Experiencing multiple concurrent functional gastrointestinal disorders is associated with greater symptom severity and worse quality of life in chronic constipation and defecation disorders

Abstract

Background Recent community‐based studies have demonstrated that experiencing multiple concurrent functional gastrointestinal disorders (FGIDs) is associated with increased somatization, worse quality of life (QoL), and greater health care utilization. However, the presence of multiple overlapping FGIDs is unstudied specifically in chronic constipation and functional defecation disorders (FDD). We investigated the prevalence and impact of additional nonconstipation FGIDs on constipation severity, anorectal physiology, anxiety and depression, and QoL, in patients with chronic constipation and FDD. Methods One‐hundred and forty‐six consecutive patients with functional constipation or irritable bowel syndrome (IBS‐C/IBS‐M) presenting to a tertiary referral Neurogastroenterology Clinic were studied. In addition, 90/146 (62%) qualified for FDD due to abnormal defecatory physiology. Patients underwent comprehensive baseline assessment comprising anorectal physiology, Bristol Stool Chart, Rome questionnaire, Knowles‐Eccersley‐Scott‐Symptom (KESS) constipation score, Hospital Anxiety, and Depression Scale, and modified 36‐Item Short Form Health Survey (SF‐36) for QoL. Additional FGIDs were diagnosed using Rome III criteria. Key Results Additional nonconstipation FGIDs occurred in 85% of patients, with a mean of 2.1 (SD 1.6) additional FGIDs. Patients with four or more additional FGIDs experienced greater constipation severity compared to those with no additional FGIDs (p = 0.004). Comorbid FGIDs were associated with worse SF‐36 scores for physical functioning (p < 0.001), role‐physical (p = 0.005), bodily pain (p < 0.001), vitality (p = 0.008), social functioning (p = 0.004), and mental health index (p = 0.031). Conclusions and Inferences Functional gastrointestinal disorders comorbidity is highly prevalent in chronic constipation and defecatory disorders, and this is associated with greater symptom severity and worse QoL. Multimodal treatments targeting comorbid FGIDs may lead to superior outcomes.

The role of repetitive transcranial magnetic stimulation therapy in functional bowel disease

“…As the number of rTMS sessions increases, these neural adaptations accumulate, potentially leading to more significant and sustained therapeutic effects (64). Studies have shown that patients with constipation are often accompanied by psychiatric symptoms such as anxiety and depression (30). In this The CSS, SAS, SDS, and SSS scale scores before rTMS treatment in the FBD treatment group with different sessions of rTMS.…”

“…The CSS (30) is a constipation score developed by the Cleveland Clinic. There are 8 self-test questions, with a full score of 30 points, and a minimum of 0 points.…”

Effects of Bifidobacterium longum 35624 in Children and Adolescents with Irritable Bowel Syndrome

“…The clinical features of the pediatric population in this region warrant specific investigation, with a higher prevalence of childhood constipation in South America than in other countries [ 22 ], accounting for one-third of pediatric gastroenterology consultations in Chile [ 23 ]. Disease overlap between IBS and functional defecation disorders is common and has been associated with increased symptom severity and decreased quality of life [ 24 ]. In the present study, the majority of participants had other DGBI including two-thirds with functional constipation, in addition to moderate or severe IBS at baseline, yet the probiotic proved to be highly effective.…”

Quality of life measures in children with Down syndrome with disorders of gut–brain interaction

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