Symptoms Of Functional Constipation Research Articles

Feasibility study for a fully decentralized clinical trial in participants with functional constipation symptoms.

Decentralized clinical trials (DCTs) leverage digital technologies to reduce dependency on study sites and intermediaries. DCT should be balanced with accessibility and data reliability while meeting regulatory requirements. Here, we conducted a pilot study for functional constipation symptoms to investigate the feasibility of DCT. The study was an open, fully remote, randomized clinical trial in participants who had functional constipation symptoms. Electronic consent was obtained remotely, and study volunteers were screened through web-based questionnaires. Subjects were randomized to either receive Lactobacillus and vitamin C supplements or vitamin C alone in a 1:1 ratio, which were delivered directly to subjects. Subjects kept track of bowel diaries daily during the 1-week baseline and 2-week treatment period using mobile applications. Bowel symptoms and the validity of the records were descriptively evaluated. A total of 30 subjects were randomized and completed the study. A total of 26.7% of subjects resided outside of the metropolitan area. Two-week Lactobacillus treatments increased the number of defecations (+0.80 vs. +0.46 times per week) and decreased the defecation time (-3.94 h vs. -1.62 h) compared to the comparator group. Overall, 67.1% of bowel diary records were completed in accordance with the schedule while 32.9% were not. Implementation of DCTs can facilitate geographic accessibility but should be guaranteed for data reliability. Prompt detection of errors and response using objective metrics would be required.

Effects of dietary fibers or probiotics on functional constipation symptoms and roles of gut microbiota: a double-blinded randomized placebo trial

ABSTRACT Dietary fibers/probiotics may relieve constipation via optimizing gut microbiome, yet with limited trial-based evidences. We aimed to evaluate the effects of formulas with dietary fibers or probiotics on functional constipation symptoms, and to identify modulations of gut microbiota of relevance. We conducted a 4-week double-blinded randomized placebo-controlled trial in 250 adults with functional constipation. Intervention: A: polydextrose; B: psyllium husk; C: wheat bran + psyllium husk; D: Bifidobacterium animalis subsp. lactis HN019 + Lacticaseibacillus rhamnosus HN001; Placebo: maltodextrin. Oligosaccharides were also included in group A to D. 16S rRNA sequencing was used to assess the gut microbiota at weeks 0, 2, and 4. A total of 242 participants completed the study. No time-by-group effect was observed for bowel movement frequency (BMF), Bristol stool scale score (BSS), and degree of defecation straining (DDS), while BSS showed mean increases of 0.95–1.05 in group A to D (all P < 0.05), but not significantly changed in placebo (P = 0.170), and 4-week change of BSS showed similarly superior effects of the interventions as compared placebo. Group D showed a marginal reduction in plasma 5-hydroxytryptamine. Group A resulted in a higher Bifidobacterium abundance than placebo at week 2 and 4. Fourteen genera showed intervention-specific increasing or decreasing trends continuously, among which Anaerostipes showed increasing trends in groups B and C, associated with BMF increase. Random forest models identified specific baseline microbial genera panels predicting intervention responders. In conclusion, we found that the dietary fibers or probiotics may relieve hard stool, with intervention-specific changes in gut microbiota relevant to constipation relief. Baseline gut microbiota may predispose the intervention responsiveness. ClincialTrials.gov number, NCT04667884.

Functional gastrointestinal disorders and nutritional status in junior high school students

