Painful constipation: a neglected entity?

Bassotti, Gabrio; Carlani, Elisa; Baldoni, Matteo; Gullà, N; Morozzi, B.; Villanacci, Vincenzo

doi:10.4321/s1130-01082011000100005

Cited by 13 publications

(7 citation statements)

References 35 publications

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“…Moreover, patients complaining of FC, and even functional defecation disorders, who reported abdominal pain and/or discomfort relieved by defecation could be simply classified as IBS‐C. On the other hand, there is a subgroup of FC patients who also complain of abdominal pain not relieved by defecation, the so‐called painful constipation …”

Section: Discussionmentioning

confidence: 99%

“…8,9,19 Moreover, patients complaining of FC, and even functional defecation disorders, who reported abdominal pain and/or discomfort relieved by defecation could be simply classified as IBS-C. On the other hand, there is a subgroup of FC patients who also complain of abdominal pain not relieved by defecation, the so-called painful constipation. [20][21][22][23] Till now, the overlap of symptoms between FC and IBS-C has represented a major challenge for clinical gastroenterologists. This is because separating constipated patients into these 2 groups is often the starting point for clinical trials and it seems very important for a better knowledge of the pathophysiology of the disease in order to choose the more appropriate diagnostic and treatment approach.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Different perception of chronic constipation between patients and gastroenterologists

Bellini

Gambaccini

Salvadori

et al. 2018

Neurogastroenterology Motil

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Different perception of chronic constipation between patients and gastroenterologists

Bellini

Gambaccini

Salvadori

et al. 2018

Neurogastroenterology Motil

Self Cite

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show abstract

“…Consequently, there are patients who meet the Rome criteria for CIC, who do not meet IBS criteria, yet still have abdominal pain. [15][16][17][22][23][24][25][26] While the Rome criteria are valuable as a standard set of rules to apply to clinical studies, their current CIC and IBS-C classifications are less useful in the clinic. In practice, a patient with constipation can alternately fulfil the criteria for CIC or IBS-C over time, 27 and, in some patients, distinguishing between CIC and IBS-C at any given timepoint may be difficult.…”

Section: Introductionmentioning

confidence: 99%

The impact of abdominal pain on global measures in patients with chronic idiopathic constipation, before and after treatment with linaclotide: a pooled analysis of two randomised, double‐blind, placebo‐controlled, phase 3 trials

Chang

Lembo

Lavins

et al. 2014

Aliment Pharmacol Ther

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BackgroundFew clinical trials in chronic idiopathic constipation (CIC) patients have evaluated abdominal symptom severity and whether CIC patients with abdominal symptoms respond similarly to patients with limited abdominal symptoms.AimsTo examine abdominal symptom severity and relationships between symptoms and global measures at baseline; compare linaclotide's effect on symptoms in subpopulations with more or less abdominal pain; and assess relationships between symptom improvement and global measures in these two subpopulations.MethodsIn two phase 3 trials, patients meeting modified Rome II CIC criteria were assigned to linaclotide 145 μg, 290 μg, or placebo once daily. Patients rated abdominal and bowel symptoms daily during 2-week pre-treatment and 12-week treatment periods. Linaclotide's effect on symptoms and global measures [constipation severity, health-related quality of life (HRQOL), treatment satisfaction] and their inter-relationships were assessed in post hoc analyses of abdominal pain subpopulations.ResultsOf 1271 CIC patients, 23%, 32%, and 43% reported moderate-to-severe abdominal pain, discomfort, and bloating, respectively, during baseline. In more-severe abdominal pain patients, abdominal symptoms were more strongly correlated than bowel symptoms with global measures, but in less-severe abdominal pain patients, abdominal and bowel symptoms were similarly correlated with global measures, at baseline and post-treatment. Linaclotide significantly improved all symptoms and global measures in both subpopulations.ConclusionsWhen abdominal pain is present in CIC, abdominal and not bowel symptoms may drive patient assessments of constipation severity, HRQOL, and treatment satisfaction. Linaclotide (145 μg and 290 μg) is an effective treatment for both abdominal and bowel symptoms, even in CIC patients with more severe abdominal pain at baseline. (Clinicaltrials.gov: NCT00765882, NCT00730015).

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“…In this context, constipation is a problem often neglected during primary attention and many possible causes and adequate diagnostic tests should be considered 8 . FCIC are frequent in pain clinics because this is a common disorder in cancer patients under opioids for pain control 9 . Face to this, the quality of life of this group is impaired due to abdominal distension and its consequences, regionally characterized by abdominal fullness sensation, continuous or stabbing pain, cramps, psychological discomfort, increased rectal compliance and decreased sensation of rectal content and, not uncommonly, with symptoms in other segments of the body, such as chest, where the expression is constrictive-type pain (splenic angle syndrome), and not the fact of feeling that their intestine is just constipated 9,10 .…”

Section: Introductionmentioning

confidence: 99%

Impacto da terapia manual visceral na melhora da qualidade de vida de pacientes com dor abdominal crônica

Ferraz¹,

Martins

Foss

2013

Rev. dor

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BACKGROUND AND OBJECTIVES: Abdominal pain secondary to functional chronic intestinal constipation (FCIC) affects a substantial number of people, especially females. This study aimed at evaluating the efficacy of manual visceral therapy in patients of a Pain Clinic to confirm this intervention as a tool to improve constipation and increase lumbar mobility and, as a consequence, better quality of life (QL). METHOD: This is a clinical trial with convenience sample of 20 patients complaining of intestinal function changes and lumbar vertebral mobility restriction. Bio-socio-demographic characteristics were analyzed and the Rome III Criteria questionnaire, Shöeber test, middle finger to floor test and quality of life inventory SF-36 were used to evaluate constipation, lumbar mobility and QL, respectively, before and after receiving manual visceral therapy (MVT). RESULTS: Patients, especially females, mean age of 38.42 ± 19.23, had significant improvement between evaluation and revaluation, in four SF-36 domains (functional capacity, pain, general health and vitality-p < 0.05) and improvement of intestinal constipation and lumbar mobility. CONCLUSION: MVT proposed and applied to individuals with chronic abdominal pain secondary to FCIC in this study was able to improve intestinal constipation and lumbar mobility, in addition to QL of participants.

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Painful constipation: a neglected entity?

Cited by 13 publications

References 35 publications

Different perception of chronic constipation between patients and gastroenterologists

Different perception of chronic constipation between patients and gastroenterologists

The impact of abdominal pain on global measures in patients with chronic idiopathic constipation, before and after treatment with linaclotide: a pooled analysis of two randomised, double‐blind, placebo‐controlled, phase 3 trials

Impacto da terapia manual visceral na melhora da qualidade de vida de pacientes com dor abdominal crônica

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