Impact of Abdominal Symptoms in Patients With Chronic Idiopathic Constipation (CIC) in the United States

Introduction: Patients with CIC report a variety of abdominal symptoms beyond reduced stool frequency or straining. However, our understanding of these additional symptoms is limited. This study examined the impact of abdominal symptoms on patients with CIC. Methods: A cross-sectional, on-line health survey collected data from 8/2020-12/2021 on US adults. CIC patients were defined using Rome IV criteria. Endpoints assessed were care, symptom burden and satisfaction with control, health care provider (HCP) management and treatment of abdominal symptoms. Categorical data were described by percentage; continuous data were described by means and standard deviation. Results: Of 29,359 total participants, 9.2% (n=2,696) met criteria for CIC. CIC patients were primarily female (68.4%), White (80.9%), with a mean age of 45.1 years. Of CIC patients who sought care in the past year (58.9%), 33.1% sought care due to not getting adequate relief of and/or worsening abdominal symptoms. Of CIC patients who had an ER visit or hospitalization in the past year (15.7%) (Table), abdominal pain (84.1%), abdominal discomfort (51.2%) and abdominal bloating (42.2%) were the most common reported reasons. 91.1% of CIC patients took a medication in the past year due to abdominal pain (63.4%), abdominal discomfort (62.2%) or abdominal bloating (45.2%). Abdominal discomfort was the symptom most experienced (58.4%), while abdominal pain was the most bothersome symptom (26.5%) and the predominant symptom limiting ability to work or conduct household chores (33.6%). CIC patients were slightly more dissatisfied than satisfied with overall control of their abdominal symptoms (37.5% vs 36.1%), and more satisfied than dissatisfied with HCP management of their abdominal symptoms (49.7% vs 19.0%). Those currently taking an Rx with or without an OTC were more satisfied with the control of their abdominal symptoms than those currently taking an OTC only (50.6% vs 30.0%) (Figure). Conclusion: CIC patients suffer with abdominal symptoms typically associated with IBS-C patients highlighting the overlap of these two common disorders of gut-brain interaction. Symptom impact is high as one-third of CIC patients sought care due to abdominal symptoms, and abdominal symptoms were the most-reported reasons for ER visits or hospitalizations.Figure 1.: Satisfaction with Control, HCP Management and Treatment of Abdominal Symptoms Table 1. - Characteristics of Patients with CIC Rome IV CIC Cohort (N=2,696) % N Female 68.4% 1,843 Age, mean (SD) 45.1 (16.8) Black or African American 10.6% 286 White 80.9% 2,180 Other 8.5% 230 Proportion of Hispanic, Latino or Spanish origin 10.0% 269 Northeast 18.7% 504 Midwest 22.5% 607 South 38.2% 1,031 West 20.5% 554 Charlson Comorbidity Index (CCI) score, mean (SD) 0.8 (1.6) Body Mass Index (BMI) (lbs/in2), mean (SD) 27.8 (7.3) Median household income (Census derived from zip code), mean (SD) 64,556 (26,352) Proportion educated more than high school 75.5% 2,036 Proportion employed per Work Productivity and Impairment (WPAI) (1) 54.3% 1,111 Sought care for bowel and/or abdominal symptoms in the past 12 months 58.9% 1,589 ER visit or hospitalization for bowel and/or abdominal symptoms, past 12 months 15.7% 422 (1) Question fielded 12/20-12/21; n=2047