Bloating is associated with worse quality of life, treatment satisfaction, and treatment responsiveness among patients with constipation‐predominant irritable bowel syndrome and functional constipation. Issue 4 (12th February 2016)

• Record Type: Journal Article
• Authors: Neri, L.; Iovino, P.
• Is Part Of: Neurogastroenterology & motility. Volume 28:Issue 4(2016)
• Page Start: 581
• Page End: 591
• Publication Date: 2016-02-12
• Subjects: bloating -- chronic constipation -- functional constipation -- irritable bowel syndrome -- patient‐reported outcomes -- quality of life -- treatment satisfaction; Gastrointestinal system -- Motility -- Periodicals; Gastrointestinal system -- Innervation -- Periodicals; 616.33
• DOI: 10.1111/nmo.12758
• Languages: English
• ISSNs: 1350-1925

Abstract

Abstract: Background: The management of bloating is unclear and its relationship with patients' well‐being and treatment satisfaction independent of other abdominal symptoms is uncharacterized. We evaluated the association of bloating with patient‐reported outcomes. Methods: Thirty‐nine centers for functional gastrointestinal disorders joined the laxative inadequate relief survey. We enrolled 2203 consecutive outpatients with functional constipation (FC) or constipation‐predominant irritable bowel syndrome (IBS‐C) in two cross‐sectional waves. Both wave 1 and 2 included the SF‐12, the patient assessment of constipation‐symptoms (PAC‐SYM), and the treatment satisfaction questionnaire for medication (TSQM‐2). Wave 2 only included a global rating of change (GRC) scale to assess patients' assessment of efficacy concerning treatment switches occurred in the 3 months prior to the interview. Bloating in the abdomen was defined on the basis of PAC‐SYM item 3. Key Results: The average age was 50.1 years (SD, 16.7) and 82.1% of patients were women. The prevalence of bloating was 91.6% ( n = 1970). Bloating was associated with SF‐12 Physical Composite Score ( p < 0.01), SF‐12 Mental Composite Score ( p < 0.01), GRC ( p < 0.01), Satisfaction with treatment effectiveness ( p < 0.01), convenience of administration ( p < 0.01), and side effects ( p < 0.01) after adjustment for possible confounders. Conclusions & Inferences: Our data suggest that patients regard bloating as a key element in assessing clinical changes and treatments' efficacy as this symptom exerts a strong influence on patient‐reported outcomes independent of possible confounders and other symptoms of constipation. Our data provide the rationale to investigate the efficacy and tolerability of new treatments specifically addressing this important, yet disregarded, patients' complain. Abstract : We sought to evaluate the association between bloating and quality of life, treatment satisfaction and treatment responsiveness among patients with constipation‐predominant irritable bowel syndrome and functional constipation. We enrolled 2203 patients in a two‐wave cross‐sectional survey: quality of life data obtained through self‐administered questionnaires were matched with reports of clinical examinations performed by gastroenterologist in 39 tertiary referral centers for the treatment of non‐organic constipation. We demonstrated that patients with non‐organic chronic constipation regard the symptom of bloating as a key element in assessing clinical changes and treatments' efficacy irrespective of the intensity of other symptoms.