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View the full abstracts from your information submitted
between December 2002 - March 2003. These results submitted
in abstract form and presented at the PAX
Congres in Amsterdam in April 2003.
Bowel Obstruction
Abstract
THE PATIENT WITH SEVERE ARD (ADHESION RELATED DISORDER);
PATTERN OF BOWEL OBSTRUCTION, BOWEL DYSFUNCTION, NUTRITIONAL,
SOCIAL AND PHYSICAN ISSUES
Background: Previous studies have documented the incidence
and cost of adhesions in the overall population. However,
to date no studies have documented the profile of patients
suffering with Adhesion Related Disorder (ARD). Method:
An internet-based survey was conducted among patients
who visit the web site www.adhesions.org, or who have
subscribed to its mailing list. Patients reporting a
diagnosis of adhesions were asked to complete a survey
regarding the numbers of years since diagnosis, the
frequency of bowel obstruction, as well as GI disturbances,
nutritional status, their ability to work and receive
disability benefits and their support structure. Results:
190 patients (20 male, 170 female) completed the survey
with the time since diagnosis of 7.7 + 0.5 years. 71%
of patients reported having had either a full or partial
obstruction, with 9.8 + 0.92 obstructions and mean (geometric)
time between obstructions of 0.93 years. 83% of respondents
report suffering from chronic pain for which 77% take
medication. 63% of these report that the medication
worsens their bowel symptoms. 76% of patients report
chronic GI disturbances, including 28% with a malabsorption
problem. 48% of patients report that they are unable
to work due to the problems caused by adhesions, and
46% of these report being unable to obtain disability
benefits. 32% of patients reported having received physical/massage
therapy and 33% of these reported receiving a benefit.
24% of patients reported that their family relationships
had not suffered and that their friends and family were
supportive of their condition. 28% of patients reported
that their physician was able to help them somewhat,
with another 31% reporting that the physician acknowledged
the problem but was unable to provide any help. Only
10% of patients reported that their physician did not
acknowledge the problem and was unwilling to help. Conclusion:
Despite shortcomings inherent in a survey of this kind,
a description of the severe ARD patient has been provided
for the first time. These data will be useful in devising
strategies for the medical, surgical, nutritional, social
and financial support of the ARD patient.
Informed Consent Abstract
ADHESIONS AND INFORMED CONSENT: PATIENT AWARENESS
OF ADHESIONS PRIOR TO SURGERY
Background: Adhesions are a significant and common
complication of surgery, and yet it appears that most
patients have never heard of the term. This study set
out to ascertain the information provided to patients
prior to surgery regarding adhesions. Method: An internet-based
survey was conducted among patients who visit the web
site of the International Adhesions Society (www.adhesions.org),
and/or who have subscribed to its mailing list. Patients
who had abdominal or pelvic surgeries were asked to
complete a questionnaire regarding the information given
to them, if any, prior to surgery regarding adhesions
and adhesion barriers. Results were stratified according
to whether the procedure was known beforehand to include
adhesiolysis. Results: 222 (20 male, 202 female) patients
completed the survey adequately concerning 479 procedures.
Overall patients reported being informed about adhesions
prior to surgery in 25% (119/479) of the procedures
they underwent. In only 50 (10.4%) of these were adhesions
mentioned as part of the informed consent and in another
69 (14.4%) adhesions were discussed but not part of
the consent. Patients reported being given information
about adhesions in 54% of procedures involving adhesiolysis
(n=161) and in 10% of procedures not involving adhesiolysis.
Patients reported being provided with information about
adhesion barriers, in 46% and 6% of procedures involving
and not involving adhesiolysis respectively. Conclusion:
Given the prevalence of adhesions, the frequency of
information provided to patients about adhesions and
adhesion barriers appeared remarkably low. Information
was more forthcoming in adhesiolysis procedures. Despite
a number of obvious caveats involved in interpreting
a study of this kind, it suggests the pre-operative
consultation and consent procedures may offer the ideal
opportunity to educate patients about adhesions. This
can only benefit both patients and doctors.
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