Poor symptomatic relief and quality of life in patients treated for "solitary rectal ulcer syndrome without external rectal prolapse".

Full Abstract

BACKGROUND:
Solitary rectal ulcer syndrome (SRUS) is a chronic disabling condition. Several therapeutic options have been advocated including conservative approaches and surgery, bringing into question their functional outcomes. This study aimed to assess treatment procedures on both anorectal complaints and quality of life (QoL) using standardised self-administered questionnaires.

MATERIALS AND METHODS:
Forty-one patients who underwent treatments for SRUS in two referral centres were reviewed. A standardised self-administered questionnaire including incontinence (Cleveland Clinic), constipation (Knowles-Eccersley-Scott symptom, KESS) and gastrointestinal quality of life index validated scoring systems was mailed to each patient (median follow-up, 36 months). Correlation between treatment options, functional results and quality of life was analysed.

RESULTS:
The mean Cleveland Clinic and KESS scores were respectively 5.3+/-5.8 (normal 0) and 19.1+/-8 (normal<9). The mean QoL score reached 89+/-28.8 (normal 125). A linear correlation between the QoL score and functional results was observed. There was no influence of treatment options on QoL results. A multivariate analysis identified five parameters predictive of a better QoL:
presence of paradoxical puborectalis contraction, absence of descending perineum, absence of procidentia, age<40 and treatment exclusively based on laxatives.

CONCLUSION:
Despite several therapeutic options including surgery, patients with SRUS still frequently complain of disturbed anorectal function and significant alteration of their QoL.

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Author information

Author/s: Meurette, G (G); Siproudhis, L (L); Regenet, N (N); Frampas, E (E); Proux, M (M); Lehur, P A (PA);

Affiliation: Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif (CCDE-IMAD), Nantes University Hospital, Hotel-Dieu, Nantes, France. Guillaume.meurette(-atsign-)wanadoo.fr

Journal and publication information

Publication Type: Journal Article; Multicenter Study

Journal: International journal of colorectal disease (Int J Colorectal Dis), published in Germany. (Language: eng)

Reference: 2008-May; vol 23 (issue 5) : pp 521-6

Dates: Created 2008/03/19; Completed 2008/07/17;

PMID: 18274765, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Adult
Aged
Biofeedback (Psychology)
Constipation - physiopathology; prevention & control; psychology
Digestive System Surgical Procedures
Electric Stimulation Therapy
Fecal Incontinence - physiopathology; prevention & control; psychology
Female
France
Gastrointestinal Tract - physiopathology
Humans
Laxatives - therapeutic use

Laxatives - therapeutic use
Male
Middle Aged
Patient Selection
Quality of Life
Questionnaires
Rectal Diseases - complications; physiopathology; psychology; therapy
Rectal Prolapse - physiopathology
Retrospective Studies
Syndrome
Time Factors
Treatment Outcome
Ulcer - complications; physiopathology; psychology; therapy

Associated Chemicals: Laxatives (0)

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