The Relationship Between Constipation, Nutritional Status, and Disease-Related Parameters in COPD Patients: A Comprehensive Comparative Analysis

Abstract

Background: Constipation is a prevalent adverse effect associated with various treatments administered to patients across a wide range of medical conditions, and it plays a particularly significant role in the management of chronic obstructive pulmonary disease (COPD) patients. Objective: To assess the relationship between nutritional status, constipation symptoms, and disease-related variables such as spirometry test results, quality of life, and disease duration in patients with COPD. Methodology: Between January and August 2019, 500 COPD patients from three tertiary care centers in Rawalpindi, Pakistan participated in the study. The Constipation Severity Instrument (CSI) was utilized to assess the severity of constipation symptoms, while the St. George Respiratory Questionnaire (SGRQ) was implemented to evaluate quality of life. The patient's nutritional status was ascertained through the utilization of a dietary frequency questionnaire. The fat-free mass index (FFMI) and body mass index (BMI) were determined through the implementation of bioelectrical impedance analysis (BIA). Results: The sample consisted primarily of males (60.4%), aged 45 years and above, and with a BMI greater than 25 kg/m², which signified a propensity for overweight or obesity. At 18.5 kg/m² on average, FFMI indicated a reduction in muscle mass. Constipation was noted to be moderate, as indicated by a mean CSI score of 35 out of 73. A correlation existed between the fact that the majority of participants were former smokers and the fact that smoking is a COPD risk factor. The mean duration of COPD was 62 months and spirometry findings indicated moderate decline in lung function. Significant impacts on symptoms and activity levels were indicated by SGRQ scores. An evident correlation was identified between elevated BMI and deteriorating outcomes associated with COPD. Increased overall CSI scores were associated with more severe symptoms of COPD and decline in lung function. A higher fiber intake was associated with improved lung function and reduced SGRQ scores, according to dietary analysis, whereas a high fat and cholesterol intake was linked to worse outcomes. Conclusion: The research underscored the substantial influence that nutritional status and constipation have on the outcomes of COPD. Enhanced pulmonary function, prolonged disease duration, and more severe disease symptoms were all associated with elevated BMI, especially in obese patients. Dietary components, particularly fiber consumption, are pivotal in the management of COPD severity and enhancement of a patient's quality of life Keywords: COPD; Constipation; Nutrition; Life Quality.