Psychological profiles and quality of life differ between patients with dyssynergia and those with slow transit constipation

Rao, Satish S.C.; Seaton, Kara; Miller, Megan; Schulze, Konrad; Brown, Charles E.; Paulson, Jessica; Zimmerman, Bridget

doi:10.1016/j.jpsychores.2007.05.016

Cited by 105 publications

(94 citation statements)

References 35 publications

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“…1 It significantly affects quality of life, and leads to a loss of work productivity and abstinence from school. 2,3 Only about one-third of constipated patients seek medical care, 2 and many patients self-treat their symptoms either by increasing fibre intake or by using over-the-counter laxatives. Recently, it has been recognised that constipation involves multiple symptoms and not merely reduced stool frequency.…”

Section: Resultsmentioning

confidence: 99%

Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation

Attaluri

Donahoe

Valestin

et al. 2011

Alimentary Pharmacology &Amp; Therapeutics

138

129

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Section: Resultsmentioning

confidence: 99%

Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation

Attaluri

Donahoe

Valestin

et al. 2011

Alimentary Pharmacology &Amp; Therapeutics

138

129

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“…Several studies have shown a higher prevalence of anxiety, depression, obsessive compulsiveness, psychoticism, and somatization. 24 Furthermore, paranoid ideation and hostility subscores were higher in patients with dyssynergia than those with slow transit constipation (STC) or healthy controls, providing evidence for significant psychological distress, more so in subjects with dyssynergia than patients with STC. 24 Sexual abuse was reported by 22-48% of subjects, mostly women, whereas physical abuse was reported by 31-74% of constipated subjects.…”

Section: Psychological Distress Abuse and Impact On Quality Of Lifementioning

confidence: 99%

“…24 Furthermore, paranoid ideation and hostility subscores were higher in patients with dyssynergia than those with slow transit constipation (STC) or healthy controls, providing evidence for significant psychological distress, more so in subjects with dyssynergia than patients with STC. 24 Sexual abuse was reported by 22-48% of subjects, mostly women, whereas physical abuse was reported by 31-74% of constipated subjects. 25,26 There was greater incidence of sexual abuse in women with pelvic floor dyssynergia.…”

Section: Psychological Distress Abuse and Impact On Quality Of Lifementioning

confidence: 99%

Diagnosis and Treatment of Dyssynergic Defecation

Rao

Patcharatrakul

2016

J Neurogastroenterol Motil

179

140

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Dyssynergic defecation is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability to coordinate the abdominal and pelvic floor muscles to evacuate stools. A detailed history, prospective stool diaries, and a careful digital rectal examination will not only identify the nature of bowel dysfunction, but also raise the index of suspicion for this evacuation disorder. Anorectal physiology tests and balloon expulsion test are essential for a diagnosis. Newer techniques such as high-resolution manometry and magnetic resonance defecography can provide mechanistic insights. Recently, randomized controlled trials have shown that biofeedback therapy is more effective than laxatives and other modalities, both in the short term and long term, without side effects. Also, symptom improvements correlated with changes in underlying pathophysiology. Biofeedback therapy has been recommended as the first-line of treatment for dyssynergic defecation. Here, we provide an overview of the burden of illness and pathophysiology of dyssynergic defecation, and how to diagnose and treat this condition with biofeedback therapy.

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“…In questo studio è stato anche osservato che la perdita di qualità di vita per stipsi cronica è maggiore nelle donne che negli uomini [87]. I pazienti con stipsi cronica da disfunzione del pavimento pelvico hanno un peggioramento della qualità di vita maggiore dei pazienti con stipsi da rallentato transito [88]. Attualmente, in Italia, il costo di malattia della stipsi, incluse le forme gravi di stipsi cronica, è totalmente a carico del paziente e della società per quanto riguarda la spesa farmaceutica, le compartecipazioni (ticket) alla spesa specialistica ed i costi indiretti, mentre grava sul SSN per i costi dell'assistenza sanitaria di I livello e dell'assistenza specialistica e dell'assistenza ospedaliera.…”

Section: Gestione Clinica Della Stipsi Cronica E Place-in-therapy DI unclassified

Clinical and economic profile of prucalopride in the treatment of chronic constipation in women

Stanghellini

Eandi

2012

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stinali, di recente autorizzato nei Paesi della Comunità Europea e disponibile anche in Italia per il trattamento della stipsi cronica idiopatica delle donne che non hanno avuto benefici dall'uso di lassativi [2]. LA STIPSI CRONICA IDIOPATICA DefinizioneLa stipsi è una sindrome (disordine plurisintomatico) costituita da molti sintomi suggestivi di disordini intestinali e/o anorettali: non solo ridotto numero di evacuazioni (< 3/ settimana) [3], ma anche difficoltà nell'espellere le feci (straining), flatulenza, feci troppo aride, fastidio addominale, dolore e gonfiore addominale, dolore rettale, sensazione di evacuazione incompleta, sensazione di falsa urgenza all'evacuazione [4]. Le più recenti definizioni di stipsi considerano sia le difficoltà dell'atto di evacuazione riferite dai soggetti affetti, sia alcuni parametri quantizzabili oggettivamente quali la frequenza dell'alvo e il tipo di feci [5,6]. Sulla base dei distur- INTRODUZIONELa stipsi cronica è un disturbo comune difficile da trattare e le opzioni disponibili per i diversi sottogruppi di stipsi sono limitate e nella maggior parte dei casi insoddisfacenti. Le forme più gravi di stipsi cronica spesso richiedono l'uso di lassativi ad alte dosi o il ricorso a terapie invasive, come evacuazioni manuali e clisteri, e talvolta a interventi di resezione del colon, nei casi limite nei quali tutti i rimedi sono inefficaci o causano effetti avversi e la malattia è fortemente inabilitante [1]. L'introduzione di un nuovo farmaco, come prucalopride, attivo nel promuovere il transito intestinale, può contribuire a migliorare la terapia dei pazienti affetti da stipsi cronica idiopatica che non hanno trovato sollievo dalle precedenti terapie con lassativi. In questa rassegna, dopo una breve analisi della fisiopatologia e della terapia farmacologica della stipsi cronica, valuteremo il profilo farmacologico, terapeutico ed economico di prucalopride, nuovo enterocinetico ad azione agonista selettiva sui recettori 5-HT4 inte- Corresponding authorProf. Mario Eandi mario.eandi@unito.it DisclosureIl presente lavoro è stato realizzato grazie a un supporto incondizionato di Shire Italia S.p.A. ABSTRACTChronic constipation is a common disorder, especially in women. Options available for different subgroups of constipation are limited and in most cases unsatisfactory. The most severe forms of chronic constipation often require the use of laxatives in high doses or the use of invasive therapies. The introduction of a new drug, such as prucalopride, active in promoting intestinal transit, can help to improve the therapy of patients with chronic idiopathic constipation who have not found relief from previous treatment with laxatives. In this review, after a brief discussion of pathophysiology and pharmacotherapy of chronic constipation, we evaluate the pharmacological profile, therapeutic and cost of prucalopride, recently authorized in the EU countries and also available in Italy for the treatment of chronic constipation in women who did not benefit from the use of laxatives.

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Psychological profiles and quality of life differ between patients with dyssynergia and those with slow transit constipation

Cited by 105 publications

References 35 publications

Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation

Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation

Diagnosis and Treatment of Dyssynergic Defecation

Clinical and economic profile of prucalopride in the treatment of chronic constipation in women

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