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Successful Physical Therapy for Constipation Related to Puborectalis Dyssynergia Improves Symptom Severity and Quality of Life

  • Original Contribution
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Diseases of the Colon & Rectum

Abstract

Purpose

This study evaluated symptom severity and quality of life in patients with puborectalis dyssynergia before and after physical therapy.

Methods

Twenty-two patients with puborectalis dyssynergia were prospectively enrolled into a multidisciplinary program for the treatment of pelvic floor and bowel disorders in this case series. All patients had functional constipation and evidence of puborectalis dyssynergia. Physical therapy and behavioral counseling were offered to all. Patients completed the Patient Health Questionnaire, the Patient-Assessment of Constipation Symptom Questionnaire, and the Patient-Assessment of Constipation Quality of Life Questionnaire.

Results

Sixteen patients successfully completed the program. Symptom severity decreased after physical therapy (2.1 ± 0.7 vs. 1.3 ± 0.9, P = 0.007). Quality of life also improved significantly (2.6 ± 0.8 vs. 1.5 ± 1.0, P = 0.007). Patients reported less physical discomfort, fewer worries/concerns, and indicated satisfaction with treatment. The difference in symptom severity was highly correlated with improvement in quality of life (r = 0.7, P = .005).

Conclusions

Successful physical therapy for patients with puborectalis dyssynergia is associated with improvements in constipation-related symptoms and in quality of life.

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Acknowledgments

The authors thank Anne McLeod, R.N., B.S.N., and Raylene Marcum, R.N. of the Michigan Bowel Control Program, and the Department of Physical Therapy at the University of Michigan Hospital for their participation and support of this project.

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Authors and Affiliations

  1. Division of Gynecology, Michigan Bowel Control Program, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan, USA

    Christina Lewicky-Gaupp M.D., Daniel M. Morgan M.D., Philip Muellerleile B.S. & Dee E. Fenner M.D.

  2. Division of Gastroenterology, Michigan Bowel Control Program, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA

    William D. Chey M.D.

  3. Women’s Hospital, L4100, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-0276, USA

    Christina Lewicky-Gaupp M.D.

Authors
  1. Christina Lewicky-Gaupp M.D.
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  2. Daniel M. Morgan M.D.
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  3. William D. Chey M.D.
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  4. Philip Muellerleile B.S.
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  5. Dee E. Fenner M.D.
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Correspondence to Christina Lewicky-Gaupp M.D..

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Lewicky-Gaupp, C., Morgan, D.M., Chey, W.D. et al. Successful Physical Therapy for Constipation Related to Puborectalis Dyssynergia Improves Symptom Severity and Quality of Life. Dis Colon Rectum 51, 1686–1691 (2008). https://doi.org/10.1007/s10350-008-9392-3

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  • DOI: https://doi.org/10.1007/s10350-008-9392-3

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