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Factor analysis identifies subgroups of constipation

Author(s): Philip G Dinning, Mike Jones, Linda Hunt, Sergio E Fuentealba, Jamshid Kalanter, Denis W King, David Z Lubowski, Nicholas J Talley, Ian J Cook

Journal: World Journal of Gastroenterology
ISSN 1007-9327

Volume: 17;
Issue: 11;
Start page: 1468;
Date: 2011;
Original page

Keywords: Factor analysis | Constipation | Symptoms | Clusters | Laxatives

AIM: To determine whether distinct symptom groupings exist in a constipated population and whether such grouping might correlate with quantifiable pathophysiological measures of colonic dysfunction.METHODS: One hundred and ninety-one patients presenting to a Gastroenterology clinic with constipation and 32 constipated patients responding to a newspaper advertisement completed a 53-item, wide-ranging self-report questionnaire. One hundred of these patients had colonic transit measured scintigraphically. Factor analysis determined whether constipation-related symptoms grouped into distinct aspects of symptomatology. Cluster analysis was used to determine whether individual patients naturally group into distinct subtypes.RESULTS: Cluster analysis yielded a 4 cluster solution with the presence or absence of pain and laxative unresponsiveness providing the main descriptors. Amongst all clusters there was a considerable proportion of patients with demonstrable delayed colon transit, irritable bowel syndrome positive criteria and regular stool frequency. The majority of patients with these characteristics also reported regular laxative use.CONCLUSION: Factor analysis identified four constipation subgroups, based on severity and laxative unresponsiveness, in a constipated population. However, clear stratification into clinically identifiable groups remains imprecise.
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