Brigitte Collins and Michelle Henderson
The recent Association of Coloproctology of Great Britain and Ireland (ACPGBI) meeting in Edinburgh was a fantastic event and focused on improving knowledge for healthcare professionals and outcomes for patients.
Our Clinical Team attended lectures and visited the poster presentations to soak up as much new information as possible. Here is a summary of their key takeaway messages.
Management of treatment-related sequelae following rectal cancer – Bowel dysfunction.
Haas, S., Faaborg, PM., Thing Oggesen, B., Kronborg CJS., Ventzel, L., Mikkelsen AH., Fassov JL., Frederiksen NA., Graugaard-Jensen, CH., Krogsgaard, M., Christensen P., Emmertsen KJ.
This poster showcased clinical practice guidelines for identifying and managing low anterior resection syndrome (LARS). It was a great reminder of what treatment options are available for this group of patients and two key points mentioned were:
- The advancement in treatment for rectal cancer has increased the number of survivors.
- 30%-80% of these survivors developed a change in bowel function (including LARS).
This poster demonstrates how research in LARS continues to be at the forefront for clinicians, and concluded that there is still an unmet need in relation to LARS. Experts recommend we keep building on our knowledge within this area to improve patients’ quality of life.
Management of treatment-related sequelae following colorectal cancer – Psychosocial distress
Haas, S., Faaborg, PM., Thing Oggesen, B., Kronborg CJS., Ventzel, L., Mikkelsen AH., Fassov JL., Frederiksen NA., Graugaard-Jensen, CH., Krogsgaard, M., Christensen P., Emmertsen KJ.
This poster raises awareness of the psychological trauma of having colorectal cancer and how it leads to reduced mental well-being including anxiety, depression and fear of cancer returning.
One recommendation stood out for us: “survivors should be assessed for signs of depression and anxiety.” We feel this should be looked into from the start of a patient’s treatment journey and continually assessed throughout, meaning we can pick up on these signs much earlier.
Many patients don’t want to complain after having life-saving surgery and don’t want to express how they are feeling. We need to be aware of the potential impact of diagnosis and surgery. Using a tool like the ‘Distress Thermometer’ as mentioned on the poster can assist in assessing levels of anxiety and depression.
Association of Coloproctology Nurses: AGM and Short Paper Session – Important elements of a bowel dysfunction service after rectal cancer surgery: semi-structured patient interviews
Claire Taylor (London)
Claire presented her team’s recent research that has been looking into for LARS patients. One of the key takeaway points is to ensure that we ask patients very early on if they are experiencing bowel dysfunction post stoma reversal.
Claire and her team found that patients are incredibly grateful they’ve had this life-saving surgery but are then reluctant to complain or maybe worried they are seen as being difficult if they say they’re having issues with their bowels.
Overall, we have got to be very clear in asking patients about their problems in order to address them as soon as possible.
Research Session
This session highlighted areas for future research. An interesting point made during the discussions was that maybe itis time we stop looking at PROMs (patient-reported outcome measures) and instead investigate PREMs (patient-reported experience measures). This is definitely a term that has been used in previous aspects of research. Now is the time to consider PREMs be it research or service outcomes.
Symposium: Pelvic Floor for the Coloproctologist
This symposium was the highlight of the ACPGBI Annual Meeting for us. Tom Dudding presented ‘The acutely constipated patient presenting on the emergency take’, and we were astonished at the number of emergency admissions for constipation. It is disappointing to see so many people coming through as emergencies for constipation. However, it was positive to see Tom’s suggestions with education and working more closely with primary care services to try and address this issue and minimise the emergency admissions.
Emma Carrington continued the pelvic floor conversation with, ‘The chronic constipated patient’, and gave away some top tips for managing these patients. Our favourite was the ‘Laxative Ninja’ tip, where we could all be ‘Laxative Ninjas’ armed with all the information we need to maximise laxatives.
Dipesh Vasant rounded off the session with, ‘State of the art update on IBS: the new BSG guidelines’. This final presentation pointed out how describing IBS as a functional disorder is not helpful, as it has negative connotations and can be stigmatising. The new guidelines describe IBS as a disorder of the ‘gut-brain axis,’ which patients will find more validating and one that the MacGregor Healthcare Clinical Team are pleased to see.
At MacGregor we have been discussing how it is time to look more closely at the psychological aspects of bowel dysfunction and how it impacts our patients. At ACPGBI, this topic was mentioned often in various sessions. It’s certainly an area to be highlighted and discussed more openly in the future. The attended lectures have given us food for thought to take this type of research into the future arena.
While attending the conference we also caught up with Cathie King, Colorectal/Stoma CNS at Raigmore Hospital in Inverness. Read Cathie’s review of her experience at the conference here.
To finish – we would like to take this opportunity to say thank you to all who made it such a great meeting and to the many of you that visited the MacGregor Healthcare stand and showed such a huge interest in the Qufora range of products.
