1
|
Hudgi A, Yan Y, Ayyala D, Rao SSC. Accuracy of patient-reported bowel symptoms for fecal incontinence: Historical recall versus prospective evaluation. Neurogastroenterol Motil 2024; 36:e14714. [PMID: 37994807 PMCID: PMC10842103 DOI: 10.1111/nmo.14714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Abstract
INTRODUCTION Fecal incontinence (FI) is characterized by both irregular and unpredictable bowel symptoms. An accurate history of symptoms is important for diagnosis and guiding management. Whether a patient's history of bowel symptoms is reliable or if there is recall bias is unknown. AIM To evaluate the accuracy of FI symptoms based on patient's recall compared with a prospective stool diary. METHODS FI (Rome IV) patients completed a bowel questionnaire that included leakage episodes and stool consistency. Subsequently they completed a one-week FI stool diary. Agreement and correlation between historical recall and stool diary were compared. RESULTS One hundred patients participated. On average they reported 12 bowel movements (BMs) and five FI episodes per week. Fifty-two percent had completed under-graduation, 33% high school and 15% postgraduation. Using recall, 23% of patients accurately reported the number of FI episodes, whereas 41% underestimated and 36% overestimated its prevalence compared to the FI diary. Similarly, the concordance for the number of BMs was 30%, urgency was 54%, amount of stool leakage was 16%, and stool consistency was 12.5%. The concordance for nocturnal FI events, use of pads and lack of stool awareness were 63%, 75%, and 66.6% respectively. CONCLUSION There is poor concordance for key bowel symptoms including the number of FI episodes as reported by FI patients, suggesting significant recall bias. Thus, historical recall of chronic FI symptoms may be less accurate. A prospective stool diary could provide more accurate information for the evaluation of FI patients.
Collapse
Affiliation(s)
- Amit Hudgi
- Division of Neurogastroenterology/Motility, Augusta University, Augusta, Georgia, USA
| | - Yun Yan
- Division of Neurogastroenterology/Motility, Augusta University, Augusta, Georgia, USA
| | | | - Satish S C Rao
- Division of Neurogastroenterology/Motility, Augusta University, Augusta, Georgia, USA
| |
Collapse
|
2
|
Wang X, Zhuang X, Zhang L, Lu Y. Changes in bowel symptoms after different pelvic organ prolapse surgeries among elderly women at the 1-year follow up. Int J Gynaecol Obstet 2023; 163:854-861. [PMID: 37465949 DOI: 10.1002/ijgo.14966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 06/30/2023] [Accepted: 06/10/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE To investigate the prevalence of bowel symptoms in patients with pelvic organ prolapse (POP), to evaluate the changes in bowel symptoms after different POP surgeries, and to identify risk factors for unrelieved bowel symptoms. METHODS This was an observational prospective cohort study conducted at Peking University First Hospital from 2020 to 2021. Demographic, clinical, and therapeutic data were collected. Participants underwent POP Quantification examination and completed the Pelvic Floor Distress Inventory-20 questionnaire at baseline and 1 year postoperatively. RESULTS The prevalence of bowel symptoms and bothersome bowel symptoms in women with POP was 46.38% and 24.40%, respectively. Surgical correction of prolapse was associated with significant relief in bowel symptoms (P < 0.05). Colpocleisis may relieve bowel symptoms better than reconstructive surgeries (41% vs. 31%, P = 0.048). However, 35% of women had at least one bowel symptom at the 1-year follow up. A long perineal body (Pb) and levator ani muscle injury were found to be predictors of unrelieved bowel symptoms in patients undergoing colpocleisis and those undergoing reconstructive surgery, respectively (odds ratio [OR] 2.306, 95% confidence interval [CI] 1.112-4.783, P = 0.025 and OR 3.245, 95% CI 1.266-8.317, P = 0.014, respectively), and perineoplasty was a protective factor for women who underwent colpocleisis (OR 0.102, 95% CI 0.025-0.417, P = 0.001) CONCLUSION: Women with POP have a high prevalence of bowel symptoms. Although bowel symptoms can be relieved after POP surgeries, one-third of women still experience bowel symptoms. A long Pb and levator ani muscle injury were associated with unrelieved bowel symptoms, while perineoplasty was a protective factor.
Collapse
Affiliation(s)
- Xiaoxiao Wang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Xinrong Zhuang
- Department of Obstetrics and Gynecology, Affiliated Hospital of Chengde Medical University, HeBei, China
| | - Lei Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Ye Lu
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| |
Collapse
|
3
|
Gete DG, Doust J, Mortlock S, Montgomery G, Mishra GD. Associations between endometriosis and common symptoms: findings from the Australian Longitudinal Study on Women's Health. Am J Obstet Gynecol 2023; 229:536.e1-536.e20. [PMID: 37499990 DOI: 10.1016/j.ajog.2023.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/28/2023] [Accepted: 07/21/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Endometriosis has been linked to higher rates of a variety of symptoms; however, the findings from longitudinal studies are scarce and inconsistent. OBJECTIVE This study aimed to examine the association between endometriosis and common symptoms in a prospective cohort study. STUDY DESIGN This study included 7606 women born from 1973 to 1978 using data from the Australian Longitudinal Study on Women's Health that were collected every 3 years from 2009 to 2018. We identified women with endometriosis based on self-reported incidence from each survey and linked administrative health data. At each survey, women also completed a checklist on the presence of 24 symptoms. Generalized estimating equations for multinomial responses were used for analyses. RESULTS Women with endometriosis had significantly more menstrual symptoms than those without endometriosis with an adjusted odds ratio (95% confidence interval) of 3.61 (3.11-4.19) for severe period pain, 2.40 (2.10-2.74) for heavy menstrual bleeding, 1.76 (1.52-2.03) for irregular bleeding, and 1.52 (1.32-1.76) for premenstrual tension. They also had higher odds of mental health problems with adjusted odds ratios of 1.67 (1.39-2.01) for depression and 1.59 (1.24-2.03) for anxiety and higher odds of allergies and nonspecific symptoms with adjusted odds of 1.62 (1.40-1.89) for allergies or hay fever or sinusitis, 1.79 (1.56-2.05) for severe tiredness, 1.56 (1.35-1.81) for sleep difficulty, and 1.77 (1.37-2.18) for palpitations. There was also a strong association with other forms of pain with an adjusted odds ratio of 1.76 (1.53-2.04) for backpain, 1.50 (1.29-1.74) for headaches or migraines, and 1.65 (1.41-1.93) for stiff or painful joints. Women with endometriosis also had increased odds of developing bowel and urinary symptoms with an adjusted odds ratio (95% confidence interval) of 1.67 (1.35-2.08) for constipation, 1.46 (1.12-1.90) for hemorrhoids or piles, 1.25 (1.03-1.52) for indigestion or heartburn, 2.80 (1.71-4.58) for urine burn or stings, and 1.37 (1.03-1.82) for vaginal discharge or irritation. The association between each symptom and endometriosis was similar whether endometriosis was surgically confirmed or clinically suspected. No association was found between endometriosis and the risk for skin problems, leaking urine, or breathing difficulty. CONCLUSION This study suggests that women with endometriosis are more likely to report not only menstrual symptoms but are also at an increased risk for mental health problems, other pain symptoms, bowel and urinary symptoms, and nonspecific symptoms, such as severe tiredness and difficulty sleeping.
