PREVALENCE AND BURDEN OF ILLNESS OF ROME IV CHRONIC IDIOPATHIC CONSTIPATION, OPIOID-INDUCED CONSTIPATION, AND OPIOID-EXACERBATED CONSTIPATION IN THE UNITED STATES.

Abstract

Chronic idiopathic constipation (CIC) and opioid-induced constipation (OIC) are disorders that negatively impact quality of life. We sought to assess the prevalence, symptom severity, and medication use among people with Rome IV CIC, OIC, and opioid-exacerbated constipation (OEC) using a nationally representative dataset with nearly 89,000 people in the US. From May 3 to June 24, 2020, we recruited a representative sample of people in the US ≥18yo to complete an online national health survey. The survey guided participants through the Rome IV CIC and OIC questionnaires, Patient-Reported Outcome Measurement Information System (PROMIS®) gastrointestinal scales (percentile 0-100; higher=more severe), and medication questions. Individuals with OEC were identified by asking those with OIC whether they experienced constipation before starting an opioid and if their symptoms worsened afterwards. Among the 88,607 participants, 5,334 (6.0%) had Rome IV CIC, and 1,548 (1.7%) and 335 (0.4%) had Rome IV OIC and OEC, respectively. When compared to people with CIC (PROMIS® score, 53.9±26.5; reference), those with OIC (62.7±28.0; adjusted p<0.001) and OEC (61.1±25.8, adjusted p=0.048) had more severe constipation symptoms. People with OIC (odds ratio [OR] 2.72, 95% confidence interval [CI] 2.04-3.62) and OEC (OR 3.52, 95% CI 2.22-5.59) were also more likely to be taking a prescription medication for their constipation versus those with CIC. In this nationwide US survey, we found that Rome IV CIC is common (6.0%) while Rome IV OIC (1.7%) and OEC (0.4%) are less prevalent. Individuals with OIC and OEC have a higher burden of illness with respect to symptom severity and prescription constipation medication use.