Linear discriminant analysis of symptoms in patients with chronic constipation

Knowles, Charles H.; Eccersley, A. J. P.; Scott, S. M.; Walker, Sharon M.; Reeves, Barnaby C; Lunniss, Peter J.

doi:10.1007/bf02236639

Cited by 216 publications

(75 citation statements)

References 17 publications

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“…We also interviewed each patient using a validated FI score (Cleveland Clinic Incontinence Score, CCIS 0-20)[9], a constipation severity score (Kess score, 0-39)[10], or an NBD score (NBD, 0-47)[11], as appropriate. Because of the heterogeneity of the population (patients with constipation or FI), each patient was classified as having a severe defecation disorder based on the severity score of their main symptom (Kess score > 20 if constipation was the main symptom[10], CCIS > 10 if FI was the main symptom[12], or NBD score > 14 for a neurological disease[11]). The evaluation of the patients prior to the treatment was conducted based on their heterogeneous background pathologies.…”

Section: Methodsmentioning

confidence: 99%

Predictive factors for compliance with transanal irrigation for the treatment of defecation disorders

Bildstein

Melchior

Gourcerol

et al. 2017

WJG

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AIMTo investigate compliance with transanal irrigation (TAI) one year after a training session and to identify predictive factors for compliance.METHODSThe compliance of one hundred eight patients [87 women and 21 men; median age 55 years (range 18-83)] suffering from constipation or fecal incontinence (FI) was retrospectively assessed. The patients were trained in TAI over a four-year period at a single institution. They were classified as adopters if they continued using TAI for at least one year after beginning the treatment or as non-adopters if they stopped. Predictive factors of compliance with TAI were based on pretreatment assessments and training progress. The outcomes of the entire cohort of patients who had been recruited for the TAI treatment were expressed in terms of intention-to-treat.RESULTSForty-six of the 108 (43%) trained patients continued to use TAI one year after their training session. The patients with FI had the best results, with 54.5% remaining compliant with TAI. Only one-third of the patients who complained of slow transit constipation or obstructed defecation syndrome continued TAI. There was an overall discontinuation rate of 57%. The most common reason for discontinuing TAI was the lack of efficacy (41%). However, 36% of the patients who discontinued TAI gave reasons independent of the efficacy of the treatment such as technical problems (catheter expulsion, rectal balloon bursting, instilled water leakage or retention, pain during irrigation, anal bleeding, anal fissure) while 23% said that there were too many constraints. Of the patients who reported discontinuing TAI, the only predictive factor was the progress of the training (OR = 4.9, 1.3-18.9, P = 0.02).CONCLUSIONThe progress of the training session was the only factor that predicted patient compliance with TAI.

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Section: Methodsmentioning

confidence: 99%

Predictive factors for compliance with transanal irrigation for the treatment of defecation disorders

Bildstein

Melchior

Gourcerol

et al. 2017

WJG

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“…A standardized clinical history was taken from all patients, including enquiry about symptoms pertinent to the diagnosis of functional constipation (KESS questionnaire) [27]: duration of symptoms, frequency of bowel movements, loss of call to stool, straining, difficult evacuation, and incomplete evacuation. In addition, the presence of the following was also ascertained: heartburn, dysphagia, regurgitation, nausea, retrosternal and abdominal pain, and bloating.…”

Section: Symptom Assessmentmentioning

confidence: 99%

Clinical Presentation and Patterns of Slow Transit Constipation Do Not Predict Coexistent Upper Gut Dysmotility

et al. 2008

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“…In contrast to previous scores for bowel [21][22][23][24][25] dysfunction it has been developed among SCI patients and covers both constipation and faecal incontinence. It was developed according to well-established and generally accepted principles, 30 and only items with acceptable reproducibility and validity were included.…”

Section: -14mentioning

confidence: 99%

“…20 Such trails require objective endpoints -for instance validated standardized symptom-based scores. Several scores for clinical assessment of constipation 21,22 or faecal [23][24][25] incontinence exist. Though widely used in other patient groups, the applicability of these scores has not been validated in SCI patients.…”

Section: Introductionmentioning

confidence: 99%

Neurogenic bowel dysfunction score

et al. 2005

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Study design: Cross-sectional questionnaire study. Objectives: To develop and validate a symptom-based score for neurogenic bowel dysfunction (NBD): NBD score. Setting: University Hospital of Aarhus, Denmark. Methods: A questionnaire including questions about background parameters (n ¼ 8), faecal incontinence (n ¼ 10), constipation (n ¼ 10), obstructed defecation (n ¼ 8), and impact on quality of life (QOL) (n ¼ 3) was sent to 589 Danish spinal cord injured (SCI) patients. The reproducibility and validity of each item was tested in 20 and 18 patients, respectively. Associations between items and impact on QOL were determined by logistic regression analysis. The NBD score was constructed from items with acceptable reproducibility and validity that were significantly associated with impact on QOL. Based on odds ratios for associations between items and impact on QOL, each item was given a corresponding number of points in the NBD score. Results: A total of 424 SCI patients responded. The following 10 items met the criteria above: frequency of bowel movements (0-6 points), headache, perspiration or discomfort before or during defecation (0-2 points), tablets and drops against constipation (0-2 points each), time used for each defecation (0-7 points), frequency of digital stimulation or evacuation (0-6 points), frequency of faecal incontinence (0-13 points), medication against faecal incontinence (0-4 points), flatus incontinence (0-2 points) and perianal skin problems (0-3 points). Differences in NBD score among patients reporting no, little, some or major impact on QOL were statistically significant (all Po0.001). Conclusion: Based on valid and reproducible questions, we have constructed a score for NBD that is correlated to impact on QOL.

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Linear discriminant analysis of symptoms in patients with chronic constipation

Cited by 216 publications

References 17 publications

Predictive factors for compliance with transanal irrigation for the treatment of defecation disorders

Predictive factors for compliance with transanal irrigation for the treatment of defecation disorders

Clinical Presentation and Patterns of Slow Transit Constipation Do Not Predict Coexistent Upper Gut Dysmotility

Neurogenic bowel dysfunction score

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