Alternating bowel pattern: what do people mean?

BACKGROUND

With the introduction of new therapies, the subgrouping of patients based on bowel pattern has become important. However, the appropriate definition of an alternating bowel pattern remains unclear.

AIM

To determine if specific symptoms are reported by people with an alternating bowel pattern.

METHODS

Using the Rochester Epidemiology Project, a series of population-based surveys were undertaken in which valid self-report gastrointestinal symptom questionnaires were mailed to 4029 randomly selected members of the community. One question asked was 'How would you describe your usual bowel pattern in the last year'?

RESULTS

3022 subjects (74%) provided questionnaire data and 2718 were eligible for this analysis, the mean age was 57 years, with a range of 20-98 years (median = 61). Of these, 9.2%, 2.5% and 7.6% reported their usual bowel pattern as being constipated, diarrhoea, or alternating respectively. At least 50% of those reporting alternating bowel pattern reported incomplete evacuation (63%), urgency (57%), straining (55%) and loose stool (50%). The proportion of alternators reporting each individual symptom was between that of diarrhoea and constipation except for mucus and incomplete evacuation; however, no symptom was unique to alternators.

CONCLUSION

People who self-report an alternating bowel pattern appear to represent a blend of constipation and diarrhoea symptoms, rather than a distinct subgroup.