Chronic Constipation May Be Manifestation of Depression

Kyle Staller, MD, MPH Massachusetts General Hospital Harvard Medical School

Dr. Kyle Staller Interview with:
Kyle Staller, MD, MPH
Massachusetts General Hospital
Harvard Medical School

Medical Research: What is the background for this study? What are the main findings?

Dr. Staller: Constipation is exceedingly common and exerts a considerable economic effect.  Although many clinicians assume that the severity of constipation symptoms is the primary driver of obligation absenteeism, our data from over 100 patients undergoing physiologic evaluation for chronic constipation demonstrates that comorbid depression was a bigger predictor or work and school absenteeism than symptom severity and quality of life.

Medical Research: What should clinicians and patients take away from your report?

Dr. Staller: We believe that constipation symptom severity and its effect on quality of life are important drivers of healthcare seeking.  However, our study suggests depression is an important mediating factor in how constipation affects people’s lives. Clinicians should consider screening for comorbid depression in their patients presenting with chronic constipation and making appropriate referrals to mental health services +/- use of adjunctive SSRIs.

Patients should remember that mental health is the lens through which many somatic symptoms are expressed.  Although patients with chronic constipation very often have true problems with gastrointestinal function, mental health problems can have an outsize impact on the ability of symptoms to affect one’s daily life.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Staller: Future research should be directed at determining the effects of a potential multidisciplinary intervention (including mental health services) on symptoms, quality of life, and absenteeism in patients with chronic constipation.


ACG2015 abstract October 2015

Co-morbid Depression, Not Symptom Severity or Disease-Specific Quality of Life, Predicts Work Absenteeism in Chronic Constipation

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Kyle Staller, MD, MPH (2015). Chronic Constipation May Be Manifestation of Depression 

Last Updated on October 22, 2015 by Marie Benz MD FAAD