Background The prevalence of functional gastrointestinal disorders (FGIDs) is increasing among students in Indonesia. More adolescents came to the clinic with symptoms of functional constipation (FC), irritable bowel syndrome (IBS), and functional dyspepsia (FD).&#x0D; Objective To analyze the relationship between the nutritional status, dietary pattern, and physical activity with the incidence of the FGIDs among Indonesian junior high school students.&#x0D; Methods A cross-sectional study, consisting of 292 students aged 11 to 14 years were recruited in March 2018. Questionnaires on the ROME Criteria for FGIDs, dietary patterns, and physical activity were distributed to the students’ parents and returned in 24 hours.&#x0D; Results The overall prevalence of FGIDs in this study was 26.4%. Among 292 junior high school students, 19.5% were diagnosed with FC, 6.2% with IBS, and 17.5% with FD. Overnourishment (overweight or obese) was found in 51.4% of the subjects. A significant association was found between FC and overnutrition (OR 2.27; 95%CI 1.21 to 4.28; P=0.011). Nutritional status did not affect the incidence of IBS nor FD. Rarely eating breakfast significantly increase the occurrence of FD (OR 4.80; 95%CI 1.61 to 13.25; P=0.004). No significant association between dietary patterns and physical activity with the prevalence of the other FGIDs.&#x0D; Conclusion Nutritional status does not significantly affect the prevalence of IBS and FD. Overnourishment is associated with increased occurrence of FC. Eating breakfast twice weekly or more may reduce the probability of FD. Lack of healthy dietary pattern and physical activity are not correlated with other FGIDs.

Evaluation of the efficacy of inulin use in children with functional constipation

Functional constipation (FC) is a common pediatric problem accounting for 3 % visits to a general pediatrician and up to 25 % visits to a pediatric gastroenterologist. Presence of FC significantly impacts a child’s health‑related quality of life and the healthcare cost burden. The North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition Guideline (NASPGHAN) recommends supportive treatment with laxatives, training, recommendations on fiber and fluid intake, and physical activity in constipation in children. Modern pharmacological treatments may be ineffective in some patients — not optimal dosage, poor compliance or use of drugs with mechanisms of action that do not affect the main pathophysiological moments. Many patients with constipation report dissatisfaction with traditional treatments due to perceived lack of efficacy.&#x0D; Objective — to study the effectiveness of the prebiotic Inulin Neo for pediatric patients with functional constipation aged 3 to 18 years.&#x0D; Materials and methods. Observation involved 48 children aged 3 to 18 years with a diagnosis of functional constipation. Patients were divided into two groups. The main group consisted of 29 children who received the prebiotic Inulin Neo. The control group included 19 children who did not receive prebiotic.&#x0D; Results. After 30 days of treatment, children of the main group vs control group demonstrated significantly better positive dynamics of the following indices: relief of abdominal pain and pain during defecation, decrease in colic and bloating, normalized frequency of defecation and consistency of stools, increased bifidoflora amount and normalized coprological indicators. The results suggest effectiveness of Inulin Neo and feasibility of its inclusion into the treatment of functional constipation in children.&#x0D; Conclusions. Symptoms of functional constipation significantly decreased or disappeared in children who received Inulin Neo, most of the indices of microbiocenosis and coprological investigations considerably improved, whereas pediatric patients of the control group demonstrated only the trend to their improvement. No intolerability signs or adverse events during Inulin Neo administration have been revealed.&#x0D;

Сучасні погляди на функціональні запори у немовлят

У даній статті йдеться про те, що запор є поширеною проблемою та спостерігається приблизно у 3–14 % немовлят, що звичайно турбує батьків і спонукає звертатись за медичною допомогою. Функціональний запор часто спостерігається у немовлят, особливо при переході з грудного молока на штучне вигодовування або на тверду їжу. При цьому чим молодша дитина, тим вище ймовірність анатомічних або органічних причин, хоча частота функціонального запору досягає 97 % усіх випадків запору в дітей. У статті обговорюється доцільність та ефективність дієтотерапії і медикаментозного лікування функціонального запору в немовлят.

