Biggest-ever study of constipation in the world

Feb 23 2005

An embarrassing medical problem that costs UK health services £50m each year is to be investigated in the biggest-ever study of the condition in the world.

Until now, constipation has largely been overlooked for major health studies but the new £650,000 project, which is funded by the British Government, led by a research team from the University of Newcastle upon Tyne, and aims to involve nearly 2,000 patients, changes that.

In Britain, nearly half a million GP consultations each year concern patients with constipation, and doctors prescribe more drugs for the condition than they do for patients with diabetes or high blood pressure.

Constipation affects one in five older people and the burden on healthcare resources is expected to increase as the proportion of older people in the population rises.

The study, called LIFELAX, aims to recruit nearly 2,000 men and women with constipation aged 55 and over from 57 GP practices, making it the biggest study ever of the condition to date.

LIFELAX will focus on the North of England, recruiting from practices in Tyne and Wear, Northumberland, County Durham, Teesside and North Yorkshire, but its outcomes will be used by the Government to inform the treatment of constipation by health professionals nationwide.

The usual method of treating constipation is to prescribe laxatives, which are the 12th most prescribed drug in the UK. Currently, one-fifth of the over-65s use laxatives.

Within LIFELAX, the research team, from Newcastle University’s Centre for Health Services Research and the Human Nutrition Research Centre, working with doctors from primary and secondary care, will examine how effectively patients can manage their constipation by making changes to their diet and lifestyle. The team will analyse results to determine the most cost-effective way of managing constipation.

Researchers will train nurses and, in some cases, GPs, to lead special consultation sessions with patients. Whilst there is a general level of agreement amongst healthcare professionals as to the sort of diet and lifestyle patients need to adopt to avoid constipation, there is no clear evidence as to the best way to get the message across.

One approach that LIFELAX will use is to offer personalised lifestyle and diet advice to patients. Another approach will be to provide an information booklet for the patient to take away from the surgery. A range of specially-designed information leaflets has been created with the help of local patients for use in the study.

The progress of each patient will be tracked over one year by the research team which will collect and analyse diet diaries and questionnaires.

Research team member Dr Amelia Lake, a registered dietitian, said: "To date, comparatively little research has been carried out to tackle constipation. This is mainly because the condition is not life-threatening and people with constipation often suffer in silence because they are too embarrassed to talk about it".

"However, we know that not only is the condition costly to health services, it has a major effect on patients’ quality of life. People with constipation are often reluctant to leave the house in case they need the toilet, or they may suffer painful bloating or feel tired and depressed".

"We hope LIFELAX will go a long way towards helping these people feel that they can live a normal life again, as well as allowing us to gather valuable data to inform advice for the future treatment of constipation in the UK and elsewhere."

LIFELAX (Diet and LIFEstyle versus LAXatives in the management of constipation in older people), is funded by the NHS Health Technology Assessment Programme.