Anorectal symptom management in pregnancy: Development of a severity scale

Background Anorectal conditions are very common and under-diagnosed in pregnancy, with severe implications on quality of life. Presently no validated scale is available to quantify the severity of symptoms and their response to therapy. The objective of this study was to create and validate a scale for symptoms associated with anal/rectal conditions. Methods Patients attending a colorectal clinic were assessed twice, for severity of anorectal symptoms; once by the new questionnaire-ColoRectal Evaluation of Clinical Therapeutics Scale (CORECTS)--followed by a direct examination by a proctologist. Linear regression analysis was performed to correlate the clinician's and CORECTS scores. In parallel, 209 pregnant women with hemorrhoids were assessed using CORECTS before and after treatment with Proctofoam-HC®. We evaluated whether scores' improvement corresponded to changes in quality of life. Results There was a significant concordance between each component of the CORECTS scale as well as impact on quality of life, with direct clinical examination of a proctologist. Significant reduction in symptoms, as measured by the scale following use of Proctofoam-HC® highly correlated with changes in quality of life before and after treatment. Conclusion CORECTS is a reliable tool in capturing the severity of symptoms associated with colorectal symptoms in pregnancy and is highly sensitive in detecting changes in symptom severity following treatment.