Bloating is associated with worse quality of life, treatment satisfaction, and treatment responsiveness among patients with constipation-predominant irritable bowel syndrome and functional constipation

L. Neri, P. Iovino, Donato Francesco Altomare, Vito Annese, Danilo Badiali, Guido Basilisco, G. Bassotti, Edda Battaglia, Gabriele Bazzocchi, Massimo Bellini, Emanuele Bendia, Luigi Benini, Giuseppe Biscaglia, Ivano Biviano, Renato Bocchini, Sebastiano Bonventre, Fabrizio Bossa, Giovanni Brandimarte, Renato Cannizzaro, Michele CicalaL. Cipolletta, Virgilio Clara, R. F. Cogliandro, Giulia Comandini, E. S. Corazziari, Sergio Crotta, Rosario Cuomo, Lucia D'Alba, F. De Giorgi, Mario Del Piano, Michela Di Fonzo, F. Di Mario, Michele Di Stefano, V. D'Onofrio, Kostantinos Efthymakis, Pierluigi Fiore, Manuela Fortuna, Walter Fries, Eleonora Gaetani, Francesca Galeazzi, A. Gasbarrini, Andrea Geccherle, Francesco Giangregorio, Lisa Girardi, Mario Grassini, Marzia Groppo, Giovanni Guarnieri, Massimiliano Lo Cascio, Roberto Lolli, Francesco Luzza, G. Macarri, Maria Marino, Stefania Miraglia, Santo Monastra, Maria Cristina Neri, Matteo Neri, Roberto Antonio Noris, S. Orselli, S. Passaretti, Alberto Paviotti, Paolo Pazzi, A. Pilotto, Piero Portincasa, Nunzio Ranaldo, P. Ravelli, Francesca Rogai, Renato Sablich, Vincenzo Savarino, Giancarlo Spinzi, V. Stanghellini, Leonardo Tammaro, F. Torresan, Paolo Usai Satta, C. Claudio Valle

Research output: Contribution to journalArticle

Abstract

Background: The management of bloating is unclear and its relationship with patients' well-being and treatment satisfaction independent of other abdominal symptoms is uncharacterized. We evaluated the association of bloating with patient-reported outcomes. Methods: Thirty-nine centers for functional gastrointestinal disorders joined the laxative inadequate relief survey. We enrolled 2203 consecutive outpatients with functional constipation (FC) or constipation-predominant irritable bowel syndrome (IBS-C) in two cross-sectional waves. Both wave 1 and 2 included the SF-12, the patient assessment of constipation-symptoms (PAC-SYM), and the treatment satisfaction questionnaire for medication (TSQM-2). Wave 2 only included a global rating of change (GRC) scale to assess patients' assessment of efficacy concerning treatment switches occurred in the 3 months prior to the interview. Bloating in the abdomen was defined on the basis of PAC-SYM item 3. Key Results: The average age was 50.1 years (SD, 16.7) and 82.1% of patients were women. The prevalence of bloating was 91.6% (n = 1970). Bloating was associated with SF-12 Physical Composite Score (p <0.01), SF-12 Mental Composite Score (p <0.01), GRC (p <0.01), Satisfaction with treatment effectiveness (p <0.01), convenience of administration (p <0.01), and side effects (p <0.01) after adjustment for possible confounders. Conclusions & Inferences: Our data suggest that patients regard bloating as a key element in assessing clinical changes and treatments' efficacy as this symptom exerts a strong influence on patient-reported outcomes independent of possible confounders and other symptoms of constipation. Our data provide the rationale to investigate the efficacy and tolerability of new treatments specifically addressing this important, yet disregarded, patients' complain.

