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

Abstract

Key Points• We demonstrated that patients with non-organic chronic constipation regard the symptom of bloating as a key element in assessing clinical changes and treatments' efficacy irrespective of the intensity of other symptoms• We sought to evaluate the association between bloating and quality of life, treatment satisfaction and treatment responsiveness among patients with constipation-predominant irritable bowel syndrome and functional constipation.• We enrolled 2203 patients in a two-wave cross-sectional survey: quality of life data obtained through selfadministered questionnaires were matched with reports of clinical examinations performed by gastroenterologists in 39 tertiary referral centers for the treatment of non-organic constipation.• Bloating was associated with poorer health-related quality of life and treatment satisfaction after adjustment for potential confounders and other constipation-related symptoms.• Bloating was associated with responsiveness to treatment after therapy switch independent of potential confounders. AbstractBackground 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

Is body mass index associated with symptom severity and health-related quality of life in irritable bowel syndrome? A cross-sectional study

“…IBS has a significant impact on patients’ QOL. 25 Our data show an association between symptom severity and QOL with regard to physical and mental health. The patients in our study reported moderate to severe IBS symptom severity and lower QOL.…”

Chronic constipation among community-dwelling older people in the East Coast region of Peninsular Malaysia

“…The majority of studies have reported that straining, lumpy and hard stools, and a sensation of incomplete evacuation are three core constipation symptoms. 8,[22][23][24] Nevertheless, our findings show that older people perceive chronic constipation based on the less frequent symptoms. This mismatch demonstrates that constipation misperception is common in older people, and thus supports our early study findings.…”

Better Understanding and Recognition of the Disconnects, Experiences, and Needs of Patients with Irritable Bowel Syndrome with Constipation (BURDEN IBS-C) Study: Results of an Online Questionnaire

“…In addition, more IBS-C patients reported experiencing residual hard, lumpy, or pebble-like stools than did CIC patients (34% vs 21%), yet fewer IBS-C patients experienced difficulty with bowel movements (23% vs 35%) [5]. Abdominal bloating was associated with worse quality of life, treatment satisfaction, and treatment responsiveness [17]; therefore, the finding that more than half of patients still experienced abdominal bloating/distension despite current treatment emphasizes the importance and difficulty of addressing all of the symptoms in this heterogeneous disorder. Both IBS-C and CIC sufferers reported similar assessments of their feelings toward their condition, its negative impact on productivity and personal activities, and their dissatisfaction with available treatments.…”