Visceral Mobilization and Functional Constipation in Stroke Survivors: A Randomized, Controlled, Double-Blind, Clinical Trial

IntroductionChronic functional constipation is common among stroke survivors. Osteopathy is an effective form of treatment as it acts on the structures surrounding the bowels that may have lost their normal capacity of resilience. The aim of the present study was to evaluate the effect of visceral mobilization on symptoms of functional constipation and static balance in stroke survivors.Materials and methodsThirty stroke survivors met the eligibility criteria and were randomly allocated to a group physical therapy and visceral manipulation or a group physical therapy. Both groups were submitted to conventional physical therapy. The group physical therapy and visceral manipulation was also submitted to visceral mobilization (sphincter inhibition and mobilization of the large intestine), whereas the group physical therapy was submitted to a sham procedure (superficial touching over the intestines). Evaluations were conducted prior to the intervention, immediately after the first intervention session and one week after the end of the five sessions. At each evaluation, the static balance was analyzed using a computerized plantar pressure sensor. Moreover, an intestinal symptoms rating scale was administered during the pre-intervention evaluation, and one week after the end of the intervention.ResultsSignificant improvements were found in intestinal symptoms (frequency of bowel movements, abdominal pain/discomfort, difficulty eliminating stools, sensation of intestinal swelling or distention, difficulty eliminating gas, sensation of incomplete bowel movement and, anal pain during bowel movement) and static balance (anteroposterior sway: F = 82.06, p = 0.0001; velocity of anteroposterior sway: F = 17.6, p = 0.001; and velocity of mediolateral sway: F = 4.41, p = 0.01).ConclusionVisceral mobilization can be part of a neurologic rehabilitation program to improve symptoms of constipation and static balance in stroke survivors.

The effects of dietary fiber on symptoms of functional constipation

功能性便秘的治疗中推荐增加膳食纤维摄入，有助于改善粪便性状、增加排便次数。膳食纤维在促进肠道动力、保护肠黏膜屏障、调节肠道菌群等方面均有积极作用，这主要与膳食纤维的理化特性及其分解产物短链脂肪酸的相关生理作用有关。但膳食纤维可能也存在一些副作用，如腹胀、胃肠胀气，这主要由膳食纤维在代谢过程中产生气体导致。伴明显腹胀的功能性便秘患者和有结肠扭转风险或病史的患者应慎重增加膳食纤维摄入。.

Impact of a probiotic product on bowel habits and microbial profile in participants with functional constipation: A randomized controlled trial.

ObjectiveTo investigate the clinical efficacy of a multi‐strain probiotic product on bowel habits and microbial profile in participants with functional constipation.MethodsThis was a randomized, double‐blind, placebo‐controlled and parallel‐arm study. Altogether 94 otherwise healthy adults aged 18 to 65 years with symptoms of functional constipation were randomized as part of the intention‐to‐treat population. The participants received a placebo or the probiotic product (1.5 × 1010 CFU/day), consisting of Lactobacillus acidophilus DDS‐1, Bifidobacterium animalis subsp. lactis UABla‐12, Bifidobacterium longum UABl‐14 and Bifidobacterium bifidum UABb‐10 over 4 weeks. Outcomes included the patient assessment of constipation‐symptom (PAC‐SYM) questionnaire, stool frequency and consistency, and microbial profile.ResultsThere were no significant between‐group differences in the PAC‐SYM score, despite significant within‐group differences (P < 0.001) over the study period. The probiotic group showed a faster normalization of stool frequency and consistency, with most participants achieving a normalized profile after 1 week. Fecal samples of the probiotic group exhibited higher relative abundance of Ruminococcaceae (P = 0.0047), including the Ruminococcus genus, and lower relative abundance of Erysipelotrichaceae (P = 0.0172) at end‐point compared with baseline. Placebo group samples showed similar abundance profiles over the study, with the exception of Clostridiaceae, which was lower at the study end‐point (P = 0.0033). Among treated participants, all four probiotic strains were significantly more abundant after the intervention.ConclusionsNo significant differences were observed in symptomology, with both groups showing a more than 20% improvement. However, the probiotic helped modulate bowel function earlier than the placebo, with a corresponding shift to a more fibrolytic microbiota.

