Prevalence and impact of constipation and bowel dysfunction induced by strong opioids: a cross-sectional survey of 520 patients with cancer pain: DYONISOS study

Figures & data

Table 1. Characteristics of the study population.

Population characteristics (n = 520)
Average age in years (±SD)	61.3 years (±12.2)
Total n of men (% of respondents)	282 (54.5%)
Average BMI in kg/m^2 (±STD)	22.8 (±4.9)
Total n of working people (% of respondents)	264 (52.1%)
WHO performance status (n and % of respondents)
0–1	160 (31.1%)
2	228 (44.44%)
3–4	126 (24.5%)
Type of healthcare (n and % of respondents)
Hospitalized patients	367 (70.6%)
Outpatients	153 (26.4%)

Table 2. KESS questionnaire responses.

	n	%
Overall KESS constipation score (n = 520)
0–8 (Not constipated)	199	38.3
9–39 (Constipated)	321	61.7
(1) Duration of constipation (n = 514)
0–18 months	395	76.8
18 months–5 years	41	8
5–10 years	17	3.3
10–20 years	22	4.3
>20 years (or all life)	39	7.6
(2) Laxative use (n = 519)
None	108	20.8
Laxatives prn or for short duration	162	31.2
Laxatives regular, long duration	204	39.3
Laxatives long duration ineffective	45	8.7
(3) Frequency of bowel movement (n = 516)
1–2 times/1–2 days	274	53.1
2 or less times/week	190	36.8
Less than once per week	44	8.5
Less than once per 2 weeks	8	1.6
(4) Unsuccessful evacuatory attempts (n = 518)
Never/rarely	172	33.2
Occasionally	211	40.7
Usually	109	21.0
Always (manual evacuation required)	26	5.0
(5) Feeling incomplete evacuation (n = 518)
Never	132	25.5
Rarely	140	27.0
Occasionally	153	29.5
Usually	79	15.3
Always	14	2.7
(6) Abdominal pain (n = 518)
Never	90	17.4
Rarely	161	31.1
Occasionally	167	32.2
Usually	86	16.6
Always	14	2.7
(7) Bloating (n = 516)
Never	136	26.4
Perceived by patient only	243	47.1
Visible to others	33	6.4
Severe, causing satiety or nausea	92	17.8
Severe with vomiting	12	2.3
(8) Enemas/digitation (n = 517)
None	304	58.8
Enemas/suppositories occasionally	148	28.6
Enemas/suppositories regular	44	8.5
Manual evacuation occasionally	19	3.7
Manual evacuation always	2	0.4
(9) Time taken (minutes in lavatory/attempt); average time required to evacuate bowel (n = 515)
Less than 5 min	175	34.0
5–10 min	228	44.3
10–30 min	103	20.0
More than 30 min	9	1.7
(10) Difficulty evacuating (causing a pain evacuation effort) (n = 520)
Never	136	26.2
Rarely	174	33.5
Occasionally	145	27.9
Usually	58	11.2
Always	7	1.3
(11) Stool consistency (n = 519)
Soft/loose/normal	189	36.4
Occasionally hard	224	43.2
Always hard	75	14.5
Always hard, usually pellet-like l	31	6.0

Figure 1. Mean KESS score according to whether the patient was constipated (constipated as assessed by the physician).

Figure 2. Mean BFI score in constipated patients (constipated as assessed by the physician).

Figure 3. Prevalence of different symptoms of OIBD (n = 385 patients).

Figure 4. Quality-of-life in constipated patients compared to non-constipated patients (PAC-QoL).

Figure 5. Quality-of-life in very and extremely constipated patients compared to non-constipated patients (PAC-QoL).

Figure 6. Quality-of-life in constipated patients compared to non-constipated patients (SF12).

Figure 7. Quality-of-life in very and extremely constipated patients compared to non-constipated patients (SF12).