European society of neurogastroenterology and motility guidelines on functional constipation in adults

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Abstract

Chronic constipation is a common disorder with a reported prevalence ranging from 3% to 27% in the general population. Several management strategies, including diagnostic tests, empiric treatments, and specific treatments, have been developed. Our aim was to develop European guidelines for the clinical management of constipation.

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Chronic constipation: a survey of the patient perspective.

J Johanson, J Kralstein (2007)

Constipation is a common, often chronic, gastrointestinal motility disorder characterized by such symptoms as straining, hard stool, and infrequent defecation. Published literature is limited regarding symptom prevalence, healthcare-seeking behaviour, and patient satisfaction with traditional therapies for chronic constipation. To assess the prevalence of chronic constipation among a random sample of Americans, to identify the frequency, severity and bothersomeness of their symptoms, and to assess satisfaction levels with traditional treatments. All members (N = 37,004) of the Knowledge Networks Panel, representative of the US population, participated in a web-based survey. Eligibility was established using a six-question screener. Of the 24,090 panellists consenting to participate, 557 met eligibility requirements and took the 45-question survey. The most prevalent symptom was straining (79%). Hard stool and straining were the top two severe symptoms, and bloating, straining and hard stool were the top three bothersome symptoms. Symptoms affected quality of life of more than half (52%) the respondents. Among those who worked or went to school, 12% experienced reduced productivity and a mean of 2.4 days of absence in the month before the survey. Most respondents had used (96%) or were using (72%) constipation relief therapy; however, nearly half (47%) were not completely satisfied, mainly because of efficacy (82%) and safety (16%) concerns. Chronic constipation is common. Individual symptoms are often severe and bothersome, and many patients are dissatisfied with traditional treatment options, primarily because of lack of efficacy.

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Rome IV Diagnostic Questionnaires and Tables for Investigators and Clinicians.

Olafur Palsson, William E Whitehead, Miranda A L van Tilburg … (2016)

The Rome IV Diagnostic Questionnaires were developed to screen for functional gastrointestinal disorders (FGIDs), serve as inclusion criteria in clinical trials, and support epidemiological surveys. Separate questionnaires were developed for adults, children/adolescents, and infants/toddlers. For the adult questionnaire, we first surveyed 1,162 adults without gastrointestinal disorders, and recommended the 90(th) percentile symptom frequency as the threshold for defining what is abnormal. Diagnostic questions were formulated and verified with clinical experts using a recursive process. The diagnostic sensitivity of the questionnaire was tested in 843 patients from 9 gastroenterology clinics, with a focus on clinical diagnoses of irritable bowel syndrome (IBS), functional constipation (FC), and functional dyspepsia (FD). Sensitivity was 62.7% for IBS, 54.7% for FD, and 32.2% for FC. Specificity, assessed in a population sample of 5,931 adults, was 97.1% for IBS, 93.3% for FD, and 93.6% for FC. Excess overlap among IBS, FC, and FD was a major contributor to reduced diagnostic sensitivity, and when overlap of IBS with FC was permitted, sensitivity for FC diagnosis increased to 73.2%. All questions were understandable to at least 90% of individuals, and Rome IV diagnoses were reproducible in ¾ of patients after one month. Validation of the pediatric questionnaires is ongoing.

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Faecal microbiota transplantation versus placebo for moderate-to-severe irritable bowel syndrome: a double-blind, randomised, placebo-controlled, parallel-group, single-centre trial

Peter Holger Johnsen, Frank Hilpüsch, Jorunn Cavanagh … (2018)

Irritable bowel syndrome (IBS) is a common condition characterised by abdominal pain, bloating, and poor quality of life. IBS might be caused by a gut dysbiosis. We aimed to compare faecal microbiota transplantation (FMT) with placebo in patients with IBS.

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Author and article information

Journal

Title: Neurogastroenterology & Motility

Abbreviated Title: Neurogastroenterology & Motility

Publisher: Wiley

ISSN (Print): 1350-1925

ISSN (Electronic): 1365-2982

Publication date Created: November 22 2019

Publication date (Electronic): November 22 2019

Affiliations

[1 ]Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) Badalona Spain

[2 ]Motility and Functional Gut Disorders Unit University Hospital Germans Trias i Pujol Badalona Spain

[3 ]Department of Medicine Autonomous University of Barcelona Badalona Spain

[4 ]Division of Gastroenterology University Hospital Zurich Zurich Switzerland

[5 ]Department of Gastroenterology and Hepatology University Hospital Zurich Zurich Switzerland

[6 ]Digestive System Research Unit University Hospital Vall d'Hebron Barcelona Spain

[7 ]Division of Gastroenterology B AOUI Verona Verona Italy

[8 ]UNC Center for Functional GI and Motility Disorders University of North Carolina Chapel Hill NC USA

[9 ]Department of Gastroenterology UMR INSERM 1073 Rouen University Hospital Rouen France

[10 ]Department of Physiology UMR INSERM 1073 & CIC INSERM 1404 Rouen University Hospital Rouen France

[11 ]General Practice Faculty of Medical Sciences Newcastle University Newcastle UK

[12 ]Department of Medicine Israelitic Hospital Hamburg Germany

[13 ]Sant Adrià de Besòs (Barcelona) Catalan Institut of Health (ICS) La Mina Primary Health Care Centre Badalona Spain

[14 ]Department of Surgery Division of General Surgery Medical University of Graz Graz Austria

[15 ]Neurogastroenterology Group Centre for Neuroscience, Surgery and Trauma Blizard Institute Barts UK

[16 ]The London School of Medicine & Dentistry Queen Mary University London London UK

[17 ]Department of Internal Medicine & Clinical Nutrition Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden

[18 ]Division of Diabetes, Endocrinology & Gastroenterology Neurogastroenterology Unit, Wythenshawe Hospital University of Manchester Manchester UK

Article

DOI: 10.1111/nmo.13762

SO-VID: f5577cb5-f93b-4314-af00-5d160b6713aa

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http://doi.wiley.com/10.1002/tdm_license_1.1

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European society of neurogastroenterology and motility guidelines on functional constipation in adults

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Abstract

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Most cited references 246

Chronic constipation: a survey of the patient perspective.

Rome IV Diagnostic Questionnaires and Tables for Investigators and Clinicians.

Faecal microbiota transplantation versus placebo for moderate-to-severe irritable bowel syndrome: a double-blind, randomised, placebo-controlled, parallel-group, single-centre trial

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