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. 2005 Sep 14;11(34):5362-6.
doi: 10.3748/wjg.v11.i34.5362.

Differing coping mechanisms, stress level and anorectal physiology in patients with functional constipation

Annie-Oo Chan  1 , Cecilia Cheng, Wai-Mo Hui, Wayne-H-C Hu, Nina-Y-H Wong, K-F Lam, Wai-Man Wong, Kam-Chuen Lai, Shiu-Kum Lam, Benjamin-C-Y Wong
Affiliations

Differing coping mechanisms, stress level and anorectal physiology in patients with functional constipation

Annie-Oo Chan et al. World J Gastroenterol. .

Abstract

Aim: To investigate coping mechanisms, constipation symptoms and anorectal physiology in 80 constipated subjects and 18 controls.

Methods: Constipation was diagnosed by Rome II criteria. Coping ability and anxiety/depression were assessed by validated questionnaires. Transit time and balloon distension test were performed.

Results: 34.5% patients were classified as slow transit type of constipation. The total colonic transit time (56 h vs 10 h, P<0.0001) and rectal sensation including urge sensation (79 mL vs 63 mL, P = 0.019) and maximum tolerable volume (110 mL vs 95 mL, P = 0.03) differed in patients and controls. Constipated subjects had significantly higher anxiety and depression scores and lower SF-36 scores in all categories. They also demonstrated higher scores of 'monitoring' coping strategy (14+/-6 vs 9+/-3, P = 0.001), which correlated with the rectal distension sensation (P = 0.005), urge sensation (P=0.002), and maximum tolerable volume (P = 0.035). The less use of blunting strategy predicted slow transit constipation in both univariate (P = 0.01) and multivariate analysis (P = 0.03).

Conclusion: Defective or ineffective use of coping strategies may be an important etiology in functional constipation and subsequently reflected in abnormal anorectal physiology.

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Figures

Figure 1
Figure 1
Self assessment of physical and mental health (SF-36) in patients and controls. Mean values of SF-36 scores for patients with constipation (line) compared with normal subjects (bar). Constipated patients differed from the normal subjects in all eight categories. They had decreased physical functioning scores (77 vs 93, P < 0.0001), role-physical scores (66 vs 87, P = 0.009), bodily pain scores (60 vs 83, P = 0.001), general health scores (45 vs 68, P < 0.0001), vitality scores (46 vs 62, P = 0.002), social functioning scores (67 vs 88, P < 0.0001), role emotional scores (56 vs 84, P = 0.001), and mental health scores (61 vs 76, P = 0.003).
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