title: The effect of parathyroidectomy on chronic constipation in patients affected by primary hyperparathyroidism.
abstract: Primary hyperparathyroidism (PHPT) is usually associated with chronic constipation; however, its prevalence is not defined by standardized criteria. The aim of the study was to evaluate both the prevalence of chronic constipation, defined by the standardized Rome diagnostic criteria III (Rome III) in PHPT, and the effect of parathyroidectomy (PTx). Fifty postmenopausal PHPT patients and 50 sex- and age-matched controls were studied. Each patient underwent mineral metabolism biochemical evaluation and completed a questionnaire and a 2-week diary card about bowel habits. PHPT patients were reevaluated after 6 months. According to Rome III, 40 % of PHPT patients had chronic constipation compared with 12 % of controls (p = 0.0002). The only difference between constipated PHPT patients (group A, n = 20) and those without constipation (group B, n = 30) was higher mean PTH values (79.9 ± 18.7 ng/l vs. 65.4 ± 26.0 ng/l; p = 0.03), which predicted the presence of constipation (p = 0.004, OR 1.059, CI 1.011-1.059). Forty percent of PHPT patients had undergone PTx. In group A, constipation was resolved in 80 % of patients after PTx compared to none of the same group who had not undergone PTx (p = 0.0007). In group B, 17.6 % of patients who had not undergone PTx became, after 6 months, constipated. According to Rome III, a higher prevalence of chronic constipation in PHPT patients was observed compared with controls. PTH levels predicted constipation. A significant reduction of chronic constipation was reported following successful surgery.
authors.affiliation: Department of Internal Medicine and Medical Disciplines, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy, jesspepe@tin.it.
authors.forename: Jessica
authors.initials: J
authors.lastname: Pepe
authors.forename: Danilo
authors.initials: D
authors.lastname: Badiali
authors.forename: Ivano
authors.initials: I
authors.lastname: Biviano
authors.forename: Italo
authors.initials: I
authors.lastname: Nofroni
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Romagnoli
authors.forename: Mirella
authors.initials: M
authors.lastname: Cilli
authors.forename: Sara
authors.initials: S
authors.lastname: Piemonte
authors.forename: Cristiana
authors.initials: C
authors.lastname: Cipriani
authors.forename: Luciano
authors.initials: L
authors.lastname: Colangelo
authors.forename: Salvatore
authors.initials: S
authors.lastname: Minisola
mesh_terms: D016022:Case-Control Studies; D003248:Constipation / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications* / Q000601:surgery*; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000378:metabolism; D016105:Parathyroidectomy / Q000379:methods; D017698:Postmenopause
chemical_list: D010281:Parathyroid Hormone
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