Fecal urgency is common in constipated patients and is associated with anxiety
Fecal urgency is common in constipated patients and is associated with anxiety
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DOI：
10.1111/nmo.13545
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发表时间：
2019-04-01
影响因子：
3.5
通讯作者：
Lembo, Anthony
中科院分区：
文献类型：
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作者：
Singh, Prashant;Takazawa, Eve;Lembo, Anthony
背景：大便急迫是一种通常与腹泻相关的症状，但也有便秘患者报告。我们的目的是（a）评估便秘患者中便尿急的患病率和负担（B）评估这些患者中中度至重度便尿急的胃肠道和精神病学预测因子。方法连续到三级胃肠病门诊就诊的便秘患者纳入研究。如果在过去3个月内>= 50%的排便（BM）与便尿急相关，则认为患者患有中度至重度便尿急。焦虑、抑郁和睡眠障碍的诊断采用患者报告结局测量信息系统（PROMIS）t评分>= 60。还使用PROMIS问卷评估腹痛和便秘的严重程度。使用单变量和逐步逻辑回归来确定中度至重度粪便紧迫感的预测因素。在139例便秘患者中，70.8%的患者报告在过去3个月内经历过便尿急，25.8%的患者报告受到严重困扰。139例患者中有27%报告中度至重度便尿急。稀便频率（OR 1.5，95% CI 1.1，2.0）和焦虑（OR 2.3，95% CI 1.1，5.0）是中度至重度便急的独立预测因素。结论和推论粪便紧迫感在便秘患者中很常见，并且经常困扰许多患者。我们确定了与便秘患者中度至重度便尿急相关的临床和精神因素，如果在未来的研究中得到验证，则具有潜在的治疗意义。
Background Fecal urgency is a symptom generally associated with diarrhea but is also reported by patients with constipation. Our aim was to (a) assess the prevalence and burden of fecal urgency in constipated patients (b) evaluate gastrointestinal and psychiatric predictors of moderate to severe fecal urgency in these patients. Methods Patients presenting consecutively to a tertiary outpatient gastroenterology clinic with constipation were included. Patients were considered to have moderate to severe fecal urgency if >= 50% of bowel movements (BMs) in the past 3 months were associated with fecal urgency. Anxiety, depression, and sleep disturbance were diagnosed using a Patient-Reported Outcomes Measurement Information System (PROMIS) t-score of >= 60. Abdominal pain and constipation severity were also assessed using PROMIS questionnaires. Univariable and stepwise logistic regression were used to identify predictors of moderate to severe fecal urgency. Key results Of 139 constipated patients, 70.8% reported experiencing fecal urgency in the past 3 months and 25.8% reported being significantly bothered by it. Moderate to severe fecal urgency was reported by 27% of 139 patients. Frequency of loose stools (OR 1.5, 95% CI 1.1, 2.0) and presence of anxiety (OR 2.3, 95% CI 1.1, 5.0) were independent predictors of moderate to severe fecal urgency. Conclusions and inferences Fecal urgency is common in patients with constipation and is frequently bothersome to many patients. We identified clinical and psychiatric factors associated with moderate to severe fecal urgency in constipated patients with potential therapeutic implications if validated in future studies.