Bloating is associated with worse quality of life, treatment satisfaction, and treatment responsiveness among patients with constipation-predominant irritable bowel syndrome and functional constipation

L. Neri, P. Iovino, Donato Francesco Altomare, Vito Annese, Danilo Badiali, Guido Basilisco, G. Bassotti, Edda Battaglia, Gabriele Bazzocchi, Massimo Bellini, Emanuele Bendia, Luigi Benini, Giuseppe Biscaglia, Ivano Biviano, Renato Bocchini, Sebastiano Bonventre, Fabrizio Bossa, Giovanni Brandimarte, Renato Cannizzaro, Michele CicalaL. Cipolletta, Virgilio Clara, R. F. Cogliandro, Giulia Comandini, E. S. Corazziari, Sergio Crotta, Rosario Cuomo, Lucia D'Alba, F. De Giorgi, Mario Del Piano, Michela Di Fonzo, F. Di Mario, Michele Di Stefano, V. D'Onofrio, Kostantinos Efthymakis, Pierluigi Fiore, Manuela Fortuna, Walter Fries, Eleonora Gaetani, Francesca Galeazzi, A. Gasbarrini, Andrea Geccherle, Francesco Giangregorio, Lisa Girardi, Mario Grassini, Marzia Groppo, Giovanni Guarnieri, Massimiliano Lo Cascio, Roberto Lolli, Francesco Luzza, G. Macarri, Maria Marino, Stefania Miraglia, Santo Monastra, Maria Cristina Neri, Matteo Neri, Roberto Antonio Noris, S. Orselli, S. Passaretti, Alberto Paviotti, Paolo Pazzi, A. Pilotto, Piero Portincasa, Nunzio Ranaldo, P. Ravelli, Francesca Rogai, Renato Sablich, Vincenzo Savarino, Giancarlo Spinzi, V. Stanghellini, Leonardo Tammaro, F. Torresan, Paolo Usai Satta, C. Claudio Valle

Research output: Contribution to journalArticlepeer-review


Background: The management of bloating is unclear and its relationship with patients' well-being and treatment satisfaction independent of other abdominal symptoms is uncharacterized. We evaluated the association of bloating with patient-reported outcomes. Methods: Thirty-nine centers for functional gastrointestinal disorders joined the laxative inadequate relief survey. We enrolled 2203 consecutive outpatients with functional constipation (FC) or constipation-predominant irritable bowel syndrome (IBS-C) in two cross-sectional waves. Both wave 1 and 2 included the SF-12, the patient assessment of constipation-symptoms (PAC-SYM), and the treatment satisfaction questionnaire for medication (TSQM-2). Wave 2 only included a global rating of change (GRC) scale to assess patients' assessment of efficacy concerning treatment switches occurred in the 3 months prior to the interview. Bloating in the abdomen was defined on the basis of PAC-SYM item 3. Key Results: The average age was 50.1 years (SD, 16.7) and 82.1% of patients were women. The prevalence of bloating was 91.6% (n = 1970). Bloating was associated with SF-12 Physical Composite Score (p <0.01), SF-12 Mental Composite Score (p <0.01), GRC (p <0.01), Satisfaction with treatment effectiveness (p <0.01), convenience of administration (p <0.01), and side effects (p <0.01) after adjustment for possible confounders. Conclusions & Inferences: Our data suggest that patients regard bloating as a key element in assessing clinical changes and treatments' efficacy as this symptom exerts a strong influence on patient-reported outcomes independent of possible confounders and other symptoms of constipation. Our data provide the rationale to investigate the efficacy and tolerability of new treatments specifically addressing this important, yet disregarded, patients' complain.

Original languageEnglish
Pages (from-to)581-591
Number of pages11
JournalNeurogastroenterology and Motility
Issue number4
Publication statusPublished - Apr 1 2016


  • Bloating
  • Chronic constipation
  • Functional constipation
  • Irritable bowel syndrome
  • Patient-reported outcomes
  • Quality of life
  • Treatment satisfaction

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Gastroenterology
  • Physiology


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