PWE-129 Gender differences in patients with chronic constipation in a tertiary referral clinic

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Abstract

Introduction

Chronic constipation (CC) is a very common symptom, and is more commonly seen in women. This difference is much more pronounced in secondary care. It is possible that the excess prevalence to secondary care is due to greater severity or to differences in healthcare seeking. This study aims to evaluate the differences in the characteristics of constipation seen in male and female patients attending a tertiary referral clinic.

Methods

The study was designed as a prospective cohort study running at a single tertiary referral clinic. Data were collected prospectively from eligible patients following informed consent using a standardised proforma, and entered into a study database. Patients were categorised according to the Rome III criteria as having Functional Constipation (FC) or Irritable Bowel Syndrome- Constipation type (IBS-C), and were asked to complete PAC-SYM and PAC-QOL questionnaires

Results

Data were collected from 827 patients between January 2007 and October 2014; of these, 766 patients were included. Of these, 103 (13%) were male. The mean age at presentation was 42 years; for males this was 49.6 years, compared to 41.1 years for females; a mean difference of 8.4 years (p<0.0001). Women were significantly younger at onset of symptoms, with a mean age of 23 years at onset of symptoms compared to 34 years for men, a mean difference of 11 years (p<0.0001). There was no significant difference in mean duration of symptoms at presentation between the sexes. Women reported significantly higher PAC-SYM and PAC-QOL scores than men. A ratio of QOL:SYM was used as a marker for coping strategies. Women had a higher mean ratio (1.12 vs 0.39) however this was non-statistically significant (p≥0.239)

Conclusions

This study reports a similar male:female ratio to other studies, with far more women than men. It also suggests that women experience symptom onset at a younger age, and that they are also younger when they present. Female patients report significantly more severe symptoms and significantly worse quality of life, with significantly higher mean PAC-SYM and PAC-QOL scores. Although QOL:SYM ratio was higher in women, suggesting greater impact of milder symptoms on QOL, this was not significant. The reasons for these differences are not clear, and further work is needed in this area

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