Recognizing and Defining Occasional Constipation: Expert Consensus Recommendations.
Journal
The American journal of gastroenterology
ISSN: 1572-0241
Titre abrégé: Am J Gastroenterol
Pays: United States
ID NLM: 0421030
Informations de publication
Date de publication:
01 11 2022
01 11 2022
Historique:
received:
25
02
2022
accepted:
29
07
2022
pubmed:
17
8
2022
medline:
8
11
2022
entrez:
16
8
2022
Statut:
ppublish
Résumé
Constipation is a common problem, affects 15% of the population, and is often self-diagnosed and self-managed. Over the past 3 decades, there have been significant advances in our understanding and management of chronic constipation, with the emerging recognition that occasional constipation (OC) is another subtype that falls outside current classifications. The purpose of this review was to describe the process of developing and proposing a new definition for OC based on expert consensus and taking into consideration the multifactorial nature of the problem such as alterations in bowel habit that include stool frequency and difficulty with stool passage, perception of the sufferer, duration of symptoms, and potential responsiveness to treatment. Leading gastroenterologists from 5 countries met virtually on multiple occasions through an online digital platform to discuss the problem of OC and recommended a practical, user-friendly definition: "OC can be defined as intermittent or occasional symptomatic alteration(s) in bowel habit. This includes a bothersome reduction in the frequency of bowel movements and/or difficulty with passage of stools but without alarming features. Bowel symptoms may last for a few days or a few weeks, and episodes may require modification of lifestyle, dietary habits and/or use of over-the-counter laxatives or bulking agents to restore a satisfactory bowel habit." Prospective studies are required to validate this definition and determine OC prevalence in the community. This review highlights current knowledge gaps and could provide impetus for future research to facilitate an improved understanding of OC and development of evidence-based management guidelines.
Identifiants
pubmed: 35971230
doi: 10.14309/ajg.0000000000001945
pii: 00000434-202211000-00015
doi:
Substances chimiques
Laxatives
0
Types de publication
Review
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1753-1758Informations de copyright
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.
Références
American Gastroenterological Association. Constipation. Clin Gastroenterol Hepatol 2018;16:PA22.
Connell AM, Hilton C, Irvine G, et al. Variation of bowel habit in two population samples. Br Med J 1965;2:1095–9.
Mitsuhashi S, Ballou S, Jiang ZG, et al. Characterizing normal bowel frequency and consistency in a representative sample of adults in the United States (NHANES). Am J Gastroenterol 2018;113:115–23.
Sandler RS, Drossman DA. Bowel habits in young adults not seeking health care. Dig Dis Sci 1987;32:841–5.
Aziz I, Whitehead WE, Palsson OS, et al. An approach to the diagnosis and management of Rome IV functional disorders of chronic constipation. Expert Rev Gastroenterol Hepatol 2020;14:39–46.
Bharucha AE, Lacy BE. Mechanisms, evaluation, and management of chronic constipation. Gastroenterology 2020;158:1232–49.e3.
Paré P, Bridges R, Champion MC, et al. Recommendations on chronic constipation (including constipation associated with irritable bowel syndrome) treatment. Can J Gastroenterol 2007;21(Suppl B):3B–22B.
Johanson JF, Kralstein J. Chronic constipation: A survey of the patient perspective. Aliment Pharmacol Ther 2007;25:599–608.
Taylor DCA, Abel JL, Martin C, et al. Comprehensive assessment of patients with irritable bowel syndrome with constipation and chronic idiopathic constipation using deterministically linked administrative claims and patient-reported data: The chronic constipation and IBS-C treatment and outcomes real-world research platform (CONTOR). J Med Econ 2020;23:1072–83.
40FR12902. Proposal to establish monographs for OTC laxative, antidiarrheal, emetic, and anti-emetic products. Fed Reg 1975;40:12902–44.
50FR2124. Laxative drug products for over-the-counter human use; tentative final monograph. Fed Reg 1985;50:2124–58.
BusinessWire Report. Global laxatives market (2020 to 2028)–sedentary lifestyles will significantly increase the demand for laxatives market–ResearchAndMarkets.com, 2021 ( https://www.businesswire.com/news/home/20210219005287/en/Global-Laxatives-Market-2020-to-2028–-Sedentary-Lifestyles-Will-Significantly-Increase-the-Demand-for-Laxatives-Market–-ResearchAndMarkets.com ). Accessed July 7, 2022.
Hinkel U, Schuijt C, Erckenbrecht JF. OTC laxative use of sodium picosulfate–results of a pharmacy-based patient survey (cohort study). Int J Clin Pharmacol Ther 2008;46:89–95.
Oh SJ, Fuller G, Patel D, et al. Chronic constipation in the United States: Results from a population-based survey assessing healthcare seeking and use of pharmacotherapy. Am J Gastroenterol 2020;115:895–905.
Werth BL, Williams KA, Fisher MJ, et al. Defining constipation to estimate its prevalence in the community: Results from a national survey. BMC Gastroenterol 2019;19:75.
Garrigues V, Gálvez C, Ortiz V, et al. Prevalence of constipation: Agreement among several criteria and evaluation of the diagnostic accuracy of qualifying symptoms and self-reported definition in a population-based survey in Spain. Am J Epidemiol 2004;159:520–6.
