Quality of life in 1870 patients with constipation and/or fecal incontinence: Constipation should not be underestimated.


Journal

Clinics and research in hepatology and gastroenterology
ISSN: 2210-741X
Titre abrégé: Clin Res Hepatol Gastroenterol
Pays: France
ID NLM: 101553659

Informations de publication

Date de publication:
11 2019
Historique:
received: 09 12 2018
revised: 25 01 2019
accepted: 13 02 2019
pubmed: 19 3 2019
medline: 21 10 2020
entrez: 19 3 2019
Statut: ppublish

Résumé

Quality of life is increasingly seen as important, but remains difficult to assess in patients with functional anorectal complaints. We aimed to quantify quality of life and to analyse the symptomatic descriptors associated with a poor outcome in patients with faecal incontinence (FI) and/or constipation. The characteristics of the patients, data from self-administered questionnaires and from physical examinations were evaluated prospectively for all cases of functional anorectal disease over a period of thirteen years. Functional anorectal disease included faecal incontinence (FI) and/or constipation. Patients with scores in the lowest quartile of the Gastrointestinal Quality of Life Index (GIQLI) were considered to have suffered severe alterations to their quality of life, and were compared with the other patients. In total, 1870 patients with functional anorectal disease were included (470 with a severely altered quality of life (GIQLI < 70)). Constipation predominated (1212/1870; 65.1%) and severe FI was frequent (761/1870; 40.9%). Severely altered quality of life was significantly associated with constipation (P = 0.0001), urinary urgency and incontinence (P = 0.0001), depression (P = 0.001), diabetes (P = 0.0224), severe FI (P = 0.0001), neurological disease (P = 0.0138) and liquid stools (P = 0.0002) in multivariate analysis. Several treatable factors are associated to an impaired quality of life in patients with functional anorectal disorders. Intervention studies are mandatory (stool consistency and frequency).

Sections du résumé

BACKGROUND
Quality of life is increasingly seen as important, but remains difficult to assess in patients with functional anorectal complaints.
OBJECTIVE
We aimed to quantify quality of life and to analyse the symptomatic descriptors associated with a poor outcome in patients with faecal incontinence (FI) and/or constipation.
METHODS
The characteristics of the patients, data from self-administered questionnaires and from physical examinations were evaluated prospectively for all cases of functional anorectal disease over a period of thirteen years. Functional anorectal disease included faecal incontinence (FI) and/or constipation. Patients with scores in the lowest quartile of the Gastrointestinal Quality of Life Index (GIQLI) were considered to have suffered severe alterations to their quality of life, and were compared with the other patients.
RESULTS
In total, 1870 patients with functional anorectal disease were included (470 with a severely altered quality of life (GIQLI < 70)). Constipation predominated (1212/1870; 65.1%) and severe FI was frequent (761/1870; 40.9%). Severely altered quality of life was significantly associated with constipation (P = 0.0001), urinary urgency and incontinence (P = 0.0001), depression (P = 0.001), diabetes (P = 0.0224), severe FI (P = 0.0001), neurological disease (P = 0.0138) and liquid stools (P = 0.0002) in multivariate analysis.
CONCLUSION
Several treatable factors are associated to an impaired quality of life in patients with functional anorectal disorders. Intervention studies are mandatory (stool consistency and frequency).

Identifiants

pubmed: 30880096
pii: S2210-7401(19)30051-8
doi: 10.1016/j.clinre.2019.02.011
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

682-687

Informations de copyright

Copyright © 2019 Elsevier Masson SAS. All rights reserved.

Auteurs

Charlène Brochard (C)

Service des maladies de l'appareil digestif, CHU de Pontchaillou, Université de Rennes 1, Rennes, France; Services d'explorations fonctionnelles digestives, CHU de Pontchaillou, Université de Rennes 1, Rennes, France; Inserm U1241, Université de Rennes 1, Rennes, France; CIC 1414, INPHY, Université de Rennes 1, Rennes, France. Electronic address: charlene.brochard@chu-rennes.fr.

Marion Chambaz (M)

Service des maladies de l'appareil digestif, CHU de Pontchaillou, Université de Rennes 1, Rennes, France.

Alain Ropert (A)

Services d'explorations fonctionnelles digestives, CHU de Pontchaillou, Université de Rennes 1, Rennes, France; CIC 1414, INPHY, Université de Rennes 1, Rennes, France.

Alexandre Merlini l'Héritier (AM)

Service des maladies de l'appareil digestif, CHU de Pontchaillou, Université de Rennes 1, Rennes, France.

Timothée Wallenhorst (T)

Service des maladies de l'appareil digestif, CHU de Pontchaillou, Université de Rennes 1, Rennes, France.

Guillaume Bouguen (G)

Service des maladies de l'appareil digestif, CHU de Pontchaillou, Université de Rennes 1, Rennes, France; Inserm U1241, Université de Rennes 1, Rennes, France; CIC 1414, INPHY, Université de Rennes 1, Rennes, France.

Laurent Siproudhis (L)

Service des maladies de l'appareil digestif, CHU de Pontchaillou, Université de Rennes 1, Rennes, France; Inserm U1241, Université de Rennes 1, Rennes, France; CIC 1414, INPHY, Université de Rennes 1, Rennes, France.

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