Evaluation of bowel habits in benign anorectal diseases

Abstract

Background: Evaluation of bowel habit is useful indicator of functional gastrointestinal disorders. Assessment of bowel habit is retrospective in nature and it is best done by questionnaire technique. Aims and objectives of the study was to look for the bowel habit in common benign anorectal disorder.Methods: One-hundred patients with benign anorectal diseases who presented in the Surgery out patient’s department (SOPD) at AIIMS Rishikesh, India from January 2014 to December 2016 were included in the study. Inclusion criteria were all the cases of benign anorectal disorder attended in the Surgery OPD and exclusion criteria were cases with malignant anorectal disease. Patients were assessed on 7 questionnaires as bowel movements (number/day), consistency, feeling of incomplete defecation and/or difficult evacuation, straining at defecation, bleeding per rectum, pain during defecation, use of laxatives. These questionnaires were given to all these patients and asked to prepare a four-week daily diary.Results: One hundred patients with benign anorectal diseases enrolled in the study. All the patients came in the follow up with four-week daily diary. Author have encountered mainly haemorrhoid, Fissure in Ano and fistula in Ano at the General Surgery OPD. Most common disease was haemorrhoid (51%) and least common was fistula in Ano (3%). Most common bowel habits in haemorrhoid was passage of hard stool (51%) whereas in fissure in Ano it was straining at stool and in fistula in Ano it was passage of hard stool (100%), straining at defecation (100%) followed by bleeding and pain during defecation (67% each). Frequency of bowel movement was one per day and consistency was hard in majority of male and female patients. Laxative was used by 29% patients mainly for hard stool, incomplete evacuation and straining at stool.Conclusions: Bowel habit can be best investigated by questionnaire technique. Stool consistency is better guide of colonic transit time. Hard stool is the major cause of majority of the benign anorectal disorder.