Sigmoid volvulus part 1: Understanding patient experiences and priorities

Sigmoid volvulus is one of the commonest presentations of bowel obstruction worldwide but remains underresearched. We aimed to discover patients' priorities in treatment options for sigmoid volvulus, and how management strategies impact their quality of life.

Patients and/or their relatives/carers who had been diagnosed with sigmoid volvulus in the last 5 years were invited to attend a Patient and Public Involvement (PPI) event. Small group and whole group facilitated discussion focused on patients' experiences, priorities and outcomes. Discussions were facilitated by colorectal consultants and surgical trainees, as well as a patient researcher.

Six patients and three relatives/carers attended the PPI event, along with a patient researcher, four surgical trainees and two consultant colorectal surgeons. Identified themes which future studies would need to consider as patient related outcome measures were: quality of life, patient and carer anxiety, communication, decision-making, recovery and the impact on carers. Patient experience was highly varied and included recurrent episodes requiring endoscopic detorsion and undergoing emergency or elective surgery. In future studies, participants would recommend the use of qualitative interviews and inclusion of patients who had died from complications of sigmoid volvulus, explored through qualitative interviews with partners and carers.

The patient and their relative/carer's experience of sigmoid volvulus is highly variable and currently underexplored. A holistic approach to treatment with shared decision-making between the patient, their carer and their surgeon is essential.