Novel approach for women’s self-management of rectal emptying difficulty

Aim To pragmatically investigate rectal emptying difficulty in women to identify if managing their symptoms with an innovative device is more effective and satisfactory than their usual care. Background Rectal emptying difficulty has a mostly unknown influence on women and frequently a hidden issue. Self-management alternatives are underappreciated. Despite the magnitude of the problem and its influence on women’s lives and healthcare, non-surgical alternatives have received little attention. Methods This cohort study of 35 female participants, recruited via secondary care outpatient clinics, used composite questionnaires before and after an 8-week intervention using the device. The questionnaire comprised of a quality of life instrument (International Consultation on Incontinence Questionnaire-Vaginal Symptoms and obstructed defaecation syndrome questionnaires), bowel diary recordings and participant feedback on using the device. Findings The device helped participants reduce the need to use their fingers (z= −2.844; p≤0.004) and offered participants improved lifestyle. There was significant reduction in difficulties to evacuate (p≤0.004), digitation to evacuate (p≤0.018), the feeling of incomplete evacuation (p≤0.002), straining to evacuate (p≤0.008) and lifestyle alteration (p≤0.046). The sense of incomplete emptying before and after using the device was significant (z= −2.646; p≤0.008), and feeling of being blocked improved (z= −3.317; p≤0.001). Stool consistency did not change. Medication to evacuate, returning to the toilet to evacuate and time needed showed no difference. Twenty-four participants (68.5%) completed the Patient Global Impression of Improvement question postintervention. Overall, 16 participants (66.7%) reported that the device was better than not using it. The results have clinical value, suggesting the device can assist women enhance their quality of life and improve physical symptoms associated with rectal emptying difficulties. Conclusions Most women with rectal emptying difficulty in this study found the device effective when compared with their usual care. Furthermore, it offers an additional conservative measure option within healthcare provision.