Epidemiologic Aspects of Complete Rectal Prolapse

Background and Aims: This study was undertaken to find out the incidence of rectal prolapse. Material and Methods: Ninety-nine patients operated on for rectal prolapse at Jyvaskyla Central Hospital were studied. Patients operated between 1988 and 1998 were studied retrospectively from hospital records using chart review and thirty-five patients operated on between 1999 and 2002 were studied prospectively using our proctologic database. Results: The annual incidence of diagnosed complete rectal prolapse in the district of Central Finland was mean 2.5 (range, 0.79–6.08) per 100 000 population. There were ten men (10 percent) and 89 women (90 percent). Median age of the patients was 69 (range, 21–91) years. Forty-eight percent of the patients had concomitant cardiovascular disease and 15 percent psychiatric illness. Anal incontinence affecting quality of life was seen in 64 percent and constipation in 72 percent of patients. Constipation tended to be more attributed to difficult evacuation (72 percent) than to impaired bowel action (18 percent). Conclusion: The annual incidence of rectal prolapse is 2.5 per 100 000 population. Rectal prolapse is associated with anal incontinence and constipation in majority of patients.

Arrowroot as a treatment for diarrhoea in irritable bowel syndrome patients: a pilot study

Objectives - Arrowroot is an old-fashioned remedy for diarrhoea, but no clinical studies have been done to evaluate its effectiveness. The aim of this pilot study was to assess its efficacy as a treatment for diarrhoea in 11 patients, all of whom had irritable bowel syndrome with diarrhoea as a feature. Methods - The patients were interviewed and a questionnaire completed on entry into the trial. They then took 10 mL arrowroot powder three times a day for one month and discontinued the treatment for the subsequent month. Questionnaires were completed after one month on treatment and at the end of the trial after one month off treatment. Results - Arrowroot reduced diarrhoea and had a long-term effect on constipation. It also eased abdominal pain. Conclusion - Arrowroot is an effective treatment for diarrhoea. Its action could be explained by several theories which relate to an increase in faecal bulk and thus a more efficient bowel action. The number of patients was small, and further studies are needed to substantiate preliminary results.

Constipation: What Does the Patient Mean?

Constipation is a very common complaint but, in the absence of a universally accepted definition, misunderstandings may result between doctor and patient. Two hundred and eighty-seven patients attending this hospital completed a questionnaire which attempted to establish what patients themselves mean by the term. Almost half considered constipation purely in terms of frequency of bowel action, without considering difficulty or pain on defaecation. Women were more likely to have infrequent bowel actions than men, and men more likely to consider such infrequency harmful. A quarter of respondents believed in the benefits of regular purgation, surprisingly with no difference in attitude between age groups, but men were much less likely to have heeded their own advice.