Insights Into Normal and Disordered Bowel Habits From Bowel Diaries

Bharucha, Adil E.; Seide, Barbara M.; Zinsmeister, Alan R.; Melton, L. Joseph

doi:10.1111/j.1572-0241.2007.01631.x

Cited by 46 publications

(37 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…75 For example, among women with constipation in the community, straining to begin defecation is more frequent (ie, approximately 40% vs approximately 20%) for hard stools than normal stools. 75 When evacuatory deficits are pronounced, even soft stools and enema fluid may be difficult to pass. After a complete purge, it will take several days for residue to accumulate such that a normal fecal mass will be formed.…”

Section: Clinical Evaluationmentioning

confidence: 99%

American Gastroenterological Association Technical Review on Constipation

2013

Self Cite

View full text Add to dashboard Cite

Section: Clinical Evaluationmentioning

confidence: 99%

American Gastroenterological Association Technical Review on Constipation

2013

Self Cite

View full text Add to dashboard Cite

“…Other investigators, however, find no association between bowel habits and either distention or bloating 12 . Urgency is more closely associated with diarrhea than with constipation 13 .…”

Section: Introductionmentioning

confidence: 99%

IBS Patients Show Frequent Fluctuations Between Loose/Watery and Hard/Lumpy Stools: Implications for Treatment

Palsson

Baggish²,

Turner³

2012

American Journal of Gastroenterology

View full text Add to dashboard Cite

Aims To determine how variable stool consistency is in patients with irritable bowel (IBS) and assess the relationship between stool consistency and gastrointestinal symptoms. Methods Individuals with a physician diagnosis of IBS were recruited by advertisement. Enrollment questionnaires included the Rome III Diagnostic Questionnaire and IBS Symptom Severity Scale. Then 185 patients meeting Rome criteria for IBS rated the consistency (using the Bristol Stool Scale) of each bowel movement (BM) for 90 days and whether the BM was accompanied by pain, urgency, or soiling. Each night they transferred BM ratings from a paper diary to an internet form and also reported the average daily intensity of abdominal pain, bloating, bowel habit dissatisfaction, and life interference of bowel symptoms. Only the longest sequence of consecutive days of diary data was used in analysis (average of 73 days). Results Patients were 89% female with average age 36.6 years. 78% had both loose/watery and hard/lumpy stools; the average was 3 fluctuations between these extremes per month. The proportion of loose/watery stools correlated r=.78 between the first and second months and the proportion of hard/lumpy stools correlated r=.85 between months. Loose/watery stools were associated with more BM-related pain, urgency, and soiling than hard/lumpy or normal stools; however, IBS-C patients had significantly more BM-unrelated abdominal pain, bloating, dissatisfaction with bowel habits, and life interference than IBS-D. Questionnaires overestimated the frequency of abnormal stool consistency and gastrointestinal symptoms compared to diaries. Conclusions Stool consistency varies greatly within individuals. However, stool patterns are stable within an individual from month to month. The paradoxical findings of greater symptom severity after individual loose/watery BMs vs. greater overall symptom severity in IBS-C implies different physiological mechanisms for symptoms in constipation compared to diarrhea. Daily symptom monitoring is more sensitive and reliable than a questionnaire.

show abstract

“…4 While bowel symptoms recorded by questionnaires and bowel diaries are correlated, 5 some patients may not accurately recall bowel symptoms 6 ; hence, symptom diaries may be more reliable.…”

mentioning

confidence: 99%

Anorectal Disorders

et al. 2016

Self Cite

View full text Add to dashboard Cite

This report defines criteria and reviews the epidemiology, pathophysiology, and management of the following common anorectal disorders: fecal incontinence (FI), functional anorectal pain, and functional defecation disorders. FI is defined as the recurrent uncontrolled passage of fecal material for at least 3 months. The clinical features of FI are useful for guiding diagnostic testing and therapy. Anorectal manometry and imaging are useful for evaluating anal and pelvic floor structure and function. Education, antidiarrheals, and biofeedback therapy are the mainstay of management; surgery may be useful in refractory cases. Functional anorectal pain syndromes are defined by clinical features and categorized into 3 subtypes. In proctalgia fugax, the pain is typically fleeting and lasts for seconds to minutes. In levator ani syndrome and unspecified anorectal pain, the pain lasts more than 30 minutes, but in levator ani syndrome there is puborectalis tenderness. Functional defecation disorders are defined by ≥2 symptoms of chronic constipation or irritable bowel syndrome with constipation, and with ≥2 features of impaired evacuation, that is, abnormal evacuation pattern on manometry, abnormal balloon expulsion test, or impaired rectal evacuation by imaging. It includes 2 subtypes: dyssynergic defecation and inadequate defecatory propulsion. Pelvic floor biofeedback therapy is effective for treating levator ani syndrome and defecatory disorders.

show abstract

Insights Into Normal and Disordered Bowel Habits From Bowel Diaries

Abstract: Background-While symptom questionnaires provide a snapshot of bowel habits, they may not reflect day-to-day variations or the relationship between bowel symptoms and stool form.

Cited by 46 publications

References 21 publications

American Gastroenterological Association Technical Review on Constipation

American Gastroenterological Association Technical Review on Constipation

IBS Patients Show Frequent Fluctuations Between Loose/Watery and Hard/Lumpy Stools: Implications for Treatment

Anorectal Disorders

Contact Info

Product

Resources

About