Prevalence and Predictors of Functional Evacuation Disorder in Patients with Chronic Constipation

Abstract Background Functional evacuation disorder (FED) is the second most common cause of functional constipation (FC) after constipation-predominant irritable bowel syndrome. However, the data on FED is relatively scanty in our region. Hence, the present study was performed to evaluate the demographics of FED and to find out the predictors of FED in patients with chronic constipation. Methods A total of 134 patients with chronic constipation diagnosed according to the Rome IV criteria who were referred for high-resolution anorectal manometry (HRAM) were retrospectively enrolled in the present study. All FC patients who underwent HRAM were asked to fill a questionnaire and underwent anorectal manometry and were submitted to the balloon expulsion test (BET). Results The mean age of patients was 43.09 ± 9.32 years old, with a total of 76 (54%) males. The most common symptom was straining during defecation (87%) followed by incomplete evacuation (86%). The prevalence of FED, diagnosed by HRAM and by the BET was 39%. Patients with FED had a significantly higher percentage of straining and sensation of anorectal blockade compared with those without FED (96 versus 82%; p < 0.01; 81 versus 44%; p < 0.001, respectively). On the multivariate regression analysis, straining > 30 minutes (odds ratio [OR] = 3.63; p = 0.03), maximum squeeze pressure (OR = 1.05; p < 0.001), and balloon volume at maximal sensation (OR = 1.06; p < 0.001) were found to be significant independent predictors of FED. Conclusion Prolonged straining and sensation of anorectal blockade were significant indicators of FED in patients with chronic constipation.

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Main Authors: Behera,Manas Kumar, Mishra,Debakanta, Sahu,Manoj Kumar, Singh,Ayaskanta, Pati,Girish Kumar, Agarwal,Shobhit, Narayan,Jimmy
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Coloproctologia 2022
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2237-93632022000300210
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spelling oai:scielo:S2237-936320220003002102022-12-19Prevalence and Predictors of Functional Evacuation Disorder in Patients with Chronic ConstipationBehera,Manas KumarMishra,DebakantaSahu,Manoj KumarSingh,AyaskantaPati,Girish KumarAgarwal,ShobhitNarayan,Jimmy chronic constipation functional evacuation disorder anorectal manometry gender Abstract Background Functional evacuation disorder (FED) is the second most common cause of functional constipation (FC) after constipation-predominant irritable bowel syndrome. However, the data on FED is relatively scanty in our region. Hence, the present study was performed to evaluate the demographics of FED and to find out the predictors of FED in patients with chronic constipation. Methods A total of 134 patients with chronic constipation diagnosed according to the Rome IV criteria who were referred for high-resolution anorectal manometry (HRAM) were retrospectively enrolled in the present study. All FC patients who underwent HRAM were asked to fill a questionnaire and underwent anorectal manometry and were submitted to the balloon expulsion test (BET). Results The mean age of patients was 43.09 ± 9.32 years old, with a total of 76 (54%) males. The most common symptom was straining during defecation (87%) followed by incomplete evacuation (86%). The prevalence of FED, diagnosed by HRAM and by the BET was 39%. Patients with FED had a significantly higher percentage of straining and sensation of anorectal blockade compared with those without FED (96 versus 82%; p < 0.01; 81 versus 44%; p < 0.001, respectively). On the multivariate regression analysis, straining > 30 minutes (odds ratio [OR] = 3.63; p = 0.03), maximum squeeze pressure (OR = 1.05; p < 0.001), and balloon volume at maximal sensation (OR = 1.06; p < 0.001) were found to be significant independent predictors of FED. Conclusion Prolonged straining and sensation of anorectal blockade were significant indicators of FED in patients with chronic constipation.info:eu-repo/semantics/openAccessSociedade Brasileira de ColoproctologiaJournal of Coloproctology (Rio de Janeiro) v.42 n.3 20222022-07-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2237-93632022000300210en10.1055/s-0042-1750761
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libraryname SciELO
language English
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author Behera,Manas Kumar
Mishra,Debakanta
Sahu,Manoj Kumar
Singh,Ayaskanta
Pati,Girish Kumar
Agarwal,Shobhit
Narayan,Jimmy
spellingShingle Behera,Manas Kumar
Mishra,Debakanta
Sahu,Manoj Kumar
Singh,Ayaskanta
Pati,Girish Kumar
Agarwal,Shobhit
Narayan,Jimmy
Prevalence and Predictors of Functional Evacuation Disorder in Patients with Chronic Constipation
author_facet Behera,Manas Kumar
Mishra,Debakanta
Sahu,Manoj Kumar
Singh,Ayaskanta
Pati,Girish Kumar
Agarwal,Shobhit
Narayan,Jimmy
author_sort Behera,Manas Kumar
title Prevalence and Predictors of Functional Evacuation Disorder in Patients with Chronic Constipation
title_short Prevalence and Predictors of Functional Evacuation Disorder in Patients with Chronic Constipation
title_full Prevalence and Predictors of Functional Evacuation Disorder in Patients with Chronic Constipation
title_fullStr Prevalence and Predictors of Functional Evacuation Disorder in Patients with Chronic Constipation
title_full_unstemmed Prevalence and Predictors of Functional Evacuation Disorder in Patients with Chronic Constipation
title_sort prevalence and predictors of functional evacuation disorder in patients with chronic constipation
description Abstract Background Functional evacuation disorder (FED) is the second most common cause of functional constipation (FC) after constipation-predominant irritable bowel syndrome. However, the data on FED is relatively scanty in our region. Hence, the present study was performed to evaluate the demographics of FED and to find out the predictors of FED in patients with chronic constipation. Methods A total of 134 patients with chronic constipation diagnosed according to the Rome IV criteria who were referred for high-resolution anorectal manometry (HRAM) were retrospectively enrolled in the present study. All FC patients who underwent HRAM were asked to fill a questionnaire and underwent anorectal manometry and were submitted to the balloon expulsion test (BET). Results The mean age of patients was 43.09 ± 9.32 years old, with a total of 76 (54%) males. The most common symptom was straining during defecation (87%) followed by incomplete evacuation (86%). The prevalence of FED, diagnosed by HRAM and by the BET was 39%. Patients with FED had a significantly higher percentage of straining and sensation of anorectal blockade compared with those without FED (96 versus 82%; p < 0.01; 81 versus 44%; p < 0.001, respectively). On the multivariate regression analysis, straining > 30 minutes (odds ratio [OR] = 3.63; p = 0.03), maximum squeeze pressure (OR = 1.05; p < 0.001), and balloon volume at maximal sensation (OR = 1.06; p < 0.001) were found to be significant independent predictors of FED. Conclusion Prolonged straining and sensation of anorectal blockade were significant indicators of FED in patients with chronic constipation.
publisher Sociedade Brasileira de Coloproctologia
publishDate 2022
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2237-93632022000300210
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