Rajput M, Saini SK. Prevalence of constipation among the general population: A community-based survey from India. Gastroenterol Nurs 2014;37:425–9.
Schmidt FMQ, de Gouveia Santos VLC, de Cássia Domansky R, et al. Prevalence of self-reported constipation in adults from the general population. Rev Esc Enferm USP 2015;49:443–52.
Werth BL, Williams KA, Pont LG. Laxative use and self-reported constipation in a community-dwelling elderly population: A community-based survey from Australia. Gastroenterol Nurs 2017;40:134–41.
Pannemans J, Van den Houte K, Fischler B, et al. Prevalence and impact of self-reported painful and non-painful constipation in the general population. Neurogastroenterol Motil 2020;32:e13783.
Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: Systematic review and meta-analysis. Am J Gastroenterol 2011;106:1582–91; quiz 1581, 1592.
Enck P, Leinert J, Smid M, et al. Prevalence of constipation in the German population–a representative survey (GECCO). United Eur Gastroenterol J 2016;4:429–37.
Sperber AD, Bangdiwala SI, Drossman DA, et al. Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome Foundation Global Study. Gastroenterology 2021;160:99–114.e3.
Lacy BE, Mearin F, Chang L, et al. Bowel disorders. Gastroenterology 2016;150:1393–407.e5.
Stern T, Davis AM. Evaluation and treatment of patients with constipation. JAMA 2016;315:192–3.
Serra J, Pohl D, Azpiroz F, et al., Functional Constipation Guidelines Working Group. European society of neurogastroenterology and motility guidelines on functional constipation in adults. Neurogastroenterol Motil 2020;32:e13762.
Ghoshal UC, Sachdeva S, Pratap N, et al. Indian consensus on chronic constipation in adults: A joint position statement of the Indian Motility and Functional Diseases Association and the Indian Society of Gastroenterology. Indian J Gastroenterol 2018;37:526–44.
Bove A, Pucciani F, Bellini M, et al. Consensus statement AIGO/SICCR: Diagnosis and treatment of chronic constipation and obstructed defecation (part I: diagnosis). World J Gastroenterol 2012;18:1555–64.
Bove A, Bellini M, Battaglia E, et al. Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation (part II: treatment). World J Gastroenterol 2012;18:4994–5013.
Camilleri M, Drossman DA, Becker G, et al. Emerging treatments in neurogastroenterology: A multidisciplinary working group consensus statement on opioid-induced constipation. Neurogastroenterol Motil 2014;26:1386–95.
McGraw T. Polyethylene glycol 3350 in occasional constipation: A one-week, randomized, placebo-controlled, double-blind trial. World J Gastrointest Pharmacol Ther 2016;7:274–82.
Udani JK, Bloom DW. Effects of kivia powder on gut health in patients with occasional constipation: A randomized, double-blind, placebo-controlled study. Nutr J 2013;12:78.
ClinicalTrials gov. NCT02423564. A study investigating the effect of Digesta-Lac in healthy adults with occasional constipation ( https://clinicaltrials.gov/ct2/show/NCT02423564 ). Accessed July 7, 2022.
Schmulson MJ, Drossman DA. What is new in Rome IV? J Neurogastroenterol Motil 2017;23:151–63.
Vanner SJ, Depew WT, Paterson WG, et al. Predictive value of the Rome criteria for diagnosing the irritable bowel syndrome. Am J Gastroenterol 1999;94:2912–7.
Whitehead WE, Palsson OS, Feld AD, et al. Utility of red flag symptom exclusions in the diagnosis of irritable bowel syndrome. Aliment Pharmacol Ther 2006;24:137–46.
Dukas L, Willett WC, Giovannucci EL. Association between physical activity, fiber intake, and other lifestyle variables and constipation in a study of women. Am J Gastroenterol 2003;98:1790–6.
Irvine EJ, Ferrazzi S, Pare P, et al. Health-related quality of life in functional GI disorders: Focus on constipation and resource utilization. Am J Gastroenterol 2002;97:1986–93.
Wald A, Scarpignato C, Kamm MA, et al. The burden of constipation on quality of life: Results of a multinational survey. Aliment Pharmacol Ther 2007;26:227–36.
Rao SSC, Seaton K, Miller MJ, et al. Psychological profiles and quality of life differ between patients with dyssynergia and those with slow transit constipation. J Psychosom Res 2007;63:441–9.
Eswaran S, Muir J, Chey WD. Fiber and functional gastrointestinal disorders. Am J Gastroenterol 2013;108:718–27.
Corsetti M, Brown S, Chiarioni G, et al. Chronic constipation in adults: Contemporary perspectives and clinical challenges. 2: Conservative, behavioural, medical and surgical treatment. Neurogastroenterol Motil 2021;33:e14070.
Slavin JL. Position of the American dietetic association: Health implications of dietary fiber. J Am Diet Assoc 2008;108:1716–31.
Rao SSC, Brenner DM. Efficacy and safety of over-the-counter therapies for chronic constipation: An updated systematic review. Am J Gastroenterol 2021;116:1156–81.