Original languageEnglish
Pages (from-to)581-591
Number of pages11
JournalNeurogastroenterology and Motility
Volume28
Issue number4
DOIs
Publication statusPublished - Apr 1 2016

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Irritable Bowel Syndrome
Constipation
Quality of Life
Symptom Assessment
Therapeutics
Laxatives
Gastrointestinal Diseases
Abdomen
Outpatients
Interviews

Keywords

  • Bloating
  • Chronic constipation
  • Functional constipation
  • Irritable bowel syndrome
  • Patient-reported outcomes
  • Quality of life
  • Treatment satisfaction

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Gastroenterology
  • Physiology

Cite this

Bloating is associated with worse quality of life, treatment satisfaction, and treatment responsiveness among patients with constipation-predominant irritable bowel syndrome and functional constipation. / Neri, L.; Iovino, P.; Altomare, Donato Francesco; Annese, Vito; Badiali, Danilo; Basilisco, Guido; Bassotti, G.; Battaglia, Edda; Bazzocchi, Gabriele; Bellini, Massimo; Bendia, Emanuele; Benini, Luigi; Biscaglia, Giuseppe; Biviano, Ivano; Bocchini, Renato; Bonventre, Sebastiano; Bossa, Fabrizio; Brandimarte, Giovanni; Cannizzaro, Renato; Cicala, Michele; Cipolletta, L.; Clara, Virgilio; Cogliandro, R. F.; Comandini, Giulia; Corazziari, E. S.; Crotta, Sergio; Cuomo, Rosario; D'Alba, Lucia; De Giorgi, F.; Del Piano, Mario; Di Fonzo, Michela; Di Mario, F.; Di Stefano, Michele; D'Onofrio, V.; Efthymakis, Kostantinos; Fiore, Pierluigi; Fortuna, Manuela; Fries, Walter; Gaetani, Eleonora; Galeazzi, Francesca; Gasbarrini, A.; Geccherle, Andrea; Giangregorio, Francesco; Girardi, Lisa; Grassini, Mario; Groppo, Marzia; Guarnieri, Giovanni; Lo Cascio, Massimiliano; Lolli, Roberto; Luzza, Francesco; Macarri, G.; Marino, Maria; Miraglia, Stefania; Monastra, Santo; Neri, Maria Cristina; Neri, Matteo; Noris, Roberto Antonio; Orselli, S.; Passaretti, S.; Paviotti, Alberto; Pazzi, Paolo; Pilotto, A.; Portincasa, Piero; Ranaldo, Nunzio; Ravelli, P.; Rogai, Francesca; Sablich, Renato; Savarino, Vincenzo; Spinzi, Giancarlo; Stanghellini, V.; Tammaro, Leonardo; Torresan, F.; Usai Satta, Paolo; Valle, C. Claudio.

In: Neurogastroenterology and Motility, Vol. 28, No. 4, 01.04.2016, p. 581-591.

