Referral for anorectal function evaluation is indicated in 65% and beneficial in 92% of patients

Table 1 Indicated referrals in the main groups of patients

	All n (% of referrals)	Indicated n (% of that group)
Incontinence	71 (43)	66 (93)1
Constipation	31 (19)	6 19)2
3rd sphincter rupture	21 (13)	21 (100)
Pain	9 (5)	0 (0)
Re-anastomosis/enterostoma	8 (5)	8 (100)
Soiling	5 (3)	0 (0)
IBD	4 (2)	4 (100)
Hemorrhoids	3 (2)	0 (0)
Anal atresia	2 (1)	2 (100)
Fistulas	2 (1)	2 (100)
Fissure	1 (1)	0 (0)
Other	9 (5)	0 (0)
Total	167 (100)	109 (653)

¹Five patients with diarrhea not indicated;

²Only patients suspected of Hirschsprung/surgery indicated, IBD-inflammatory bowel disease;

³Percentage of all referrals.

Table 2 Reason for referral and effect of treatment on patients

2004-2006		Treatment according to the patients						Symptoms change after treatment
Reason for referral	Patients	Treatment1>	Diet n (%)	Medication n (%)	Surgery n (%)	Physiotherapy n (%)	Expectative n (%)	VAS		Category
								Before	After	Improved	Reassured	Worse
Incontinence2	71	100	8	32	123	26	22	5	5.7	20	39	7
Constipation	31	35	3	12	34	7	10	5	6.2	11	17	1
3rd sphincter rupture	21	22	2	1		2	17	7.1	7.2	2	15	1
Anal pain	9	8		1	15		6	3.5	5.1	3	5
Surg/Stoma	8	8			6		2	6.3	7	2	4
Soiling	5	7	2	3	2			3.4	4.8	3	1	1
IBD	4	4		2			2	4.8	6.5	2	2
Hemorrhoids	3	6	1	3	26			4.3	6.3	2	1
Anal atresia	2	2		1			1	6	7.5	2
Fistula	2	2					2	4	5.5	1	1
Fissure	1	2		1	15			2	8	1
Pouchitis	1	1					1	8	7			1
Other	9	12	1	1	8	1	1	5.1	6.7	5	3	1
Average (SD)								5.1b	6.1b
								(2.4)	(2.3)
Total (%)	167	209	17 (8)	57 (27)	35 (17)	36 (16)	64 (31)			54 (35)	88 (57)	12 (8)

¹Treatment as answered by patients, several treatments per patient possible;

²Including all subgroups;

³Sphincter repair;

⁴Rectocele repair;

⁵Fissurectomy;

⁶Hemorroidectomy.

^bP < 0.0001.

Table 3 A comparison between the proposed therapeutic advice and followed therapy. A therapy can consist of more components

	All therapies (%)	Diet (%)	Medication (%)	Physiother (%)	Expectative (%)	Surgery (%)
Followed	130 (80)	7 (100)	54 (71)	32 (73)	31 (100)	36 (90)
Not followed	32 (20)	0	22 (29)	12 (27)	0	4 (10)
Total	162 (100)	7 (100)	76 (100)	44 (100)	31 (100)	40 (100)