Pelvic Floor Symptom Related Distress in Chronic Constipation Correlates With a Diagnosis of Irritable Bowel Syndrome With Constipation and Constipation Severity but Not Pelvic Floor Dyssynergia
Singh Prashant, 서윤진, Ballou Sarah, Ludwig Andrew, Hirsch William, Rangan Vikram, Iturrino Johanna, Lembo Anthony, Nee Judy W,
소속 상세정보
( Singh Prashant )
Beth Israel Deaconess Medical Center Division of Gastroenterology
서윤진 ( Seo Yoon-Jin )
Beth Israel Deaconess Medical Center Division of Gastroenterology
( Ballou Sarah )
Beth Israel Deaconess Medical Center Division of Gastroenterology
( Ludwig Andrew )
Beth Israel Deaconess Medical Center Division of Gastroenterology
( Hirsch William )
Beth Israel Deaconess Medical Center Division of Gastroenterology
( Rangan Vikram )
Beth Israel Deaconess Medical Center Division of Gastroenterology
( Iturrino Johanna )
Beth Israel Deaconess Medical Center Division of Gastroenterology
( Lembo Anthony )
Beth Israel Deaconess Medical Center Division of Gastroenterology
( Nee Judy W )
Beth Israel Deaconess Medical Center Division of Gastroenterology
Abstract
Background/Aims: Although symptoms related to the pelvic floor, such as pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTS), are common in patients with chronic constipation (CC), its impact is not clear. Our aims were to investigate the following (1) compare pelvic floor symptom related dysfunction in irritable bowel syndrome with constipation (IBS-C) and functional constipation (FC), and (2) symptom correlation with findings on anorectal manometry (ARM) and balloon expulsion test.
Methods: This was a retrospective analysis of patients with CC undergoing ARM. IBS-C and FC were diagnosed by Rome III criteria. Pelvic Floor Distress Inventory (PFDI-20) was used to measure pelvic floor symptom distress. Constipation Severity Scale was used to assess constipation severity.
Results: A total of 107 patients underwent ARM (64 FC, 43 IBS-C). The overall PFDI-20 score in IBS-C was higher compared with FC patients (118.0 vs 79.2, P = 0.001). In those with IBS-C, POP, LUTS, and colorectal symptoms subscales were all higher compared with FC patients (P < 0.05 for each). On multivariable regression, IBS-C (P = 0.001) and higher constipation severity (P = 0.001) were both independently associated with higher PFDI scores. ARM parameters and abnormal balloon expulsion test did not correlate with PFDI scores.
Conclusions: Compared with FC patients, those with IBS-C have significantly higher distress from pelvic floor specific symptoms including POP and LUTS. Higher abdominal pain among IBS-C patients did not entirely explain these findings. A diagnosis of IBS-C and higher constipation severity correlated with PFDI-20 scores, but dyssynergia did not.
키워드
Constipation; Defecation; Lower urinary tract symptoms; Manometry; Pelvic floor
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