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Experts define treatment failure for chronic constipation
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A group of European gastroenterologists has established a definition of failure of a treatment to provide adequate relief for patients with chronic constipation, focusing on five key symptoms and their severities.
“The publication highlights a newly developed instrument to help the non-specialist identify when there has been insufficient response to a particular treatment for constipation,” Anton Emmanuel, MD, of the University College Hospital in London, told Healio Gastroenterology. “Patients’ subjective response to constipation treatment is highly variable, and so a group of European experts undertook a Delphi process to produce a simple 5-question tool that helps identify non-responders. The intention is that this will allow patients to be transitioned up the treatment ladder if needed, rather than left in limbo with an insufficient treatment.”
Anton Emmanuel
The international committee arrived at five diagnostic statements, any of which indicate a treatment’s failure to provide adequate relief if applicable to a patient over 2 weeks of treatment:
- The patient reports an inadequate number of bowel movements most of the time, and reports complete bowel movements occur fewer than 3 days per week;
- Patients report straining on most occasions, or report straining is worsening;
- Stool consistency does not improve and Bristol Stool Scale score is less than 3;
- Patients report another sign or symptom of chronic constipation has had insufficient improvement; and
- Patient has poor tolerability of the treatment.
The committee also developed a questionnaire to be used as a patient reported outcome measure, which they have called the “F-PAR Tool,” which is being validated in an ongoing study. – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.
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