PREVALENCE OF CONSTIPATION IN PATIENTS WITH ADVANCED KIDNEY DISEASE.

Abstract

For people on peritoneal dialysis (PD), constipation is associated with technique failure. For those on haemodialysis (HD), constipation has been associated with a reduction in quality of life. The objectives of this study were to (i) determine the prevalence of functional constipation; (ii) compare patient perception of constipation with Rome III criteria for functional constipation; (iii) describe the prevalence of constipation and stool form using Bristol Stool Form Scale (BSFS); (iv) determine differences in bowel habit and stool form between those on dialysis compared to pre-dialysis; and (v) determine the diagnostic accuracy of self-perception and the Rome III criteria against the BSFS. A cross-sectional group of pre-dialysis (eGFR < 15 ml/min) and dialysis patients were recruited. A total of 148 patients participated (98 HD, 21 PD and 21 pre-dialysis). completed a questionnaire consisting of self-perception of the presence of constipation, simplified questions from the Rome III criteria for functional constipation, scored their stool form using the BSFS and reported laxative use. The prevalence of constipation using the Rome III criteria was 12.3%; patient perception 46.3% and 25.7% using the BSFS. Prevalence differed according to the tool used. No single method alone is sufficient for accurately determining if a patient is constipated. Relying on patients' self-perception may be unreliable. Ideally patient assessment of constipation should incorporate both the Rome III criteria and BSFS in a method such as the one designed as a result of this research. Further research is needed to assess its usability and practicality in clinical practice.