Outcome of behavioural treatment for idiopathic chronic constipation. Issue 9 (September 2014)

• Record Type: Journal Article
• Authors: Yang, L. S.; Khera, A.; Kamm, M. A.
• Is Part Of: Internal medicine journal. Volume 44:Issue 9(2014)
• Page Start: 858
• Page End: 864
• Publication Date: 2014-09
• Subjects: Medicine -- Periodicals; 616
• DOI: 10.1111/imj.12490
• Languages: English
• ISSNs: 1444-0903

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="imj12490-sec-0001" sec-type="section"> <title>Background/Aim</title> <p>Behavioural therapy is effective in patients with chronic intractable constipation despite standard treatment, but long‐term results in unselected patients are unclear. This study investigates the effects of behavioural therapy on symptoms, subjective well‐being, and the physical and mental quality of life.</p> </sec> <sec id="imj12490-sec-0002" sec-type="section"> <title>Methods</title> <p>Patients who had failed standard care for idiopathic chronic constipation underwent behavioural therapy in a specialist clinic. Symptom severity and quality of life were assessed before and after therapy using the 'Constipation Scoring System' and the Short‐Form 36 questionnaire. The primary outcome was subjective perception of improvement. Secondary outcomes were symptoms of constipation and quality of life scores.</p> </sec> <sec id="imj12490-sec-0003" sec-type="section"> <title>Results</title> <p>Of 233 consecutive patients with self‐reported constipation (median symptom duration 5–10 years, median age 44 years, females 86%), 180 (77%) completed treatment in a median of three (range 1–7) sessions. One hundred and sixty‐five patients (71% of all referrals or 92% of those completing treatment) reported subjective improvement. Median bowel frequency improved from once every 2–7 days to 1–3 per day (<italic>P</italic> = 0.05). Pain and bloating improved in more than 80% of patients. The Short‐Form 36 physical (<italic>P</italic> < 0.05) and mental (<italic>P</italic> < 0.05) composite scores improved significantly. Patients with a longer duration of symptoms were less likely to complete treatment. Digital evacuation prior to treatment was a predictor of poor outcome.</p> </sec> <sec id="imj12490-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Behavioural therapy is associated with significant improvement in symptoms of chronic constipation and quality of life. Non‐drug therapies that successfully treat patients with functional gut disorders resistant to standard treatment are needed in the mainstream provision of care.</p> </sec> </abstract>