Linear discriminant analysis of symptoms in patients with chronic constipation: Validation of a new scoring system (KESS)

Knowles, Charles H.; Eccersley, James; Scott, Mark; Walker, Sharon M.; Reeves, Barnaby C; Lunniss, Peter J.

doi:10.1016/s0016-5085(00)80553-3

Cited by 72 publications

(124 citation statements)

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“…Eventually, 103 patients with clinically significant rectocele were selected to analyze the efficacy of clinical treatment, clinical treatment combined with biofeedback therapy, and surgical repair. Although a specific scoring system for obstructed defecation syndrome has been proposed (2,19) , at our institution, Wexner's constipation score has been widely used in investigations involving functional constipation symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Proper treatment requires the identification of all associated dysfunctions and the quantification of symptoms (most often excessive straining, feeling of incomplete evacuation, difficult evacuation, infrequent evacuation and the need for digitally assisted evacuation) by means of a scoring system (1,2,19) . Obstructed defecation syndrome is associated with anatomic changes (rectocele, intussusception, mucosal prolapse and perineal descent) and∕or functional changes (non-relaxation or paradoxical contraction/ anismus) a complete clinical investigation is required, if possible with techniques capable of identifying all dysfunctions.…”

Section: Introductionmentioning

confidence: 99%

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Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Murad-Regadas

Regadas

Rodrigues

et al. 2012

Arq. Gastroenterol.

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-Context -Management of patients with obstructed defecation syndrome is still controversial. Objective -To analyze the efficacy of clinical, clinical treatment followed by biofeedback, and surgical treatment in patients with obstructed defecation, rectocele and multiple dysfunctions evaluated with echodefecography. Methods -The study included 103 females aged 26-84 years with obstructed defecation, grade-II/III rectocele and multiple dysfunctions on echodefecography. Patients were distributed into three treatment groups and constipation scores were assigned. Group I: 34 (33%) patients with significant improvement of symptoms through clinical management only. Group II: 14 (14%) with improvement through clinical treatment plus biofeedback. Group III: 55 (53%) referred to surgery due to treatment failure. Results -Group I: 20 (59%) patients had grade-II rectocele, 14 (41%) grade-III. Obstructed defecation syndrome was associated with intussusception (41%), mucosal prolapse (41%), anismus (29%), enterocele (9%) or 2 dysfunctions (23%). The average constipation score decreased significantly from 11 to 5. Group II: 11 (79%) grade-II rectocele, 3 (21%) grade-III, associa ted with intussusception (7%), mucosal prolapse (43%), anismus (71%) or 2 dysfunctions (29%). There was significant decrease in constipation score from 13 to 6. Group III: 8 (15%) grade-II rectocele, 47 (85%) grade-III, associated with intussusception (42%), mucosal prolapse (40%) or 2 dysfunctions (32%). The constipation score remained unchanged despite clinical treatment and biofeedback. Twenty-three underwent surgery had a significantly decrease in constipation score from 12 to 4. The remaining 32 (31%) patients which 22 refused surgery, 6 had low anal pressure and 4 had slow transit. Conclusions -Approximately 50% of patients with obstructed defecation, rectocele and multiple dysfunctions presented a satisfactory response to clinical treatment and/or biofeedback. Surgical repair was mainly required in patients with grade-III rectocele whose constipation scores remained high despite all efforts. HEADINGS -Rectocele. Constipation. Pelvic floor. Imaging, three-dimensional.None disclosure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Murad-Regadas

Regadas

Rodrigues

et al. 2012

Arq. Gastroenterol.

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“…Recently, constipation has been I�tRODUCtIO� External rectal prolapse is ap rotrusion beyond the anal canal of all layers of the rectal �all. It may protrude permanently or becomem anifest upon increased abdominalp ressure, most frequently by moreprecisely classified into ten different and graded symptoms of theK ESS (Kno�les-Eccersley-ScottSymptom questionnaire) score (11). Using this score, �e havedemonstrated that patients �ith internalrectal intussusception improves constipation, including incomplete evacution of stool,a fter resection rectopexy �ith suture (12).…”

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confidence: 99%

Resection Rectopexy for External Rectal Prolapse Reduces Constipation and Anal Incontinence

et al. 2007

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Backgroundand Aims: the main aim was to examineconstipation and anal incontinence in patients before and after resection for external rectal prolapse.Material andMethods: twenty patients hadligamentpreservingsuturerectopexy and sigmoid resection (resection rectopexy) for external rectal prolapse by laparoscopic (n =15) or open (n =5)technique during 2001-2005. they were prospectively evaluated for constipationa nd anal incontinence using validated incontinence and Kess-constipation scores.Resultsand Conclusions: Constipation score was significantly reduced from mean 7.7 (5.4-9.9) to 4.5 (2.5-6.4) after median 4months (1-19) and to 4.3 (2.2-6.3) after median 17 months (4-51).S ix and four patients were constipated preoperatively and 17 months postoperatively,respectively.the four symptoms feeling incomplete evacuation of stool, minutes in lavatory per attempt, use of enemas/digitation and painful evacuation effort were significantly reduced, whilsts tool consistency increased. Fourteen patiens (70%) had anal incontinence. Corresponding and significant reductionintheir scores were from mean 12.5 (9.4-15.5) to 5.1 (2.1-8.1) and to 3.6 (1.3-5.9). incontinence was improved in 13 and unaltered in one patient(s). twop atients with worse outcome had increased stool consistency and constipation scores. Resection rectopexy for rectal prolapse reduced anal incontinenceand constipation.

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“…Informed written consent was obtained from all patients. Patients were asked to fill a standardized questionnaire for constipation severity (KESS) and quality of life (GIQLI) scores before the procedure [20][21][22].…”

Section: Methodsmentioning

confidence: 99%

Percutaneous endoscopic caecostomy for severe constipation in adults: feasibility, durability, functional and quality of life results at 1 year follow-up

et al. 2014

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Linear discriminant analysis of symptoms in patients with chronic constipation: Validation of a new scoring system (KESS)

Cited by 72 publications

References 0 publications

Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Resection Rectopexy for External Rectal Prolapse Reduces Constipation and Anal Incontinence

Percutaneous endoscopic caecostomy for severe constipation in adults: feasibility, durability, functional and quality of life results at 1 year follow-up

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