Patient Assessment of Constipation Quality of Life (PAC-QOL) is used to measure the QOL in patients with constipation [22]. The PAC-QOL consists of 28 items grouped into four subscales (physical discomfort, psychosocial discomfort, worries and concerns, and satisfaction). The first three subscales provide a patient dissatisfaction index, with an overall score from 0 to 96 (lower scores correspond to better QOL). The satisfaction subscale includes four items with a global score from 0 to 16. Each patient’s self-reported definitive outcome is defined as poor (0–4), fairly good (5–8), good (9–12), or excellent (13–16). The Japanese version of the PAC-QOL (JPAC-QOL) has been validated and was used in the present study [23].

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