Symptomatology and treatment outcomes in patients with occult constipation in Region Gävleborg 2017-2019

Abstract: Introduction Occult constipation (OC) – a subtype of constipation causing chronic or recurring gastrointestinal symptoms in the absence of classic symptoms of overt constipation – is a differential diagnosis that should be considered in patients with gastrointestinal symptoms of unclear etiology. Previous studies have investigated the symptomatology of OC and compared treatment regimens but to our knowledge there have been no studies comparing symptomatology with treatment outcomes to investigate whether some symptoms could be related to a better prognosis. Aim The aims of this study were to describe the symptoms present in patients with OC as well as investigate possible association between symptoms and treatment outcomes. Method This was a retrospective review of patient records including 88 patients under 18 years old with diagnosed constipation treated by Dr. Magnus Liljedahl at Gävle Hospital between 2017 and 2019. Results Out of the 88 patients included in the study, six (6.8 %) were classed as having suspected OC, 18 (20.5 %) confirmed OC and 44 (50.0 %) overt constipation. The most common symptoms in patients with OC were abdominal pain, fatigue, headache, back pain, and nausea. On follow-up, 16 patients with OC were symptom-free and three had symptoms remaining. When comparing symptomatology of OC with treatment outcomes no statistically significant differences were seen between the groups. Conclusion This study gives an overview of the symptoms seen in OC but limited information on any association between symptomatology and treatment outcomes. It does, however, emphasize that OC is a differential diagnosis in patients with gastrointestinal symptoms of unclear etiology.