Research output: Contribution to journalArticle

Neri, L, Iovino, P, Altomare, DF, Annese, V, Badiali, D, Basilisco, G, Bassotti, G, Battaglia, E, Bazzocchi, G, Bellini, M, Bendia, E, Benini, L, Biscaglia, G, Biviano, I, Bocchini, R, Bonventre, S, Bossa, F, Brandimarte, G, Cannizzaro, R, Cicala, M, Cipolletta, L, Clara, V, Cogliandro, RF, Comandini, G, Corazziari, ES, Crotta, S, Cuomo, R, D'Alba, L, De Giorgi, F, Del Piano, M, Di Fonzo, M, Di Mario, F, Di Stefano, M, D'Onofrio, V, Efthymakis, K, Fiore, P, Fortuna, M, Fries, W, Gaetani, E, Galeazzi, F, Gasbarrini, A, Geccherle, A, Giangregorio, F, Girardi, L, Grassini, M, Groppo, M, Guarnieri, G, Lo Cascio, M, Lolli, R, Luzza, F, Macarri, G, Marino, M, Miraglia, S, Monastra, S, Neri, MC, Neri, M, Noris, RA, Orselli, S, Passaretti, S, Paviotti, A, Pazzi, P, Pilotto, A, Portincasa, P, Ranaldo, N, Ravelli, P, Rogai, F, Sablich, R, Savarino, V, Spinzi, G, Stanghellini, V, Tammaro, L, Torresan, F, Usai Satta, P & Valle, CC 2016, 'Bloating is associated with worse quality of life, treatment satisfaction, and treatment responsiveness among patients with constipation-predominant irritable bowel syndrome and functional constipation', Neurogastroenterology and Motility, vol. 28, no. 4, pp. 581-591. https://doi.org/10.1111/nmo.12758
Neri, L. ; Iovino, P. ; Altomare, Donato Francesco ; Annese, Vito ; Badiali, Danilo ; Basilisco, Guido ; Bassotti, G. ; Battaglia, Edda ; Bazzocchi, Gabriele ; Bellini, Massimo ; Bendia, Emanuele ; Benini, Luigi ; Biscaglia, Giuseppe ; Biviano, Ivano ; Bocchini, Renato ; Bonventre, Sebastiano ; Bossa, Fabrizio ; Brandimarte, Giovanni ; Cannizzaro, Renato ; Cicala, Michele ; Cipolletta, L. ; Clara, Virgilio ; Cogliandro, R. F. ; Comandini, Giulia ; Corazziari, E. S. ; Crotta, Sergio ; Cuomo, Rosario ; D'Alba, Lucia ; De Giorgi, F. ; Del Piano, Mario ; Di Fonzo, Michela ; Di Mario, F. ; Di Stefano, Michele ; D'Onofrio, V. ; Efthymakis, Kostantinos ; Fiore, Pierluigi ; Fortuna, Manuela ; Fries, Walter ; Gaetani, Eleonora ; Galeazzi, Francesca ; Gasbarrini, A. ; Geccherle, Andrea ; Giangregorio, Francesco ; Girardi, Lisa ; Grassini, Mario ; Groppo, Marzia ; Guarnieri, Giovanni ; Lo Cascio, Massimiliano ; Lolli, Roberto ; Luzza, Francesco ; Macarri, G. ; Marino, Maria ; Miraglia, Stefania ; Monastra, Santo ; Neri, Maria Cristina ; Neri, Matteo ; Noris, Roberto Antonio ; Orselli, S. ; Passaretti, S. ; Paviotti, Alberto ; Pazzi, Paolo ; Pilotto, A. ; Portincasa, Piero ; Ranaldo, Nunzio ; Ravelli, P. ; Rogai, Francesca ; Sablich, Renato ; Savarino, Vincenzo ; Spinzi, Giancarlo ; Stanghellini, V. ; Tammaro, Leonardo ; Torresan, F. ; Usai Satta, Paolo ; Valle, C. Claudio. / Bloating is associated with worse quality of life, treatment satisfaction, and treatment responsiveness among patients with constipation-predominant irritable bowel syndrome and functional constipation. In: Neurogastroenterology and Motility. 2016 ; Vol. 28, No. 4. pp. 581-591.
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abstract = "Background: The management of bloating is unclear and its relationship with patients' well-being and treatment satisfaction independent of other abdominal symptoms is uncharacterized. We evaluated the association of bloating with patient-reported outcomes. Methods: Thirty-nine centers for functional gastrointestinal disorders joined the laxative inadequate relief survey. We enrolled 2203 consecutive outpatients with functional constipation (FC) or constipation-predominant irritable bowel syndrome (IBS-C) in two cross-sectional waves. Both wave 1 and 2 included the SF-12, the patient assessment of constipation-symptoms (PAC-SYM), and the treatment satisfaction questionnaire for medication (TSQM-2). Wave 2 only included a global rating of change (GRC) scale to assess patients' assessment of efficacy concerning treatment switches occurred in the 3 months prior to the interview. Bloating in the abdomen was defined on the basis of PAC-SYM item 3. Key Results: The average age was 50.1 years (SD, 16.7) and 82.1{\%} of patients were women. The prevalence of bloating was 91.6{\%} (n = 1970). Bloating was associated with SF-12 Physical Composite Score (p <0.01), SF-12 Mental Composite Score (p <0.01), GRC (p <0.01), Satisfaction with treatment effectiveness (p <0.01), convenience of administration (p <0.01), and side effects (p <0.01) after adjustment for possible confounders. Conclusions & Inferences: Our data suggest that patients regard bloating as a key element in assessing clinical changes and treatments' efficacy as this symptom exerts a strong influence on patient-reported outcomes independent of possible confounders and other symptoms of constipation. Our data provide the rationale to investigate the efficacy and tolerability of new treatments specifically addressing this important, yet disregarded, patients' complain.",
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author = "L. Neri and P. Iovino and Altomare, {Donato Francesco} and Vito Annese and Danilo Badiali and Guido Basilisco and G. Bassotti and Edda Battaglia and Gabriele Bazzocchi and Massimo Bellini and Emanuele Bendia and Luigi Benini and Giuseppe Biscaglia and Ivano Biviano and Renato Bocchini and Sebastiano Bonventre and Fabrizio Bossa and Giovanni Brandimarte and Renato Cannizzaro and Michele Cicala and L. Cipolletta and Virgilio Clara and Cogliandro, {R. F.} and Giulia Comandini and Corazziari, {E. S.} and Sergio Crotta and Rosario Cuomo and Lucia D'Alba and {De Giorgi}, F. and {Del Piano}, Mario and {Di Fonzo}, Michela and {Di Mario}, F. and {Di Stefano}, Michele and V. D'Onofrio and Kostantinos Efthymakis and Pierluigi Fiore and Manuela Fortuna and Walter Fries and Eleonora Gaetani and Francesca Galeazzi and A. Gasbarrini and Andrea Geccherle and Francesco Giangregorio and Lisa Girardi and Mario Grassini and Marzia Groppo and Giovanni Guarnieri and {Lo Cascio}, Massimiliano and Roberto Lolli and Francesco Luzza and G. Macarri and Maria Marino and Stefania Miraglia and Santo Monastra and Neri, {Maria Cristina} and Matteo Neri and Noris, {Roberto Antonio} and S. Orselli and S. Passaretti and Alberto Paviotti and Paolo Pazzi and A. Pilotto and Piero Portincasa and Nunzio Ranaldo and P. Ravelli and Francesca Rogai and Renato Sablich and Vincenzo Savarino and Giancarlo Spinzi and V. Stanghellini and Leonardo Tammaro and F. Torresan and {Usai Satta}, Paolo and Valle, {C. Claudio}",
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TY - JOUR

