RESUMO
BACKGROUND AND STUDY AIMS: Addition of a reminder program to conventional indications improves colonoscopy. The aim of this study was to evaluate the effectiveness of a short telephone call reminder (STCR) on a patient's first colonoscopy. PATIENTS AND METHODS: One day before colonoscopy, we made a STCR of <â10 minutes to 141 randomly selected patients of 258 recruited. The STCRs informed patients about the procedure date, indications for taking laxatives, and dietetic requirements. Questions were clarified only when patients asked directly. We evaluated bowel preparation, quality indicators, and patient satisfaction. Data were expressed as meanâ±âSD and percentages. Statistical differences were evaluated by Student's t and Chi squared tests; alphaâ=â0.05. All authors had access to the study data and reviewed and approved the final manuscript. RESULTS: The STCR group had better bowel preparation which was demonstrated by higher completion frequency (97.16â% vs. 82.05â%), in less time (4.52â±â3.06 vs. 5.38â±â3.03 hours) intake of laxative, and higher Boston's scale (7.66â±â2.42 vs. 5.2â±â1.65). Quality indicators of colonoscopy were better in patients that received a STCR [cecal intubation rate: 100.00â% vs. 87.18â%; polyp detection: 42.55â% vs. 9.4â%; and cecal arrival time (min): 12.09â±â3.62 vs. 15.09â±â5.02]. STCR patients were more satisfied (97.87â% vs. 55.56â%) and would repeat colonoscopy (21.99â% vs. 11.11â%). CONCLUSIONS: A simple additional step such as a STCR improves quality of bowel preparation, quality indicators, and satisfaction of patients undergoing their first colonoscopy. Clinical trial registry in Mexico City General Hospital: DI/16/107/3/108.
RESUMO
[This corrects the article DOI: 10.1055/s-0043-117954.].
RESUMO
AIM: To investigate the anal sphincter and rectal factors that may be involved in fecal incontinence that develops following fistulotomy (FIAF). METHODS: Eleven patients with FIAF were compared with 11 patients with idiopathic fecal incontinence and with 11 asymptomatic healthy subjects (HS). All of the study participants underwent anorectal manometry and a barostat study (rectal sensitivity, tone, compliance and capacity). The mean time since surgery was 28 ± 26 mo. The postoperative continence score was 14 ± 2.5 (95%CI: 12.4-15.5, St Mark's fecal incontinence grading system). RESULTS: Compared with the HS, the FIAF patients showed increased rectal tone (42.63 ± 27.69 vs 103.5 ± 51.13, P = 0.002) and less rectal compliance (4.95 ± 3.43 vs 11.77 ± 6.9, P = 0.009). No significant differences were found between the FIAF patients and the HS with respect to the rectal capacity; thresholds for the non-noxious stimuli of first sensation, gas sensation and urge-to-defecate sensation or the noxious stimulus of pain; anal resting pressure or squeeze pressure; or the frequency or percentage of relaxation of the rectoanal inhibitory reflex. No significant differences were found between the FIAF patients and the patients with idiopathic fecal incontinence. CONCLUSION: In patients with FIAF, normal motor anal sphincter function and rectal sensitivity are preserved, but rectal tone and compliance are impaired. The results suggest that FIAF is not due to alterations in rectal sensitivity and that the rectum is more involved than the anal sphincters in the genesis of FIAF.