title: Is-it possible to distinguish irritable bowel syndrome with constipation from functional constipation?
abstract: BACKGROUND
  The Rome III criteria classify patients complaining of constipation into two main groups: patients with functional constipation (FC) and patients with constipation predominant irritable bowel syndrome (IBS-C). The purpose of this study was to identify differences in the intensity of symptoms and total and segmental colonic transit time in these two types of patients.
  
  
  METHODS
  We performed a prospective evaluation of 337 outpatients consecutively referred for chronic constipation and classified according to the Rome III criteria as FC or IBS-C. They were asked to report symptom intensity, on a 10-point Likert scale, for diarrhea, constipation, bloating and abdominal pain. Stool form was reported using the Bristol scale, and colonic transit time was measured by using multiple-ingestion single-marker single-film technique. Statistical analysis was completed by a discriminant analysis.
  
  
  RESULTS
  Female gender and obstructed defecation was more frequent in IBS-C patients than in FC patients. IBS-C patients reported greater symptom intensity than FC patients, but stool form, and total and segmental colonic transit time were not different between the two groups. Multivariate logistic regression showed that only two parameters, bloating and abdominal pain, were related to the IBS-C or to the FC phenotype, and discriminant analysis showed that these two parameters were sufficient to give a correct classification of 71% of the patients.
  
  
  CONCLUSIONS
  Our study suggests that self-evaluation of abdominal pain and bloating is more helpful than colonic transit time in classifying patient as IBS-C or FC.
authors.affiliation: Department of Physiology, Paris Descartes University, Paris, France. michel.bouchoucha@avc.aphp.fr.|Gastroenterology Department, Avicenne Hospital Bobigny, 93009, Bobigny Cedex, France. michel.bouchoucha@avc.aphp.fr.
authors.forename: M
authors.initials: M
authors.lastname: Bouchoucha
authors.affiliation: Department of Surgery, Sherbrooke University Medical School, Sherbrooke, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Devroede
authors.affiliation: Gastroenterology Department, Avicenne Hospital Bobigny, 93009, Bobigny Cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Bon
authors.affiliation: Gastroenterology Department, Avicenne Hospital Bobigny, 93009, Bobigny Cedex, France.
authors.forename: B
authors.initials: B
authors.lastname: Bejou
authors.affiliation: Gastroenterology Department, Avicenne Hospital Bobigny, 93009, Bobigny Cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Mary
authors.affiliation: Gastroenterology Department, Avicenne Hospital Bobigny, 93009, Bobigny Cedex, France.
authors.forename: R
authors.initials: R
authors.lastname: Benamouzig
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000328:Adult; D003106:Colon / Q000503:physiopathology; D003248:Constipation / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D059026:Diagnostic Self Evaluation; D005243:Feces; D005260:Female; D005772:Gastrointestinal Transit / Q000502:physiology; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications / Q000175:diagnosis; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000175:diagnosis*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D063189:Symptom Assessment / Q000379:methods*
keywords: Abdominal pain; Bloating; Constipation; Functional bowel disorders; Irritable bowel syndrome