Collapse
Affiliation(s)
- Dereje G Gete
- Australian Woman and Girls' Health Research Centre, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Jenny Doust
- Australian Woman and Girls' Health Research Centre, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Sally Mortlock
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Grant Montgomery
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Gita D Mishra
- Australian Woman and Girls' Health Research Centre, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| |
Collapse
|
4
|
Sacomori C, Martinez-Mardones MB, Lorca LA, Solé LI. Commentary: Functional bowel complaints and the impact on quality of life after colorectal cancer surgery in the elderly. Front Oncol 2023; 13:1150181. [PMID: 37182155 PMCID: PMC10167014 DOI: 10.3389/fonc.2023.1150181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/13/2023] [Indexed: 05/16/2023] Open
Affiliation(s)
- Cinara Sacomori
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Mónica Belén Martinez-Mardones
- Servicio de Salud Metropolitano Oriente, Hospital del Salvador, Santiago, Chile
- Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - Luz Alejandra Lorca
- Servicio de Salud Metropolitano Oriente, Hospital del Salvador, Santiago, Chile
| | | |
Collapse
|
5
|
Shore ND, Stenzl A, Pieczonka C, Klaassen Z, Aronson WJ, Karsh L, Ryan CJ, Ortiz J, Srinivasan S, Mohamed AF, Verholen F. Impact of darolutamide on local symptoms: pre-planned and post hoc analyses of the ARAMIS trial. BJU Int 2023; 131:452-460. [PMID: 36087070 DOI: 10.1111/bju.15887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess, the effect of darolutamide (a structurally distinct androgen receptor inhibitor) on urinary and bowel symptoms, using data from the phase III ARAMIS trial (NCT02200614) that showed darolutamide significantly reduced the risk of metastasis and death versus placebo. PATIENTS AND METHODS Patients with non-metastatic castration-resistant prostate cancer (nmCRPC) were randomised 2:1 to darolutamide (n = 955) or placebo (n = 554). Local symptom control was assessed by first prostate cancer-related invasive procedures and post hoc analyses of time to deterioration in quality of life (QoL) using total urinary and bowel symptoms, and individual questions for these symptoms from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Prostate Cancer Module subscales and Functional Assessment of Cancer Therapy-Prostate prostate cancer subscale. Prostate-specific antigen (PSA) responses were correlated with urinary and bowel adverse events (AEs). RESULTS Fewer patients receiving darolutamide (4.7%) versus placebo (9.6%) underwent invasive procedures, and time to first procedure was prolonged with darolutamide (hazard ratio 0.42, 95% confidence interval 0.28-0.62). Darolutamide significantly (P < 0.01) delayed worsening of QoL for total urinary and bowel symptoms versus placebo, mostly attributed by individual symptoms of urinary frequency, associated pain, and interference with daily activities. AEs of urinary retention and dysuria were less frequent with darolutamide, and greater PSA response (≥90%, ≥50% and <90%, <50%) among darolutamide-treated patients was associated with lower incidences of urinary retention (2.2%, 4.2%, 5.1%) and dysuria (0.5%, 3.2%, 5.1%), respectively. CONCLUSIONS Darolutamide demonstrated a positive impact on local disease recurrence and symptom control in patients with nmCRPC, delayed time to deterioration in QoL related to urinary and bowel symptoms, and a favourable safety profile showing similar incidence of urinary- and bowel-related AEs compared with placebo.
Collapse
Affiliation(s)
- Neal D Shore
- Carolina Urologic Research Center, Atlantic Urology Clinics, Myrtle Beach, SC, USA
| | | | | | | | - William J Aronson
- University of California and VA Medical Center Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | | | | | | | | | | | | |
Collapse
|
6
|
Burch J, Wright J, Taylor C, Wilson A, Norton C. 'He's a surgeon, like I'm not going to waste his time': interviews to determine healthcare needs of people with low anterior resection syndrome after rectal cancer surgery. Colorectal Dis 2023; 25:880-887. [PMID: 36633117 DOI: 10.1111/codi.16475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/19/2022] [Accepted: 01/02/2023] [Indexed: 01/13/2023]
Abstract
AIM The aim of this study was to determine the views of people on their healthcare needs when managing their bowel symptoms following an anterior resection. METHOD One-to-one, semi-structured interviews were undertaken, after consent and completion of three questionnaires. Results were analysed using a modified framework analysis and presented narratively. RESULTS Twenty three participants aged 38-75 years were interviewed; 10 were men. Most had low anterior resection syndrome (LARS) scores indicating 'major LARS', Bowel Function Index scores ranged from 28 to 65. The two most bothersome symptoms were faecal incontinence and unpredictable bowel function. Data were grouped into three broad themes: 'treatment consequences', 'strategies and compromises' and 'healthcare needs.' Each theme had four subthemes, such as 'bowel dysfunction' in the theme 'treatment consequences'. Bowel symptoms were common and persistent. Symptom management often required multiple interventions. Expressed healthcare needs included managing expectations through clinician-led information. Participants needed knowledgeable clinicians to enquire about and assess symptoms, provide and reiterate information as well as making an onward referral to enable symptom management. Peers improved the adaptation process through support and advice. Our findings indicate that participants' needs are not being fully met. CONCLUSION People with LARS have unmet healthcare requirements needed to meet their individual goals. We propose these are addressed by using the acronym 'LARS': a Learned clinician who Asks and assesses bowel symptoms, Revisiting the topic to address new or persisting symptoms as well as Signposting, advising or referring onwards as needed.
