Biopsychosocial Model and Perceived Constipation Severity According to the Constipation Phenotype

Area of Science:

• Gastroenterology
• Functional Bowel Disorders
• Medical Research

Background:

• Constipation is a common symptom in patients diagnosed with functional bowel disorders.
• Understanding factors influencing perceived constipation severity is crucial for effective patient management.
• Previous research has explored various contributing elements, but a comprehensive analysis across different clinical phenotypes is needed.

Purpose of the Study:

• To investigate the relationship between perceived constipation severity and demographic, clinical, physiological, and psychological parameters.
• To analyze how these relationships differ across various clinical phenotypes of constipation.

Main Methods:

• A cohort of 407 constipated patients underwent comprehensive clinical, physiological, and psychological evaluations.
• Perceived constipation severity was assessed using self-reported measures.
• Stepwise linear regression analysis was employed to identify significant associations in the overall population and within specific clinical groups.

Main Results:

• The study population comprised predominantly females (81%) with a mean age of 47.4 years.
• Irritable Bowel Syndrome (IBS) was diagnosed in 65% of patients, and 62% experienced defecation disorders.
• Abnormal depression scores were noted in 49% of patients. Constipation severity positively correlated with bloating and negatively with Bristol stool form across all phenotypes. In IBS patients, constipation severity was also linked to abdominal pain.

Conclusions:

• Perceived constipation severity is associated with clinical and physiological factors, but not demographic or psychological factors.
• The specific relationships between constipation severity and these factors are dependent on the clinical phenotype.
• These findings highlight the importance of considering individual clinical characteristics when addressing constipation.