Clinical and laboratory characteristics of patients with functional constipation and irritable bowel syndrome with constipation

Relevance. Functional bowel diseases (FBD) represent one of the most significant and complex problems in modern gastroenterology and general medicine. Their relevance is determined by a combination of factors: their extremely high prevalence, significant negative impact on patients' quality of life, significant direct and indirect economic costs to healthcare systems, diagnostic difficulties, and the limited effectiveness of existing therapeutic approaches. The constant updating of scientific understanding of pathogenesis and the refinement of diagnostic criteria (Rome IV criteria) only highlight the dynamic nature of this field of medicine and the need for close attention from researchers and clinicians. The study was conducted at the Elizavetinskaya Hospital.

The aim of the study was to evaluate microbial diversity and markers of intestinal inflammation in patients with functional bowel diseases.

Materials and methods. The study involved 30 patients with a confirmed diagnosis of functional bowel disease: 15 patients with irritable bowel syndrome with predominantly constipation and 15 with functional constipation. All patients completed an original questionnaire, underwent a complete physical examination, and underwent laboratory and instrumental diagnostics. Gastroscopy and colonoscopy were performed to rule out organic pathology of the upper and lower gastrointestinal tract. To assess the level of fecal calprotectin and intestinal biocenosis, two stool samples were collected from each patient without the use of laxatives and not frozen.

Results and conclusions. Patients with functional constipation had a longer duration of constipation compared to patients with irritable bowel syndrome and constipation. Fecal calprotectin levels were elevated to the «gray zone» more frequently in patients with functional constipation than in patients with irritable bowel syndrome and constipation. Patients with irritable bowel syndrome and constipation had a more pronounced reduction in the key commensal flora than those with functional constipation. However, pathogenic and opportunistic flora were virtually absent in the group of patients with irritable bowel syndrome and constipation, unlike those with functional constipation.

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