Abstract：
The aim of this work was to determine the clinical efficacy of high-volume transanal irrigation (TAI) in patients with constipation and/or faecal incontinence using validated symptom and quality of life questionnaires.
This was a prospective cohort study of 114 consecutive patients with constipation and/or faecal incontinence (Rome IV defined) who started TAI. A comprehensive questionnaire was completed at baseline and 4, 12, 26 and 52 weeks\' follow-up. The primary objective was significant symptom reduction [≥30%; Cleveland Clinic Constipation Score (CCCS) and St Marks Incontinence Score (SMIS)] in those who continued TAI at 52 weeks. Secondary objectives were (1) continuation rates of TAI, (2) effect on quality of life (QoL) and (3) identification of predictors for continuation.
A total of 59 (51.8%) patients with constipation, 26 (22.8%) with faecal incontinence and 29 (25.4%) with coexistent symptoms were included. At 52 weeks, 41 (36.0%) patients continued TAI, 63 (55.2%) stopped and 10 (8.8%) patients were lost to follow-up. In those who continued TAI at 52 weeks (n = 41), no reduction of constipation symptoms was observed. Median Patient Assessment of Constipation Quality of Life scores decreased on most domains, indicating QoL improvement. Reduction of faecal incontinence occurred in 5/9 (55.6%) patients with faecal incontinence and in 3/10 (30.0%) patients with coexistent symptoms. The median SMIS per-individual decreased in patients with coexistent symptoms (2; interquartile range 0-4; p = 0.023). Median Fecal Incontinence Quality of Life scores increased in most domains, indicating improved QoL. No clinical characteristics predicted continuation.
One-third (n = 41) of patients continued TAI at 52 weeks. In those who continued TAI at 52 weeks, symptoms of faecal incontinence (SMIS) were reduced but not constipation (CCCS). QoL related to both constipation and faecal incontinence improved. No clinical characteristics predicted continuation.
This was a prospective cohort study of 114 consecutive patients with constipation and/or faecal incontinence (Rome IV defined) who started TAI. A comprehensive questionnaire was completed at baseline and 4, 12, 26 and 52 weeks\' follow-up. The primary objective was significant symptom reduction [≥30%; Cleveland Clinic Constipation Score (CCCS) and St Marks Incontinence Score (SMIS)] in those who continued TAI at 52 weeks. Secondary objectives were (1) continuation rates of TAI, (2) effect on quality of life (QoL) and (3) identification of predictors for continuation.
A total of 59 (51.8%) patients with constipation, 26 (22.8%) with faecal incontinence and 29 (25.4%) with coexistent symptoms were included. At 52 weeks, 41 (36.0%) patients continued TAI, 63 (55.2%) stopped and 10 (8.8%) patients were lost to follow-up. In those who continued TAI at 52 weeks (n = 41), no reduction of constipation symptoms was observed. Median Patient Assessment of Constipation Quality of Life scores decreased on most domains, indicating QoL improvement. Reduction of faecal incontinence occurred in 5/9 (55.6%) patients with faecal incontinence and in 3/10 (30.0%) patients with coexistent symptoms. The median SMIS per-individual decreased in patients with coexistent symptoms (2; interquartile range 0-4; p = 0.023). Median Fecal Incontinence Quality of Life scores increased in most domains, indicating improved QoL. No clinical characteristics predicted continuation.
One-third (n = 41) of patients continued TAI at 52 weeks. In those who continued TAI at 52 weeks, symptoms of faecal incontinence (SMIS) were reduced but not constipation (CCCS). QoL related to both constipation and faecal incontinence improved. No clinical characteristics predicted continuation.
摘要：
目的：这项工作的目的是使用经过验证的症状和生活质量问卷来确定高容量经肛门冲洗（TAI）在便秘和/或大便失禁患者中的临床疗效。
方法：这是一项前瞻性队列研究，对114名开始TAI的便秘和/或大便失禁患者（罗马IV定义）进行了研究。在基线和第4、12、26和52周随访时完成综合问卷。主要目标是在52周时持续TAI的患者中，症状显着减少[≥30％；克利夫兰临床便秘评分（CCCS）和圣马克斯失禁评分（SMIS）]。次要目标是(1)TAI的延续率，（2）对生活质量（QoL）的影响和（3）持续预测因子的识别。
结果:共有59例(51.8%)便秘患者,包括26例（22.8％）的大便失禁和29例（25.4％）的共存症状。52周时,41例（36.0％）患者继续TAI，63例（55.2%）患者停止随访，10例（8.8%）患者失访。在那些在52周(n=41)继续TAI的人中，没有观察到便秘症状的减少。便秘患者生活质量评分的中位数在大多数领域都有所下降，表明QoL改善。5/9（55.6％）的大便失禁患者和3/10（30.0％）的同时存在症状的患者大便失禁减少。在有共存症状的患者中，每个个体的SMIS中位数降低（2；四分位数范围0-4；p=0.023）。大便失禁生活质量评分中位数在大多数领域都有所增加，表明QoL改善。没有临床特征预测继续。
结论：三分之一（n=41）的患者在52周时继续TAI。在那些在52周继续TAI的人中，大便失禁(SMIS)症状减轻,但便秘(CCCS)症状不明显.与便秘和大便失禁相关的QoL改善。没有临床特征预测继续。
方法：这是一项前瞻性队列研究，对114名开始TAI的便秘和/或大便失禁患者（罗马IV定义）进行了研究。在基线和第4、12、26和52周随访时完成综合问卷。主要目标是在52周时持续TAI的患者中，症状显着减少[≥30％；克利夫兰临床便秘评分（CCCS）和圣马克斯失禁评分（SMIS）]。次要目标是(1)TAI的延续率，（2）对生活质量（QoL）的影响和（3）持续预测因子的识别。
结果:共有59例(51.8%)便秘患者,包括26例（22.8％）的大便失禁和29例（25.4％）的共存症状。52周时,41例（36.0％）患者继续TAI，63例（55.2%）患者停止随访，10例（8.8%）患者失访。在那些在52周(n=41)继续TAI的人中，没有观察到便秘症状的减少。便秘患者生活质量评分的中位数在大多数领域都有所下降，表明QoL改善。5/9（55.6％）的大便失禁患者和3/10（30.0％）的同时存在症状的患者大便失禁减少。在有共存症状的患者中，每个个体的SMIS中位数降低（2；四分位数范围0-4；p=0.023）。大便失禁生活质量评分中位数在大多数领域都有所增加，表明QoL改善。没有临床特征预测继续。
结论：三分之一（n=41）的患者在52周时继续TAI。在那些在52周继续TAI的人中，大便失禁(SMIS)症状减轻,但便秘(CCCS)症状不明显.与便秘和大便失禁相关的QoL改善。没有临床特征预测继续。
