Biopsychosocial Model and Perceived Constipation Severity According to the Constipation Phenotype
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ORIGINAL ARTICLE
Biopsychosocial Model and Perceived Constipation Severity According to the Constipation Phenotype Michel Bouchoucha1,2,4 · Marinos Fysekidis3 · David Deutsch3 · Bakhtiar Bejou3 · Jean‑Marc Sabate2 · Robert Benamouzig2 Received: 9 June 2020 / Accepted: 3 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Constipation is a frequent complaint of patients with functional bowel disorders. The present study aimed to evaluate the relationship between the perceived constipation severity with demographics, clinical, physiological, and psychological parameters in constipated patients. Patients and Methods Four hundred seven constipated patients were included and had clinical, physiological, and psychological evaluation. The self-reported severity of constipation was analyzed using stepwise linear regression in the total population and within each clinical group. Results The patients were mainly of female gender (81%) and were 47.4 ± 16.5 years old. They complained of IBS (65%), and 62% had defecation disorders. The depression scale was abnormal in 200 patients (49%). The relationships of the constipation severity varied according to the Rome IV phenotype. In all phenotypes, it was positively associated with bloating severity, and negatively with Bristol stool form. In IBS patients, perceived constipation severity was also associated with abdominal pain severity. Conclusion Our data support the hypothesis that perceived constipation severity is associated with clinical and physiological factors but not demographics and psychological factors. Besides, the relationships of perceived constipation severity with these factors vary according to clinical phenotypes. Keywords Constipation · Functional bowel disorders · Irritable bowel syndrome · Depression · Anxiety
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10620-020-06654-z) contains supplementary material, which is available to authorized users. * Michel Bouchoucha [email protected] 1
Physiology Department, Université René Descartes, Paris V, Paris, France
2
Gastroenterology Department, Avicenne Hospital, Bobigny, France
3
Nutrition Department, Hôpital Privé de l’Est Parisien, 33600 Aulnay Sous Bois, France
4
Service de Gastro‑Entérologie, CEFRED (Centre d’Exploration Fonctionnelle et de Rééducation Digestive), Hôpital Avicenne, 125, rue de Stalingrad, 93009 Bobigny Cedex, France
Constipation is a frequently reported complaint by patients with functional gastrointestinal disorders (FGIDs). For many patients, it simply means infrequent stools, while for other patients, constipation is used to describe hard stools, straining, anorectal blockage, or a sense of incomplete emptying after a bowel movement [1]. The most widely used criteria to clinically assess chronic idiopathic constipation are Rome Criteria that separate constipated patients into patients with bowel disorders [2]: functional constipation (FC), and irr
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