Clinical features and quality of life of patients with idiopathic megacolon

PATIENTS AND METHODS: the retrospective study of clinical features and diagnostic tests results included 81 patients with idiopathic megacolon/megarectum (2004–2022). The diagnosis of megacolon/megarectum was confirmed with a barium enema, Hirschsprung’s disease was excluded based on anorectal manometry and (if needed) rectal Swenson biopsy. The QoL was assessed by IBSQOL questionnaire; clinical symptoms were assessed with a point scale.

RESULTS: the quality of life in patients with idiopathic megacolon has most affected energy (emotional and physical) and physical role (work/main activity). In univariate analysis the significant correlation was revealed between QoL and age, sex, rate of defecation without assistance, rate of integral parameters “abdominal discomfort” and “defecation difficulties”, duration of anamnesis, Wexner constipation scale rate and gut transit time (p < 0,05). In the same time, the presence or absence of constipation or anal incontinence (leakage), colon and rectum sizes (based on barium enema), parameters of defecografy and rectal compliance test have not correlated with a QoL. No significant difference of QoL in patients added to conservative treatment and operated after. Due to multivariate analysis (multiple linear regression) the age and rate of “abdominal discomfort” and “defecation difficulties” were only independent factors affected quality of life.

CONCLUSION: in terms of quality of life, idiopathic megacolon has the greatest impact on general tone and ability to perform basic professional activities. Independent factors that statistically significantly affect the assessment of quality of life are the age of patients and the severity of symptoms of abdominal discomfort and defecation disorders.

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