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Efficacy of multidisciplinary approach in treatment of constipation: a pilot study
P Y Y Lau1, B Fung, W C S Meng
1Kwong Wah Hospital, Hong Kong: Department of Surgery. patrickyylau@yahoo.com
Objective:
To evaluate a multidisciplinary Hong Kong treatment programme for patients with constipation.
Design:
Pilot study.
Setting:
A joint collaboration among the departments of surgery, physiotherapy, and dietetics in a regional hospital in Hong Kong.
Patients:
Thirty-one constipated patients with normal colonic transit and pelvic floor dyssynergia.
Intervention:
Multidisciplinary treatment including dietary modification, bowel habit adjustment, and physiotherapy.
Main Outcome Measures:
Anorectal manometry, fibre intake, subjective improvement, bowel frequency, Bristol score, and straining time and effort.
Results:
Significant improvement was found in mean fibre intake, straining time and effort, but not in anal manometric results. A total of 78% of patients demonstrated more than 50% improvement in subjective symptoms, whereas 70% of the patients enjoyed objective improvement in pelvic floor dyssynergia documented by electromyography and anal pressure during a push effort.
Conclusion:
The multidisciplinary rehabilitative programme for constipated patients significantly improved symptoms. Electromyography and anal pressure during a push effort are useful tools for objective assessment of the treatment effect.
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