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Differences between painless and painful constipation among community women
Adil E Bharucha1, G Richard Locke, Alan R Zinsmeister
1Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
The American Journal of Gastroenterology
|February 9, 2006
Summary
Painful constipation (PC) patients, unlike those with painless constipation (PLC), report poorer health and more symptoms, resembling irritable bowel syndrome (IBS) more closely. This suggests PC and PLC should be distinct categories in clinical criteria.
Area of Science:
- Gastroenterology
- Functional Bowel Disorders
Background:
- Rome II criteria group painful constipation (PC) and painless constipation (PLC) under functional constipation (FC).
- Clinical differences between PC and PLC within FC are not well understood.
Purpose of the Study:
- To compare clinical features of PC and PLC.
- To differentiate PC and PLC from constipation-predominant irritable bowel syndrome (C-IBS) and non-C-IBS.
Main Methods:
- A questionnaire was administered to a random sample of 5,200 adult women.
- Telephone follow-up was used for non-responders.
- Data were analyzed to compare clinical features across groups.
Main Results:
- Prevalence of PLC (7.1%) was higher than PC (0.9%).
- PC patients reported worse general health, more somatic and urinary urgency symptoms, and higher hysterectomy rates compared to PLC.
- Bowel symptoms significantly impacted quality of life (QOL) in 18% of PC versus 9% of PLC.
Conclusions:
- Painful constipation (PC) patients share more clinical similarities with constipation-predominant irritable bowel syndrome (C-IBS) than with painless constipation (PLC).
- The findings support separating PC from PLC in diagnostic criteria and clinical trials.
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