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

M. Bellini, P. Usai-Satta, A. Bove, R. Bocchini, F. Galeazzi, E. Battaglia, P. Alduini, E. Buscarini, G. Bassotti, B. Massimo, M. Santino, G. Dario, U.S. Paolo, B. Antonio, B. Renato, B. Edda, A. Pietro, G. Francesca, B. Gabrio, P. PieroB. Leonilde, D. Lucia, B. Danilo, N.M. Cristina, M. Nicola, D.S. Michele, G. Claudio, G. Fabio, T. Luigi, C. Salvatore, C. Giovanni, C. Federico, P. Iovino, M.L. Maria, M.G. Cristian, R. Silvia, S. Vincenzo, S. Sergio, B. Elisabetta, M. Guido, C. Renato, P. Sandro, A. Matteo, C. Rosario, Z.F. Paolo, M. Carmine, B. Roberta, M. Giuseppe, P. Filippo, S. Marco, L.M. Antonia, R. Maurizio, S.M. Flavia, D.B. Manuela, S. Elisabetta, A. Andrea, D. Marco, L. Gioacchino, P. Sergio, M. Raffaele, Q. Mariano, T. Francesco, V. Luigi, P. D'Urso Antonino, T. Ottaviano, N.R. Antonio, M. Fabio, C. Maurizio, L. Alessandra, L. Adriano, N. Matteo, G. Mario, Renato Cannizzaro

Research output: Contribution to journalArticle

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. © 2017 The Author(s).
Original languageEnglish
Article number11
Number of pages11
JournalBMC Gastroenterology
Volume17
Issue number1
DOIs
Publication statusPublished - 2017

Keywords

  • Diagnosis
  • Functional constipation
  • Irritable bowel syndrome
  • Treatment
  • antibiotic agent
  • anxiolytic agent
  • calgranulin
  • enema
  • gastrointestinal agent
  • herbaceous agent
  • laxative
  • macrogol
  • prucalopride
  • spasmolytic agent
  • adult
  • anorectal pressure
  • Article
  • breath analysis
  • Bristol scale
  • celiac disease
  • chronic constipation
  • clinical assessment
  • clinical feature
  • comorbidity
  • constipation
  • controlled study
  • diagnostic test
  • diet therapy
  • dietary fiber
  • digital rectal examination
  • disease classification
  • disease duration
  • disease severity
  • feces level
  • female
  • follow up
  • gastroenterologist
  • human
  • irritable colon
  • Italian (citizen)
  • major clinical study
  • male
  • medical record
  • medical specialist
  • nerve stimulation
  • PAC-QoL questionnaire
  • PAC-SYM questionnaire
  • prescription
  • psychotherapy
  • quality of life
  • questionnaire
  • rating scale
  • serology
  • thyroid gland
  • treatment response
  • aged
  • chronic disease
  • colonoscopy
  • defecography
  • evaluation study
  • Irritable Bowel Syndrome
  • Italy
  • middle aged
  • procedures
  • severity of illness index
  • symptom assessment
  • Adult
  • Aged
  • Chronic Disease
  • Colonoscopy
  • Constipation
  • Defecography
  • Digital Rectal Examination
  • Female
  • Humans
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Symptom Assessment

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    Bellini, M., Usai-Satta, P., Bove, A., Bocchini, R., Galeazzi, F., Battaglia, E., Alduini, P., Buscarini, E., Bassotti, G., Massimo, B., Santino, M., Dario, G., Paolo, U. S., Antonio, B., Renato, B., Edda, B., Pietro, A., Francesca, G., Gabrio, B., ... Cannizzaro, R. (2017). Chronic constipation diagnosis and treatment evaluation: The "CHRO.CO.DI.T.E." study. BMC Gastroenterology, 17(1), [11]. https://doi.org/10.1186/s12876-016-0556-7