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Loose stools lead to fecal incontinence among gynecological cancer survivors.
Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden / Clinical Cancer Epidemiology, Sahlgrenska Academy, Gothenburg, Sweden.
Department of Gynecological Oncology, Sahlgrenska University Hospital, Gothenburg, Swede.
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2011 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 50, no 2, 233-242 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Many patients treated with radiotherapy to the pelvic region report a change in bowel habits. Loose stools, urgency and fecal incontinence may have a significant impact on daily life and social functioning.

MATERIAL AND METHODS: We attempted to follow up 789 women, treated with pelvic radiotherapy for a gynecological cancer during 1991 to 2003 at two departments of gynecological oncology in Sweden. A control group of 478 women from the Swedish Population Registry was also included. As a preparatory study, we made in-depth interviews with 26 women previously treated for gynecological cancer. Based on their narratives, we constructed a study-specific questionnaire including 351 questions and validated it face-to-face. The questionnaire covered questions of physical symptoms originating in the pelvis, demographics, psychological and quality of life factors. In relation to bowel symptoms, 60 questions were asked.

RESULTS: Six-hundred and sixteen (78%) gynecological cancer survivors and 344 (72%) control women participated. Two-hundred and twenty-six (37%) cancer survivors reported loose stools at least once a week. Eighty-three percent of the survivors with loose stools every day reported defecation urgency with fecal leakage, compared to 20% of cancer survivors without loose stools. Cancer survivors with loose stools at least once a week were 7.7 times more likely to suffer from defecation urgency with fecal leakage (95% CI 4.4-13.3) compared to those who had loose stools once a month or less. In order to avoid loose stools affected survivors with loose stools often skipped meals (13%), made an active choice of food (47%) and preferentially used prescribed medication (36%).

DISCUSSION: There is a relation between loose stools and defecation urgency with fecal leakage among long-term gynecological cancer survivors treated with pelvic radiotherapy. Targeting loose stools can possibly help survivors to decrease frequency of fecal leakage.

Place, publisher, year, edition, pages
Taylor & Francis, 2011. Vol. 50, no 2, 233-242 p.
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:liu:diva-113977DOI: 10.3109/0284186X.2010.535013ISI: 000286830500009PubMedID: 21231784Scopus ID: 2-s2.0-78651469301OAI: oai:DiVA.org:liu-113977DiVA: diva2:786059
Available from: 2015-02-04 Created: 2015-02-04 Last updated: 2017-04-28Bibliographically approved

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Åvall-Lundqvist, Elisabeth

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