Chronic constipation : Is the work-up worth the cost ?
Meeting of The American Society of Colon and Rectal Surgeons. Seattle, Washington (USA), 1996/06/09.
Chronic constipation can be a disabling condition that may require colectomy.
Evaluation has been included as a way to select appropriate patients for colectomy and may also be extensive, unrevealing, and costly.
This study was undertaken to determine the cost and use of evaluation and outcome of patients with chronic constipation.
Patients with chronic constipation were reviewed for severity of symptoms, diagnostic studies performed, treatment, and outcome.
The costs of the diagnostic studies were determined at our institution.
Fifty-one patients were identified with chronic constipation ; all were referred by other physicians.
Mean age was 54 (range, 21-81) years ; 59 percent were females.
Average number of bowel movements per week was two (range, 0-4), and average duration of symptoms was five years (range, 1-20).
Forty-three of 51 (84 percent) colonoscopies or barium enemas were normal.
Thirteen of 51 (25 percent) colonic transit studies were abnormal.
Twenty-six of 51 (51 percent) patients underwent defecography ; 12 (46 percent) were abnormal.
Thirty-seven of 51 (74 percent) underwent anal manometry ; 5 (14 percent) were abnormal.
One of 18 (6 percent) rectal biopsies demonstrated Hirschsprung's disease.
Overall, 8 patients (16 percent) were diagnosed with outlet obstruction, 12 (24 percent) with colonic inertia, and 31 (61 percent) with constipation of unclear etiology. (...)
Mots-clés Pascal : Constipation, Chronique, Diagnostic, Exploration, Transit digestif, Manométrie, Coût, Intérêt, Analyse avantage coût, Homme, Appareil digestif pathologie, Intestin pathologie, Economie santé
Mots-clés Pascal anglais : Constipation, Chronic, Diagnosis, Exploration, Digestive transit, Manometry, Costs, Interest, Cost benefit analysis, Human, Digestive diseases, Intestinal disease, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0230156
Code Inist : 002B13B03. Création : 11/06/1997.