Spinal structure and function in individuals with chronic functional constipation: A case-control study

Background and aim Assessing the structure and function of the spine in patients suffering from chronic functional constipation could provide valuable insights for developing effective treatment strategies. This case-control study aimed to evaluate and compare spinal structure and function in affected individuals relative to asymptomatic controls. Methods A total of 72 participants were enrolled, comprising 36 with chronic functional constipation and 36 matched controls. Severity of constipation was quantified using the Constipation Severity Instrument (CSI), while bowel habits were documented via a stool diary and characterized using the Bristol Stool Scale. Spinal posture and mobility were evaluated with the Spine Mouse posture and mobility measurement device. Trunk muscle endurance was evaluated through standardized trunk endurance tests and the Sahrmann Core Stability Test. Data were analyzed using Independent Samples t-tests and Chi-square tests. Results No significant intergroup differences were observed in sagittal thoracic, lumbar, or sacral angles, or in spinal mobility parameters (p > 0.05). However, the constipation group demonstrated significantly reduced endurance in trunk flexor (p < 0.001), extensor (p = 0.006), right lateral flexor (p = 0.001), and left lateral flexor muscles (p < 0.001), along with lower performance on the Sahrmann test (p = 0.030), indicating diminished spinal stability. Conclusions Decreased trunk muscle endurance was found in individuals with chronic functional constipation compared to healthy controls. Spinal posture and mobility parameters of the groups were similar. It may be important to consider the assessment of spinal stability in individuals with chronic functional constipation and recommend spinal stabilization exercises in management of these individuals.