The effects of conservative treatment for constipation on symptom severity and quality of life in community-dwelling adults

PURPOSE: Constipation is a common symptom in the general community that incurs considerable cost and negative effects on quality of life. This article reports the effects of an individualized, multimodal, conservative intervention on symptom severity and quality of life in community-dwelling adults who presented with constipation and specific lower urinary tract symptoms to a community-based continence service. DESIGN: The study was a within-subject, pretest-posttest design that utilized purposeful recruitment. The sample was drawn from a clinical population of patients attending a community-based continence service. METHODS: Twenty-seven community-dwelling adults aged 35 to 83 years (mean age 63.85 years) who presented with lower urinary tract symptoms and constipation received individualized conservative treatment of constipation that comprised advice on dietary supplementation, fluid intake, exercise, position to defecate, the gastrocolic reflex, and over-the-counter laxatives. Participants completed the Patient Assessment of Constipation Symptom Questionnaire (PAC-SYM) and the Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) prior to the intervention and 8 to 12 weeks later. RESULTS: Wilcoxon signed ranks test results indicated that the intervention significantly reduced the severity of overall constipation symptoms measured by the PAC-SYM (t= 75.5, P< .01). In particular, there were significant improvements for the abdominal symptoms and stool symptoms subscales. Participants also reported statistically significant improvements in their overall quality of life as measured by the PAC-QOL (t = 48.5, P< .01). There were significant improvements in relation to psychosocial discomfort, worries and concerns, and satisfaction as measured by the PAC-QOL. While no participants felt in control of their situation “all of the time” prior to treatment, 26.9% of participants reported feeling in control of their situation “all of the time” following treatment. CONCLUSION: The severity of constipation symptoms are reduced following a multimodal, individually tailored conservative intervention. This improvement in symptoms corresponds with quality-of-life improvements.