Functional Constipation in Older Adults: Prevalence, Clinical Symptoms and Subtypes, Association with Frailty, and Impact on Quality of Life

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Sandra Arco ◽  
Esther Saldaña ◽  
Mateu Serra-Prat ◽  
Elisabet Palomera ◽  
Yolanda Ribas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Clinical Symptoms ◽  
Functional Constipation ◽  
Colonic Transit ◽  
Rome Iii Criteria ◽  
Frail Patients ◽  
Rome Iii ◽  
Defecation Disorder

<b><i>Introduction:</i></b> Functional constipation (FC) is very prevalent in older adults, especially in women, but its relationship with frailty is not fully understood. The aims were to assess FC prevalence, clinical symptoms and subtypes, association with frailty, and impact on quality of life (QoL) in older people. <b><i>Methods:</i></b> This epidemiological study included 384 individuals aged over 70 years recruited from the community, a hospital, and a nursing home and stratified into robust, pre-frail, and frail groups (Fried criteria). The following criteria were evaluated: frailty, FC (Rome III criteria), stool consistency (Bristol Stool Chart), comorbidities (Charlson), dependency (Barthel), QoL (EQ5D), and clinical and sociodemographic data. Defined by symptom aggregation were 2 main clinical subtypes as follows: slow colonic transit time (CTT) and functional defecation disorder (FDD). <b><i>Results:</i></b> Mean age was 79.11 ± 6.43 years. Overall FC prevalence was 26.8%, higher in women (32.4% women vs. 21.8% men; <i>p</i> = 0.019) and highest in frail patients (41.7% frail vs. 33.9% pre-frail vs. 24.2% robust; <i>p</i> &#x3c; 0.001). Straining and hard stools (Bristol 1–2) were the most prevalent symptoms (89.3 and 75.7%, respectively). Frailty and benzodiazepine intake were independently associated with FC. Patients with FC obtained poorer QoL scores in the EQ5D (perceived health 66.09 ± 17.8 FC patients vs. 56.4 ± 19.03 non-FC patients; <i>p</i> &#x3c; 0.05). The FDD subtype became significantly more prevalent as frailty increased (6.5, 25.8, and 67.7% for robust, pre-frail, and frail patients, respectively); the slow CTT subtype was significantly more frequent in robust patients (38.5% robust vs. 30.5% pre-frail vs. 23.1% frail), <i>p</i> = 0.002. <b><i>Discussion/Conclusion:</i></b> FC prevalence in older adults was high, especially in women, and was associated with frailty and poor QoL. Clinical subtypes as related to frailty phenotypes reflect specific pathophysiological aspects and should lead to more specific diagnoses and improved treatment.

Su1360 Different Perception of Constipation Between Patients and Gastroenterologists: Rome III Criteria, Disease Severity and Quality of Life

2015 ◽  
Vol 148 (4) ◽  
pp. S-485
Author(s):  
Dario Gambaccini ◽  
Massimo Bellini ◽  
Stefano Salvadori ◽  
Gabrio Bassotti ◽  
Edda Battaglia ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Disease Severity ◽  
Rome Iii Criteria ◽  
Rome Iii

scholarly journals Anorectal biofeedback: an effective therapy, but can we shorten the course to improve access to treatment?

2019 ◽  
Vol 12 ◽  
pp. 175628481983607
Author(s):  
Yoav Mazor ◽  
John E. Kellow ◽  
Gillian M. Prott ◽  
Michael P. Jones ◽  
Allison Malcolm
Keyword(s):  
Quality Of Life ◽  
Faecal Incontinence ◽  
Chronic Constipation ◽  
Functional Constipation ◽  
Rectal Sensation ◽  
Access To Treatment ◽  
Bowel Movements ◽  
Defecation Disorder ◽  
Improve Access

