Sa1385 Hydroxy-α-Sanshool Enhances Colonic Rhythmic Propulsive Motor Activity and Ameliorates Postoperative Delayed Defecation in Rat

Background: Chronic constipation is one of the most common gastrointestinal disorders throughout the world.Many patients with severe constipation are resistant to pharmacological treatments and operations.Objective: To evaluate the efficacy of multidisciplinary approach in patients with severe constipation through a long-term follow-up.Methods: Three hundred and ninety-one patients diagnosed with constipation according to Rome III criteria accepted multidisciplinary treatment or standard medical treatment between March, 2010 and April, 2013.The multidisciplinary constipation clinic in a tertiary care setting with dietary modification, exercise therapy, bowel habit adjustment, abdominal breathing exercise and drug therapy.Constipation symptoms, quality of life (SF-36), anxiety and depression were assessed before enrollment and after therapy.Results: Two hundred and eighty-eight subjects were treated by multidisciplinary treatment and 235 subjects complete the follow-up.The mean age of patients was 50.6 ± 16.0 years.74.7% of patients were female.The mean duration of follow-up was 2.3 years.The weekly bowel movements was higher in the multidisciplinary group than the medication group(5 (3, 7) vs. 3.0 (2, 4), P<0.001).There was significant improvement on Bristol score (3 (3, 3) vs. 3 (2, 3), P=0.032), straining effort (4 (3, 5) vs. 8 (6.75, 9.0), P<0.001) and straining time (10 (7, 13) vs. 15 (10, 17), P=0.002).Significant improvement was also noted with multidisciplinary treatment on straining at defecations(31.1% vs. 59.8%,P=0.005), Hard stools(24.3%vs. 52.4%,P=0.005) and sensation of anorectal obstruction(8.5% vs. 35.4%,P<0.001).The proportion of patients with laxative/ enema use was lower in multidisciplinary group than the medication group(27.6%vs. 63.4%,P<0.001).Meanwhile, the score of quality of life (N=13) were significant higher compared with baseline.Multidisciplinary treatment also reduced score of anxiety (33.07±6.31 vs. 35.13±4.05,P=0.032)and depression(37.59±9.45 vs. 44.07±6.77,P<0.001)(N=44).Conclusion: This study suggest that multidisciplinary approach improves long-term constipation symptoms.Improvement in quality of life was also seen in patients attending the multidisciplinary constipation clinic.