Andrew Davies, Norah Fagan, Jenny Power, Amy Taylor
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Despite international consensus diagnostic criteria for functional and opioid-induced constipation (Rome IV diagnostic criteria), the term 'constipation' means different things to different people, impacting assessment, diagnosis and management.</p><p><strong>Aim: </strong>To investigate the association between persons with advanced cancer self-reporting of constipation, response to the Rome IV diagnostic criteria statements for opioid-induced constipation and differences according to personal demographics.</p><p><strong>Design: </strong>Multicentre prospective observational study.</p><p><strong>Setting/participants: </strong>Twenty-four community, hospice and hospital research sites in 10 European countries recruited 1200 adults with cancer taking opioids for cancer/cancer-treatment related pain.</p><p><strong>Results: </strong>In response to the simple question <i>'Are you constipated?'</i>, 549 (45.5%) participants replied 'yes', 588 (49%) replied 'no' and 59 (5%) were 'unsure', but 713 (59.5%) participants met the Rome IV diagnostic criteria. Only 439 (61.5%) participants that met these criteria answered the simple question positively, whilst 230 (39%) answered negatively, although there was a statistically significant association between responses to the simple question and the criteria (χ<sup>2</sup>(1, <i>N</i> = 1136) = 149.945, <i>p</i> = 0.00001). There were certain significant differences in self-reporting according to age and country of origin.</p><p><strong>Conclusions: </strong>There is disparity between patients' self-reporting of constipation and the Rome IV diagnostic criteria. People with advanced cancer, especially those receiving opioid analgesics, need to be regularly assessed for constipation, but the use of a single question (<i>'Are you constipated?'</i>) is inadequate.Registry: European Study of Opioid Induced Constipation (E-StOIC), NCT05149833, https://clinicaltrials.gov/study/NCT05149833, 08/12/2021.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"553-562"},"PeriodicalIF":3.6000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"'Constipation': One word, many meanings amongst persons with cancer: An observational study.\",\"authors\":\"Andrew Davies, Norah Fagan, Jenny Power, Amy Taylor\",\"doi\":\"10.1177/02692163251325711\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Constipation is common in people with advanced cancer and is associated with significant morbidity and health economic burden, but it is often sub-optimally managed. Despite international consensus diagnostic criteria for functional and opioid-induced constipation (Rome IV diagnostic criteria), the term 'constipation' means different things to different people, impacting assessment, diagnosis and management.</p><p><strong>Aim: </strong>To investigate the association between persons with advanced cancer self-reporting of constipation, response to the Rome IV diagnostic criteria statements for opioid-induced constipation and differences according to personal demographics.</p><p><strong>Design: </strong>Multicentre prospective observational study.</p><p><strong>Setting/participants: </strong>Twenty-four community, hospice and hospital research sites in 10 European countries recruited 1200 adults with cancer taking opioids for cancer/cancer-treatment related pain.</p><p><strong>Results: </strong>In response to the simple question <i>'Are you constipated?'</i>, 549 (45.5%) participants replied 'yes', 588 (49%) replied 'no' and 59 (5%) were 'unsure', but 713 (59.5%) participants met the Rome IV diagnostic criteria. Only 439 (61.5%) participants that met these criteria answered the simple question positively, whilst 230 (39%) answered negatively, although there was a statistically significant association between responses to the simple question and the criteria (χ<sup>2</sup>(1, <i>N</i> = 1136) = 149.945, <i>p</i> = 0.00001). There were certain significant differences in self-reporting according to age and country of origin.</p><p><strong>Conclusions: </strong>There is disparity between patients' self-reporting of constipation and the Rome IV diagnostic criteria. 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引用次数: 0
摘要
背景：便秘在晚期癌症患者中很常见，并与显著的发病率和健康经济负担相关，但往往管理不善。尽管功能性便秘和阿片类药物引起的便秘的国际共识诊断标准（罗马IV诊断标准），“便秘”一词对不同的人意味着不同的东西，影响评估、诊断和管理。目的：探讨晚期癌症患者便秘自述与阿片类药物引起便秘的罗马IV诊断标准陈述的反应之间的关系以及个人人口统计学差异。设计：多中心前瞻性观察研究。环境/参与者：10个欧洲国家的24个社区、临终关怀和医院研究点招募了1200名患有癌症的成年人，他们服用阿片类药物来治疗癌症/癌症治疗相关的疼痛。结果：在回答“你便秘吗？”， 549名（45.5%）参与者回答“是”，588名（49%）回答“否”，59名（5%）回答“不确定”，但713名（59.5%）参与者符合罗马IV诊断标准。只有439（61.5%）名符合这些标准的参与者对简单问题的回答是肯定的，而230（39%）名回答是否定的，尽管对简单问题的回答与标准之间存在统计学上显著的关联（χ2(1, N = 1136) = 149.945, p = 0.00001）。根据年龄和原籍国的不同，自我报告有一定的显著差异。结论：患者自述便秘与罗马IV诊断标准存在差异。晚期癌症患者，特别是那些接受阿片类镇痛药的患者，需要定期进行便秘评估，但使用一个问题（“你便秘吗？”）是不够的。注册：欧洲阿片类药物诱导便秘研究（E-StOIC）， NCT05149833, https://clinicaltrials.gov/study/NCT05149833, 08/12/2021。
'Constipation': One word, many meanings amongst persons with cancer: An observational study.
Background: Constipation is common in people with advanced cancer and is associated with significant morbidity and health economic burden, but it is often sub-optimally managed. Despite international consensus diagnostic criteria for functional and opioid-induced constipation (Rome IV diagnostic criteria), the term 'constipation' means different things to different people, impacting assessment, diagnosis and management.
Aim: To investigate the association between persons with advanced cancer self-reporting of constipation, response to the Rome IV diagnostic criteria statements for opioid-induced constipation and differences according to personal demographics.
Setting/participants: Twenty-four community, hospice and hospital research sites in 10 European countries recruited 1200 adults with cancer taking opioids for cancer/cancer-treatment related pain.
Results: In response to the simple question 'Are you constipated?', 549 (45.5%) participants replied 'yes', 588 (49%) replied 'no' and 59 (5%) were 'unsure', but 713 (59.5%) participants met the Rome IV diagnostic criteria. Only 439 (61.5%) participants that met these criteria answered the simple question positively, whilst 230 (39%) answered negatively, although there was a statistically significant association between responses to the simple question and the criteria (χ2(1, N = 1136) = 149.945, p = 0.00001). There were certain significant differences in self-reporting according to age and country of origin.
Conclusions: There is disparity between patients' self-reporting of constipation and the Rome IV diagnostic criteria. People with advanced cancer, especially those receiving opioid analgesics, need to be regularly assessed for constipation, but the use of a single question ('Are you constipated?') is inadequate.Registry: European Study of Opioid Induced Constipation (E-StOIC), NCT05149833, https://clinicaltrials.gov/study/NCT05149833, 08/12/2021.
期刊介绍：
Palliative Medicine is a highly ranked, peer reviewed scholarly journal dedicated to improving knowledge and clinical practice in the palliative care of patients with far advanced disease. This outstanding journal features editorials, original papers, review articles, case reports, correspondence and book reviews. Essential reading for all members of the palliative care team. This journal is a member of the Committee on Publication Ethics (COPE).
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