Fecal urgency is common in constipated patients and is associated with anxiety

Abstract

Background Fecal urgency is a symptom generally associated with diarrhea but is also reported by patients with constipation. Our aim was to (a) assess the prevalence and burden of fecal urgency in constipated patients (b) evaluate gastrointestinal and psychiatric predictors of moderate to severe fecal urgency in these patients. Methods Patients presenting consecutively to a tertiary outpatient gastroenterology clinic with constipation were included. Patients were considered to have moderate to severe fecal urgency if ≥50% of bowel movements (BMs) in the past 3 months were associated with fecal urgency. Anxiety, depression, and sleep disturbance were diagnosed using a Patient‐Reported Outcomes Measurement Information System (PROMIS) t‐score of ≥60. Abdominal pain and constipation severity were also assessed using PROMIS questionnaires. Univariable and stepwise logistic regression were used to identify predictors of moderate to severe fecal urgency. Key results Of 139 constipated patients, 70.8% reported experiencing fecal urgency in the past 3 months and 25.8% reported being significantly bothered by it. Moderate to severe fecal urgency was reported by 27% of 139 patients. Frequency of loose stools (OR 1.5, 95% CI 1.1, 2.0) and presence of anxiety (OR 2.3, 95% CI 1.1, 5.0) were independent predictors of moderate to severe fecal urgency. Conclusions and inferences Fecal urgency is common in patients with constipation and is frequently bothersome to many patients. We identified clinical and psychiatric factors associated with moderate to severe fecal urgency in constipated patients with potential therapeutic implications if validated in future studies.

Dopa responsive irritable bowel syndrome: restless bowel syndrome or a gastrointestinal variant of restless legs syndrome?

“…In a recent study on IBS-C, about 71% of patients reported faecal urgency. Like urge to move of typical RLS, urge to defaecate is associated with the unpleasant sensation (pain or bloating) in the abdomen 19. Mangel et al define faecal urgency as ‘unpleasant sensation that one needs to rush to the toilet or they may soil themselves’.…”

Anxiety and Depression in School-age Patients With Spinal Muscular Atrophy: a Cross-sectional Study

“…In the current study, the patients with digestive system dysfunction had a signi cantly higher anxiety and depression rate than those without digestive system complications. Studies have found that constipation and diarrhea often aggravate the anxiety of patients, and anxiety may affect the course of the disease through the neuroendocrine regulatory system, further aggravating the clinical symptoms of patients and exacerbating constipation [31,32]. A study on Parkinson's disease (PD) patients showed that severe constipation and motor symptoms were closely related to depression; the researchers explained that involvement of the enteric plexus of the gastrointestinal tract and dorsal motor nucleus of the vagus (DMV) initially causes constipation in PD patients, and subsequent spread to the raphe nuclei and locus coeruleus leads to depressive mood [33].…”

Anxiety and depression in school-age patients with spinal muscular atrophy: a cross-sectional study

“…In the current study, the patients with digestive system dysfunction had a significantly higher anxiety and depression rate than those without digestive system complications. Studies have found that constipation and diarrhea often aggravate the anxiety of patients, and anxiety may affect the course of the disease through the neuroendocrine regulatory system, further aggravating the clinical symptoms of patients and exacerbating constipation [31,32]. A study on Parkinson's disease (PD) patients showed that severe constipation and motor symptoms were closely related to depression; the researchers explained that involvement of the enteric plexus of the gastrointestinal tract and dorsal motor nucleus of the vagus (DMV) initially causes constipation in PD patients, and subsequent spread to the raphe nuclei and locus coeruleus leads to depressive mood [33].…”