Background: Instrumented anorectal biofeedback (BF) improves symptoms and quality of life in patients with faecal incontinence and defecation disorder-associated chronic constipation. However, demand for BF greatly outweighs availability, so refinement of the BF protocol, in terms of the time and resources required, is of importance. Our aim was to evaluate the outcomes of an abbreviated BF protocol in patients with defecation disorder-associated chronic constipation and/or faecal incontinence compared to standard BF. Methods: Data were collected from consecutive patients ( n = 31; age 54 ± 15; 29 females; 61% functional constipation) undergoing an intentionally abbreviated BF protocol, and compared in a 1:2 ratio with 62 age, gender and functional anorectal disorder-matched control patients undergoing a standard BF. Outcomes included change in symptoms, physiology, patient satisfaction and quality of life. Results: On intention to treat, patients in both protocols showed significant improvement in symptom scores and the magnitude did not differ between groups. Impact on quality of life, satisfaction and control over bowel movements improved in both protocols, but satisfaction improved to a greater extent in the standard BF protocol ( p = 0.009). Physiological parameters were unchanged after BF apart from improvement in rectal sensation in the standard BF group compared to abbreviated BF ( p ⩽ 0.002). Conclusions: Abbreviated anorectal BF offered to patients travelling from far away was not different to a standard BF in providing substantial, at least short term, improvements in symptoms of constipation and faecal incontinence, quality of life and feeling of control over bowel movements. Refinement of the standard BF protocol according to individual patient phenotypes and desired outcomes warrants further study in order to maximize efficacy and improve access for patients.

scholarly journals Comparative evaluation of efficacy of Pinaverium monotherapy and combination therapy of Pinaverium with itopride hydrochloride in patients with cross irritable bowel syndrome with constipation and postpradial distress syndrome

2019 ◽  
Vol 3 (20) ◽  
pp. 54-57
Author(s):  
O. V. Krapivnaya ◽  
S. A. Alekseenko
Keyword(s):  
Irritable Bowel Syndrome ◽  
Combination Therapy ◽  
Distress Syndrome ◽  
Clinical Symptoms ◽  
Rome Iii Criteria ◽  
Sf 36 ◽  
Rome Iii ◽  
Itopride Hydrochloride ◽  
Irritable Bowel

Forty-seven patients with overlap between irritable bowel syndrome with constipation and (IBS-C) and postpradial distress syndrome (PDS) complying with Rome III criteria were treated with pinaverium in combination with itopride and 58 patients with IBS-C-PDS overlap were treated with pinaverium for 4 weeks. Clinical symptoms and quality of life by SF-36 were estimated at baseline and after 4 weeks of treatment. Pinaverium and Itopride combination therapy significantly improved both IBS-C and PDS-like symptoms, and SF-36 scores when compared to Pinaverium monotherapy over a 4-week period.

S1215 Quality of Life Impairment in Community Subjects with Functional Dyspepsia Defined According to the ROME III Criteria

2009 ◽  
Vol 136 (5) ◽  
pp. A-215 ◽  
Author(s):  
Pertti Aro ◽  
Jukka Ronkainen ◽  
Tom Storskrubb ◽  
Elisabeth Bolling-Sternevald ◽  
Nicholas J. Talley ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Dyspepsia ◽  
Rome Iii Criteria ◽  
Rome Iii

Efficacy of Acupuncture for Chronic Constipation: A Systematic Review

2013 ◽  
Vol 41 (04) ◽  
pp. 717-742 ◽  
Author(s):  
Tao Zhang ◽  
Tony Y. Chon ◽  
Baoyan Liu ◽  
Alexander Do ◽  
Guangxi Li ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medical Therapy ◽  
Meta Analysis ◽  
Cleveland Clinic ◽  
Functional Constipation ◽  
Colonic Transit ◽  
Bowel Movements ◽  
Conventional Medical Therapy ◽  
Better Than

This study was to evaluate the efficacy and safety of acupuncture for chronic functional constipation. Randomized controlled trials were searched in several databases. The primary outcome was a change in the number of weekly spontaneous bowel movements. The secondary outcomes included colonic transit activity, effective rate, Cleveland Clinic Score, and health-related quality of life score. Meta-analysis was done by using RevMan 5.1. After strict screening, 15 RCTs were included, containing 1256 participants. All of them were conducted in China and published in Chinese journals. Meta-analysis indicated that acupuncture for chronic functional constipation was probably as effective as conventional medical therapy in the change of bowel movements. For the colonic transit activity, acupuncture might be the same as conventional medical therapy and could be better than sham acupuncture. For the Cleveland Clinic Score, acupuncture was unlikely inferior to conventional medical therapy and the deep acupuncture was better than normal depth acupuncture in abdominal region. No obvious adverse event was associated with acupuncture for constipation. In conclusion, acupuncture for chronic functional constipation is safe and may improve weekly spontaneous bowel movements, quality of life, and relevant symptoms. However, the evidence was limited by the small sample size and the methodological quality.

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