Collapse
Affiliation(s)
- Jennie Burch
- St Mark's the National Bowel Hospital, London, UK
| | | | - Claire Taylor
- Department of Surgery, London North West University Healthcare NHS Trust, London, UK
| | - Ana Wilson
- Wolfson Unit for Endoscopy, St Mark's Hospital and Departments of Surgery and Cancer, Imperial College London, London, UK.,Department of Surgery, St Mark's Hospital, London, UK
| | - Christine Norton
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| |
Collapse
|
7
|
Asnong A, D’Hoore A, Wolthuis A, Van Molhem Y, Van Geluwe B, Devoogdt N, De Groef A, De Vrieze T, Dams L, Geraerts I. Is evaluation by questionnaires sufficient to cover all aspects of bowel symptoms in rectal cancer patients after low anterior resection? Colorectal Dis 2022; 24:611-620. [PMID: 35040548 PMCID: PMC9306656 DOI: 10.1111/codi.16055] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/05/2022] [Accepted: 01/08/2022] [Indexed: 01/01/2023]
Abstract
AIM The aim of the study was to investigate whether bowel symptoms related to low anterior resection for rectal cancer can be sufficiently well evaluated by the Low Anterior Resection Syndrome (LARS) questionnaire score or the ColoRectal Functional Outcome (COREFO) questionnaire compared with a stool diary. METHOD All patients underwent low anterior resection for rectal cancer. They were asked to fill out a stool diary, the LARS questionnaire and the COREFO questionnaire, at 1, 4, 6 and 12 months after low anterior resection or stoma closure. The main outcome measure was the amount of association (calculated by means of canonical correlation analysis) between items on anal incontinence for faeces, frequency of bowel movements, clustering of bowel movements, urgency and soiling. RESULTS Ninety-five patients were included. Items on anal incontinence for faeces and frequency of bowel movements were significantly correlated between the LARS questionnaire or the COREFO questionnaire, versus the stool diary, respectively. Items on soiling were significantly correlated between the COREFO questionnaire and the stool diary. CONCLUSION Although the LARS questionnaire and the COREFO questionnaire are reliable and valid for measuring low anterior resection syndrome after rectal cancer, our results show that there are no strong associations with the stool diary. Therefore, we can conclude that there is additional clinical information to be obtained from the stool diary. In order to evaluate all aspects of low anterior resection syndrome, we suggest the addition of a stool diary or a combination of different measurement methods during patient follow-up.
Collapse
Affiliation(s)
- Anne Asnong
- Department of Rehabilitation SciencesKU Leuven – University of LeuvenLeuvenBelgium
| | - André D’Hoore
- Department of Abdominal SurgeryUniversity Hospitals GasthuisbergLeuvenBelgium,KU Leuven – University of LeuvenLeuvenBelgium
| | - Albert Wolthuis
- Department of Abdominal SurgeryUniversity Hospitals GasthuisbergLeuvenBelgium,KU Leuven – University of LeuvenLeuvenBelgium
| | - Yves Van Molhem
- Department of Abdominal SurgeryOLV HospitalsAalst/Asse/NinoveBelgium
| | - Bart Van Geluwe
- Department of Abdominal SurgeryUniversity Hospitals GasthuisbergLeuvenBelgium
| | - Nele Devoogdt
- Department of Rehabilitation SciencesKU Leuven – University of LeuvenLeuvenBelgium,Center for LymphedemaUniversity Hospitals LeuvenLeuvenBelgium
| | - An De Groef
- Department of Rehabilitation SciencesKU Leuven – University of LeuvenLeuvenBelgium,Department of Rehabilitation SciencesUniversity of AntwerpAntwerpBelgium,International Research Group Pain in MotionBrusselsBelgium
| | - Tessa De Vrieze
- Department of Rehabilitation SciencesKU Leuven – University of LeuvenLeuvenBelgium,Department of Rehabilitation Sciences and PhysiotherapyMOVANTUniversity of AntwerpAntwerpBelgium
| | - Lore Dams
- Department of Rehabilitation SciencesKU Leuven – University of LeuvenLeuvenBelgium,International Research Group Pain in MotionBrusselsBelgium,Department of Rehabilitation Sciences and PhysiotherapyMOVANTUniversity of AntwerpAntwerpBelgium
| | - Inge Geraerts
- Department of Rehabilitation SciencesKU Leuven – University of LeuvenLeuvenBelgium
| |
Collapse
|
8
|
Raimondo D, Cocchi L, Raffone A, Del Forno S, Iodice R, Maletta M, Aru AC, Salucci P, Ambrosio M, Mollo A, Youssef A, Casadio P, Seracchioli R. Pelvic floor dysfunction at transperineal ultrasound and chronic constipation in women with endometriosis. Int J Gynaecol Obstet 2022; 159:505-512. [PMID: 34995357 DOI: 10.1002/ijgo.14088] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 12/15/2021] [Accepted: 01/06/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the association between sonographic findings at transperineal ultrasound (TPU) and chronic constipation (CC) in women with endometriosis. METHODS An observational prospective cohort study was performed by enrolling all endometriosis women scheduled for surgery between September 2019 and October 2020. Women underwent TPU at rest and during Valsalva maneuver evaluating levator-hiatal-area (LHA), antero-posterior diameter (APD), levator-ani muscle (LAM)-coactivation. Ultrasound findings were compared between women with and without CC in the whole study population, and subsequently in two subgroups [only ovarian and deep infiltrating endometriosis (DIE)]. RESULTS 87 women were enrolled: 29 (33%) with CC and 58 (67%) without CC. Women with endometriosis and CC showed a smaller LHA during Valsalva, less LHA and APD enlargement from rest to maximum Valsalva, a higher prevalence of LAM-coactivation compared to women without CC. In ovarian-subgroup, women with CC had smaller LHA at Valsalva, less enlargement of LHA and APD from rest to maximum Valsalva and higher prevalence of LAM-coactivation compared to non-CC patients. In DIE-subgroup, TPU did not significantly differ between CC and non-CC patients. CONCLUSION TPU signs of pelvic floor muscle hypertone are more frequent in endometriosis patients with CC compared to those without constipation, particularly in women affected by isolated ovarian endometriosis.
