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Risk Factors for Fecal Urgency Among Individuals With and Without Diarrhea, Based on Data From the National Health and Nutrition Examination Survey.

ABSTRACT: BACKGROUND & AIMS:Fecal urgency is a common symptom among patients with gastrointestinal disorders, but can also occur in healthy individuals with normal bowel habits. There have been few studies of fecal urgency in the general population. We performed a cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES) to analyze the prevalence of and risk factors for this symptom. METHODS:We analyzed data from 4676 persons who completed the Bowel Health Questionnaire from the NHANES, from 2009 through 2010. The NHANES sampled a nationally representative group of adults in the United States and provides information on demographics, medical comorbidities, and dietary habits of survey participants. The Bowel Health Questionnaire provided additional information about bowel symptoms such as urgency, incontinence, constipation, and diarrhea. We identified individuals with fecal urgency and calculated differences in fecal urgency among subgroups using chi-squared analysis. We used logistic regression to identify factors associated with urgency. RESULTS:In our study population, the prevalence of fecal urgency was 3.3%; 29.5% of individuals with fecal urgency had diarrhea. The prevalence of fecal urgency was significantly higher in individuals who had diarrhea (14.8%) than in individuals without diarrhea (3.1%). Older age, female sex, poverty, urinary urge incontinence, diarrhea, and increased stool frequency were all associated with fecal urgency on multivariable analysis. Decreased fiber intake and increased carbohydrate intake were associated with urgency among individuals with diarrhea. CONCLUSIONS:In an analysis of data from 4676 individuals who completed a Bowel Health Questionnaire from the NHANES, we found a significantly higher proportion of individuals with diarrhea to have fecal urgency. However, most individuals with fecal urgency do not have diarrhea. Factors associated with fecal urgency vary among individuals with and without diarrhea.

SUBMITTER: Rangan V

PROVIDER: S-EPMC6098738 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Risk Factors for Fecal Urgency Among Individuals With and Without Diarrhea, Based on Data From the National Health and Nutrition Examination Survey.

Rangan Vikram V Mitsuhashi Shuji S Singh Prashant P Ballou Sarah S Hirsch William W Sommers Thomas T Nee Judy J Iturrino Johanna J Lembo Anthony A

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 20180221 9

<h4>Background & aims</h4>Fecal urgency is a common symptom among patients with gastrointestinal disorders, but can also occur in healthy individuals with normal bowel habits. There have been few studies of fecal urgency in the general population. We performed a cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES) to analyze the prevalence of and risk factors for this symptom.<h4>Methods</h4>We analyzed data from 4676 persons who completed the Bowel ...[more]

PMID: 29474972

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Project description:ObjectiveOversampling of Asian American individuals in the National Health and Nutrition Examination Survey (NHANES) provides a unique opportunity to assess the population-level cardiovascular health (CVH) in the fastest-growing racial group in the US.MethodsThe Life's Essential 8 (LE8) score and its components were calculated in self-reported Asian American individuals ≥20 years of age and free of cardiovascular disease in the NHANES cycles from 2011-March 2020. Multivariable adjusted linear and logistic regression models were used for analysis.ResultsAmong 2,059 Asian American individuals, the weighted mean LE8 score was 69.1 (0.4) with US-born [69.0 (0.8)] and foreign-born individuals [69.1 (0.4)] having similar CVH. From 2011 to March 2020, CVH in the overall population [69.7 (0.8) to 68.1 (0.8); Ptrend: 0.009] and foreign-born individuals [69.7 (0.8) to 67.7 (0.8); Ptrend: 0.005] declined. Decreasing trends were noted in the body mass index score irrespective of stratification and in the blood pressure scores in the overall population and foreign-born Asian American individuals. Compared with US-born individuals, the odds of ideal levels of smoking [ORadj:<5 years: 2.23 (95%CI: 1.45-3.44); 5-15 years: 1.97 (95%CI: 1.27-3.05); 15-30 years: 1.61 (95%CI: 1.11-2.34); ≥30 years: 1.69(95%CI:1.20-2.36)] and diet [ORadj: <5 years: 1.87 (95%CI: 1.26-2.79); 5-15 years: 2.00 (95%CI: 1.38-2.89); 15-30 years: 1.74 (95%CI: 1.14-2.68)] were higher in foreign-born individuals. Foreign-born individuals had lower odds of ideal physical activity levels [ORadj: 5-15 years: 0.55 (95%CI: 0.39-0.79); 15-30 years: 0.68 (95%CI: 0.49-0.95)] and ideal cholesterol levels [ORadj: 5-15 years: 0.59 (95%CI: 0.42-0.82); 15-30 years: 0.54 (95%CI :0.38-0.76); ≥30 years: 0.52 (95%CI: 0.38-0.76)].ConclusionThe CVH in Asian American individuals declined from 2011 to March 2020. The odds of ideal CVH decreased with increasing duration of stay in the US, with foreign-born individuals residing in the US for ≥30 years having ∼28% lower odds of ideal CVH compared with US-born individuals.

