Chronic constipation diagnosis and treatment evaluation: The "CHRO.CO.DI.T.E." study

Massimo Bellini, Paolo Usai-Satta, Antonio Bove, Renato Bocchini, Francesca Galeazzi, Edda Battaglia, Pietro Alduini, Elisabetta Buscarini, Gabrio Bassotti, Bellini Massimo, Marchi Santino, Gambaccini Dario, Usai Satta Paolo, Bove Antonio, Bocchini Renato, Battaglia Edda, Alduini Pietro, Galeazzi Francesca, Bassotti Gabrio, Balzano AntonioPortincasa Piero, Bonfrate Leonilde, D'Alba Lucia, Badiali Danilo, Neri Maria Cristina, Muscatiello Nicola, Di Stefano Michele, Giannelli Claudio, Goffredo Fabio, Turco Luigi, Camilleri Salvatore, Ceccarelli Giovanni, Corti Federico, Paola Iovino, Montalbano Luigi Maria, Morreale Gaetano Cristian, Rentini Silvia, Savarino Vincenzo, Segato Sergio, Buscarini Elisabetta, Manfredi Guido, Cannizzaro Renato, Passaretti Sandro, Alessandri Matteo, Cuomo Rosario, Zito Francesco Paolo, Mellone Carmine, Barbera Roberta, Milazzo Giuseppe, Pucciani Filippo, ChroCoDiTE Study Group, AIGO

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Article number11
JournalBMC Gastroenterology
Volume17
Issue number1
DOIs
Publication statusPublished - Jan 14 2017
Externally publishedYes

Keywords

  • Diagnosis
  • Functional constipation
  • Irritable bowel syndrome
  • Treatment

ASJC Scopus subject areas

  • Gastroenterology

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