Perceptions of and Practices for the Management of Constipation: Results of a Korean National Survey
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Background/Aims: Although guidelines exist regarding the evaluation and management of patients with chronic constipation (CC), little is known about real-world clinical practice patterns. This study aimed to evaluate the various practices used to manage CC patients in various clinical settings in South Korea. Methods: A nationwide web-based survey was conducted, randomly selecting gastroenterologists and non-gastroenterologists. The 25-item questionnaire included physicians’ perceptions and practices regarding the available options for diagnosing and managing CC patients in Korea. Results: The study participants comprised 193 physicians (86 gastroenterologists, 44.6%) involved in the clinical management of CC patients. The mean clinical experience was 12 years. Only 21 of 193 respondents (10.9%) used the Rome criteria when diagnosing CC. The Bristol Stool Form Scale was used by 29% of the respondents (56/193), while the digital rectal examination was performed by 11.9% of the respondents (23/193). Laboratory testing and colonoscopies were performed more frequently by gastroenterologists than by non-gastroenterologists (both p=0.001). Physiologic testing was used more frequently by gastroenterologists (p=0.046), physicians at teaching hospitals, and physicians with clinical experience ≤10 years (both p<0.05). There were also significant differences in the preference for laxatives depending on the type of hospital. Conclusions: There were discrepancies in the diagnosis and management of CC patients depending on the clinical setting. The utilization rates of the Bristol Stool Form Scale and digital rectal examination by physicians are low in real-world clinical practice. These results imply the need for better and more practical training of physicians in the assessment and management of CC.
Abstract
Background/Aims: Although guidelines exist regarding the evaluation and management of patients with chronic constipation (CC), little is known about real-world clinical practice patterns. This study aimed to evaluate the various practices used to manage CC patients in various clinical settings in South Korea. Methods: A nationwide web-based survey was conducted, randomly selecting gastroenterologists and non-gastroenterologists. The 25-item questionnaire included physicians’ perceptions and practices regarding the available options for diagnosing and managing CC patients in Korea. Results: The study participants comprised 193 physicians (86 gastroenterologists, 44.6%) involved in the clinical management of CC patients. The mean clinical experience was 12 years. Only 21 of 193 respondents (10.9%) used the Rome criteria when diagnosing CC. The Bristol Stool Form Scale was used by 29% of the respondents (56/193), while the digital rectal examination was performed by 11.9% of the respondents (23/193). Laboratory testing and colonoscopies were performed more frequently by gastroenterologists than by non-gastroenterologists (both p=0.001). Physiologic testing was used more frequently by gastroenterologists (p=0.046), physicians at teaching hospitals, and physicians with clinical experience ≤10 years (both p<0.05). There were also significant differences in the preference for laxatives depending on the type of hospital. Conclusions: There were discrepancies in the diagnosis and management of CC patients depending on the clinical setting. The utilization rates of the Bristol Stool Form Scale and digital rectal examination by physicians are low in real-world clinical practice. These results imply the need for better and more practical training of physicians in the assessment and management of CC.
참고문헌 (21)
- Suares NC, "Prevalence of, and risk factors for, chronic idiopathic constipation in the community : systematic review and meta-analysis", Am J Gastroenterol, 106, pp.1582~1591 (2011)
- Jun DW, "A population-based study on bowel habits in a Korean community : prevalence of functional constipation and self-reported constipation", Dig Dis Sci, 51, pp.1471~1477 (2006)
- Johanson JF, "Chronic constipation : a survey of the patient perspective", Aliment Pharmacol Ther, 25, pp.599~608 (2007)
- Leung L, "Chronic constipation : an evidence-based review", J Am Board Fam Med, 24, pp.436~451 (2011)
- Serra J, "Clinical practice guidelines for the management of constipation in adults. Part 2 : Diagnosis and treatment", Gastroenterol Hepatol, 40, pp.303~316 (2017)
- Ford AC, "American College of Gastroenterology monograph on the management of irritable bowel syndrome and chronic idiopathic constipation", Am J Gastroenterol, 109(Suppl 1), pp.S2~S26 (2014)
- Serra J, "European society of neurogastroenterology and motility guidelines on functional constipation in adults", Neurogastroenterol Motil, 32, pp.e13762~ (2020)
- Carter D, "Comparison of strategies and goals for treatment of chronic constipation among gastroenterologists and general practitioners", Ann Gastroenterol, 31, pp.71~76 (2018)
- Shin JE, "Guidelines for the diagnosis and treatment of chronic functional constipation in Korea, 2015 revised edition", J Neurogastroenterol Motil, 22, pp.383~411 (2016)
- Werth BL, "Defining constipation to estimate its prevalence in the community : results from a national survey", BMC Gastroenterol, 19, pp.75~ (2019)
- Lacy BE, "Bowel disorders", Gastroenterology, 150, pp.1393~1407 (2016)
- Gwee KA, "Assessment of the Asian Neurogastroenterology and Motility Association chronic constipation criteria : an Asian multicenter cross-sectional study", J Neurogastroenterol Motil, 23, pp.262~272 (2017)
- Dimidi E, "Perceptions of constipation among the general public and people with constipation differ strikingly from those of general and specialist doctors and the Rome IV criteria", Am J Gastroenterol, 114, pp.1116~1129 (2019)
- Oh SJ, "Chronic constipation in the United States : results from a population-based survey assessing healthcare seeking and use of pharmacotherapy", Am J Gastroenterol, 115, pp.895~905 (2020)
- Pepin C, "The yield of lower endoscopy in patients with constipation : survey of a university hospital, a public county hospital, and a Veterans Administration medical center", Gastrointest Endosc, 56, pp.325~332 (2002)
- Saad RJ, "Do stool form and frequency correlate with whole-gut and colonic transit? Results from a multicenter study in constipated individuals and healthy controls", Am J Gastroenterol, 105, pp.403~411 (2010)
- Jaruvongvanich V, "Prediction of delayed colonic transit using Bristol stool form and stool frequency in eastern constipated patients : a difference from the West", J Neurogastroenterol Motil, 23, pp.561~568 (2017)
- Tantiphlachiva K, "Digital rectal examination is a useful tool for identifying patients with dyssynergia", Clin Gastroenterol Hepatol, 8, pp.955~960 (2010)
- Nelson AD, "Comparison of efficacy of pharmacological treatments for chronic idiopathic constipation : a systematic review and network meta-analysis", Gut, 66, pp.1611~1622 (2017)
- Müller-Lissner S, "Levels of satisfaction with current chronic constipation treatment options in Europe : an internet survey", Aliment Pharmacol Ther, 37, pp.137~145 (2013)
- Belsey JD, "Systematic review and meta analysis : polyethylene glycol in adults with non-organic constipation", Int J Clin Pract, 64, pp.944~955 (2010)