Different perception of chronic constipation between patients and gastroenterologists

Area of Science:

• Gastroenterology
• Clinical Medicine
• Patient-Reported Outcomes

Background:

• A significant portion of individuals self-diagnose constipation (SDC) but may not meet established Rome Criteria.
• The Rome Criteria differentiate functional constipation (FC) from constipation-predominant irritable bowel syndrome (IBS-C), yet some SDC patients fall outside these classifications (no Rome Constipation; NRC).

Purpose of the Study:

• To determine the prevalence of FC and IBS-C diagnoses among SDC subjects.
• To compare demographic and clinical characteristics, symptom profiles, and quality of life across different SDC subgroups: FC, IBS-C, and NRC.

Main Methods:

• A survey was administered to 934 patients and 980 accompanying persons over 2 months to assess FC and IBS-C.
• SDC subjects completed assessments for stool consistency (Bristol scale), constipation severity (CSI), obstructed defecation (ODS), and quality of life (PAC-QoL).
• Laxative and enema use was also evaluated.

Main Results:

• SDC individuals were significantly more likely to meet Rome III criteria (OR 20.5).
• 13.5% of SDC subjects were classified as NRC.
• NRC patients reported lower ODS, CSI, and PAC-QoL scores, higher Bristol scale values, and less laxative/enema use compared to IBS-C and FC groups, with no differences observed between IBS-C and FC.

Conclusions:

• The Rome III criteria effectively identify SDC subjects with a greater clinical impact.
• The findings suggest that the clinical distinction between FC and IBS-C may not be adequately supported by current data.
• Further research may be needed to refine diagnostic criteria for SDC.