Chronic constipation diagnosis and treatment evaluation: the "CHRO.CO.DITE" study

被引：56

作者：

Bellini, Massimo ^{[1
,10
]}

Usai-Satta, Paolo ^{[2
,11
]}

Bove, Antonio ^{[3
,12
]}

Bocchini, Renato ^{[4
,13
]}

Galeazzi, Francesca ^{[5
,16
]}

Battaglia, Edda ^{[6
,14
]}

Alduini, Pietro ^{[7
,15
]}

Buscarini, Elisabetta ^{[8
,35
]}

Bassotti, Gabrio ^{[9
,17
]}

Balzano, Antonio ^{[18
]}

Portincasa, Piero ^{[19
]}

Bonfrate, Leonilde ^{[19
]}

D'Alba, Lucia ^{[20
]}

Badiali, Danilo ^{[21
]}

Marchi, Santino ^{[10
]}

Gambaccini, Dario ^{[10
]}

Neri, Maria Cristina ^{[22
]}

Muscatiello, Nicola ^{[23
]}

Di Stefano, Michele ^{[24
]}

Giannelli, Claudio ^{[25
]}

Goffredo, Fabio ^{[25
]}

Turco, Luigi ^{[26
]}

Camilleri, Salvatore ^{[27
]}

Ceccarelli, Giovanni ^{[28
]}

Iovino, Paola ^{[29
]}

Montalbano, Luigi Maria ^{[30
]}

Morreale, Gaetano Cristian ^{[31
]}

Rentini, Silvia ^{[32
]}

Savarino, Vincenzo ^{[33
]}

Segato, Sergio ^{[34
]}

Manfredi, Guido ^{[35
]}

Cannizzaro, Renato ^{[36
]}

Passaretti, Sandro ^{[37
]}

Alessandri, Matteo ^{[37
]}

Corti, Federico ^{[28
]}

Cuomo, Rosario ^{[38
]}

Zito, Francesco Paolo ^{[38
]}

Mellone, Carmine ^{[39
]}

Barbera, Roberta ^{[40
]}

Milazzo, Giuseppe ^{[41
]}

Pucciani, Filippo ^{[42
]}

Soncini, Marco ^{[43
]}

Lai, Maria Antonia ^{[44
]}

Ruggeri, Maurizio ^{[45
]}

Savarese, Maria Flavia ^{[46
]}

De Bona, Manuela ^{[47
]}

Surrenti, Elisabetta ^{[48
]}

Arini, Andrea ^{[49
]}

Dinelli, Marco ^{[50
]}

Leandro, Gioacchino ^{[51
]}

机构：

[1] Univ Pisa, Dept Gastroenterol, Gastrointestinal Unit, Via Paradisa 2, I-56127 Pisa, Italy

[2] Brotzu Hosp, Gastroenterol Unit, Cagliari, Italy

[3] AORN A Cardarelli, Naples, Italy

[4] Malatesta Novello Private Hosp, Cesena, Italy

[5] Univ Padua, Dept Surg Oncol & Gastroenterol, Div Gastroenterol, Padua, Italy

[6] Cardinal Massaia Hosp, Gastroenterol Unit, Asti, Italy

[7] San Luca Hosp, Digest Endoscopy Unit, Lucca, Italy

[8] Maggiore Hosp, Gastroenterol & Digest Endoscopy Unit, Crema, Italy

[9] Gastrointestinal & Hepatol Sect, Clin & Expt Med, Perugia, Italy

[10] UO Gastroenterol Univ AOU Pisana, Pisa, Italy

[11] Azienda Ospedaliera G. Brotzu, SC Gastroenterol, Cagliari, Italy

[12] AORN A Cardarelli, UO Gastroenterol Endoscopia Digest, Naples, Italy

[13] Casa Cura Malatesta Novello, Gastroenterol Endoscopia Digest, Fisiopatol Endoscopia Digest, Cesena, Italy

[14] Ospedale Cardinal Massaja, SOC Gastroenterol, Asti, Italy

[15] Osped Lucca, UO Gastroenterol, Lucca, Italy

[16] Azienda Osped Univ Padova, UO Gastroenterol Univ, Padua, Italy

[17] Univ Perugia, Dipartimento Med Interna, Sez Gastroenterol Epatol, I-06100 Perugia, Italy

[18] Azienda Osped Rilevanza Nazl A Cardarelli, Naples, Italy

[19] Univ Bari, Dipartimento Sci Biomed & Oncol Umana, Clin Med A Murri, I-70121 Bari, Italy

[20] Az Osped San Giovanni Addolorata, UOC Gastroenterol Endoscopia Digest, Rome, Italy

[21] Dip Med Interna Special Med, Rome, Italy

[22] Pio Albergo Trivulzio, Ambulatorio Gastroenterol Endoscopia Digest, Milan, Italy

