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Stool consistency tied to pain perception, anxiety, depression

24 Aug 2017

The Bristol Stool Form Scale (BSFS) is significantly and positively correlated with pain perception and anxiety, a recent observational study has shown.

The study included 38 healthy participants (mean age 22.5±1.1 years) who were assessed according to stool form, constipation, obesity, psychological state pain sensation and cold pain threshold. Exclusion criteria were serious neurological conditions, diabetes, menstruation and medications such as sedatives and analgesics.

The BSFS was used to evaluate stool form while the Cleveland Clinic Constipation score (CCS) was used to assess constipation. Von Frey monofilaments (VFM) were used to measure pain sensation while various questionnaires were used to assess the psychological states of the participants.

Simple linear regression analysis showed that BSFS was significantly positively correlated with pain from 100 g of VFM pressure, as measured by the visual analogue scale (pain-VAS 100 g; r=0.341; p<0.05).

BSFS was also significantly associated with anxiety, measured both the state (r=0.480; p<0.01) and trait (r=0.500; p<0.01) anxiety domains of the State-Trait Anxiety Inventory Questionnaire (STAI-S and STAI-T, respectively).

Pain-VAS 100g was also significantly positively correlated with STAI-S (r=0.357; p<0.05) and STAI-T (r=0.386; p<0.05).

On the other hand, body mass index (BMI) was significantly positively correlated with anxiety, measured by STAI-S (r=0.395; p<0.05) and STAI-T (r=0.398; p<0.05), and depression, measured by the depression subscale of Hospital Anxiety and Depression Scale (HADS-D; r=0.487; p<0.05).

BSFS was a significant predictor for pain-VAS 100 g (B, 2.929; 95 percent CI, 0.949 to 4.909; p=0.0005) and pain-VAS 600g (B, 6.366; 0.876 to 11.855; p=0.024). Pain catastrophizing scale was also a significant predictor of pain-VAS 100 g (B, 0.181; 0.021 to 0.431; p=0.028).

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