Painful or Mild-Pain Constipation? A Clinically Useful Alternative to Classification as Irritable Bowel Syndrome with Constipation Versus Functional Constipation

Bouchoucha, Michel; Devroede, Ghislain; Mary, Florence; Bon, Cyriaque; Bejou, Bakhtiar; Bénamouzig, Robert

doi:10.1007/s10620-018-4995-6

Cited by 25 publications

(25 citation statements)

References 23 publications

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“…Clinical description for some of these patients was previously published. 19 The initial colonic endoscopic examination, and the examination for any organic diseases (ie, metabolic, endocrine, neurologic, and psychiatric etiologies) did not present any organic cause to explain the patients' complaints. 1…”

Section: Subjectsmentioning

confidence: 89%

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Influence of Age and Body Mass Index on Total and Segmental Colonic Transit Times in Constipated Subjects

Bouchoucha

Fysekidis

Rompteaux

et al. 2019

J Neurogastroenterol Motil

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Background/Aims Discordant data are found in the literature for the relationships between total and segmental colonic transit time (CTT) and demographic parameters. The aim of this study is to examine the influence of age, and body mass index (BMI) on total and segmental CTT in constipated subjects. Methods We included 354 constipated patients on this cross-sectional study. According to the Rome III criteria, patients were classified as having irritable bowel syndrome with constipation, or functional constipation. All patients filled the Bristol stool form, and reported the severity of constipation, bloating, and abdominal pain on a 10-point Likert scale. Total and segmental CTT were measured using radiopaque markers. Results Females were 84% of patients, with a mean age of 46.0 ± 15.9 years. The association between total and segmental CTT with age and BMI was significant after adjustment for gender, clinical phenotype, the presence of defecation disorders, and abdominal pain or bloating intensity despite the severity of symptoms, and the frequency of defecation disorders were higher in irritable bowel syndrome with constipation than in functional constipation patients. By comparison with subjects less than 30 years, rectosigmoid transit time (RSTT) was lower in patients between 30 and 60 years. Age was negatively associated with RSTT (P = 0.004). By comparison with patients with normal BMI, RSTT and total CTT were lower in patients of the overweight group. BMI was negatively associated with RSTT (P < 0.001). The severity of constipation was correlated with total (P < 0.001), right (P = 0.002), and left CTT (P = 0.049). Conclusion Age and BMI are both associated with RSTT in constipated patients.

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Section: Subjectsmentioning

confidence: 89%

“…These results confirm that there is no difference in patients with constipation; the only difference is in the severity of abdominal pain. 19 Further studies are needed to evaluate the influence of age, BMI, and gender in healthy subjects in order to define normal or delayed CTT values.…”

Section: Discussionmentioning

confidence: 99%

Influence of Age and Body Mass Index on Total and Segmental Colonic Transit Times in Constipated Subjects

Bouchoucha

Fysekidis

Rompteaux

et al. 2019

J Neurogastroenterol Motil

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“…For example, IBS-C and FC, or because the disorders, have insufficiently precise definition like BL/distension in the Rome IV criteria where the authors state that these patients "may also report symptoms of mild AP and/or minor bowel movement abnormalities" [4]. It is not surprising that many studies found only minimal physiological changes between 2 homologous phenotypes such as IBS-C and FC [17]. Therefore, despite the fact that Rome criteria were used in many drug studies, the rationale for the use of these drugs in patients with specific Rome phenotypes remains discussed and open to debate [9].…”

Section: Discussionmentioning

confidence: 99%

“…As previously described [17][18][19], all patients underwent a firstline morphologic evaluation (colonoscopy and/or radiological examination) and the exclusion of drug abuse, metabolic, endocrine, neurologic, and psychiatric etiologies in order to eliminate an organic cause to their complaint.…”

Section: Clinical Evaluationmentioning

confidence: 99%

“…Patients filled out a standard clinical questionnaire based on diagnostic questions for FGIDs as defined by the Rome III criteria [17,19,20]. The patients were then classified as having functional esophageal disorders (globus, chest pain, heartburn, dysphagia), functional gastroduodenal disorders (epigastric pain, postprandial distress, aerophagia), FBD (IBS and its subtypes; constipation, diarrhea, BL, nonspecific bowel disorders), AP, and functional anal disorders (fecal incontinence, levator ani syndrome, proctalgia fugax, nonspecific anal pain, difficult defecation) [4,[21][22][23][24].…”

Section: Clinical Evaluationmentioning

confidence: 99%

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Data Mining Approach for the Characterization of Functional Bowel Disorders According to Symptom Intensity Provides a Small Number of Homogenous Groups

Bouchoucha

Devroede

Fysekidis

et al. 2019

Dig Dis

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An elevated anxiety level among prepubertal autistic boys with non‐treatment‐seeking functional gastrointestinal disorders: A case–control study

et al. 2021

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Children with autism commonly suffer from comorbid functional gastrointestinal disorders (FGID) and anxiety. The raised prevalence of both conditions in autism suggests complex reciprocal relationships, which are seldom explored in non-treatment-seeking FGID. The relationships between subtypes of FGID and anxiety are also unclear. This study recruited boys with autism and age-matched typically developing (TD) boys, aged 4-11 years, who were not actively seeking help for gastrointestinal problems. Their parents completed the Rome IV Diagnostic Questionnaires for Pediatric FGID. Four groups of children with and without autism/FGID were identified and compared on their anxiety level using the Spence children's anxiety scale. In 69 boys with autism and 69 age-matched TD boys, FGID were identified in 22 and 16 boys, respectively. ANCOVA demonstrated a significant interaction effect of autism and FGID on anxiety (F[1, 129] = 5.43, p = 0.021), while conditional logistic regression identified an interaction effect of autism and anxiety on the odds of FGID (OR 1.038, 95% CI 1.002-1.075, p = 0.038). Explorative post hoc analysis showed higher anxiety in functional nausea and vomiting disorder (p = 0.033) and functional abdominal pain disorder (p = 0.029) among boys with autism than TD boys with the same respective subtypes of FGID. In summary, among prepubertal boys with autism, the presence of FGID that are non-treatment-seeking in nature, has a significantly stronger association with higher levels of anxiety than TD boys. The strength of association may be more prominent in subtypes of FGID. Possible pathomechanisms including the underlying microbiota spectra and inflammatory paths should be explored in future studies. Lay summaryAnxiety and gastrointestinal problems are common symptoms in autism. Given that gut health could be linked to emotions, their association in young boys with autism was studied. The presence of nausea vomiting, or abdominal pain were associated with raised anxiety among boys with autism, yet this was not observed in typically developing boys. This suggests that anxiety among autistic children could be partly explained by the presence of FGID.

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Painful or Mild-Pain Constipation? A Clinically Useful Alternative to Classification as Irritable Bowel Syndrome with Constipation Versus Functional Constipation

Abstract: Painful constipation and mild-pain constipation could be an alternative way to identify constipated patients than using the diagnosis of IBS-C and FC for clinical evaluation and drug studies.

Cited by 25 publications

References 23 publications

Influence of Age and Body Mass Index on Total and Segmental Colonic Transit Times in Constipated Subjects

Influence of Age and Body Mass Index on Total and Segmental Colonic Transit Times in Constipated Subjects

Data Mining Approach for the Characterization of Functional Bowel Disorders According to Symptom Intensity Provides a Small Number of Homogenous Groups

An elevated anxiety level among prepubertal autistic boys with non‐treatment‐seeking functional gastrointestinal disorders: A case–control study

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