Collapse
Affiliation(s)
- Diego Raimondo
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero, Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, Bologna, 40138, Italy
| | - Laura Cocchi
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero, Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, Bologna, 40138, Italy
| | - Antonio Raffone
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero, Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, Bologna, 40138, Italy.,Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Simona Del Forno
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero, Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, Bologna, 40138, Italy
| | - Raffaella Iodice
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero, Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, Bologna, 40138, Italy
| | - Manuela Maletta
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero, Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, Bologna, 40138, Italy
| | - Anna Chiara Aru
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero, Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, Bologna, 40138, Italy
| | - Paolo Salucci
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero, Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, Bologna, 40138, Italy
| | - Marco Ambrosio
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero, Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, Bologna, 40138, Italy
| | - Antonio Mollo
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero, Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, Bologna, 40138, Italy
| | - Aly Youssef
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, 84081, Baronissi, Italy
| | - Paolo Casadio
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero, Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, Bologna, 40138, Italy
| | - Renato Seracchioli
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero, Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Via Massarenti 13, Bologna, 40138, Italy
| |
Collapse
|
9
|
Burch J, Swatton A, Taylor C, Wilson A, Norton C. Managing Bowel Symptoms After Sphincter-Saving Rectal Cancer Surgery: A Scoping Review. J Pain Symptom Manage 2021; 62:1295-1307. [PMID: 34119617 DOI: 10.1016/j.jpainsymman.2021.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/21/2021] [Accepted: 05/28/2021] [Indexed: 11/26/2022]
Abstract
CONTEXT Rectal cancer is common and it is often treated by surgery with or without chemoradiation. Cancer treatment frequently results in bowel symptoms. OBJECTIVES The review aim was to chart the management options for bowel symptoms following rectal cancer surgery. METHODS A scoping review was undertaken searching nine healthcare databases, using relevant search terms and Boolean operators following PRISMA-ScR guidance. Data were extracted into an Excel spreadsheet using headings from the United Kingdom Department of Health guidance and are reported narratively. RESULTS 30 heterogeneous studies met the inclusion criteria, including 853 patients. The most commonly reported bowel symptom was fecal incontinence; the most frequent management strategy was sacral nerve stimulation. Most studies reported on a single management option, often used to manage more than one bowel symptom. Often failure to satisfactorily improve symptoms using options such as medication was needed prior to progressing to other management options. In some studies more than one management option was used, such as rehabilitation programmes. CONCLUSION It is likely that to effectively manage the bowel symptoms experienced after rectal cancer treatment, more than one management option may be used-. Additionally, different management options may need to be tried concurrently.
Collapse
Affiliation(s)
- Jennie Burch
- St Mark's Hospital, Harrow, Middlesex; HA1 3UJ part of London North West University Healthcare NHS Trust, Harrow, Middlesex.
| | - Anna Swatton
- St Mark's Hospital, Harrow, Middlesex; HA1 3UJ part of London North West University Healthcare NHS Trust, Harrow, Middlesex
| | - Claire Taylor
- St Mark's Hospital, Harrow, Middlesex; HA1 3UJ part of London North West University Healthcare NHS Trust, Harrow, Middlesex
| | - Ana Wilson
- St Mark's Hospital, Harrow, Middlesex; HA1 3UJ part of London North West University Healthcare NHS Trust, Harrow, Middlesex; Imperial College, London
| | | |
Collapse
|
10
|
Dos Santos IR, de Abreu GE, Dourado ER, Martinelli Braga AAN, Lobo VA, de Carvalho IWB, Bastos Netto JM, Barroso U. Emotional and behavioural problems in children and adolescents: The role of constipation. J Paediatr Child Health 2021; 57:1003-1008. [PMID: 33565678 DOI: 10.1111/jpc.15368] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 11/29/2022]
Abstract
AIM The functional constipation (FC) is a source of an expressive suffering in children, negatively affecting their emotional, social, and physical well-being. The objective of this study is to describe the clinical and behavioural characteristics of children/adolescents with FC. METHODS A cross-sectional, observational, analytical study was conducted in public places by interviewing parents of children/adolescents about their child's bowel habits and psychological profile. Bowel symptoms were investigated using the Rome IV criteria. The Strengths and Difficulties Questionnaire (SDQ) was used to evaluate the emotional and behavioural problems. RESULTS Of 799 children/adolescents included, 424 (53.1%) were female. Mean age was 9.1 ± 2.7 years. FC prevalence was 20.4%. The most common symptoms in Rome IV criteria were 'painful or hard bowel movements' (n = 110; 67.5%; 95% confidence interval: 60.0-74.3) and 'retentive posturing or excessive volitional stool retention' (n = 89; 54.6%; 95% confidence interval: 46.9-62.1). Median scores for internalising symptoms (7; interquartile range (IQR): 4-9 vs. 5; IQR: 2-7; P < 0.001) and externalising symptoms (7; IQR 4-11 vs. 6; IQR 3-9; P < 0.001) were higher in constipated children compared to non-constipated participants, respectively. The SDQ domains that were associated with FC were emotional symptoms (median 4, P < 0.001) and conduct problems (median 3, P < 0.001). No association was found between faecal incontinence and median scores for the internalising/externalising symptoms. All Rome IV criteria were associated with abnormal overall SDQ scores. CONCLUSION Children and adolescents with FC had more emotional and behavioural problems irrespective of whether faecal incontinence was present or not, with higher scores for internalising and externalising symptoms compared to non-constipated children.
