Volume 51, Number 11, 1686-1691, DOI: 10.1007/s10350-008-9392-3

Successful Physical Therapy for Constipation Related to Puborectalis Dyssynergia Improves Symptom Severity and Quality of Life

Christina Lewicky-Gaupp, Daniel M. Morgan, William D. Chey, Philip Muellerleile and Dee E. Fenner

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Abstract

Purpose  

This study evaluated symptom severity and quality of life in patients with puborectalis dyssynergia before and after physical therapy.

Methods  

Twenty-two patients with puborectalis dyssynergia were prospectively enrolled into a multidisciplinary program for the treatment of pelvic floor and bowel disorders in this case series. All patients had functional constipation and evidence of puborectalis dyssynergia. Physical therapy and behavioral counseling were offered to all. Patients completed the Patient Health Questionnaire, the Patient-Assessment of Constipation Symptom Questionnaire, and the Patient-Assessment of Constipation Quality of Life Questionnaire.

Results  

Sixteen patients successfully completed the program. Symptom severity decreased after physical therapy (2.1 ± 0.7 vs. 1.3 ± 0.9, P = 0.007). Quality of life also improved significantly (2.6 ± 0.8 vs. 1.5 ± 1.0, P = 0.007). Patients reported less physical discomfort, fewer worries/concerns, and indicated satisfaction with treatment. The difference in symptom severity was highly correlated with improvement in quality of life (r = 0.7, P = .005).

Conclusions  

Successful physical therapy for patients with puborectalis dyssynergia is associated with improvements in constipation-related symptoms and in quality of life.

Key words  Constipation - Physical therapy - Quality of life

Presented at the American Urogynecologic Society Meeting, West Hollywood, Florida, September 27–29, 2007.

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