[23] UO Gastroenterol Univ, Foggia, Italy

[24] Fondazione IRCCS Policlinico S Matteo, UO Med Interna I, Pavia, Italy

[25] Az Osped San Camillo Forlanini, UOC Gastroenterol Riabilitat, Rome, Italy

[26] PO Copertino, UOC Chirurg Gen, SS Endoscopia Digest, Lecce, Italy

[27] Osped M Raimondi San Cataldo, UOC Gastroenterol, Caltanissetta, Italy

[28] Ospedale Versilia, UOC Gastroenterol Endoscopia Digest, Viareggio, Italy

[29] Univ Salerno, Dipartimento Med Chirurg, Salerno, Italy

[30] Ospedali Riuniti Villa Sofia Cervello Palermo, UOC Gastroenterologia, Palermo, Italy

[31] Policlin Palermo, Gastroenterol Epatol, Palermo, Italy

[32] Azienda Osped Univ Senese, UOC Gastroenterol Endoscopia Operat, Dipartimento Oncol, Siena, Italy

[33] IRCCS AO Univ San Martino IST, UO Clin Gastroenterol Endoscopia, Genoa, Italy

[34] AOU Macchi, UO Gastroenterol Endoscopia Digest, Varese, Italy

[35] Osped Maggiore Crema, UO Gastroenterolo Endoscopia Digest, Crema, Italy

[36] Ist Nazl Tumori IRCCS, Ctr Riferimento Oncol, SOC Gastroenterol Oncol, Aviano, Italy

[37] UO Gastroenterol Osped Univ San Raffaele, Milan, Italy

[38] Univ Naples Federico II, Dipartimento Med Clin & Sperimentale, Naples, Italy

[39] Osped Valdichiana, UOS Endoscopia Digest, Montepulciano, Italy

[40] Ospedale San Giuseppe Multimed, Milan, Italy

[41] Osped Vittorio Emanuele III, UOC Med & Lungodegenza, Salemi, Italy

[42] Univ Florence, Dipartimento Chirurg & Med Traslaz, I-50121 Florence, Italy

[43] Osped San Carlo Borromeo Milano, UOC Gastroenterol, Milan, Italy

[44] Univ Cagliari, AOU Policlin Monserrato, Dipartimento Med Interna, I-09124 Cagliari, Italy

[45] Osped Sant Andrea, UO Gastroenterol, Rome, Italy

[46] AO Ist Ospitalieri Cremona, UOC Endoscopia Digest & Gastroenterol, Cremona, Italy

[47] Osped S Maria Del Prato, UOC Gastroenterol, Feltre, Italy

[48] AOU Careggi, SOS Fisiopatol Apparato Digerente & Motil, Florence, Italy

[49] Policlin Paolo Giaccone, UO Gastroenterol Epatol, Palermo, Italy

[50] Azienda Osped San Gerardo, UO Endoscopia Digest, Monza, Italy

来源：

BMC GASTROENTEROLOGY | 2017年 / 17卷

关键词：

Functional constipation; Irritable bowel syndrome; Diagnosis; Treatment; IRRITABLE-BOWEL-SYNDROME; RECTAL EXAMINATION; NORTH-AMERICA; HEALTH-CARE; PREVALENCE; GASTROENTEROLOGY; QUESTIONNAIRE; EPIDEMIOLOGY; PERSPECTIVE; VALIDATION;

D O I：

10.1186/s12876-016-0556-7

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: According to Rome criteria, chronic constipation (CC) includes functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C). Some patients do not meet these criteria (No Rome Constipation, NRC). The aim of the study was is to evaluate the various clinical presentation and management of FC, IBS-C and NRC in Italy. Methods: During a 2-month period, 52 Italian gastroenterologists recorded clinical data of FC, IBS-C and NRC patients, using Bristol scale, PAC-SYM and PAC-QoL questionnaires. In addition, gastroenterologists were also asked to record whether the patients were clinically assessed for CC for the first time or were in follow up. Diagnostic tests and prescribed therapies were also recorded. Results: Eight hundred seventy-eight consecutive CC patients (706 F) were enrolled (FC 62.5%, IBS-C 31.3%, NRC 6. 2%). PAC-SYM and PAC-QoL scores were higher in IBS-C than in FC and NRC. 49.5% were at their first gastroenterological evaluation for CC. In 48.5% CC duration was longer than 10 years. A specialist consultation was requested in 31.6%, more frequently in IBS-C than in NRC. Digital rectal examination was performed in only 56.4%. Diagnostic tests were prescribed to 80.0%. Faecal calprotectin, thyroid tests, celiac serology, breath tests were more frequently suggested in IBS-C and anorectal manometry in FC. More than 90% had at least one treatment suggested on chronic constipation, most frequently dietary changes, macrogol and fibers. Antispasmodics and psychotherapy were more frequently prescribed in IBS-C, prucalopride and pelvic floor rehabilitation in FC. Conclusions: Patients with IBS-C reported more severe symptoms and worse quality of life than FC and NRC. Digital rectal examination was often not performed but at least one diagnostic test was prescribed to most patients. Colonoscopy and blood tests were the "first line" diagnostic tools. Macrogol was the most prescribed laxative, and prucalopride and pelvic floor rehabilitation represented a "second line" approach. Diagnostic tests and prescribed therapies increased by increasing CC severity.

引用

页数：11

共 28 条

[1] Being constipated: A bad omen for your cardiovascular system? [J].