DA-9701 improves colonic transit time and symptoms in patients with functional constipation: A prospective study.

DA-9701, a newly developed prokinetic agent formulated with Pharbitis Semen and Corydalis Tuber, has been shown to effectively treat functional dyspepsia. Recently, it has also been suspected to improve gastrointestinal motor function. The aims of this study were to assess the effect of DA-9701 on colonic transit time (CTT) and symptoms of functional constipation. Thirty-three patients with functional constipation based on the Rome III criteria were prospectively enrolled. The patients received 30-mg DA-9701 three times a day for 24days. CTT was estimated initially and at the end of treatment. Symptoms such as spontaneous bowel movements, straining, stool form, feeling of incomplete emptying and anorectal blockage, abdominal discomfort and pain, overall defecation satisfaction, and incidence of adverse events were also analyzed. Twenty-seven patients completed the study. DA-9701 was associated with a significantly reduced CTT from 34.9±17.6 to 23.7±19.1h (P=0.001). Segmental CTT also significantly decreased after treatment (right CTT: from 16.8 [0.0-28.8] to 6.0 [0.0-25.2] hours, P<0.001; rectosigmoid transit time: from 13.2 [0.0-38.4] to 6.0 [0.0-33.6] hours, P=0.021). In addition, all constipation-related subjective symptoms, including spontaneous bowel movement frequency, significantly improved compared with those before treatment. Serious adverse events did not occur. DA-9701 accelerates colonic transit and safely improves symptoms in patients with functional constipation. Therefore, we suggest that this novel agent could help to treat patients with this condition.

Development of a core outcome set for clinical trials in childhood constipation: a study using a Delphi technique

ObjectivePatients, their parents and healthcare professionals (HCPs) have a different perception regarding the symptoms of functional constipation (FC). Consequently, a lack of agreement exists on definitions and outcomes used in...

The Prevalence and Symptoms Characteristic of Functional Constipation Using Rome III Diagnostic Criteria among Tertiary Education Students.

Background and AimsFunctional constipation is very common with heterogeneous symptoms that have substantial impact on patient quality of life as well as medical resources which are rarely reported as life-threatening. The aim of this study is to examine the prevalence and symptoms characteristic of functional constipation (FC) by using Rome III diagnostic criteria among tertiary education students with an intention to introduce treatment in the future.MethodsDemographic, socio-economics characteristics and symptoms of FC using the Rome III criteria were sought using a questionnaire administered to Malaysian students in a tertiary education setting. Other data obtained were the general health status, lifestyle factors and anthropometric measurements. Using a simple random sampling method, a total of 1662 students were recruited in the study with a response rate of 95.0%. Sampled data are presented as frequency and percentage and stratified accordingly into categories for Chi-square analysis.ResultsThe prevalence of functional constipation among the students was 16.2%, with a significantly higher prevalence among women (17.4%) than men (12.5%). Hard or lumpy stool, incomplete evacuation, anorectal obstruction and straining were reported as the commonest symptoms experienced. Type 3 was the most frequent stool consistency experienced among the constipated individuals (35.2%). Only 4.4% of individuals reported having less than three defecations per week. Using univariable analysis, FC was significantly associated with sex (odds ratio: 1.48, 95% CI: 1.06–2.06) and age group (odds ratio: 1.34, 95% CI: 1.01–1.79) with P value < 0.05 significance level. In multivariate logistic regression analysis, only sex was found significantly associated with FC (adjusted odds ratio: 1.53, 95% CI: 1.08–2.17, P < 0.05).ConclusionsBased on the prevalence rate, constipation is a common problem among tertiary education students (16.2%), with significantly more prevalence among the female respondents. Early detection of symptoms and further intervention studies focusing on treatment recommendation in improving the symptoms are essential.

Psychological characteristics and GoNogo research of patients with functional constipation.

