TY - JOUR
T1 - Chronic constipation diagnosis and treatment evaluation
T2 - The "CHRO.CO.DI.T.E." study
AU - Bellini, Massimo
AU - Usai-Satta, Paolo
AU - Bove, Antonio
AU - Bocchini, Renato
AU - Galeazzi, Francesca
AU - Battaglia, Edda
AU - Alduini, Pietro
AU - Buscarini, Elisabetta
AU - Bassotti, Gabrio
AU - Massimo, Bellini
AU - Santino, Marchi
AU - Dario, Gambaccini
AU - Paolo, Usai Satta
AU - Antonio, Bove
AU - Renato, Bocchini
AU - Edda, Battaglia
AU - Pietro, Alduini
AU - Francesca, Galeazzi
AU - Gabrio, Bassotti
AU - Antonio, Balzano
AU - Piero, Portincasa
AU - Leonilde, Bonfrate
AU - Lucia, D'Alba
AU - Danilo, Badiali
AU - Cristina, Neri Maria
AU - Nicola, Muscatiello
AU - Michele, Di Stefano
AU - Claudio, Giannelli
AU - Fabio, Goffredo
AU - Luigi, Turco
AU - Salvatore, Camilleri
AU - Giovanni, Ceccarelli
AU - Federico, Corti
AU - Iovino, Paola
AU - Maria, Montalbano Luigi
AU - Cristian, Morreale Gaetano
AU - Silvia, Rentini
AU - Vincenzo, Savarino
AU - Sergio, Segato
AU - Elisabetta, Buscarini
AU - Guido, Manfredi
AU - Renato, Cannizzaro
AU - Sandro, Passaretti
AU - Matteo, Alessandri
AU - Rosario, Cuomo
AU - Paolo, Zito Francesco
AU - Carmine, Mellone
AU - Roberta, Barbera
AU - Giuseppe, Milazzo
AU - Filippo, Pucciani
AU - ChroCoDiTE Study Group, AIGO
PY - 2017/1/14
Y1 - 2017/1/14
N2 - Background: According to Rome criteria, chronic constipation (CC) includes functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C). Some patients do not meet these criteria (No Rome Constipation, NRC). The aim of the study was is to evaluate the various clinical presentation and management of FC, IBS-C and NRC in Italy. Methods: During a 2-month period, 52 Italian gastroenterologists recorded clinical data of FC, IBS-C and NRC patients, using Bristol scale, PAC-SYM and PAC-QoL questionnaires. In addition, gastroenterologists were also asked to record whether the patients were clinically assessed for CC for the first time or were in follow up. Diagnostic tests and prescribed therapies were also recorded. Results: Eight hundred seventy-eight consecutive CC patients (706 F) were enrolled (FC 62.5%, IBS-C 31.3%, NRC 6.2%). PAC-SYM and PAC-QoL scores were higher in IBS-C than in FC and NRC. 49.5% were at their first gastroenterological evaluation for CC. In 48.5% CC duration was longer than 10 years. A specialist consultation was requested in 31.6%, more frequently in IBS-C than in NRC. Digital rectal examination was performed in only 56.4%. Diagnostic tests were prescribed to 80.0%. Faecal calprotectin, thyroid tests, celiac serology, breath tests were more frequently suggested in IBS-C and anorectal manometry in FC. More than 90% had at least one treatment suggested on chronic constipation, most frequently dietary changes, macrogol and fibers. Antispasmodics and psychotherapy were more frequently prescribed in IBS-C, prucalopride and pelvic floor rehabilitation in FC. Conclusions: Patients with IBS-C reported more severe symptoms and worse quality of life than FC and NRC. Digital rectal examination was often not performed but at least one diagnostic test was prescribed to most patients. Colonoscopy and blood tests were the "first line" diagnostic tools. Macrogol was the most prescribed laxative, and prucalopride and pelvic floor rehabilitation represented a "second line" approach. Diagnostic tests and prescribed therapies increased by increasing CC severity.
AB - Background: According to Rome criteria, chronic constipation (CC) includes functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C). Some patients do not meet these criteria (No Rome Constipation, NRC). The aim of the study was is to evaluate the various clinical presentation and management of FC, IBS-C and NRC in Italy. Methods: During a 2-month period, 52 Italian gastroenterologists recorded clinical data of FC, IBS-C and NRC patients, using Bristol scale, PAC-SYM and PAC-QoL questionnaires. In addition, gastroenterologists were also asked to record whether the patients were clinically assessed for CC for the first time or were in follow up. Diagnostic tests and prescribed therapies were also recorded. Results: Eight hundred seventy-eight consecutive CC patients (706 F) were enrolled (FC 62.5%, IBS-C 31.3%, NRC 6.2%). PAC-SYM and PAC-QoL scores were higher in IBS-C than in FC and NRC. 49.5% were at their first gastroenterological evaluation for CC. In 48.5% CC duration was longer than 10 years. A specialist consultation was requested in 31.6%, more frequently in IBS-C than in NRC. Digital rectal examination was performed in only 56.4%. Diagnostic tests were prescribed to 80.0%. Faecal calprotectin, thyroid tests, celiac serology, breath tests were more frequently suggested in IBS-C and anorectal manometry in FC. More than 90% had at least one treatment suggested on chronic constipation, most frequently dietary changes, macrogol and fibers. Antispasmodics and psychotherapy were more frequently prescribed in IBS-C, prucalopride and pelvic floor rehabilitation in FC. Conclusions: Patients with IBS-C reported more severe symptoms and worse quality of life than FC and NRC. Digital rectal examination was often not performed but at least one diagnostic test was prescribed to most patients. Colonoscopy and blood tests were the "first line" diagnostic tools. Macrogol was the most prescribed laxative, and prucalopride and pelvic floor rehabilitation represented a "second line" approach. Diagnostic tests and prescribed therapies increased by increasing CC severity.
KW - Diagnosis
KW - Functional constipation
KW - Irritable bowel syndrome
KW - Treatment
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U2 - 10.1186/s12876-016-0556-7
DO - 10.1186/s12876-016-0556-7
M3 - Article
C2 - 28088179
AN - SCOPUS:85009410494
VL - 17
JO - BMC Gastroenterology
JF - BMC Gastroenterology
SN - 1471-230X
IS - 1
M1 - 11
ER -