T1 - Bloating is associated with worse quality of life, treatment satisfaction, and treatment responsiveness among patients with constipation-predominant irritable bowel syndrome and functional constipation

AU - Neri, L.

AU - Iovino, P.

AU - Altomare, Donato Francesco

AU - Annese, Vito

AU - Badiali, Danilo

AU - Basilisco, Guido

AU - Bassotti, G.

AU - Battaglia, Edda

AU - Bazzocchi, Gabriele

AU - Bellini, Massimo

AU - Bendia, Emanuele

AU - Benini, Luigi

AU - Biscaglia, Giuseppe

AU - Biviano, Ivano

AU - Bocchini, Renato

AU - Bonventre, Sebastiano

AU - Bossa, Fabrizio

AU - Brandimarte, Giovanni

AU - Cannizzaro, Renato

AU - Cicala, Michele

AU - Cipolletta, L.

AU - Clara, Virgilio

AU - Cogliandro, R. F.

AU - Comandini, Giulia

AU - Corazziari, E. S.

AU - Crotta, Sergio

AU - Cuomo, Rosario

AU - D'Alba, Lucia

AU - De Giorgi, F.

AU - Del Piano, Mario

AU - Di Fonzo, Michela

AU - Di Mario, F.

AU - Di Stefano, Michele

AU - D'Onofrio, V.

AU - Efthymakis, Kostantinos

AU - Fiore, Pierluigi

AU - Fortuna, Manuela

AU - Fries, Walter

AU - Gaetani, Eleonora

AU - Galeazzi, Francesca

AU - Gasbarrini, A.

AU - Geccherle, Andrea

AU - Giangregorio, Francesco

AU - Girardi, Lisa

AU - Grassini, Mario

AU - Groppo, Marzia

AU - Guarnieri, Giovanni

AU - Lo Cascio, Massimiliano

AU - Lolli, Roberto

AU - Luzza, Francesco

AU - Macarri, G.

AU - Marino, Maria

AU - Miraglia, Stefania

AU - Monastra, Santo

AU - Neri, Maria Cristina

AU - Neri, Matteo

AU - Noris, Roberto Antonio

AU - Orselli, S.

AU - Passaretti, S.

AU - Paviotti, Alberto

AU - Pazzi, Paolo

AU - Pilotto, A.

