Author
- Katherine Clark1
- Calvary Mater Newcastle1
2015
Excerpt
Though unproven, palliative care guidelines recommend plain abdominal x-rays to assess constipation. This work aimed to investigate the degree of agreement between individual clinician’s numerical faecal loading (FL) scores derived from plain x-rays and whether FL scores correlated with:
1). Patients’ self-reported constipation symptoms;
2). Objectively measured Colon Transit Times (CTT). Consenting participants underwent
CTT testing with an abnormal test indicative of an objective diagnosis of constipation.
This test requires participants to have an x-ray 5 days after administration of a capsule containing 24 radio-opaque markers with retention of ≥ 5 markers abnormal. These x-rays were then used to assign clinician’s FL scores. Participant’s symptoms were recorded with the Patient Assessment of Constipation Symptom (PAC-SYM) tool. Descriptive statistics detailed participant’s characteristics with other analyses summarizing degrees of agreement between clinician’s FL scores and whether FL scores predicted CTT or correlated with PAC-SYM. Data was available from 30 participants with the results highlighting poor agreement between FL scores (14/18 pairings disagreeing at the 0.05 level). Only one reported a difference in the FL scores of the slow (n=11) and normal transit groups (n=19). No correlations were observed between PAC-SYM scores and FL. This work failed to support the routine use of plain abdominal radiographs in the assessment of constipation in palliative care.
1). Patients’ self-reported constipation symptoms;
2). Objectively measured Colon Transit Times (CTT). Consenting participants underwent
CTT testing with an abnormal test indicative of an objective diagnosis of constipation.
This test requires participants to have an x-ray 5 days after administration of a capsule containing 24 radio-opaque markers with retention of ≥ 5 markers abnormal. These x-rays were then used to assign clinician’s FL scores. Participant’s symptoms were recorded with the Patient Assessment of Constipation Symptom (PAC-SYM) tool. Descriptive statistics detailed participant’s characteristics with other analyses summarizing degrees of agreement between clinician’s FL scores and whether FL scores predicted CTT or correlated with PAC-SYM. Data was available from 30 participants with the results highlighting poor agreement between FL scores (14/18 pairings disagreeing at the 0.05 level). Only one reported a difference in the FL scores of the slow (n=11) and normal transit groups (n=19). No correlations were observed between PAC-SYM scores and FL. This work failed to support the routine use of plain abdominal radiographs in the assessment of constipation in palliative care.