An insight into the effect of the crosstalk between autonomic function and clinical manifestations of functional constipation

Background Abnormal brain-gut interactions have a role in functional gastrointestinal disorders. The autonomic nervous system (ANS) is influenced by emotions, possibly affecting the disease status of sufferers with functional constipation (FC). However, their correlations are unclear. This research aims to ascertain the association between ANS function and psychological status, constipation severity, and life quality of FC sufferers. Methods According to heart rate variability (HRV) tests, 139 FC sufferers were classified into low frequency (LF)/high frequency (HF) normal, LF/HF sympathetic, and LF/HF parasympathetic groups. The scores of Zung’s Self-Rating Anxiety and Depression Scale (SAS/SDS), Constipation Scoring System (CSS), Patient Assessment of Constipation Symptom (PAC-SYM), and Patient Assessment of Constipation Quality of Life (PAC-QOL) were compared. Anorectal manometry and electrointestinogram parameters were assessed. The associations between the patients’ life quality and ANS function, mental or psychological status, and constipation severity were assessed. Results Anorectal physiology and intestinal electric activity were not different among the groups. Compared with the LF/HF normal group, the sympathetic group had a higher SAS/SDS score, a higher PAC-SYM score and a higher PAC-QOL score. The parasympathetic group manifested the highest CSS score, which might result from a predominance of depression. Regression analysis showed that anxiety/depression and ANS functional state significantly affected the life quality of FC sufferers. Conclusions FC sufferers with autonomic dysfunction apparently coexisted with anxiety/depression. The life quality of FC sufferers was negatively affected by ANS function and anxiety/depression. Autonomic adjustments, psychological interventions, and central nervous system drugs might help to treat FC.