ABSTRACT: Background: Chronic constipation is usually associated with young women, and urinary and sexual dysfunction have been reported as co-morbidity. Elderly men also appear to suffer from chronic constipation, as well as lower urinary tract symptoms and erectile dysfunction, but their association as co-morbidity has not been studied in the community. Aim: To determine the prevalence of bowel symptoms in our community with particular reference to the association with urinary and sexual dysfunction in the male population. Methods: A population based cross sectional survey involving 2276 subjects (1143 male, 1133 female) representative of the Singapore population demographics was conducted to evaluate the prevalence of chronic bowel disturbances, lower urinary tract symptoms (LUTS), and erectile dysfunction (ED). Results: The prevalence of chronic constipation was 25.1% overall, with the highest in men age ≥70 years (35.8%) followed by women age 20-29 years (30.5%). The commonest symptoms reported in chronic constipation were hard stool (95.1%), straining (90.9%) and incomplete evacuation (53.8%). Bloating was often experienced by 25.5% of the community, among whom 61.1% had some form of bowel disturbance. In men age ≥30 years, LUTS (7.8% v 3.1%) and ED (60.5% v 48.6%) were more common in men with than without chronic constipation; constipation was an independent predictor of ED. Conclusions: In this Asian urban community, chronic constipation was more common than previously suspected, and urinary and erectile dysfunction were found to be co-morbidity in men. © 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Journal of Gastroenterology and Hepatology 07/2012; · 2.87 Impact Factor
ABSTRACT: To study the epidemiology, symptom characteristics and impact of IBS in an urban Asian population.
A validated bowel symptom questionnaire was administered at face-to-face interviews to a random sample of 3,000 households in Singapore.
The response rate was 78.2% (n = 2,276, 1,143 males and 1,133 females). The age, sex, and racial distribution of our respondents were similar to the general population and there was no significant difference between respondents and nonrespondents by type of household. The prevalence of IBS was 11.0%, 10.4%, and 8.6% by Manning (>1 criteria), Rome I and Rome II criteria, respectively. There was a higher prevalence of IBS in those <50 years of age (9.7%vs 5.8% 50 or > years, p = 0.002), with more than 6 years of education (9.8%vs 5.9% 6 year or <, p = 0.002) and living in landed property (16.8%vs 8.2% living in apartments and public housing, p = 0.008). There was no striking preponderance of female IBS subjects. Chronic constipation was a more common bowel disturbance than chronic diarrhea among our IBS subjects (51.0%vs 12.8%).
The prevalence and impact of IBS in our Asian urban society are greater than previously appreciated. We believe that our results provide a useful window to the future trends of gastrointestinal diseases for health and education authorities in developing Asian countries to look into.
The American Journal of Gastroenterology 06/2004; 99(5):924-31. · 7.28 Impact Factor
ABSTRACT: In South-East Asia and Northern Australia, melioidosis (infection with Burkholderia pseudomallei) is a known cause of severe community-acquired sepsis. However, melioidosis presenting primarily as prostatic abscesses is very rare.
The presenting features, investigations and management outcome of five patients who developed melioidotic prostatic abscesses from 1997 to 2000 were reviewed in the present study.
The mean age at presentation was 53 years (range: 29-69). Old age and diabetes mellitus were predisposing factors. All patients had a fever of at least 38.5 degrees C and presented with obstructive urinary symptoms culminating in urinary retention. Presence of prostatic abscess was demonstrated by transrectal ultrasound in all cases. The abscesses were drained with transurethral resection of the prostate. One patient required re-resection while another patient developed severe septic shock requiring intensive care and -inotropic support. There was no mortality in our series.
Elderly diabetic men presenting with fever and urinary tract obstruction in endemic areas may harbour an unusual but potentially life threatening melioidotic prostatic abscess. Transrectal ultrasound and bacteriological confirmation are mandatory. Prompt surgical drainage coupled with appropriate antibiotics are keys to a favourable outcome.
ANZ Journal of Surgery 07/2002; 72(6):408-10. · 1.25 Impact Factor