PWE-172 A National Biofeedback Practitioners Service Evaluation

Etherson, KJ; Horrocks, Emma J; Scott, Mark; Knowles, CH; Yiannakou, Yian

doi:10.1136/gutjnl-2014-307263.432

Cited by 1 publication

(1 citation statement)

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“…In general, a step-wise approach is undertaken, with first-line conservative treatment, such as lifestyle advice and laxatives (primary care), followed by nurse-led bowel retraining programmes, sometimes including focussed biofeedback and psychosocial support (secondary/tertiary care). Although these treatments may improve symptoms in more than half of patients, they are very poorly standardised in the UK and are not universally successful [ 17 ]. Thus, patients with intractable symptoms and impaired QOL may be offered a range of costly, irreversible surgical interventions with unpredictable results [ 18 , 19 ], sometimes resulting in major adverse events (AEs) or a permanent stoma.…”

Section: Introductionmentioning

confidence: 99%

Low-volume versus high-volume initiated trans-anal irrigation therapy in adults with chronic constipation: study protocol for a randomised controlled trial

Emmett

Mason

et al. 2017

Trials

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BackgroundConstipation is common in adults and up to 20% of the population report this symptom. Chronic constipation (CC), usually defined as more than 6 months of symptoms, is less common but results in 0.5 million UK GP consultations per annum. The effect of symptoms on measured quality of life (QOL) is significant, and CC consumes significant health care resources. In the UK, it is estimated that 10% of district nursing time is spent on constipation. Trans-anal irrigation therapy has become a widely used treatment despite a lack of robust efficacy data to support its use. The long-term outcome of treatment is also unclear. A randomised comparison of two different methods of irrigation (high- and low-volume) will provide valuable evidence of superiority of one system over the other, as well as providing efficacy data for the treatment as a whole.MethodsParticipants will be recruited based on predetermined eligibility criteria. Following informed consent, they will be randomised to either high-volume (HV) or low-volume (LV) irrigation and undergo standardised radiological and physiological investigations. Following training, they will commence home irrigation with the allocated device. Data will be collected at 1, 3, 6 and 12 months according to a standardised outcomes framework. The primary outcome is PAC-QOL, measured at 3 months. The study is powered to detect a 10% difference in outcome between systems at 3 months; this means that 300 patients will need to be recruited.DiscussionThis study will be the first randomised comparison of two different methods of trans-anal irrigation. It will also be the largest prospective study of CC patients treated with irrigation. It will provide evidence for the effectiveness of irrigation in the treatment of CC, as well as the comparative effectiveness of the two methods. This will enable more cost-effective and evidence-based use of irrigation. Also, the results will be combined with the other studies in the CapaCiTY programme to generate an evidence-based treatment algorithm for CC in adults.Trial registrationISRCTN, identifier: ISRCTN11093872. Registered on 11 November 2015. Trial not retrospectively registered. Protocol version 3 (22 January 2016).Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-1882-y) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%