Psychological morbidity in women with idiopathic constipation

OBJECTIVE: The aim of this study was to examine psychological morbidity in women with idiopathic constipation. METHODS: Three age-matched groups of 47 women with idiopathic constipation (excess straining or decreased bowel frequency), 28 healthy women, and 26 women with Crohn's disease completed a newly devised Perception of Female Self questionnaire, the Intimacy subscale of the Inventory of Interpersonal Problems, the Feminine Traits from the Bem Sex Role Inventory, and the General Health Questionnaire. Thirteen patients had a low bowel frequency (<2/wk), 30 had a normal bowel frequency, and four had increased bowel frequency (>3/day). Of 29 patients with a measured whole gut transit time, 19 had slow and 10 had normal transit. RESULTS: Patients with constipation had significantly increased psychological and social morbidity (anxiety, depression, and social dysfunction) (p = 0.022), increased somatization (p = 0.019), and less satisfaction in their sexual life (p = 0.001) than healthy women. Constipated women with slow transit or decreased bowel frequency did not differ significantly from those with normal transit and bowel frequency. Women with Crohn's disease did not differ significantly on any test from healthy controls. CONCLUSIONS: Women with idiopathic constipation have increased psychological morbidity, altered perception about female self, and impaired intimate relationships. These factors are not present in women with "organic" GI illness also associated with abdominal pain.