Brief Article
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World J Gastroenterol. Mar 21, 2011; 17(11): 1468-1474
Published online Mar 21, 2011. doi: 10.3748/wjg.v17.i11.1468
Factor analysis identifies subgroups of constipation
Philip G Dinning, Mike Jones, Linda Hunt, Sergio E Fuentealba, Jamshid Kalanter, Denis W King, David Z Lubowski, Nicholas J Talley, Ian J Cook
Philip G Dinning, Linda Hunt, Sergio E Fuentealba, Ian J Cook, Department of Gastroenterology, St. George Hospital, University of New South Wales, Kogarah, NSW 2217, Australia
Mike Jones, Department of Psychology, Macquarie University, NSW 2109, Australia
Jamshid Kalanter, Gastroenterology Research Unit, Nepean Hospital, University of Sydney, Sydney, NSW 2050, Australia
Denis W King, David Z Lubowski, Department of Colorectal Surgery, St. George Hospital, Kogarah, NSW 2217, Australia
Nicholas J Talley, Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL 32224, United States
Author contributions: Dinning PG, Jones M, Talley NJ and Cook IJ designed the study and wrote the paper; Hunt L and Fuentealba SE collated all data and maintained the database; Kalanter J, King DW, Lubowski DZ and Cook IJ distributed the majority of questionnaires; Jones M performed all analysis.
Correspondence to: Dr. Phil G Dinning, PhD, Department of Gastroenterology, St George Hospital, University of New South Wales, Kogarah, NSW 2217, Australia. p.dinning@unsw.edu.au
Telephone: +61-2-91132817 Fax: +61-2-91133993
Received: June 16, 2010
Revised: January 13, 2011
Accepted: January 20, 2011
Published online: March 21, 2011
Abstract

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.

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