Supplementary Material for: The actual condition of chronic constipation in real-world clinical settings and its impact on various aspects of daily life

Introduction: Chronic constipation is common, but its characteristics and impact on various aspects of daily life remain unclear. This study examined patient characteristics and assessed how background factors, constipation symptoms, and defecation status impact daily life dissatisfaction, quality of life (QOL), and psychological states. Methods: A multicenter, prospective, observational study on outpatients with moderate to severe chronic constipation was conducted. The Chronic Constipation-Therapeutic Efficacy and Satisfaction Test (CC-TEST) and validated questionnaires such as the Hospital Anxiety and Depression Scale (HADS) and Short Form Health Survey-8 (SF-8) were administered to assess symptoms, defecation status, and daily life. Correlation and multiple regression analyses explored factor relationships. Results: The analysis included 201 participants. Despite treatment, with over half using magnesium oxide, many patients remained dissatisfied. Younger patients and females reported more severe abdominal symptoms, while older patients experienced greater defecation difficulty. All constipation symptoms correlated with daily life dissatisfaction, with abdominal discomfort showing the strongest association. Abdominal symptoms were significantly associated with the Mental Component Summary (MCS) of the SF-8, HADS anxiety, and HADS depression scores. Most defecation status components showed no correlation with SF-8 MCS, HADS anxiety, or HADS depression scores. Multivariate analysis revealed that abdominal symptoms, especially discomfort, significantly impacted daily life dissatisfaction and reduced SF-8 MCS scores. Conclusions: Many patients with moderate to severe chronic constipation experience long-term symptoms and remain dissatisfied with treatment. Abdominal symptoms such as discomfort and pain significantly affect their daily life, QOL, and psychological well-being. Reducing abdominal symptoms may be crucial for improving treatment outcomes.