Project description:Even before the COVID-19 pandemic, there was mounting interest in remote testing solutions for audiology. The ultimate goal of such work was to improve access to hearing healthcare for individuals that might be unable or reluctant to seek audiological help in a clinic. In 2015, Diane Van Tasell patented a method for measuring an audiogram when the precise signal level was unknown (patent US 8,968,209 B2). In this method, the slope between pure-tone thresholds measured at 2 and 4 kHz is calculated and combined with questionnaire information in order to reconstruct the most likely audiograms from a database of options. An approach like the Van Tasell method is desirable because it is quick and feasible to do in a patient's home where exact stimulus levels are unknown. The goal of the present study was to use machine learning to assess the effectiveness of such audiogram-estimation methods. The National Health and Nutrition Examination Survey (NHANES), a database of audiologic and demographic information, was used to train and test several machine learning algorithms. Overall, 9,256 cases were analyzed. Audiometric data were classified using the Wisconsin Age-Related Hearing Impairment Classification Scale (WARHICS), a method that places hearing loss into one of eight categories. Of the algorithms tested, a random forest machine learning algorithm provided the best fit with only a few variables: the slope between 2 and 4 kHz; gender; age; military experience; and self-reported hearing ability. Using this method, 54.79% of the individuals were correctly classified, 34.40% were predicted to have a milder loss than measured, and 10.82% were predicted to have a more severe loss than measured. Although accuracy was low, it is unlikely audibility would be severely affected if classifications were used to apply gains. Based on audibility calculations, underamplification still provided sufficient gain to achieve ~95% correct (Speech Intelligibility Index ≥ 0.45) for sentence materials for 88% of individuals. Fewer than 1% of individuals were overamplified by 10 dB for any audiometric frequency. Given these results, this method presents a promising direction toward remote assessment; however, further refinement is needed before use in clinical fittings.

Project description:ImportanceAccurate and practical measures of nutrition security are needed to assess and monitor its prevalence and to identify its associated risk factors in the US.ObjectiveTo propose a nutrition security measure derived from combining self-assessed food security and diet quality indicators available in the National Health and Nutrition Examination Survey (NHANES) and to assess the prevalence and associated sociodemographic and health factors of nutrition security.Design, setting, and participantsThis cross-sectional study used data from 6 cycles of NHANES, which collects data on general health status and behaviors, dietary intake, physiological measurements, and sociodemographic characteristics, conducted from 2007 to 2018. All participants were adults aged 20 years or older. Statistical analysis was performed between October 2023 and April 2024.ExposuresSociodemographic and health characteristics, including age, sex, race and ethnicity, marital status, household size, presence of children in the household, educational level, poverty to income ratio (PIR), Supplemental Nutrition Assistance Program (SNAP) participation, weight status, chronic conditions, and health insurance coverage.Main outcomes and measuresA nutrition security measure was derived from combining self-assessed food security, measured using the US Department of Agriculture Household Food Security Survey Module, and self-rated diet quality indicators. Four nutrition security status categories were created from dichotomized food security and diet quality measures: food secure with high diet quality (FSHD), food secure with low diet quality (FSLD), food insecure with high diet quality (FIHD), and food insecure with low diet quality (FILD). Only respondents classified as FSHD were considered to be nutrition secure.ResultsThe unweighted analytic sample included 28 898 NHANES participants. The weighted mean [SD] age of participants was 47.3 [14.5] years; 51.9% (weighted) of the sample was female; 11.1% identified as Black, 13.6% as Hispanic, and 67.4% as White individuals; and 35.6% of those surveyed were classified by the proposed measure as nutrition insecure (ie, FSLD, FIHD, or FILD). Of these participants, 20.2% (95% CI, 19.4%-21.0%) were categorized as being nutrition insecure due to FSLD, 8.4% (95% CI, 7.8%-9.1%) due to FIHD, and 7.0% (95% CI, 6.4%-7.6%) due to FILD. The remaining 64.4% (95% CI, 63.2%-65.7%) were classified as FSHD (ie, nutrition secure). Younger age (20-44 years: average marginal effect [AME], -0.193; 95% CI, -0.217 to -0.168), low income (PIR <1.30: AME, -0.111; 95% CI, -0.136 to -0.085), lower educational level (≤high school diploma: AME, -0.135; 95% CI, -0.156 to -0.114), racial and ethnic minority status (Hispanic: AME, -0.054; 95% CI, -0.075 to -0.032), SNAP participation (AME, -0.073; 95% CI, -0.099 to -0.047), obesity (AME, -0.118; 95% CI, -0.138 to -0.097), and self-reported fair or poor general health (AME, -0.239; 95% CI, -0.260 to -0.217) were factors associated with nutrition insecurity.Conclusions and relevanceThis cross-sectional study proposed a feasible and practical measure for assessing and monitoring nutrition security using validated measures in the NHANES. This study laid the groundwork for exploring other national datasets and performing regular data collection of key dimensions for nutrition security assessment and monitoring in the US.

Dataset Information

Risk Factors for Fecal Urgency Among Individuals With and Without Diarrhea, Based on Data From the National Health and Nutrition Examination Survey.

Publications

Risk Factors for Fecal Urgency Among Individuals With and Without Diarrhea, Based on Data From the National Health and Nutrition Examination Survey.

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