Completed Research Project

Preventing and managing faecal incontinence after sphincter-saving surgery for colorectal cancer:  A two phase study to determine post-operative bowel problems and self care practices and to evaluate a newly developed community education programme

Investigators: Nikoletti S, Young J, Levitt M, King M, Chidlow C & Hollingsworth S.

Funding: National Continence Management Strategy: Faecal Continence Grants Program ($99,223).  Additional resource funding National Continence Management Strategy ($31,638).

Abstract: People with colorectal cancer are known to experience bowel problems after sphincter-saving surgery, but there is a lack of research on patients’ perspectives of the extent of these problems and how they are managed after the acute effects of surgery have resolved.  There is also a lack of research on patients’ informational needs in relation to the prevention and management of bowel problems. Bowel problems were identified in a group of 59 colorectal patients 6-24 months after surgery and these results were used to develop an education program to prevent or better manage bowel problems. The program included a public interactive seminar, booklet and video. Three hundred and thirty six colorectal patients, family members and the general public attended the seminar. The effectiveness of the educational program was evaluated by testing participants’ knowledge about bowel problems and self-care practices before, one week (posttest 1) and 11 weeks (posttest 2) after the educational intervention.  A comparison group was included for baseline evaluation. The five most frequently reported problems occurring after bowel surgery were incomplete evacuation, urgency, excessive flatus, needing to return to the toilet and not being able to control wind.  Faecal incontinence was reported by 32% (n=104) of the participants. Baseline bowel knowledge scores for both the intervention and control groups were poor (mean test scores were 38% and 41% respectively).  Significant increases in bowel knowledge scores were reported at posttest 1 (60%) and at posttest 2 (74%). The educational resources developed for this study were launched nationally by the National Continence Management Strategy, and are available free of charge from the National Continence Helpline.