Outcome and Quality of Life Studies 

Constipation and/or Fecal Incontinence

Development of the Constipation Severity Instrument and Constipation-Related Quality of Life Measure

Constipation is an extremely prevalent problem reported to occur in about 15-30% of patients in the United States.  Despite the prevalence of constipation, currently no instrument exists that adequately addresses this problem and no gold standard has been identified to evaluate symptoms. This study will develop two instruments: one to evaluate constipation severity and one to measure constipation-related quality of life.  Additionally, this study will investigate how well these instruments correlate to physical testing results at the UCSF Center for Pelvic Physiology.

Biofeedback Therapy as Treatment for Constipation and/or Fecal Incontinence: Efficacy, Patient Satisfaction, and Predictors of Success

Anorectal biofeedback has become the standard of care for pelvic floor dyssynergia and is often considered the treatment of choice for fecal incontinence despite a paucity of prospective, placebo-controlled, randomized trials. This study aims to further define the success of anorectal biofeedback for both constipation and fecal incontinence by examining patients' satisfaction and perception of improvement along with their changes in physical symptoms and severity and related quality of life. In addition, this study examines a combination of psychological parameters by using a validated instrument to assess which factors may predict the success of biofeedback for both conditions. This study has the potential to assist health care providers in deciding which patients are most likely to benefit from this treatment and perhaps provide insight into what other therapies may be used in conjunction with biofeedback. As a result, this will provide an opportunity to create a more personalized and effective treatment for patients with constipation and/or fecal incontinence. 

Inflammatory Bowel Disease, Ulcerative Colitis, Crohn's Disease and Familial Adenomatous Polyposis

The Effect of Rectal Resection on Bowel, Bladder, and Sexual Function in Patients with Inflammatory Bowel Disease

Proctectomy (removal of the entire rectum) for patients with ulcerative colitis (UC) and Crohn's Disease has been observed by many clinicians to result in serious side effects related to pelvic surgery. This study aims to assess the change in bowel, bladder, and sexual function in men and women after proctectomy for UC and Crohn's disease and determine how this change affects the quality of life of the patient.