A pilot study of factors influencing bowel function after colorectal anastomosis

This study was undertaken to assess subjective bowel function after anterior resection and to search for clinical characteristics that might affect the functional results.

A total of 70 patients answered a questionnaire concerning bowel function a median of 65 months after anterior resection, and 40 patients responded to the same questionnaire a median of 60 months after colonic resection.

Median frequency of bowel movement per 24 hours was two (range, 0.2-9) after rectal resection and one (range, 0.4-6) after colonic resection (P < 0.001). Incontinence for loose stools (P < 0.01), need to wear a pad (P < 0.05), and need to return to the toilet after defecation (P < 0.05) was more common in the rectal resection group. In the latter group, advanced age, use of descending or transverse colon for anastomosis, and large amount of intraoperative bleeding was associated with fecal incontinence (P < 0.05). Preoperative radiotherapy was correlated with a high bowel frequency (P = 0.003).

These data indicate that alterations of subjective bowel function frequently observed after colorectal anastomosis may be affected by both surgical technique and adjuvant radiotherapy.