Differences between painless and painful constipation among community women

Adil Eddie Bharucha, G. Richard Locke, Alan R. Zinsmeister, Barbara M. Seide, Kimberly McKeon, Cathy D. Schleck, L. Joseph Melton

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

BACKGROUND: In the Rome II criteria, patients with both constipation and abdominal pain (AP) (i.e., "painful constipation" (PC)), who do not satisfy criteria for irritable bowel syndrome (IBS) are included in the same functional constipation (FC) category as patients with constipation without AP (i.e., "painless constipation" (PLC)). What differences, if any, exist between FC without (i.e., PLC) and with AP (i.e., PC) are unclear. METHODS: To compare clinical features among PLC, PC, constipation-predominant IBS (C-IBS), and non-C-IBS, a validated questionnaire was mailed (with telephone follow-up of nonresponders) to an age-stratified random sample of 5,200 adult women in Olmsted County, Minnesota. RESULTS: Altogether, 2,800 women (53%) responded. The age-adjusted prevalence of PLC (7.1 per 100; 95% confidence interval (95% CI), 6.2-8.0) was higher compared to PC (0.9 per 100; 95% CI, 0.6-1.2). Compared to PLC, patients with PC reported worse general health (i.e., excellent or very good = 37.5%vs 51.2%), more somatic symptoms (mean score = 1.3 vs 0.9), and urinary urgency (% often = 58%vs 32%), and had a higher prevalence of hysterectomy. Bowel symptoms significantly impacted ≥1 domain of quality of life (QOL) in 18% of PC versus 9% of PLC. In a logistic discriminant model, age, general health, impact of bowel symptoms on QOL, somatic symptoms, and urinary urgency independently discriminated between bowel subtypes. CONCLUSIONS: Patients with PC more closely resemble those with C-IBS than PLC. Consideration should be given to separating PC from PLC in the Rome criteria and in therapeutic trials.

Original languageEnglish (US)
Pages (from-to)604-612
Number of pages9
JournalAmerican Journal of Gastroenterology
Volume101
Issue number3
DOIs
StatePublished - Mar 2006

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Constipation
Abdominal Pain
Irritable Bowel Syndrome
Quality of Life
Confidence Intervals
Health

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Bharucha, A. E., Locke, G. R., Zinsmeister, A. R., Seide, B. M., McKeon, K., Schleck, C. D., & Melton, L. J. (2006). Differences between painless and painful constipation among community women. American Journal of Gastroenterology, 101(3), 604-612. https://doi.org/10.1111/j.1572-0241.2006.00435.x

Differences between painless and painful constipation among community women. / Bharucha, Adil Eddie; Locke, G. Richard; Zinsmeister, Alan R.; Seide, Barbara M.; McKeon, Kimberly; Schleck, Cathy D.; Melton, L. Joseph.

In: American Journal of Gastroenterology, Vol. 101, No. 3, 03.2006, p. 604-612.

Research output: Contribution to journalArticle

Bharucha, AE, Locke, GR, Zinsmeister, AR, Seide, BM, McKeon, K, Schleck, CD & Melton, LJ 2006, 'Differences between painless and painful constipation among community women', American Journal of Gastroenterology, vol. 101, no. 3, pp. 604-612. https://doi.org/10.1111/j.1572-0241.2006.00435.x
Bharucha, Adil Eddie ; Locke, G. Richard ; Zinsmeister, Alan R. ; Seide, Barbara M. ; McKeon, Kimberly ; Schleck, Cathy D. ; Melton, L. Joseph. / Differences between painless and painful constipation among community women. In: American Journal of Gastroenterology. 2006 ; Vol. 101, No. 3. pp. 604-612.
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abstract = "BACKGROUND: In the Rome II criteria, patients with both constipation and abdominal pain (AP) (i.e., {"}painful constipation{"} (PC)), who do not satisfy criteria for irritable bowel syndrome (IBS) are included in the same functional constipation (FC) category as patients with constipation without AP (i.e., {"}painless constipation{"} (PLC)). What differences, if any, exist between FC without (i.e., PLC) and with AP (i.e., PC) are unclear. METHODS: To compare clinical features among PLC, PC, constipation-predominant IBS (C-IBS), and non-C-IBS, a validated questionnaire was mailed (with telephone follow-up of nonresponders) to an age-stratified random sample of 5,200 adult women in Olmsted County, Minnesota. RESULTS: Altogether, 2,800 women (53{\%}) responded. The age-adjusted prevalence of PLC (7.1 per 100; 95{\%} confidence interval (95{\%} CI), 6.2-8.0) was higher compared to PC (0.9 per 100; 95{\%} CI, 0.6-1.2). Compared to PLC, patients with PC reported worse general health (i.e., excellent or very good = 37.5{\%}vs 51.2{\%}), more somatic symptoms (mean score = 1.3 vs 0.9), and urinary urgency ({\%} often = 58{\%}vs 32{\%}), and had a higher prevalence of hysterectomy. Bowel symptoms significantly impacted ≥1 domain of quality of life (QOL) in 18{\%} of PC versus 9{\%} of PLC. In a logistic discriminant model, age, general health, impact of bowel symptoms on QOL, somatic symptoms, and urinary urgency independently discriminated between bowel subtypes. CONCLUSIONS: Patients with PC more closely resemble those with C-IBS than PLC. Consideration should be given to separating PC from PLC in the Rome criteria and in therapeutic trials.",
author = "Bharucha, {Adil Eddie} and Locke, {G. Richard} and Zinsmeister, {Alan R.} and Seide, {Barbara M.} and Kimberly McKeon and Schleck, {Cathy D.} and Melton, {L. Joseph}",
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T1 - Differences between painless and painful constipation among community women

