Background: In terms of temporality, constipation is categorized as either acute or chronic. When chronic constipation occurs without alarm features and secondary causes, it is labeled as functional chronic constipation (FCC, Rome IV). While constipation symptoms are traditionally viewed as chronic, some individuals encounter shorter yet recurring episodes. Recently, the term "Occasional constipation (OC)" has been proposed to describe intermittent or sporadic symptomatic changes in bowel habits, such as a bothersome decrease in the frequency of bowel movements and/or difficulty with stool passage, but without alarming features.
Aim: To describe the clinical and psychological profile, as well as associated factors in subjects who suffer from OC in an open population in Mexico
Material and Methods: We conducted a cross-sectional study using an electronic questionnaire to evaluate sociodemographic data, associated symptoms, bowel movement characteristics (BSFS), anxiety and depression (HAD scale), quality of life (PAC-QOL questionnaire), physical activity (IPAQ), and dietary habits (Mini-ECCA). The definition of OC followed the criteria proposed by Rao et al. (Am J Gastroenterol. 2022 Nov 1;117(11):1753–8.). We compared the characteristics and associated factors among different groups: healthy individuals, rarely constipated, FCC, and those experiencing OC.
Results: 704 subjects were evaluated (62% women, mean age 30.4 ± 11 years), 260 subjects (37%) met the criteria for OC, and 67 (9.5%) for FCC. No differences were found regarding comorbidities, medication consumption, or the degree of overweight/obesity. OC had lower frequency of abdominal distension (68.8% vs. 82.1%, p=0.034), excessive straining (73.5% vs. 86.6%, p=0.025), and a lower frequency of bowel movements (79.6% vs. 91%, p=0.032) compared to the FCC. Patients with OC had a median number of days per year with constipation symptoms of 24. Participants reported that symptoms of constipation appear or worsen when traveling, and 89.7% of OC cases improve upon returning from a trip, compared to 65.8% of patients with CC (p<0.0001). Patients with OC reported a greater improvement in symptoms with fiber consumption (p=0.05) and an increase in fluid intake (p=0.00001), while patients with CC showed improvement with medication use (p=0.0001).OC had a worse quality of life and lower scores on the Mini-ECCA than subjects without constipation and/or with symptoms rarely, but better than patients with FCC (Table).
Conclusions: OC represent the most frequent type of constipation (up to 37.5%). Also, our study highlights significant differences between patients with OC and FCC in terms of symptoms, travel-related exacerbation, quality of life and response to treatment strategies.

Luis Valdovinos-Garcia

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