Variation of Bowel Habit in Two Population Samples

Abstract

Inquiries about bowel habit were made of 1,055 persons not seeking medical advice in an industrial community and of 400 patients, without known gastro-intestinal disease, attending a general medical practitioner’s surgery. Of the whole population 99% (99.3% in the industrial community and 98.25% in the general practice) fell within the frequency limits of three or more bowel actions weekly up to three actions daily. From these results it is suggested that fewer than three bowel actions weekly and more than three bowel actions daily may be regarded as unusual. Only two subjects in the combined series of 1,455 persons had one bowel action a week. Four subjects had more than three bowel actions daily, and in each case there is reason to believe that this frequency was abnormal. All 11 subjects in the combined series who had fewer than three bowel actions weekly were women. In both series more women than men had fewer than five bowel actions weekly. No simple correlation between bowel habit and age was observed. There was no correlation between bowel habit and nationality. Four per cent. of the industrial population and 16% of those seen in general practice regarded themselves as “constipated.” The use of this term sometimes correlated with infrequent bowel actions, and sometimes with hardness of the stool, but often it bore no relation to bowel frequency or stool consistency. A correlation was observed between increasing bowel frequency and the subjects’ opinion of the stool as “ loose.” Of the total population 19.7% (16% in the industrial community, 29 % in general practice) took laxatives. The difference between the two series with regard to laxative-taking can be ascribed to different age distributions within the samples. The proportion of subjects who took laxatives increased with age in both series. No subject under 20 took laxatives more than once weekly, and only three of the 266 subjects in this age group took any laxatives. Only 20% of those who took laxatives in the combined series considered themselves “constipated”. © 1965, British Medical Journal Publishing Group. All rights reserved.