Functional bowel disorders in pregnancy: effect on quality of life, evaluation and management

Abstract

Objective: To characterize functional bowel disorders in a population of pregnant women, evaluating effects on quality of life, management and follow up.

Design: Prospective cohort.

Setting: University center, USA.

Population: Women in the first trimester (n = 104).

Methods: After enrollment evaluations, measures were repeated in the third trimester. Overall bowel function was assessed using the Rome III Questionnaire for Functional Bowel Disorders. Quality of life symptoms were assessed with the Irritable Bowel Syndrome Quality of Life Measure. Physician documentation of bowel symptoms and subsequent treatment in pregnancy were ascertained by retrospective chart review.

Main outcome measure: Quality of life in first trimester.

Results: A majority (75%) of the women at the first trimester evaluation reported having one or more functional bowel disorders. The overall quality of life status was rated highly functional, with a total average score of 94.9. Of the 75 women reporting functional bowel disorders, only 18 (24%) were identified in the medical record. Overall documentation of any bowel function was identified in the majority (64%) of cases. Most commonly, no discussion of treatment was documented, and follow up was recorded in only 27% of women with dysfunction.

Conclusions: Nearly three-quarters of women in the first trimester report symptoms consistent with functional bowel disorders. Overall quality of life measures are highly rated. There is a discrepancy between what women report regarding bowel dysfunction and what is documented by providers within the medical record.

Keywords: Bowel function; constipation; medical records; pregnancy; quality of life.