The emotional state, psychological characteristics, cognitive function, and the relevance among above factors in patients with functional constipation (FC) are complex. This study aimed to investigate whether FC symptoms might be related to implicit processing such as psychological characteristics and emotional somatization.Thirty-five FC patients and 24 normal volunteers were recruited to collect event-related potentials (ERP) behavior and electroencephalogram data when simple digital GoNogo visual tasks were performed. Hamilton Depression Scale (HAMD-17), Hamilton Anxiety Scale (HAMA), Symptom Checklist, and Eysenck Personality Inventory (EPQ) were assessed before the ERP test.There was significant difference in average score, positive index, somatization, obsessive-compulsive disorder, anxiety, depression and psychoticism in HAMD-17, HAMA, Symptom Checklist, and extroversion or introversion and neuroticism in EPQ between the FC patients group and the normal control group (P < 0.05). There was a significant difference in the amplitude of ERP-P300 at site F4, F7, and FZ (P < 0.05).FC patients showed anxiety and depression. The asymmetric forebrain abnormal activities in the 2 hemispheres might initiate implicit automatic processing, such as somatization and obsessive-compulsive disorder, in order to cope with painful experience caused by anxiety and depression in patients with FC. Cognitive dysfunction of implicit processing might be involved in the abnormality of visual communication and information processing.

Status and related factors of chronic functional constipation in community elders

Objective To investigate the status and related factors of chronic functional constipation in community elders. Methods Totally 892 elders of 11 communities at Lucheng district of Wenzhou from August 2013 to December 2015 were investigated by sample survey; methods as household survey, survey in community public health station and outpatient survey, etc. were used to develop a unified questionnaire to collect information. The chronic functional constipation was evaluated by Rome III diagnostic criteria, and statistical processing was analyzed by single-factor analysis and multi-factor logistic regression analysis. Results Totally 257 elders acquired functional constipation, and the morbidity was 28.81%, and bowel movements were less than 3 times per week. Defecation laborious and poor stool were the main symptoms of functional constipation in elders. Independent risk factors of functional constipation in community elderly patients were: too much meat intake, few vegetables and fruit intake, drinking little water, few daily activities and depression (P<0.05). Conclusions Eating habits of partial fine diet fatness, little fiber and water intake, little exercise etc. and depression are closely related to chronic functional constipation in community elderly patients. Key words: Constipation; Elders; Risk factors; Investigation

Transverse incision transvaginal rectocele repair combined with levatorplasty and biological graft insertion: technical details and case series outcomes.

The purpose of this report is twofold: first, to detail our operative approach to rectocele repair, and second, to report on the outcomes. Transverse incision transvaginal rectocele repair combined with levatorplasty and biological graft placement is detailed using hand-drawn sketches and intraoperative photographs. All patients with symptoms of functional constipation and non-emptying rectocele operated on from May 2007 to March 2013 at our institution were enrolled in this study. Data from a prospectively maintained database were retrospectively analyzed. Preoperative and postoperative functional outcomes were studied using a validated 31-point obstructed defecation (OD) scoring system. Follow-up was 1 year. Twenty-three patients underwent the procedure. The mean age of patients was 55 years (range 28-79 years). The OD severity score improved from the preoperative mean of 21.6 to postoperative mean of 5.5 (p = 0.001). Three out of four patients with initial symptoms of dyspareunia (75%) reported significant improvement in dyspareunia, while 2 out of 19 patients without initial symptoms of dyspareunia (11%) reported mild dyspareunia following the repair. One patient (4%) required operative drainage of a hematoma. Another patient (4%) developed symptomatic recurrence which was confirmed radiologically. In properly selected patients, the technique described leads to significant improvement in symptoms of OD and low recurrence without an increased rate of dyspareunia.

