Abstract
Non-drug therapies for the management of chronic constipation in adults: the CapaCiTY research programme including three RCTs
Highlights
Chronic constipation affects 1–2% of adults and significantly affects quality of life
CapaCiTY trial 2: at 3 months, there was a modest reduction in the Patient Assessment of Constipation Quality of Life score, from a mean of 2.4 to 2.2 points, in the low-volume transanal irrigation group compared with a larger mean reduction of 0.6 points in the high-volume transanal irrigation group
CapaCiTY trial 3: laparoscopic ventral mesh rectopexy resulted in a substantial short-term mean reduction in the Patient Assessment of Constipation Quality of Life score (–1.09 points, 95% confidence interval –1.76 to –0.41 points) and beneficial changes in all other outcomes; significant increases in cost (£5012, 95% confidence interval £4446 to £5322) resulted in only modest increases in quality of life (0.043 qualityadjusted life-years, 95% confidence interval –0.005 to 0.093 quality-adjusted life-years), with an incremental cost-effectiveness ratio of £115,512 per quality-adjusted life-year
Summary
Chronic constipation affects 1–2% of adults and significantly affects quality of life. Some people (1–2% of the population) suffer symptoms that are chronic, disabling and refractory to basic treatments. Such people, who are most commonly female, are usually referred to secondary care, with many progressing to tertiary specialist investigations. Management of chronic constipation (CC) is generally stepwise, with first-line conservative treatment, such as lifestyle advice and laxatives (primary care), followed by nurse-led bowel retraining programmes, sometimes including focused biofeedback (secondary/tertiary care). Such treatments are poorly standardised in the UK and far from universally successful. Patients with intractable symptoms and impaired quality of life (QoL) may subsequently be offered irreversible surgical interventions that have unpredictable results
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
