title: Chronic constipation, irritable bowel syndrome with constipation and constipation with pain/discomfort: similarities and differences.
abstract: OBJECTIVE
  Some patients with chronic constipation (CC) have abdominal pain and discomfort (painful CC) without fulfilling the criteria for irritable bowel syndrome (IBS). Our aim was to investigate similarities and differences among nonpainful CC, painful CC, and CC in patients with IBS according to prevalence, individual symptoms, associated factors, and impact on health-related quality of life and use of medical resources.
  
  
  METHODS
  We conducted a telephone survey of a random sample of the Spanish population (N=1500). Bowel symptoms were recorded using the Rome III questionnaire, health-related quality of life using the short form-12 (SF-12) and quality of live in constipation-20 (CVE-20) questionnaires, and self-reported constipation, lifestyle habits, and consultation behavior using an ad hoc questionnaire.
  
  
  RESULTS
  The overall prevalence of CC was 19.2%, with prevalence by subgroups being 13.9% for nonpainful CC, 2.0% for painful CC, and 3.3% for CC in patients with IBS. CC was more prevalent among women at a ratio of 2.7:1. Subjects with painful CC and CC in patients with IBS were younger, reported more constipation, and had more symptoms than subjects with nonpainful CC. Age and physical activity were significantly associated with CC. Symptoms associated with consultation were abdominal pain and digitation. Nonpainful CC patients were more satisfied with laxative use than were the other subgroups. Subjects with CC showed a significant impairment in the physical and mental component of the SF-12 questionnaire.
  
  
  CONCLUSIONS
  CC appears to be a spectrum; most patients do not have abdominal pain/discomfort but others (with otherwise quite similar characteristics) are patients with IBS or are out of any established diagnosis.
authors.affiliation: Department of Digestive Diseases, San Carlos Clinical Hospital, Complutense University, San Carlos Clinical Hospital Health Research Institute (Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC)), Madrid, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Rey
authors.affiliation: Service of Gastroenterology, Centro Médico Teknon, Institute of Functional and Motor Digestive Disorders, Barcelona, Spain.
authors.forename: Agustín
authors.initials: A
authors.lastname: Balboa
authors.affiliation: Service of Gastroenterology, Centro Médico Teknon, Institute of Functional and Motor Digestive Disorders, Barcelona, Spain.
authors.forename: Fermín
authors.initials: F
authors.lastname: Mearin
mesh_terms: D003248:Constipation / Q000150:complications*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications*