, Volume 9, Issue 2, pp 133-137
Date: 08 Jul 2005

Quality of life after colectomy for colonic inertia

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Abstract

Background

Total abdominal colectomy (TAC) with ileorectal anastomosis represents the procedure of choice in patients with colonic inertia and relieves constipation in the majority of patients. The aim of this study was to assess postoperative long–term health related quality of life in these patients in relation to their functional outcome.

Methods

A consecutive series of patients with isolated colonic inertia who underwent TAC between 1993 and 1999 was identified from a clinical database and investigated in a cohort outcome study. Functional variables including the weekly number of bowel movements (BM), abdominal pain, bloating and distension, fecal incontinence, and the use of medications for BM assistance were assessed preoperatively and postoperatively. Main outcome measure was healthrelated quality of life assessed at follow–up using the SF–36 Health Survey.

Results

A total of 17 women with a mean age of 47.8 years (SD=14.3 years) were assessed and were followed postoperatively for 58.3±27.3 months. Preoperatively, all patients were constipated with less than one bowel movement per week, used laxatives, and experienced abdominal pain, bloating and distension. Postoperatively, all patients had some relief of constipation symptoms, with 3.7±2.8 bowel movements/day; 41% complained of abdominal pain, 65% of bloating, 29% required BM assistance, and 47% had occasional incontinence to gas or liquid stool. The SF–36 scores were significantly lower than those of the general population (p<0.005). In univariate regression analysis, postoperative abdominal pain was predictive for lower scores in general health and vitality and the need for BM assistance for lower scores in physical role functioning, social functioning, and emotional role limitations.

Conclusions

After TAC, quality of life is significantly reduced in patients with colonic inertia despite successful relief of symptoms of constipation. Postoperative pain and functional impairment are predictive of lower quality of life scores.

Note This study was reported in part as an oral presentation at the Annual Meeting of the American Society of Colon and Rectal Surgeons, 2–8 June 2002, Chicago, USA, and as a poster at the Annual Meeting of the Association of Coloproctology of Great Britain and Ireland, Manchester, United Kingdom, 2–5 July 2002.