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,23]]},"references-count":59,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["medicina59071347"],"URL":"https:\/\/doi.org\/10.3390\/medicina59071347","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,23]]}}}