Normative Values for Colonic Transit Time and Patient Assessment of Constipation in Adults With Functional Constipation: Systematic Review With Meta-Analysis

Availability of normative patient outcome data may assist in designing experiments and estimating sample sizes. The purpose of this review was to determine normative ranges for colonic transit time (CTT), Patient Assessment of Constipation-Symptoms (PAC-SYM), and Patient Assessment of Constipation-Q...

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Main Authors: Larry E Miller, Alvin Ibarra, Arthur C Ouwehand
Format: Article
Language:English
Published: SAGE Publishing 2017-08-01
Series:Clinical Medicine Insights: Gastroenterology
Online Access:https://doi.org/10.1177/1179552217729343
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spelling doaj-b05933f3221344b0af9bb412bb108a602020-11-25T01:12:23ZengSAGE PublishingClinical Medicine Insights: Gastroenterology1179-55222017-08-011010.1177/1179552217729343Normative Values for Colonic Transit Time and Patient Assessment of Constipation in Adults With Functional Constipation: Systematic Review With Meta-AnalysisLarry E Miller0Alvin Ibarra1Arthur C Ouwehand2Miller Scientific Consulting, Asheville, NC, USAGlobal Health and Nutrition Sciences, DuPont Nutrition & Health, Kantvik, FinlandGlobal Health and Nutrition Sciences, DuPont Nutrition & Health, Kantvik, FinlandAvailability of normative patient outcome data may assist in designing experiments and estimating sample sizes. The purpose of this review was to determine normative ranges for colonic transit time (CTT), Patient Assessment of Constipation-Symptoms (PAC-SYM), and Patient Assessment of Constipation-Quality of Life (PAC-QOL) in adults diagnosed with functional constipation per Rome III guidelines. Pooled estimates were derived from random-effects meta-analysis. Meta-regression was used to explore sources of heterogeneity among studies. A total of 24 studies (3786 patients) were included in the review. In 10 studies with 1119 patients, pooled CTT was 58 hours (95% confidence interval [CI]: 50-65 hours). Publication bias was not evident (Egger P  = .51); heterogeneity was high ( I 2  = 92%, P  < .001). In meta-regression, geographical location explained 57% of the between-study variance, with CTT significantly longer in studies conducted in Europe (71 hours) compared with Asia (49 hours) or the Americas (44 hours). In 9 studies with 2061 patients, pooled PAC-SYM was 1.70 (95% CI: 1.58-1.83). Publication bias was not evident (Egger P  = .44). Heterogeneity was high ( I 2  = 90%, P  < .001); however, no study or patient factor influenced PAC-SYM in meta-regression. In 12 studies with 1805 patients, pooled PAC-QOL was 1.97 (95% CI: 1.70-2.24). Publication bias was not evident (Egger P  = .28); heterogeneity was high ( I 2  = 98%, P  < .001). In meta-regression, age explained 52% of the between-study variance, with older age associated with lower PAC-QOL scores. Overall, in adults diagnosed with functional constipation per Rome III criteria, significant heterogeneity in CTT, PAC-SYM, and PAC-QOL exists among studies. Variability among studies may be explained by geography and patient factors.https://doi.org/10.1177/1179552217729343
collection DOAJ
language English
format Article
sources DOAJ
author Larry E Miller
Alvin Ibarra
Arthur C Ouwehand
spellingShingle Larry E Miller
Alvin Ibarra
Arthur C Ouwehand
Normative Values for Colonic Transit Time and Patient Assessment of Constipation in Adults With Functional Constipation: Systematic Review With Meta-Analysis
Clinical Medicine Insights: Gastroenterology
author_facet Larry E Miller
Alvin Ibarra
Arthur C Ouwehand
author_sort Larry E Miller
title Normative Values for Colonic Transit Time and Patient Assessment of Constipation in Adults With Functional Constipation: Systematic Review With Meta-Analysis
title_short Normative Values for Colonic Transit Time and Patient Assessment of Constipation in Adults With Functional Constipation: Systematic Review With Meta-Analysis
title_full Normative Values for Colonic Transit Time and Patient Assessment of Constipation in Adults With Functional Constipation: Systematic Review With Meta-Analysis
title_fullStr Normative Values for Colonic Transit Time and Patient Assessment of Constipation in Adults With Functional Constipation: Systematic Review With Meta-Analysis
title_full_unstemmed Normative Values for Colonic Transit Time and Patient Assessment of Constipation in Adults With Functional Constipation: Systematic Review With Meta-Analysis
title_sort normative values for colonic transit time and patient assessment of constipation in adults with functional constipation: systematic review with meta-analysis
publisher SAGE Publishing
series Clinical Medicine Insights: Gastroenterology
issn 1179-5522
publishDate 2017-08-01
description Availability of normative patient outcome data may assist in designing experiments and estimating sample sizes. The purpose of this review was to determine normative ranges for colonic transit time (CTT), Patient Assessment of Constipation-Symptoms (PAC-SYM), and Patient Assessment of Constipation-Quality of Life (PAC-QOL) in adults diagnosed with functional constipation per Rome III guidelines. Pooled estimates were derived from random-effects meta-analysis. Meta-regression was used to explore sources of heterogeneity among studies. A total of 24 studies (3786 patients) were included in the review. In 10 studies with 1119 patients, pooled CTT was 58 hours (95% confidence interval [CI]: 50-65 hours). Publication bias was not evident (Egger P  = .51); heterogeneity was high ( I 2  = 92%, P  < .001). In meta-regression, geographical location explained 57% of the between-study variance, with CTT significantly longer in studies conducted in Europe (71 hours) compared with Asia (49 hours) or the Americas (44 hours). In 9 studies with 2061 patients, pooled PAC-SYM was 1.70 (95% CI: 1.58-1.83). Publication bias was not evident (Egger P  = .44). Heterogeneity was high ( I 2  = 90%, P  < .001); however, no study or patient factor influenced PAC-SYM in meta-regression. In 12 studies with 1805 patients, pooled PAC-QOL was 1.97 (95% CI: 1.70-2.24). Publication bias was not evident (Egger P  = .28); heterogeneity was high ( I 2  = 98%, P  < .001). In meta-regression, age explained 52% of the between-study variance, with older age associated with lower PAC-QOL scores. Overall, in adults diagnosed with functional constipation per Rome III criteria, significant heterogeneity in CTT, PAC-SYM, and PAC-QOL exists among studies. Variability among studies may be explained by geography and patient factors.
url https://doi.org/10.1177/1179552217729343
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