ABSTRACT
Background: A minimum of physical activity and low liquid intake are factors that havebeen associated with constipation. The health emergency brought on by the COVID-19pandemic has resulted in adopting behavior, such as sheltering-in-place (less mobility) anddietary changes, creating a scenario we believe to be an adequate model for examining theappearance of symptoms of constipation and its associated factors. At present, there are no reports in the literature that establish a relation between a change in bowel movement habitand being under the current lockdown. Thus, the aim of our study was to evaluate theincidence of symptoms of constipation and associated factors during the lockdown implementedto contain the spread of COVID-19 in Mexico.Methods: A cross-sectional and descriptive study was conducted on an open population,applying an electronic survey (4 weeks after lockdown due to COVID-19 in Mexico) toevaluate: demographic characteristics, physical activity, water and fiber intake, appearanceof constipation symptoms (including stool consistency), and quality of life. Incidence (newcases) of constipation after the lockdown (“new-onset” constipation) was calculated and the95% CI was reported. A comparative analysis of the categorical variables and continuousvariables was carried out between the participants with “new-onset” constipation and thosewith no constipation during the lockdown, utilizing the Student’s t test, the Mann-WhitneyU test, the chi-square test, or the Wilcoxon test, as appropriate. Statistical significance wasset a p < 0.05.Results: Out of 678 subjects evaluated, 170 (25%, 95% CI 21.7-28.4) developed symptomsof “new-onset” constipation, with a significant decrease in the number of daily bowelmovements (p<0.05) and stool consistency (p<0.05) during lockdown (Figure 1). Furthermore,in the “new-onset” constipation population, there was a higher proportion of subjects(48%) who stopped exercising during the pandemic compared to the subjects who did notdevelop constipation symptoms (29%, p=0.0005, OR 2.23, CI 95% 1.4-3.48, Figure 2).The multivariate analysis (logistic regression) showed that female sex (p=0.001), water intake(p=0.039), and physical activity (p=0.012) were associated with “new-onset” constipation.Conclusions: In conclusion, in our study we found that one-fourth of the population thatreduced their physical activity and drank less water due to mobility restrictions imposedfor epidemiologic reasons, in the face of the COVID-19 pandemic, developed “new-onset”constipation symptoms. Given those results, appropriate physical activity and adequateliquid intake during prolonged periods of lockdown should be recommended to preventsaid symptoms.(Image Presented)Number of bowel movements, days of physical activity and stool consistency before and after the lockdown(Image Presented)Percentage of subjects who stop physical activity during the pandemic among groups.