11/23/2023 0 Comments Treatment for ibs2, 18 IBS-C and CIC also pose a significant financial burden to patients and healthcare systems. IBS-C and CIC are both associated with recurrent, bothersome symptoms that profoundly reduce patients’ quality of life (QoL) 16, 17 and productivity, and increase the number of missed days of work or school. 15 Risk factors for CIC include female sex, reduced caloric intake, and increasing age. 1, 8, 13 IBS most commonly presents between the ages of 25 and 54 years, 12, 14 and the overall prevalence is 67% higher in women internationally. 7–9 In the US, the prevalence of IBS-C is 4.3–5.2% of patients with IBS, 10–12 while the mean prevalence of CIC is 12.0–19.0%. The prevalence of constipation in the general population ranges from 2% to 27%, with the variability arising from differing definitions and populations. 6 In this review, we present current approaches to the differential diagnosis and multifaceted management of both IBS-C and CIC. 6 NPs and PAs need to be familiar with the latest evidence on the recognition and diagnosis of IBS-C and CIC in order to provide safe and effective healthcare. Patients with IBS-C and CIC often seek medical care owing to difficulty with BMs or abdominal pain and bloating 5 and will often first seek medical care from their primary care providers, who may include nurse practitioners (NPs) and physician assistants (PAs). 2 Therefore, in clinical practice, there may be little separation between the symptoms of the two disorders, and patients may migrate from one diagnosis to the other over the course of their disorder. 1, 3 One study of patients with CIC with and without abdominal symptoms found that patient-reported disease severity tracked closely with the presence of abdominal symptoms and suggested that abdominal symptoms could provide a measurement of disease severity along a continuum. 1, 2 Nonetheless, symptom overlap does occur between these two disorders, and IBS-C and CIC share symptoms of infrequent bowel movements (BMs), straining during defecation, hard and/or lumpy stools, and the sensation of incomplete evacuation.Īlthough these two disorders are considered distinct in terms of diagnostic criteria, recent studies have demonstrated that they may exist along a spectrum of severity. Abdominal pain is considered the hallmark symptom of IBS-C but is not necessarily the predominant symptom in CIC. CIC is defined by the frequency of specific bowel symptoms, such as straining and incomplete evacuation, which can be accompanied by abdominal symptoms such as pain or bloating, in patients who do not meet the criteria for IBS. 1–3 Irritable bowel syndrome (IBS) is defined by the presence of recurrent abdominal pain associated with a change in defecation and is subtyped by the predominant stool pattern (ie, constipation for IBS-C). Irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC), sometimes referred to as functional constipation, are two symptom-based disorders of gut–brain interaction defined by the Rome diagnostic criteria.
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