Evaluation of the impact of overlapping upper gastrointestinal symptoms on the clinical characteristics of patients with functional constipation, along with risk factor analysis

J Dig Dis. 2024 Mar;25(3):176-190. doi: 10.1111/1751-2980.13268.

Abstract

Objectives: Functional constipation (FC), a common functional gastrointestinal disorder, is usually overlapping with upper gastrointestinal symptoms (UGS). We aimed to explore the clinical characteristics of patients with FC overlapping UGS along with the related risk factors.

Methods: The differences in the severity of constipation symptoms, psychological state, quality of life (QoL), anorectal motility and perception function, autonomic function, and the effect of biofeedback therapy (BFT) among patients with FC in different groups were analyzed, along with the risk factors of overlapping UGS.

Results: Compared with patients with FC alone, those with FC overlapping UGS had higher scores in the Patient Assessment of Constipation Symptoms and Self-Rating Anxiety Scale and lower scores in the Short Form-36 health survey (P < 0.05). Patients with FC overlapping UGS also had lower rectal propulsion, more negative autonomic nervous function, and worse BFT efficacy (P < 0.05). Overlapping UGS, especially overlapping functional dyspepsia, considerably affected the severity of FC. Logistic regression model showed that age, body mass index (BMI), anxiety, exercise, and sleep quality were independent factors influencing overlapping UGS in patients with FC.

Conclusions: Overlapping UGS reduces the physical and mental health and the QoL of patients with FC. It also increases the difficulty in the treatment of FC. Patient's age, BMI, anxiety, physical exercise, and sleep quality might be predictors for FC overlapping UGS.

Keywords: anorectal motility; biofeedback therapy; functional constipation; overlap; risk factors.

MeSH terms

  • Adult
  • Aged
  • Anxiety
  • Biofeedback, Psychology
  • Constipation* / etiology
  • Constipation* / physiopathology
  • Constipation* / psychology
  • Female
  • Gastrointestinal Diseases / etiology
  • Gastrointestinal Diseases / physiopathology
  • Gastrointestinal Diseases / psychology
  • Gastrointestinal Motility / physiology
  • Humans
  • Male
  • Middle Aged
  • Quality of Life*
  • Risk Factors
  • Severity of Illness Index