AU - Bharucha, Adil Eddie

AU - Locke, G. Richard

AU - Zinsmeister, Alan R.

AU - Seide, Barbara M.

AU - McKeon, Kimberly

AU - Schleck, Cathy D.

AU - Melton, L. Joseph

PY - 2006/3

Y1 - 2006/3

N2 - BACKGROUND: In the Rome II criteria, patients with both constipation and abdominal pain (AP) (i.e., "painful constipation" (PC)), who do not satisfy criteria for irritable bowel syndrome (IBS) are included in the same functional constipation (FC) category as patients with constipation without AP (i.e., "painless constipation" (PLC)). What differences, if any, exist between FC without (i.e., PLC) and with AP (i.e., PC) are unclear. METHODS: To compare clinical features among PLC, PC, constipation-predominant IBS (C-IBS), and non-C-IBS, a validated questionnaire was mailed (with telephone follow-up of nonresponders) to an age-stratified random sample of 5,200 adult women in Olmsted County, Minnesota. RESULTS: Altogether, 2,800 women (53%) responded. The age-adjusted prevalence of PLC (7.1 per 100; 95% confidence interval (95% CI), 6.2-8.0) was higher compared to PC (0.9 per 100; 95% CI, 0.6-1.2). Compared to PLC, patients with PC reported worse general health (i.e., excellent or very good = 37.5%vs 51.2%), more somatic symptoms (mean score = 1.3 vs 0.9), and urinary urgency (% often = 58%vs 32%), and had a higher prevalence of hysterectomy. Bowel symptoms significantly impacted ≥1 domain of quality of life (QOL) in 18% of PC versus 9% of PLC. In a logistic discriminant model, age, general health, impact of bowel symptoms on QOL, somatic symptoms, and urinary urgency independently discriminated between bowel subtypes. CONCLUSIONS: Patients with PC more closely resemble those with C-IBS than PLC. Consideration should be given to separating PC from PLC in the Rome criteria and in therapeutic trials.

AB - BACKGROUND: In the Rome II criteria, patients with both constipation and abdominal pain (AP) (i.e., "painful constipation" (PC)), who do not satisfy criteria for irritable bowel syndrome (IBS) are included in the same functional constipation (FC) category as patients with constipation without AP (i.e., "painless constipation" (PLC)). What differences, if any, exist between FC without (i.e., PLC) and with AP (i.e., PC) are unclear. METHODS: To compare clinical features among PLC, PC, constipation-predominant IBS (C-IBS), and non-C-IBS, a validated questionnaire was mailed (with telephone follow-up of nonresponders) to an age-stratified random sample of 5,200 adult women in Olmsted County, Minnesota. RESULTS: Altogether, 2,800 women (53%) responded. The age-adjusted prevalence of PLC (7.1 per 100; 95% confidence interval (95% CI), 6.2-8.0) was higher compared to PC (0.9 per 100; 95% CI, 0.6-1.2). Compared to PLC, patients with PC reported worse general health (i.e., excellent or very good = 37.5%vs 51.2%), more somatic symptoms (mean score = 1.3 vs 0.9), and urinary urgency (% often = 58%vs 32%), and had a higher prevalence of hysterectomy. Bowel symptoms significantly impacted ≥1 domain of quality of life (QOL) in 18% of PC versus 9% of PLC. In a logistic discriminant model, age, general health, impact of bowel symptoms on QOL, somatic symptoms, and urinary urgency independently discriminated between bowel subtypes. CONCLUSIONS: Patients with PC more closely resemble those with C-IBS than PLC. Consideration should be given to separating PC from PLC in the Rome criteria and in therapeutic trials.

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