Quality of Life Concepts

Secondary Health Conditions

Cleveland Clinic Constipation Scoring System (CCSS)

Description: A scale of constipation severity.

Format: Not available.

Scoring: Scores range from 0 to 30, with higher scores representing more severe symptoms.

Administration and Burden: Not available.

Psychometrics for SCI: Not available.

Languages: English.

QoL Construct: The CCSS is a Health-Related Quality of Life measure that corresponds to Box C (achievements) on Dijker’s Model.

Permissions/Where to Obtain: Not available; See the following article for details:

Agachan F, Chen T, Pfeifer J, Reissman P, Wexner SD.  A constipation scoring system to simplify evaluation and management of constipated patients.  Dis Colon Rectum 1996;39:681.

CLICK ON THE LISTED SECONDARY HEALTH CONDITIONS ON THE LEFT TO READ HOW THE CCSS HAS BEEN USED WITH A PARTICULAR CONDITION


Bowel Dysfunction SCI Studies: One prospective, randomized controlled multi-center trial.

  1. Christensen P, Bazzocchi G, Coggrave M, Abel R, Hultling C, Krogh K , Media S, Laurberg S. A randomized, controlled trial of transanal irrigation versus conservative bowel management in spinal cord-injured patients. Gastroenterology 2006;131:738-47.

Sensitivity to Impact: Christensen et al. (2006) compared outcomes of transanal irrigation with conservative bowel management in patients with SCI (N = 87).  Measures included the Neurogenic Bowel Dysfunction (NBD) score, St. Mark’s Fecal Incontinence, Cleveland Clinic Constipation Scoring System (CCSS), and the Modified American Society of Colorectal Surgeon Fecal Incontinence Score. Results showed that compared with conservative bowel management, transanal irrigation improves constipation, fecal incontinence, and symptom-related quality of life (QoL). The CCSS correlated well with objective physiologic findings in constipated patients (non-SCI) to allow uniformity in assessment of the severity of constipation.

Suggestions for Use: The CCSS is a measure of health-related QoL that has been validated in non-SCI clinical samples. Although SCI intervention studies using this measure highlight the potential of the CCSS for use in the SCI population, further work is necessary to further establish its psychometric properties and clinical utility.   

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