Assessment of severity of chronic diseases of rectum

Introduction. Most modern classifi cations of chronic benign diseases of the anorectal region are based on an assessment of the severity of the morphological changes that occur with these diseases. However, the direct relationship between the stage of the disease and the severity of its clinical manifestations is not always traced. Thus, there is a need to develop a tool for assessing the severity of the disease as a complement to the current morphological classifi cation.

Material and methods. The study was carried out in 2018–2019, 239 patients (110 men, 129 women) were included. The median age was 35 years (ranging from 19 to 70 years). Nosological composition: 175 patients with chronic hemorrhoids, 37 with chronic anal fi ssure, 19 patients with a combination of anal fi ssure and hemorrhoids, 8 patients with idiopathic anal itching. All patients were interviewed for the main symptoms of anorectum diseases. After that, it was proposed to evaluate their condition on a visual analogue scale (VAS), from 0 to 10. Then, a model was constructed for the dependence of the severity of the disease on the frequency of symptoms in the form of a linear regression equation with calculation of regression coefficients.

Results. The data obtained is a score for the contribution of each of the symptoms, which can be used as a scale for assessing the severity of anorectum diseases.

Discussion. The results of our study provide an opportunity to stratify the symptoms of participation in the formation of the clinical picture of the disease. The contribution of each symptom was evaluated individually using mathematical modeling methods. Such a combination would make it possible to give an exhaustive description of the condition, including both the organic manifestations of the disease and clinical symptoms.

Conclusions. The results of this study made it possible to create an assessment tool — a scale for determining the severity of chronic benign diseases of the rectum as an addition to the existing classifi cations based on morphological changes. 

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