The spectrum of constipation-predominant irritable bowel syndrome and chronic idiopathic constipation: US survey assessing symptoms, care seeking, and disease burden

Am J Gastroenterol. 2015 Apr;110(4):580-7. doi: 10.1038/ajg.2015.67. Epub 2015 Mar 17.


Introduction: The irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) are associated with substantial symptom and disease burden. Although typically classified as distinct diseases, symptoms frequently overlap.

Aim: The objective of this study was to characterize symptom and disease burden in IBS-C and CIC sufferers and examine a subset of CIC sufferers with abdominal symptoms.

Methods: In a US population-based survey, respondents meeting the Rome III criteria for IBS-C or CIC rated symptom frequency and bothersomeness, missed work and disrupted productivity, and degree of obtaining and satisfaction with physician care. CIC respondents were analyzed in two subgroups: those with abdominal symptoms ≥once weekly (CIC-A) and those without (CIC-NA).

Results: Of the 10,030 respondents, 328 met the criteria for IBS-C and 552 for CIC (363 CIC-A; 189 CIC-NA). All symptoms were significantly more frequent in IBS-C vs. CIC respondents (P<0.0001). Constipation was extremely/very bothersome in 72% of IBS-C respondents, 62% of CIC-A, and 40% of CIC-NA (P<0.01 all pairs). All 11 other measured symptoms were significantly more bothersome in IBS-C and CIC-A vs. CIC-NA respondents. In IBS-C vs. CIC-A, abdominal discomfort, bloating, straining, and pellet-like stools were also significantly more bothersome, with other remaining symptoms similar. Gastrointestinal symptoms disrupted productivity a mean of 4.9 days per month in IBS-C respondents, 3.2 in CIC-A, and 1.2 in CIC-NA (P<0.001 all pairs); missed days were similar in IBS-C and CIC-A respondents.

Conclusion: CIC respondents with abdominal symptoms experience greater disease burden compared with CIC respondents without frequent abdominal symptoms and have a disease burden profile that is similar to IBS-C respondents.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Chronic Disease
  • Cohort Studies
  • Constipation / economics
  • Constipation / epidemiology*
  • Constipation / etiology*
  • Constipation / physiopathology
  • Cost of Illness*
  • Efficiency
  • Female
  • Gastrointestinal Tract / physiopathology*
  • Health Behavior*
  • Health Surveys
  • Humans
  • Incidence
  • Irritable Bowel Syndrome / complications*
  • Irritable Bowel Syndrome / economics
  • Irritable Bowel Syndrome / epidemiology
  • Irritable Bowel Syndrome / physiopathology
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Severity of Illness Index
  • Time Factors
  • United States / epidemiology