RESUMO
OBJECTIVE: To evaluate a multidisciplinary Hong Kong treatment programme for patients with constipation. DESIGN: Pilot study. SETTING: A joint collaboration among the departments of surgery, physiotherapy, and dietetics in a regional hospital in Hong Kong. PATIENTS: Thirty-one constipated patients with normal colonic transit and pelvic floor dyssynergia. INTERVENTION: Multidisciplinary treatment including dietary modification, bowel habit adjustment, and physiotherapy. MAIN OUTCOME MEASURES: Anorectal manometry, fibre intake, subjective improvement, bowel frequency, Bristol score, and straining time and effort. RESULTS: Significant improvement was found in mean fibre intake, straining time and effort, but not in anal manometric results. A total of 78% of patients demonstrated more than 50% improvement in subjective symptoms, whereas 70% of the patients enjoyed objective improvement in pelvic floor dyssynergia documented by electromyography and anal pressure during a push effort. CONCLUSION: The multidisciplinary rehabilitative programme for constipated patients significantly improved symptoms. Electromyography and anal pressure during a push effort are useful tools for objective assessment of the treatment effect.