Constipation linked to survival of patients with idiopathic interstitial pneumonias, finds study

A new study published in the journal of Respiratory Investigation showed that constipation may have therapeutic value since it is an independent predictive factor for individuals with idiopathic interstitial pneumonias (IIPs). Idiopathic pulmonary fibrosis (IPF), the most common phenotype of IIPs, has a prognosis that is influenced by a number of clinical variables, including age, sex, dyspnea, body mass index (BMI), smoking status, pulmonary function, and radiological abnormalities. The prognosis of many chronic illnesses is impacted by constipation that lowers quality of life. According to reports, people who have constipation are more likely than those who do not to suffer from coronary heart disease, ischemic stroke, and all-cause death. According to a meta-analysis, children who had constipation were more likely to acquire asthma later on.

The impact of constipation on the prognosis of IIPs is yet unknown, though. Basic research has indicated that the gut microbiota may have an impact on pulmonary fibrosis, despite the fact that IIPs are chronic inflammatory illnesses with an uncertain cause. As with other chronic conditions, constipation may have a correlation with the prognosis of IIPs. Thus, Sho Takuma and colleagues used a time-dependent multivariate analysis that was controlled for clinical variables in the current investigation to examine the relationship between constipation and the prognosis of patients with IIPs.

This study looked back at the relationship between constipation and survival outcomes in patients with idiopathic interstitial pneumonias (IIPs) in this single-centre observational analysis. To do this, they employed a marginal structural model (MSM) analysis, controlling for lung function measures (percent predicted forced vital capacity and diffusing capacity for carbon monoxide), age, sex, body mass index, and treatment type (including immunosuppressants, corticosteroids, and antifibrotic agents).

The study comprised 433 individuals with IIPs, including 148 and 285 patients with idiopathic pulmonary fibrosis [IPF] and those without IPF. Constipation struck 238 people throughout the monitoring period. Constipation was substantially linked to a worse overall survival rate, according to the MSM analysis. Constipation was substantially linked to a worse survival rate when the use of antifibrotic medications was weighted individually as nintedanib or pirfenidone. Additionally, independent of the severity of the disease, a subgroup analysis revealed that constipation was linked to a worse survival rate in both IPF and non-IPF patients. Overall, this study clearly indicates the independent occurrence of constipation from that of idiopathic interstitial pneumonias.

Reference:

Takuma, S., Mori, K., Karayama, M., Inoue, Y., Yasui, H., Hozumi, H., Suzuki, Y., Furuhashi, K., Fujisawa, T., Enomoto, N., Inui, N., & Suda, T. (2024). Association of constipation with the survival of patients with idiopathic interstitial pneumonias. In Respiratory Investigation (Vol. 62, Issue 6, pp. 1204–1208). Elsevier BV. https://doi.org/10.1016/j.resinv.2024.10.010