Postoperative quality of life in patients with chronic slow-transit constipation according to the PAC-QOL scale

Abstract

Chronic constipation is a common heterogeneous condition affecting all population groups, with its prevalence increasing with age. The prevalence of chronic constipation varies from 3% to 27% in the general population. Worldwide, the average prevalence of constipation is 16%, with a prevalence of 33.5% in adults aged 60—110 years. Information about the quality of life in patients with chronic slow transit constipation (CSTC) in Ukraine is very limited.

Objective — to assess the quality of life in patients with chronic slow transit constipation using the Patient Assessment of Constipation Quality of Life Questionnaire (PAC‑QOL) scale after surgical treatment.

Materials and methods. 107 patients with CSTC were examined and treated at the surgical department of the Saint Michael Clinical Hospital in the period 2011—2023.

Results. Significant improvements in all PAC‑QOL scale indicators were observed one year after surgery. The physical component score decreased from 2.78±0.52 to 1.01±0.32; p <0.01; the psychological component score decreased from 1.90±0.48 to 0.83±0.41; p <0.01; the anxiety component score decreased from 1.99±0.31 to 0.72±0.34; p <0.01; and the satisfaction component score decreased from 2.35±0.60 to 0.84±0.47. The total PAC‑QOL score decreased from 2.14±0.23 to 0.82±0.35; p <0.01. A reduction in the PAC‑QOL score was observed one year after surgery, with an average improvement of 61.5±14.9% (ranging from 6.2% to 77.2%). The highest percentage of improvement was registered in the «Satisfaction» component, with an increase of 81.2±15.0% (ranging from 33.3% to 88.2%), while the lowest improvement was in the psychological component, 56.7±16.1% (ranging from 0.0% to 78.6%). For the physical component, the percentage of improvement was 63.14±11.23% (ranging from 30.0% to 81.82%), and for the worries component, it was 64.0±15.75% (ranging from 0.0% to 77.2%).

Conclusions. According to the PAC‑QOL scale, surgical treatment involving colectomy improves quality of life significantly in the long‑term postoperative period in patients with CSTC who are resistant to conservative therapy. Overall PAC‑QOL scores improved by 61.51%, as did all components: physical (63.14%), psychological (56.73%), anxiety (64.0%), and satisfaction (81.2%).