March 15, 2018
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Diet, obesity, depression linked to chronic diarrhea

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Prashant Singh
Prashant Singh

High carbohydrate consumption, obesity and depression are among the key risk factors associated with chronic diarrhea in a recent study of a nationally representative cohort published in the American Journal of Gastroenterology. Women and non-white individuals were also found to be at higher risk for the condition.

Prashant Singh, MBBS, of the division of gastroenterology at Beth Israel Deaconess Medical Center and Harvard Medical School, and colleagues, wrote that the study — which also determined the overall prevalence of the condition in the U.S. — was the first such analysis of its kind.

“Chronic diarrhea is highly prevalent in the general population and is associated with reduced health-related quality of life, high health care utilization and increased economic burden,” Singh told Healio Gastroenterology and Liver Disease. “To date, no study has used a national representative sample of adults to estimate the prevalence of chronic diarrhea in the United States. Furthermore, no population-based study in the U.S. has evaluated risk factors for chronic diarrhea.”

The study cohort included 5,246 adults and who completed the bowel health questionnaire in the National Health and Nutrition Examination Survey 2009-2010 data set. Investigators calculated chronic diarrhea using the Bristol stool form scale (BSFS), defined as a type 6 or 7. The weighted prevalence of chronic diarrhea in the study population was 6.6% (95% CI; 5.8-7.4).

The researchers also used prevalence estimates and prevalence odds ratios (PORs) to identify several demographic, lifestyle and dietary factors that correlated with chronic diarrhea.

High daily carbohydrate intake (POR = 1.56; 95% CI, 1.02-2.4), obesity (POR = 2.04; 95% CI, 1.44-2.89), feeling depressed (POR= 1.84; 95% CI, 1.21-2.8), older age (POR = 1.02; 95% CI, 1.01-1.02) and female sex (POR = 1.68; 95% CI, 1.28-2.21) all positively correlated with chronic diarrhea. Comparatively, non-Hispanic white race (POR = 0.49; 05% CI, 0.29-0.81) and higher education (POR = 0.6; 95% CI, 0.43-0.83) negatively correlated with chronic diarrhea.

“Ours is the first population-based study to identify that high carbohydrate intake was independently associated with chronic diarrhea, emphasizing that diet plays an important role in the pathophysiology of chronic diarrhea,” Singh said. “We also found that obesity was positively correlated with chronic diarrhea. Future studies should investigate the mechanism underlying this association, which would allow us to develop targeted therapeutic approach for these patients.” – by Alex Young

Disclosures: The authors report no relevant financial disclosures.