Biopsychosocial Model and Perceived Constipation Severity According to the Constipation Phenotype

Dig Dis Sci. 2021 Oct;66(10):3588-3596. doi: 10.1007/s10620-020-06654-z. Epub 2020 Oct 19.

Michel Bouchoucha 1 2 3, Marinos Fysekidis 4, David Deutsch 4, Bakhtiar Bejou 4, Jean-Marc Sabate 5, Robert Benamouzig 5


Author information

1Physiology Department, Université René Descartes, Paris V, Paris, France. michel.bouchoucha@aphp.fr.

2Gastroenterology Department, Avicenne Hospital, Bobigny, France. michel.bouchoucha@aphp.fr.

3Service de Gastro-Entérologie, CEFRED (Centre d'Exploration Fonctionnelle et de Rééducation Digestive), Hôpital Avicenne, 125, rue de Stalingrad, 93009, Bobigny Cedex, France. michel.bouchoucha@aphp.fr.

4Nutrition Department, Hôpital Privé de l'Est Parisien, 33600, Aulnay Sous Bois, France.

5Gastroenterology Department, Avicenne Hospital, Bobigny, France.


Purpose: Constipation is a frequent complaint of patients with functional bowel disorders. The present study aimed to evaluate the relationship between the perceived constipation severity with demographics, clinical, physiological, and psychological parameters in constipated patients.

Patients and methods: Four hundred seven constipated patients were included and had clinical, physiological, and psychological evaluation. The self-reported severity of constipation was analyzed using stepwise linear regression in the total population and within each clinical group.

Results: The patients were mainly of female gender (81%) and were 47.4 ± 16.5 years old. They complained of IBS (65%), and 62% had defecation disorders. The depression scale was abnormal in 200 patients (49%). The relationships of the constipation severity varied according to the Rome IV phenotype. In all phenotypes, it was positively associated with bloating severity, and negatively with Bristol stool form. In IBS patients, perceived constipation severity was also associated with abdominal pain severity.

Conclusion: Our data support the hypothesis that perceived constipation severity is associated with clinical and physiological factors but not demographics and psychological factors. Besides, the relationships of perceived constipation severity with these factors vary according to clinical phenotypes.

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