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Abstract

Background: Acute appendicitis is a common surgical emergency, often linked to luminal obstruction. Constipation, a potential contributor to such obstruction, has not been thoroughly studied as a predisposing factor.
Objective: To assess the incidence and associated factors of constipation in patients undergoing appendectomy for acute appendicitis.
Methods: This retrospective, questionnaire-based observational study was conducted at Chettinad Hospital and Research Institute. Fifty patients who underwent laparoscopic or open appendectomy were surveyed regarding bowel habits and lifestyle factors prior to symptom onset.
Results: Of the 50 patients (mean age 32 years; 66% male), 58% reported constipation before surgery. Constipation was more prevalent among females (65%) and those with comorbidities (91% vs. 44%, p = 0.015). Significant associations were found between constipation and unbalanced diet (75% vs. 35%, p = 0.004), as well as low water intake (<1.5 L/day, p = 0.02). Trends toward increased constipation were observed with frequent outside food consumption, poor sleep, and lack of exercise, though not statistically significant. Smoking and alcohol use showed no significant association.
Conclusion: Constipation is prevalent among appendicitis patients and is significantly associated with comorbidities, poor diet, and inadequate hydration. The high incidence of constipation in this cohort, along with its significant associations, supports the hypothesis that constipation may play a causative role in the development of acute appendicitis. By contributing to luminal obstruction through fecal stasis or fecalith formation, constipation may initiate or exacerbate the inflammatory process within the appendix. Identifying and addressing these modifiable factors may aid in risk stratification, early diagnosis, and preventive strategies in surgical populations