Collapse
Affiliation(s)
- Ivana R Dos Santos
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| | - Glícia E de Abreu
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| | - Eneida R Dourado
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| | - Ana A N Martinelli Braga
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| | - Victoria A Lobo
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| | | | - José M Bastos Netto
- Division of Urology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Ubirajara Barroso
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.,Urology Department, Hospital das Clínicas, Federal University of Bahia, Salvador, Bahia, Brazil
| |
Collapse
|
11
|
Liu W, Xu JM, Zhang YX, Lu HJ, Xia HO. The Relationship Between Food Consumption and Bowel Symptoms Among Patients With Rectal Cancer After Sphincter-Saving Surgery. Front Med (Lausanne) 2021; 8:642574. [PMID: 34235160 PMCID: PMC8255470 DOI: 10.3389/fmed.2021.642574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/05/2021] [Indexed: 11/13/2022] Open
Abstract
Dietary self-management is an important strategy for controlling bowel symptoms after sphincter-saving surgery; however, the dietary factors influencing bowel symptoms are not completely clear. This study aimed to explore the relationship between the specific consumption of food components and bowel symptoms. This study applied a cross-sectional study design. Using convenience sampling, a total of 169 patients with rectal cancer after sphincter-saving surgery were selected from a tertiary hospital. Data were collected through three questionnaires, including general and treatment-related questionnaires, the Memorial Sloan Kettering Cancer Center (MSKCC) bowel function scale-Chinese version, and the Food Frequency Questionnaire. Multiple linear regression analysis was used to analyze the collected data. It was found that the consumption of fruit, cholesterol, and protein and the interaction of cereals and milk products were the main dietary factors affecting bowel symptoms in patients after sphincter-saving surgery. The consumption of protein and fruit was negatively correlated with the symptoms of frequent and urgent defecation, and the consumption of fruit and protein was negatively correlated with general bowel function. The consumption of fruit was negatively correlated with the abnormal feeling of defecation, and the interaction between cereals and milk products was positively correlated with the abnormal feeling of defecation. The results of this study provide evidence for medical staff to further develop scientific dietary education programs to relieve bowel symptoms and promote the quality of life of patients in the future. More research is also needed to explore the mechanisms of the effects of different food components on bowel symptoms in patients after sphincter-saving surgery in the future.
Collapse
Affiliation(s)
- Wen Liu
- School of Nursing, Fudan University, Shanghai, China.,Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Jian Min Xu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yu Xia Zhang
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hui Juan Lu
- School of Nursing, Fudan University, Shanghai, China
| | - Hai Ou Xia
- School of Nursing, Fudan University, Shanghai, China
| |
Collapse
|
12
|
Aslam H, Mohebbi M, Ruusunen A, Dawson SL, Williams LJ, Berk M, Holloway-Kew KL, Collier F, Loughman A, Pasco JA, Jacka FN. Associations between dairy consumption and constipation in adults: A cross-sectional study. Nutr Health 2021; 28:31-39. [PMID: 33827333 DOI: 10.1177/02601060211004784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The current study aimed to assess the association between dairy consumption and constipation in the general adult population. DESIGN Data from the Geelong Osteoporosis Study were used to assess the association between dairy consumption and constipation in women (n=632) and men (n=609). Information on milk, yogurt and cheese, and constipation were self-reported. Total dairy was calculated by summing the intake of milk, yogurt and cheese and expressed as servings per day. Multivariable logistic regression models adjusted for irritable bowel syndrome, major depressive disorders, mobility, body mass index, age and fibre intake were used to examine the odds ratio (OR) and 95% confidence interval (CI) between the consumption of categories of total dairy, milk, yogurt, cheese, and constipation. RESULTS In women, consumption of 1-2 servings/d of total dairy was associated with reduced odds for constipation (OR: 0.49; 95% CI: 0.26-0.90; P=0.021) compared to consuming <1 serving/d of total dairy after adjusting for covariates. Also, consumption of 1-4 servings/d of milk was associated with marginally reduced odds for constipation (OR: 0.63; 95% CI: 0.39-1.02; P=0.058) compared to women who consumed <1 serving/d of milk after adjusting for covariates. There were no significant associations detected between other types of dairy consumption and constipation in women, and none in men. CONCLUSION In women, consumption of moderate amounts of dairy is associated with reduced odds for constipation whereas in men no associations were detected between dairy consumption and constipation. Further studies are warranted to confirm results.