AU - Portincasa, Piero

AU - Ranaldo, Nunzio

AU - Ravelli, P.

AU - Rogai, Francesca

AU - Sablich, Renato

AU - Savarino, Vincenzo

AU - Spinzi, Giancarlo

AU - Stanghellini, V.

AU - Tammaro, Leonardo

AU - Torresan, F.

AU - Usai Satta, Paolo

AU - Valle, C. Claudio

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Background: The management of bloating is unclear and its relationship with patients' well-being and treatment satisfaction independent of other abdominal symptoms is uncharacterized. We evaluated the association of bloating with patient-reported outcomes. Methods: Thirty-nine centers for functional gastrointestinal disorders joined the laxative inadequate relief survey. We enrolled 2203 consecutive outpatients with functional constipation (FC) or constipation-predominant irritable bowel syndrome (IBS-C) in two cross-sectional waves. Both wave 1 and 2 included the SF-12, the patient assessment of constipation-symptoms (PAC-SYM), and the treatment satisfaction questionnaire for medication (TSQM-2). Wave 2 only included a global rating of change (GRC) scale to assess patients' assessment of efficacy concerning treatment switches occurred in the 3 months prior to the interview. Bloating in the abdomen was defined on the basis of PAC-SYM item 3. Key Results: The average age was 50.1 years (SD, 16.7) and 82.1% of patients were women. The prevalence of bloating was 91.6% (n = 1970). Bloating was associated with SF-12 Physical Composite Score (p <0.01), SF-12 Mental Composite Score (p <0.01), GRC (p <0.01), Satisfaction with treatment effectiveness (p <0.01), convenience of administration (p <0.01), and side effects (p <0.01) after adjustment for possible confounders. Conclusions & Inferences: Our data suggest that patients regard bloating as a key element in assessing clinical changes and treatments' efficacy as this symptom exerts a strong influence on patient-reported outcomes independent of possible confounders and other symptoms of constipation. Our data provide the rationale to investigate the efficacy and tolerability of new treatments specifically addressing this important, yet disregarded, patients' complain.

AB - Background: The management of bloating is unclear and its relationship with patients' well-being and treatment satisfaction independent of other abdominal symptoms is uncharacterized. We evaluated the association of bloating with patient-reported outcomes. Methods: Thirty-nine centers for functional gastrointestinal disorders joined the laxative inadequate relief survey. We enrolled 2203 consecutive outpatients with functional constipation (FC) or constipation-predominant irritable bowel syndrome (IBS-C) in two cross-sectional waves. Both wave 1 and 2 included the SF-12, the patient assessment of constipation-symptoms (PAC-SYM), and the treatment satisfaction questionnaire for medication (TSQM-2). Wave 2 only included a global rating of change (GRC) scale to assess patients' assessment of efficacy concerning treatment switches occurred in the 3 months prior to the interview. Bloating in the abdomen was defined on the basis of PAC-SYM item 3. Key Results: The average age was 50.1 years (SD, 16.7) and 82.1% of patients were women. The prevalence of bloating was 91.6% (n = 1970). Bloating was associated with SF-12 Physical Composite Score (p <0.01), SF-12 Mental Composite Score (p <0.01), GRC (p <0.01), Satisfaction with treatment effectiveness (p <0.01), convenience of administration (p <0.01), and side effects (p <0.01) after adjustment for possible confounders. Conclusions & Inferences: Our data suggest that patients regard bloating as a key element in assessing clinical changes and treatments' efficacy as this symptom exerts a strong influence on patient-reported outcomes independent of possible confounders and other symptoms of constipation. Our data provide the rationale to investigate the efficacy and tolerability of new treatments specifically addressing this important, yet disregarded, patients' complain.

KW - Bloating

KW - Chronic constipation

KW - Functional constipation

KW - Irritable bowel syndrome

KW - Patient-reported outcomes

KW - Quality of life

KW - Treatment satisfaction

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U2 - 10.1111/nmo.12758

DO - 10.1111/nmo.12758

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VL - 28

SP - 581

EP - 591

JO - Neurogastroenterology and Motility

JF - Neurogastroenterology and Motility

SN - 1350-1925

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