Clinical effects of biofeedback therapy on functional constipation caused by pelvic floor dys-synergia

Objective To explore the clinical effects of biofeedback (BF) therapy on functional constipation (FC) caused by pelvic floor dys-synergia (PFD). Methods Forty patients with FC caused by PFD were enrolled and given BF therapy twice a week for 5 weeks. Constipation symptom scores and anal motility were recorded before and after the therapy. Results All the patients enrolled finished the BF therapy, with a total effectiveness rate of 80%. Both the constipation symptom scores and anal residual pressure during defecation had decreased significantly after therapy. Rectal gradient pressure, however, had increased significantly. Conclusion Biofeedback can relieve the clinical symptoms of FC and improve pelvic floor coordination during defecation. It is worth applying in clinical practice. Key words: Biofeedback; Pelvic floor dys-synergia; Constipation; Constipation symptom scores; Anal motility

Impact of Functional Constipation on Health-Related Quality of Life in Preschool Children and Their Families in Xi’an, China

AimFunctional constipation (FC) is one of the common diseases among children. The aim of this study was to investigate the health-related quality of life (HRQOL) in preschool children diagnosed with FC and the impact of the condition on affected families.MethodsIn this cross-sectional, case-control study, 152 children aged 3–6 years with FC, 176 healthy children aged 3–6 years without FC, and their primary caregivers were selected. Chinese versions of the PedsQLTM 4.0 Generic Core Scale and the Family Impact Module (FIM) were used to assess childhood HRQOL and the impact of FC on family members, respectively. HRQOL scores were compared between children with FC and healthy children. In addition, a multiple step-wise regression with demographic variables of children and their caregivers, family economic status, duration and symptoms of FC, as independent variables, was used to determine factors that influenced HRQOL in children and had impacted caregivers.ResultsScores of physical, emotional, social and school functions, and summary scales were significantly lower in children with FC than in healthy children (p < 0.05). Physical, emotional, social, cognitive, and communication scores for caregivers, as well as daily activities and relationships for families of children with FC, were significantly lower than those of caregivers and families with healthy children (p < 0.05). Children’s ages, duration of FC, symptoms of FC, the child-caregiver relationship, family economic status, and caregiver education level emerged as the main factors influencing HRQOL in children, caregivers, and family members. ConclusionsFC had a significant impact on HRQOL of affected children and their caregivers, as well as their family functions. Social characteristics of children and caregivers, duration and symptoms of FC and family economic status significantly affected HRQOL of children and caregivers, as well as family functions of children with FC.

Functional Gastrointestinal Symptoms in Children with Anxiety Disorders

This study examined the incidence and correlates of functional gastrointestinal symptoms in children with anxiety disorders. Participants were 6-13 year old children diagnosed with one or more anxiety disorders (n = 54) and non-clinical control children (n = 51). Telephone diagnostic interviews were performed with parents to determine the presence and absence of anxiety disorders in children. Parents completed a questionnaire that elicited information about their child's gastrointestinal symptoms associated with functional gastrointestinal disorders in children, as specified by the paediatric Rome criteria (Caplan et al., Journal of Pediatric Gastroenterology & Nutrition, 41, 296-304, 2005a). Parents and children also completed a symptom severity measure of anxiety. As expected, children with anxiety disorders were significantly more likely to have symptoms of functional gastrointestinal disorders (FGID), compared to children without anxiety disorders. That is, 40.7 % of anxious children had symptoms of a FGID compared to 5.9 % of non-anxious control children. Children with anxiety disorders were significantly more likely to have symptoms of functional constipation, and showed a trend for a higher incidence of irritable bowel syndrome symptoms compared to non-anxious control children. Furthermore, higher anxiety symptom severity was characteristic of anxious children with symptoms of FGID, compared to anxious children without FGID symptoms and non-anxious control children. Also, children with anxiety disorders, regardless of FGID symptoms, were more likely to have a biological family member, particularly a parent or grandparent, with a gastrointestinal problem, compared to non-anxious control children. The high incidence of FGID symptoms in children with anxiety disorders warrants further research on whether gastrointestinal symptoms reduce following psychological treatments for childhood anxiety disorders, such as cognitive behavioural therapy.