P. Alduini

The daily diary and the questionnaire are not equivalent for the evaluation of bowel habits

BACKGROUND It is unclear whether questionnaires and diary cards, which are widely used to collect data on bowel habits, provide analogous information. AIMS We verified the concordance between the data provided by a daily diary and a retrospective questionnaire. METHODS A 4-week diary (DIARY) concerning bowel habits was compiled by 221 subjects. They were also asked to fill out a questionnaire on their bowel habits before (BEF) and after (AFT) the diary period. RESULTS Concerning bowel movements, no significant difference was detected in the concordance between BEF and DIARY (rho: 0.80), AFT and DIARY (rho: 0.84), or BEF and AFT (rho: 0.84). The mean concordance in the other defecation-related parameters between BEF and DIARY (K: 0.62) and between DIARY and AFT (K: 0.63) were both significantly lower than that seen between BEF and AFT (K: 0.80; p<0.01). CONCLUSION A considerable discrepancy between the two methods of assessment was found. The higher concordance between BEF and AFT than between DIARY and AFT regarding defecation-related parameters suggests that when a subject recalls events, even those from the recent past, he/she tends to generalize, reporting more or less the same data for different periods of time. These two instruments cannot be viewed as interchangeable, and their inherent differences must be taken into account when deciding which one to employ in different settings.

Diagnosis and treatment of faecal incontinence: Consensus statement of the Italian Society of Colorectal Surgery and the Italian Association of Hospital Gastroenterologists.

Faecal incontinence is a common and disturbing condition, which leads to impaired quality of life and huge social and economic costs. Although recent studies have identified novel diagnostic modalities and therapeutic options, the best diagnostic and therapeutic approach is not yet completely known and shared among experts in this field. The Italian Society of Colorectal Surgery and the Italian Association of Hospital Gastroenterologists selected a pool of experts to constitute a joint committee on the basis of their experience in treating pelvic floor disorders. The aim was to develop a position paper on the diagnostic and therapeutic aspects of faecal incontinence, to provide practical recommendations for a cost-effective diagnostic work-up and a tailored treatment strategy. The recommendations were defined and graded on the basis of levels of evidence in accordance with the criteria of the Oxford Centre for Evidence-Based Medicine, and were based on currently published scientific evidence. Each statement was drafted through constant communication and evaluation conducted both online and during face-to-face working meetings. A brief recommendation at the end of each paragraph allows clinicians to find concise responses to each diagnostic and therapeutic issue.

Su1360 Different Perception of Constipation Between Patients and Gastroenterologists: Rome III Criteria, Disease Severity and Quality of Life

three groups was made: 40 (74%) constipation, 7 (13%) incontinence and 7 (13%) both constipation and incontinence. Underlying disorders were characterized in neurological problems (24), previous gynaecological (12), anal (7), colorectal (5), urological (4) and other bowel surgery (3). Colon-transit time studies were performed in 29 (54%) and anorectal function in 18 (33%) of patients. Thirtytwo (59%) patients stopped RC after a median time of 6 months, because of ineffectiveness and side-effects. Twenty-two (41%) continued with a median time of 12 months. No significant difference was found between patients who stopped and continued RC concerning age, sex, constipation, incontinence and both constipation and incontinence, underlying disorders, anorectal function, colon-transit time or Beck Depression Score. SF-36 showed that patients still using rectal cleansing have more energy and are less fatigued, other areas showed no difference. Conclusion: Retrograde colon cleansing is an effective alternative in 41% of patients with chronic constipation or fecal incontinence who are not responding to medical therapy and biofeedback exercises. In this study, no significant difference in demography or medical history was found between patients who stopped and continued.