Issn Print: 0143-3636

Publication Date: 2003/03/01


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7. Relationship of radionuclide proctography results to symptoms in chronic constipation

M. T. Eltringham; A. Mackie; E. McCauley; J. Y. Yiannakou

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Excerpt

Background: Proctography is widely used in the management of chronic severe constipation. This condition has been sub-classified into slow transit constipation and obstructive constipation (OC). Patients with OC would be expected to have more obstructive symptoms and delayed rectal emptying on radionuclide defaecating proctography (RDP). This study aimed to assess the relationship of symptoms to the results of RDP in patients with chronic severe constipation.
Methods: Eighty-one consecutive female patients were assessed prospectively using a proforma. Six key symptoms associated with OC were scored on a 5-point scale. The total for obstructive symptoms, the ‘O’ score, was calculated. Fifty-nine patients underwent RDP, measuring evacuation time, percentage and rate, pelvic floor descent (PFD) and rectocele size.
Results: Four proformas were incomplete and therefore excluded. There was no correlation of ‘O’ score to evacuation time, percentage or rate, PFD, or rectocele size. Individual symptom scores also did not correlate significantly with evacuation rate (straining, P = 0.64; pain on defaecation, P = 0.31; digitation, P = 0.49; vaginal pressure, P = 0.37; unsuccessful attempts, P = 0.40; and time spent at defaecation, P = 0.90). When divided into two groups, normal and prolonged evacuation by RDP, there was no significant difference in the ‘O’ score between these groups.
Conclusion: This study has shown no correlation between symptoms and RDP results in patients with chronic severe constipation. This may be due to variability in patients' symptoms.
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