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CC BY-NC-ND 4.0 · Journal of Coloproctology 2022; 42(03): 210-216
DOI: 10.1055/s-0042-1750761
Original Article

Prevalence and Predictors of Functional Evacuation Disorder in Patients with Chronic Constipation

Manas Kumar Behera
1   Department of Hepatology, SCB Medical College and Hospital, Cuttack, Odisha, India
,
Debakanta Mishra
2   Department of Gastroenterology, IMS and SUM Hospital, Bhubaneswar, Odisha, India
,
Manoj Kumar Sahu
2   Department of Gastroenterology, IMS and SUM Hospital, Bhubaneswar, Odisha, India
,
Ayaskanta Singh
2   Department of Gastroenterology, IMS and SUM Hospital, Bhubaneswar, Odisha, India
,
Girish Kumar Pati
2   Department of Gastroenterology, IMS and SUM Hospital, Bhubaneswar, Odisha, India
,
Shobhit Agarwal
2   Department of Gastroenterology, IMS and SUM Hospital, Bhubaneswar, Odisha, India
,
Jimmy Narayan 
2   Department of Gastroenterology, IMS and SUM Hospital, Bhubaneswar, Odisha, India
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Financial Support The authors have no sources of funding to declare
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Abstract

Background Functional evacuation disorder (FED) is the second most common cause of functional constipation (FC) after constipation-predominant irritable bowel syndrome. However, the data on FED is relatively scanty in our region. Hence, the present study was performed to evaluate the demographics of FED and to find out the predictors of FED in patients with chronic constipation.

Methods A total of 134 patients with chronic constipation diagnosed according to the Rome IV criteria who were referred for high-resolution anorectal manometry (HRAM) were retrospectively enrolled in the present study. All FC patients who underwent HRAM were asked to fill a questionnaire and underwent anorectal manometry and were submitted to the balloon expulsion test (BET).

Results The mean age of patients was 43.09 ± 9.32 years old, with a total of 76 (54%) males. The most common symptom was straining during defecation (87%) followed by incomplete evacuation (86%). The prevalence of FED, diagnosed by HRAM and by the BET was 39%. Patients with FED had a significantly higher percentage of straining and sensation of anorectal blockade compared with those without FED (96 versus 82%; p < 0.01; 81 versus 44%; p < 0.001, respectively). On the multivariate regression analysis, straining > 30 minutes (odds ratio [OR] = 3.63; p = 0.03), maximum squeeze pressure (OR = 1.05; p < 0.001), and balloon volume at maximal sensation (OR = 1.06; p < 0.001) were found to be significant independent predictors of FED.

Conclusion Prolonged straining and sensation of anorectal blockade were significant indicators of FED in patients with chronic constipation.

Keywords

chronic constipation - functional evacuation disorder - anorectal manometry - gender

Data Availability Statement

All data are reported in the present manuscript.


Contribution of the Authors

Behera M. K.: Preparation and presentation of the published work through the creation of the initial draft, data collection, review of the literature, and development of the finalized manuscript; Mishra D.: Data collection, critical review, commentary, and revision of the manuscript; Sahu M. K.: Critical review, commentary, and revision of the manuscript; Singh A.: Data collection, critical review, and final revision of the manuscript; Pati G. K.: Data collection and final revision of the manuscript; Agarwal S.: Data collection, revision of the manuscript; Narayan J.: Design of the study, revision of the final draft, critical review, and commentary.




Publication History

Received: 23 January 2022

Accepted: 06 May 2022

Article published online:
20 September 2022

© 2022. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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