Prevalence of constipation in cystic fibrosis patients: a systematic review of observational studies.

Abstract Objective To systematically revise the literature in search of data about the prevalence of constipation in patients with cystic fibrosis (CF) according to the publications in this field, which partly refer to guidelines defined in 2010 by The European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). Sources Systematic review selecting articles based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), including CF patients of all ages. Sources of information were selected to identify the articles without period limitation for the searching: CADTH – Canadian Agency for Drugs and Technologies in Health, CINAHL Complete, Clinical Trials US NIH, Cochrane Library, Embase, MEDLINE via Ovid, Scopus, Web Of Science, PubMed, SciELO, MEDLINE and LILACS through the Biblioteca Virtual em Saude (BVS), Health Systems Evidence, PDQ Evidence, CRD Canadian Agency for Drugs and Technologies in Health, INAHTA – International Network of Agencies for Health Technology Assessment, and PEDro. Findings The prevalence of constipation in CF patients was reported in eight observational studies. Only two studies assessed the frequency of constipation as a primary objective; in the others, constipation was quoted along with the prevalence of the spectrum of gastrointestinal manifestations. Altogether, the publications included 2018 patients, and the reported prevalence varied widely from 10% to 57%. Only two of the six articles published after 2010 followed the definition recommended by the ESPGHAN. Conclusions Constipation is a frequent but still insufficiently assessed complaint of CF patients. The use of diverse diagnostic criteria restricts comparison and epidemiological conclusions, thus future studies should compulsorily apply the ESPGHAN definition.