Collapse
Affiliation(s)
- Hajara Aslam
- 98475Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Australia
| | | | - Anu Ruusunen
- 98475Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Australia.,Department of Psychiatry, Kuopio University Hospital, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | - Samantha L Dawson
- 98475Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Australia.,Environmental & Genetic Epidemiology Research, Murdoch Children's Research Institute, Royal Children's Hospital, Australia
| | - Lana J Williams
- 98475Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Australia
| | - Michael Berk
- 98475Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Australia.,Department of Psychiatry and the Florey Institute of Neuroscience and Mental Health Department, Orygen, The Centre of Excellence in Youth Mental Health, The University of Melbourne, Australia
| | - Kara L Holloway-Kew
- 98475Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Australia
| | - Fiona Collier
- 98475Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Australia.,Barwon Health, Australia.,Geelong Centre for Emerging Infectious Disease, Australia
| | - Amy Loughman
- 98475Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Australia
| | - Julie A Pasco
- 98475Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Australia.,Barwon Health, Australia.,Department of Medicine - Western Health, The University of Melbourne, Australia.,Joint senior Authors
| | - Felice N Jacka
- 98475Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Australia.,Black Dog Institute, Australia.,Joint senior Authors
| |
Collapse
|
13
|
Pannemans J, Van den Houte K, Fischler B, Piessevaux H, Carbone F, Tack J. Prevalence and impact of self-reported painful and non-painful constipation in the general population. Neurogastroenterol Motil 2020; 32:e13783. [PMID: 31975471 DOI: 10.1111/nmo.13783] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/01/2019] [Accepted: 11/24/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Chronic constipation, defined by the Rome IV criteria, is a highly prevalent functional bowel disorder with major overlap with other bowel disorders. Therefore, a pooled-analysis to evaluate the presence of self-reported constipation in the general population was conducted. Further, its association with other bowel symptoms and its health-economic impact was analyzed. METHODS Collection of information on bowel symptoms' prevalence and their impact was done through an Internet survey (Medistrat Internet panel). The analysis focused on patients who reported constipation symptoms over the last 12 months. Firstly, participants who with or without constipation were compared. Secondly, subjects reporting constipation with (PC) or without abdominal pain (NPC) were studied. KEY RESULTS: A total of 1012 subjects (45.2 ± 0.5 years old, 62% females), of whom 217 (21%) reported constipation, completed the survey. Women were significantly more represented in the group reporting constipation compared to those with other bowel symptoms (81.57% vs 56.60%, P < .0001). Subjects reporting constipation experienced more additional bowel symptoms than those who did not report constipation [3(2-6) vs 2(1-4), P < .0001]. Of those with constipation, 134 patients reported NPC compared to 83 patients with PC. The presence of PC was associated with higher prevalence of diarrhea symptoms, alternating bowel movements, bloating, cramps, gas, and altered stool frequency and consistency (all P < .01). Out of 83 PC patients, 38 (45.24%) fulfilled the Rome IV IBS criteria. CONCLUSION Self-reported constipation, often associated with other bowel symptoms, is a highly prevalent condition in the Belgian general population. Especially when abdominal pain is present, this generates major healthcare costs.
Collapse
Affiliation(s)
- Jasper Pannemans
- TARGID (Translational Research Center for Gastrointestinal Disorders), University of Leuven, Leuven, Belgium
| | - Karen Van den Houte
- TARGID (Translational Research Center for Gastrointestinal Disorders), University of Leuven, Leuven, Belgium
| | | | - Hubert Piessevaux
- Service de Gastroentérologie, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - Florencia Carbone
- TARGID (Translational Research Center for Gastrointestinal Disorders), University of Leuven, Leuven, Belgium
| | - Jan Tack
- TARGID (Translational Research Center for Gastrointestinal Disorders), University of Leuven, Leuven, Belgium
| |
Collapse
|
14
|
Poole OV, Uchiyama T, Skorupinska I, Skorupinska M, Germain L, Kozyra D, Holmes S, James N, Bugiardini E, Woodward C, Quinlivan R, Emmanuel A, Hanna MG, Panicker JN, Pitceathly RDS. Urogenital symptoms in mitochondrial disease: overlooked and undertreated. Eur J Neurol 2019; 26:1111-1120. [PMID: 30884027 PMCID: PMC6767393 DOI: 10.1111/ene.13952] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/11/2019] [Indexed: 11/30/2022]
Abstract
Background and purpose Bowel symptoms are well documented in mitochondrial disease. However, data concerning other pelvic organs is limited. A large case–control study has therefore been undertaken to determine the presence of lower urinary tract symptoms (LUTS) and sexual dysfunction in adults with genetically confirmed mitochondrial disease. Methods Adults with genetically confirmed mitochondrial disease and control subjects were recruited from a specialist mitochondrial clinic. The presence and severity of LUTS and their impact on quality of life, in addition to sexual dysfunction and bowel symptoms, were captured using four validated questionnaires. Subgroup analysis was undertaken in patients harbouring the m.3243A>G MT‐TL1 mitochondrial DNA mutation. A subset of patients underwent urodynamic studies to further characterize their LUTS. Results Data from 58 patients and 19 controls (gender and age matched) were collected. Adults with mitochondrial disease had significantly more overactive bladder (81.5% vs. 56.3%, P = 0.039) and low stream (34.5% vs. 5.3%, P = 0.013) urinary symptoms than controls. Urodynamic studies in 10 patients confirmed that bladder storage symptoms predominate. Despite high rates of LUTS, none of the patient group was receiving treatment. Female patients and those harbouring the m.3243A>G MT‐TL1 mutation experienced significantly more sexual dysfunction than controls (53.1% vs. 11.1%, P = 0.026, and 66.7% vs. 26.3%, P = 0.011, respectively). Conclusions Lower urinary tract symptoms are common but undertreated in adult mitochondrial disease, and female patients and those harbouring the m.3243A>G MT‐TL1 mutation experience sexual dysfunction. Given their impact on quality of life, screening for and treating LUTS and sexual dysfunction in adults with mitochondrial disease are strongly recommended.
Collapse
Affiliation(s)
- O V Poole
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - T Uchiyama
- Department of Uro-Neurology, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK.,Department of Neurology, School of Medicine, International University of Health and Welfare, Chiba, Japan.,Department of Neurology, School of Medicine, International University of Health and Welfare Ichikawa Hospital, Chiba, Japan
| | - I Skorupinska
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - M Skorupinska
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - L Germain
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - D Kozyra
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - S Holmes
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - N James
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - E Bugiardini
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - C Woodward
- Neurogenetics Unit, National Hospital for Neurology and Neurosurgery, London, UK
| | - R Quinlivan
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK.,Dubowitz Neuromuscular Centre, Great Ormond Street Hospital, London, UK
| | - A Emmanuel
- Gastro-Intestinal Physiology Unit, University College London Hospital, London, UK
| | - M G Hanna
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - J N Panicker
- Department of Uro-Neurology, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - R D S Pitceathly
- MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| |
Collapse
|
15
|
Abstract
OBJECTIVE Chronic watery diarrhoea is a classical symptom of collagenous colitis (CC). However, in some cases, the typical histologic findings of CC can be found in patients without this symptom. In this study we have performed a follow up on patients with a confirmed histological diagnosis of CC without the typical symptom watery diarrhoea. PATIENTS AND METHODS A structured medical record follow-up was performed on the subgroup of patients without watery diarrhoea but diagnosed with the typical CC histologic appearance in a previous study of microscopic colitis. RESULTS At follow up after a median time of 8 years (range: 0.33-12 years), five of these fifteen patients developed bowel symptoms but only two developed characteristic CC symptoms with watery diarrhoea. CONCLUSION The majority of patients without chronic watery diarrhoea at diagnosis remained free from this symptom during follow up and only in a few cases symptoms attributed to CC developed.
Collapse
Affiliation(s)
- Mari Thörn
- a Department of Medical Sciences , Uppsala University , Uppsala , Sweden
- b Swedish Medical Products Agency
| | - Daniel Sjöberg
- c Center for Clinical Research Dalarna , Falu Hospital , Falun , Sweden
| | - Tommy Holmström
- d Department of Internal Medicine , Mariehamn , Åland , Finland
| | - Anders Rönnblom
- a Department of Medical Sciences , Uppsala University , Uppsala , Sweden
| |
Collapse
|
16
|
Long X, Li X, Ma L, Lu J, Liao S, Gui R. Clinical and endoscopic-pathological characteristics of colorectal polyps: an analysis of 1,234 cases. Int J Clin Exp Med 2015; 8:19367-19373. [PMID: 26770577 PMCID: PMC4694477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 10/06/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE To analyze the correlation of clinical symptom and endoscopic-pathological characteristics of colorectal polyps. METHODS A retrospective study was performed on 1,234 continuous colorectal polyp patients. Their clinical, colonoscopic and pathological data were collected and analyzed. RESULTS In 1,234 patients, 46.0% cases were asymptomatic, and 54.0% cases were symptomatic, and the female to male ratio was 2.23:1 and 1.74:1, respectively (P = 0.048). The mean polyp size in symptomatic group was significantly larger than asymptomatic group [7.6±5.1 mm (95% CI: 7.2, 8.0) vs. 6.3±3.7 mm (95% CI: 6.0, 6.6), P < 0.001]. Tubu-villous polyp and villous polyp occurred more frequently in symptomatic group, compared with asymptomatic group (P = 0.002). In symptomatic group, 37.4% cases complained of abdominal pain and 62.6% cases complained of bowel habit alteration. The polyp number in abdominal pain group was larger than bowel habit alteration group (P = 0.036). Three major symptoms of bowel habit alteration were diarrhea, constipation and hematochezia, with proportion of 54.2% (278/513), 27.7% (142/513) and 18.1% (93/513), respectively. The hematochezia group had larger polyp size than diarrhea group (P = 0.001) and consisted of more villous component than the constipation patients (P = 0.005). CONCLUSION Almost half of colorectal polyp patients do not complain of bowel symptoms, especially the male. Colorectal polyp patients have bowel habit alteration more commonly than abdominal pain. Half of patients with bowel habit alteration demonstrate diarrhea. The hematochezia patients are more susceptible to advanced adenomas than the diarrhea and constipation ones.
Collapse
Affiliation(s)
- Xiaohua Long
- Department of Gastroenterology, The Fifth Affiliated Hospital of Sun Yat-sen UniversityZhuhai 519000, China
| | - Xiaofeng Li
- Department of Gastroenterology, The Fifth Affiliated Hospital of Sun Yat-sen UniversityZhuhai 519000, China
| | - Lin Ma
- Department of Oncology, The Fifth Affiliated Hospital of Sun Yat-sen UniversityZhuhai 519000, China
| | - Jing Lu
- Department of Gastroenterology, The Fifth Affiliated Hospital of Sun Yat-sen UniversityZhuhai 519000, China
| | - Suhuan Liao
- Department of Gastroenterology, The Fifth Affiliated Hospital of Sun Yat-sen UniversityZhuhai 519000, China
| | - Ruohu Gui
- Department of Gastroenterology, Central Hospital of Hengyang City, The Hengyang Affiliated Hospital of Southern Medical UniversityHengyang 421000, China
| |
Collapse
|
17
|
Sriram D, McManus A, Emmerton L, Parsons R, Jiwa M. Development and validation of a clinical decision-making aid for screening bowel symptoms in community pharmacies. J Eval Clin Pract 2014; 20:260-6. [PMID: 24628772 DOI: 10.1111/jep.12120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/10/2014] [Indexed: 01/24/2023]
Abstract
RATIONALE, AIMS AND OBJECTIVES Bowel symptoms are common, and community pharmacies are an ideal setting for health advice about these symptoms. The aim of this study was to develop and validate a questionnaire for use with adults presenting to community pharmacies with lower bowel symptoms. The purpose of the questionnaire was to stratify people into those requiring medical follow-up for symptoms and those with self-limiting symptoms. METHOD A self-administered questionnaire, named the Jodi Lee test (JLT), was developed in three stages - review of the literature, questionnaire design and statistical validation - against a validated screening tool, the patient consultation questionnaire (PCQ), to assess the sensitivity and specificity of JLT. The questionnaire was developed to be simple, easy for all pharmacy staff to use and require no score calculation. Its application was designed to facilitate referral from pharmacy assistants to pharmacists and from pharmacists to medical practitioners. RESULTS The questionnaire comprises eight questions. It has a Flesh-Kincaid reading score of 79.5. By considering different score thresholds on the PCQ, a receiver operator characteristic (ROC) curve was calculated to assess the effectiveness of the JLT. From a sample of 118 subjects, the area under the ROC curve was 0.94. At a threshold score of 30 on the PCQ, the sensitivity was 100%. The specificity was 65%. CONCLUSION The JLT has high sensitivity for identifying patients with symptoms of serious bowel disease. It is also likely to identify patients who have symptoms of relatively benign disease who would benefit from medical advice.
Collapse
Affiliation(s)
- Deepa Sriram
- Department of Medical Education, Faculty of Health Sciences, Curtin University, Western Australia, Australia
| | | | | | | | | |
Collapse
|
18
|
Donovan KA, Boyington AR, Judson PL, Wyman JF. Bladder and bowel symptoms in cervical and endometrial cancer survivors. Psychooncology 2014; 23:672-8. [PMID: 24481859 DOI: 10.1002/pon.3461] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 11/04/2013] [Accepted: 11/14/2013] [Indexed: 11/07/2022]
Abstract
BACKGROUND Previous studies likely underestimate the prevalence of bowel and bladder symptoms in gynecologic cancer survivors. We sought to estimate the prevalence of these symptoms in cervical and endometrial cancer survivors who had completed treatment 1 year previously compared with non-cancer controls, and to examine factors associated with more severe symptoms in survivors. METHODS As part of a larger quality of life study, survivors who were 1-year posttreatment for cervical or endometrial cancer (n = 104) completed measures of bladder and bowel symptoms. An age-matched and race/ethnicity-matched sample of women with no history of cancer was recruited for comparison purposes. RESULTS Survivors reported a higher prevalence of bladder symptoms, specifically storage and incontinence symptoms, than non-cancer controls. Prevalence rates for bowel symptoms in survivors were higher than those reported in previous studies. Greater symptom severity was associated with younger age, lower annual incomes, and less education. Other correlates included higher body mass index and history of smoking. As hypothesized, more severe symptoms were associated with radical hysterectomy and pelvic radiation. CONCLUSIONS Bladder and bowel symptoms are more prevalent in cervical and endometrial cancer survivors than non-cancer controls. Future research should replicate these findings in a larger, prospective study.
Collapse
Affiliation(s)
- Kristine A Donovan
- Health Outcomes and Behavior Program, Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | | | | | | |
Collapse
|
19
|
Abstract
The majority of women with pelvic organ prolapse and stress urinary incontinence report more than one symptom that affects urinary, bowel, or sexual function. Most research studies on outcomes following surgery for pelvic organ prolapse and stress incontinence focus on anatomic outcomes and relief of symptoms specific to prolapse and/or stress incontinence. Pelvic symptoms related to voiding function such as de novo urgency or incontinence, bowel function, and sexual function are clinically important outcomes but are infrequently reported. Deterioration of pelvic symptoms postoperatively is associated with decreased patient satisfaction, which underscores the importance of effectively assessing functional and anatomic treatment outcomes. Future studies of reconstructive pelvic surgery should routinely include multiple domain functional outcomes specifically addressing voiding, defecatory, and sexual function.
Collapse
Affiliation(s)
- Saya Segal
- Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, 1000 Courtyard, Ravdin, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Lily A. Arya
- Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, 1000 Courtyard, Ravdin, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Ariana L. Smith
- Division of Urology, Department of Surgery, University of Pennsylvania Health System, 299 South 8th Street, Philadelphia, PA 19104, USA
| |
Collapse
|
20
|
Abstract
PURPOSE The aim of this study was to characterize differences in health-related quality of life among women presenting for treatment of fecal incontinence. METHODS Among 155 women presenting for treatment of fecal incontinence in a specialty clinic, validated questionnaires measured impact on quality of life (Modified Manchester Health Questionnaire) and severity (the Fecal Incontinence Severity Index). Bowel symptoms, including frequency, urgency, and stool consistency, were ascertained. Comorbid diseases were self-reported. Linear regression models were constructed from significant univariate variables to examine differences observed in quality of life scores. RESULTS The average age was 58.7 +/- 11.5 years, with no differences found in quality of life scores according to race, body mass index, or number of vaginal deliveries (P > .05). Younger age, increased urinary incontinence symptoms, prior cholecystectomy, prior hysterectomy, and severity of bowel symptoms correlated with a negative impact on quality of life in univariate analysis (P < .05). Average severity scores were 30.5 +/- 13.7, with moderate correlation seen with increasing severity and quality of life scores (R2 = 0.60). After controlling for severity, women had increased quality of life scores with more bowel urgency (15 points; 95% CI, 8.1-21.2), harder stool consistency (10 points; 95% CI, 3.8-16.3), and prior hysterectomy (9 points; 95% CI, 2.7-15.4). CONCLUSION Bowel symptoms and having undergone a hysterectomy had the greatest negative impact on quality of life in women seeking treatment for fecal incontinence. Targeting individualized treatments to improve bowel symptoms may improve quality of life for women with fecal incontinence.
Collapse
Affiliation(s)
- Alayne D. Markland
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC) Department of Veterans Affairs Medical Center, Birmingham, AL,University of Alabama at Birmingham, Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care
| | - W. Jerod Greer
- University of Alabama at Birmingham, Department of Obstetrics and Gynecology,Division of Women's Pelvic Medicine and Reconstructive Surgery
| | - Alicia Vogt
- Division of Women's Pelvic Medicine and Reconstructive Surgery
| | - David T. Redden
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC) Department of Veterans Affairs Medical Center, Birmingham, AL,University of Alabama at Birmingham School of Public Health
| | - Patricia S. Goode
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC) Department of Veterans Affairs Medical Center, Birmingham, AL,University of Alabama at Birmingham, Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care
| | - Kathryn L. Burgio
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC) Department of Veterans Affairs Medical Center, Birmingham, AL,University of Alabama at Birmingham, Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care
| | - Holly E. Richter
- University of Alabama at Birmingham, Department of Obstetrics and Gynecology,Division of Women's Pelvic Medicine and Reconstructive Surgery
| |
Collapse
|