Study Provides Insight into Pain and Nutritional Status of COPD Patients

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A team of investigators stress the impact of the disease on patients as mortality rates grow worldwide.

A recent study out of Istanbul, Turkey has observed the effects of constipation symptoms and the nutritional status on disease-related parameters in people struggling with chronic obstructive pulmonary disease (COPD).

COPD remains a leading cause of morbidity and mortality worldwide. The team believed the disease would become more prevalent in the coming decades, with COPD death expected to reach 5.4 million annually by 2060.

The team also noted how few studies regarding COPD and its impact on the quality of life (QoL_ of patients were available, which prompted the current study.

The investigators studied how symptoms such as dyspnea and chronic cough in patients with COPD could affect food intake and negatively impact their QoL.

Poor food intake among people with COPD could lead to malnutrition, reduced appetite, a lack of physical activity, decreased muscle mass, airway limitation, and obesity—the last of which has a prevalence of 18-64% in COPD individuals.

In an effort to uncover more about the impact of constipation and other ailments on patients with COPD, the team conducted a single cross-sectional study of 48 patients admitted to Medicana International Istanbul Private Hospital from January 2019 to August 2019.

The participants were 30 years or older with a positive diagnosis of COPD and no infections.

Defecation frequency, intensity and difficulty were examined in participants using the Constipation Severity Instrument (CSI). It was comprised of 3 subscales including obstructive defecation, colonic inertia and pain.

The European Society for Clinical Nutrition and Metabolism (ESPEN) recommendations were used to determine malnutrition in participants, and a food frequency questionnaire was also used to gauge nutritional status.

Finally, the St. George's Respiratory Questionnaire (SGRQ) was used for assessment of respiratory QoL.

Despite the myriad of tests, the results remained inconclusive.

According to the study, there was no correlation between body mass index (BMI) and COPD in patients, and a negative correlation between CSI subscales and SGRQ symptom scores. Likewise, there was a weak negative correlation between Vitamin E intake and COPD duration.

The team was unable to find ample connections between constipation, COPD and a negative impact on the quality of life.

However, the team did note that 1 particular group in the study suffered from shortness of breath and discomfort from constipation. Additionally, there were correlations identified between CSI subscales and COPD disease parameters, though at weak levels.

Nutrient intake did change among some participants, but not substantially.

The investigators stressed for the continuation of studies involving COPD and its impact on the QOL of individuals, once again referencing the lack of material published on the subject. To the team’s knowledge, only 1 similar investigation exists.

The study, which took place in China, was performed on 191 patients with COPd and was also inconclusive to its endpoint.

In the present study, the team urged for larger sample sizes and a keener focus on the subject. They believed more progress could be made regarding the relationship between COPD and the QoL of those afflicted with the disease.

“There is a need for more clinical studies to more clearly determine the effect of constipation on COPD disease symptoms,” the team wrote.

The study, “Comparison of constipation and nutritional status with disease-related parameters in COPD patients,” was published online in The International Journal of Clinical Practice.