title: Chronic constipation in hypercalcemic patients with primary hyperparathyroidism.
abstract: BACKGROUND
  Chronic constipation (C), among gastrointestinal symptoms, is commonly associated with primary hyperparathyroidism (PHPT) and probably attributable to hypercalcemia.
  
  
  OBJECTIVE
  To evaluate in patients affected with PHPT the prevalence of C utilizing a validated questionnaire and the current prevalence of C compared to that observed in the past and to evaluate the relationship between C and the severity of PHPT.
  
  
  METHODS
  55 outpatients affected with PHPT, admitted to our Department of Internal Medicine and Medical Specialities in the years (2006-2009) were studied (group 1: 50 postmenopausal women and 5 men, mean age 61.9 +/- 9.4 years), together with 55 sex and age matched controls (group 2). Also considered were a group of PHPT patients observed, in the same ambulatory, during the years '70-'80 (group 3). A questionnaire, Rome II criteria, was administered and used to define C, whereas only anamneses were used to define C in group 3.
  
  
  RESULTS
  The prevalence of C in patients with PHPT was 21.8% in group 1 vs 12.7% in group 2 (n.s.) and 32.7% in group 3. There is a decreasing trend in the prevalence of C in patients with PHPT as observed from 1970-89 to 2006-2009 (p < 0.05). The reduction of C was associated together with a significant reduction in the serum calcium level (p < 0.001). The presence of C vs its absence in patients with PHPT is characterized by higher values of calcemia (p < 0.001), ionized calcium (p < 0.001), and parathyroid hormone (p = 0.019).
  
  
  CONCLUSIONS
  The actual prevalence of C in patients with PHPT is not significantly different from that found in the control group and is decreasing with respect to the past years. Moreover, C seems to be associated with the severity of the disease rather than with the diagnosis of PHPT per se.
authors.affiliation: Unit of Internal Medicine, Nuovo Regina Apostolorum Hospital, Albano Laziale, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ragno
authors.forename: J
authors.initials: J
authors.lastname: Pepe
authors.forename: D
authors.initials: D
authors.lastname: Badiali
authors.forename: S
authors.initials: S
authors.lastname: Minisola
authors.forename: E
authors.initials: E
authors.lastname: Romagnoli
authors.forename: C
authors.initials: C
authors.lastname: Severi
authors.forename: E
authors.initials: E
authors.lastname: D'Erasmo
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003248:Constipation / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis / Q000453:epidemiology*; D049950:Hyperparathyroidism, Primary / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012384:Rome / Q000453:epidemiology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors