Prospective cohort study of high-volume transanal irrigation in patients with constipation and/or faecal incontinence.

Autor: Vollebregt PF; Department of Gastroenterology and Hepatology, Amsterdam University Medical Centres, Amsterdam, The Netherlands., Dekker L; Proctos Kliniek, Bilthoven, The Netherlands.; Department of Surgery, Amsterdam University Medical Centres, Amsterdam, The Netherlands., Han-Geurts IJM; Proctos Kliniek, Bilthoven, The Netherlands., Felt-Bersma RJF; Department of Gastroenterology and Hepatology, Amsterdam University Medical Centres, Amsterdam, The Netherlands.; Proctos Kliniek, Bilthoven, The Netherlands.
Jazyk: angličtina
Zdroj: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland [Colorectal Dis] 2023 Aug; Vol. 25 (8), pp. 1658-1670. Date of Electronic Publication: 2023 May 31.
DOI: 10.1111/codi.16628
Abstrakt: Aim: The aim of this work was to determine the clinical efficacy of high-volume transanal irrigation (TAI) in patients with constipation and/or faecal incontinence using validated symptom and quality of life questionnaires.
Method: This was a prospective cohort study of 114 consecutive patients with constipation and/or faecal incontinence (Rome IV defined) who started TAI. A comprehensive questionnaire was completed at baseline and 4, 12, 26 and 52 weeks' follow-up. The primary objective was significant symptom reduction [≥30%; Cleveland Clinic Constipation Score (CCCS) and St Marks Incontinence Score (SMIS)] in those who continued TAI at 52 weeks. Secondary objectives were (1) continuation rates of TAI, (2) effect on quality of life (QoL) and (3) identification of predictors for continuation.
Results: A total of 59 (51.8%) patients with constipation, 26 (22.8%) with faecal incontinence and 29 (25.4%) with coexistent symptoms were included. At 52 weeks, 41 (36.0%) patients continued TAI, 63 (55.2%) stopped and 10 (8.8%) patients were lost to follow-up. In those who continued TAI at 52 weeks (n = 41), no reduction of constipation symptoms was observed. Median Patient Assessment of Constipation Quality of Life scores decreased on most domains, indicating QoL improvement. Reduction of faecal incontinence occurred in 5/9 (55.6%) patients with faecal incontinence and in 3/10 (30.0%) patients with coexistent symptoms. The median SMIS per-individual decreased in patients with coexistent symptoms (2; interquartile range 0-4; p = 0.023). Median Fecal Incontinence Quality of Life scores increased in most domains, indicating improved QoL. No clinical characteristics predicted continuation.
Conclusion: One-third (n = 41) of patients continued TAI at 52 weeks. In those who continued TAI at 52 weeks, symptoms of faecal incontinence (SMIS) were reduced but not constipation (CCCS). QoL related to both constipation and faecal incontinence improved. No clinical characteristics predicted continuation.
(© 2023 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.)
Databáze: MEDLINE
Externí odkaz: