{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:44:41Z","timestamp":1790750681870,"version":"4.1.0"},"reference-count":27,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Frontline Gastroenterol"],"accepted":{"date-parts":[[2014,4,27]]},"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A recent randomised trial suggested that an algorithmic approach to investigating and managing gastrointestinal symptoms of pelvic radiation disease (PRD) is beneficial and that specially trained nurses can manage patients as effectively as a gastroenterologist.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The aim of the development and peer review of the guide was to make the algorithm used in the trial accessible to all levels of clinician.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Experts who manage patients with PRD were asked to review the guide, rating each section for agreement with the recommended measures and suggesting amendments if necessary. Specific comments were discussed and incorporated as appropriate, and this process was repeated for a second round of review.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>34 gastroenterologists, 10 nurses, 9 dietitians, 7 surgeons and 5 clinical oncologists participated in round one. Consensus (defined prospectively as 60% or more panellists selecting \u2018strongly agree\u2019 or \u2018agree\u2019) was reached for 27 of the original 28 sections in the guide, with a median of 75% of panellists agreeing with each section. 86% of panellists agreed that the guide was acceptable for publication or acceptable with minor revisions. 55 of the original 65 panellists participated in round two. 89% agreed it was acceptable for publication after the first revision. Further minor amendments were made in response to round two.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Development of the guide in response to feedback included<\/jats:p>\n                  <jats:p>\u25b8\u2002improvement of occasional algorithmic steps<\/jats:p>\n                  <jats:p>\u25b8\u2002a more user-friendly layout<\/jats:p>\n                  <jats:p>\u25b8\u2002clearer timeframes for referral to other teams<\/jats:p>\n                  <jats:p>\u25b8\u2002expansion of reference list<\/jats:p>\n                  <jats:p>\u25b8\u2002addition of procedures to the appendix.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/flgastro-2014-100468","type":"journal-article","created":{"date-parts":[[2014,6,17]],"date-time":"2014-06-17T22:34:57Z","timestamp":1403044497000},"page":"53-72","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":67,"title":["Guidance: The practical management of the gastrointestinal symptoms of pelvic radiation disease"],"prefix":"10.1136","volume":"6","author":[{"given":"H Jervoise N","family":"Andreyev","sequence":"first","affiliation":[{"name":"The GI and Nutrition Team, The Royal Marsden NHS Foundation Trust, London and Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann C","family":"Muls","sequence":"additional","affiliation":[{"name":"The GI and Nutrition Team, The Royal Marsden NHS Foundation Trust, London and Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Norton","sequence":"additional","affiliation":[{"name":"King's College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Ralph","sequence":"additional","affiliation":[{"name":"The GI and Nutrition Team, The Royal Marsden NHS Foundation Trust, London and Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"Watson","sequence":"additional","affiliation":[{"name":"The GI and Nutrition Team, The Royal Marsden NHS Foundation Trust, London and Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Shaw","sequence":"additional","affiliation":[{"name":"The GI and Nutrition Team, The Royal Marsden NHS Foundation Trust, London and Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James O","family":"Lindsay","sequence":"additional","affiliation":[{"name":"Digestive Diseases Clinical Academic Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,6,17]]},"reference":[{"key":"2025090709255843000_6.1.53.1","doi-asserted-by":"publisher","DOI":"10.1177\/1756283X10377126"},{"key":"2025090709255843000_6.1.53.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2009.11.027"},{"key":"2025090709255843000_6.1.53.3","first-page":"95","article-title":"Pancreatic insufficiency secondary to abdominal radiotherapy","volume":"19","author":"Dookeran","year":"1993","journal-title":"Eur J Surg Oncol"},{"key":"2025090709255843000_6.1.53.4","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.56.661.804"},{"key":"2025090709255843000_6.1.53.5","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(07)70341-8"},{"key":"2025090709255843000_6.1.53.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199507063330101"},{"key":"2025090709255843000_6.1.53.7","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1002\/nau.20798","article-title":"An International Urogynaecological Association (IUGA)\/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction","volume":"29","author":"Haylen","year":"2010","journal-title":"Neurol Urodyn"},{"key":"2025090709255843000_6.1.53.8","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-300563"},{"key":"2025090709255843000_6.1.53.9","first-page":"112","article-title":"Small bowel bacterial overgrowth: a comprehensive review","volume":"3","author":"Dukowicz","year":"2007","journal-title":"Gastroenterol Hepatol"},{"key":"2025090709255843000_6.1.53.10","doi-asserted-by":"publisher","DOI":"10.1159\/000103892"},{"key":"2025090709255843000_6.1.53.11","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12456"},{"key":"2025090709255843000_6.1.53.12","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1111\/j.1365-277X.2009.00963.x","article-title":"Coping mechanisms used by women in an attempt to avoid symptoms of chronic radiation enteritis","volume":"22","author":"Abayomi","year":"2009","journal-title":"J Hum Nutr Diet"},{"key":"2025090709255843000_6.1.53.13","unstructured":"Department of Health. National Diet and Nutrition Survey: Headline results from Years 1 and 2 (combined) of the rolling programme 2008\/9\u20132009\/10. 2011. http:\/\/www.dh.gov.uk\/en\/Publicationsandstatistics\/Publications\/PublicationsStatistics\/ DH_128166"},{"key":"2025090709255843000_6.1.53.14","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2003.01760.x"},{"key":"2025090709255843000_6.1.53.15","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/j.1365-2982.2006.00835.x","article-title":"Chronic constipation: advances in management","volume":"19","author":"Wald","year":"2007","journal-title":"Neurogastroenterol Motil"},{"key":"2025090709255843000_6.1.53.16","unstructured":"National Institute of Health and Care Excellence. Management of faecal incontinence in adults: CG 49. London: NICE, 2007."},{"key":"2025090709255843000_6.1.53.17","doi-asserted-by":"crossref","first-page":"S45","DOI":"10.2214\/AJR.07.7096","article-title":"MRI of pelvic floor dysfunction: review","volume":"191","author":"Law","year":"2008","journal-title":"AJR Online"},{"key":"2025090709255843000_6.1.53.18","first-page":"493","article-title":"Disorders of the Pelvic Floor and Anorectum","volume":"37","author":"Rao","year":"2008","journal-title":"Gastorenterol Clin North Am"},{"key":"2025090709255843000_6.1.53.19","doi-asserted-by":"publisher","DOI":"10.1023\/A:1024180319005"},{"key":"2025090709255843000_6.1.53.20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2006.02920.x"},{"key":"2025090709255843000_6.1.53.21","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-006-0801-1"},{"key":"2025090709255843000_6.1.53.22","first-page":"44","article-title":"Formalin treatment of radiation-induced hemorrhagic proctitis","volume":"81","author":"Rubinstein","year":"1986","journal-title":"Am J Gastroenterol"},{"key":"2025090709255843000_6.1.53.23","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1016\/j.ijrobp.2013.08.034","article-title":"Randomised trial of argo plasma coagulation therapy versus topical formalin for persistent rectal bleeding","volume":"87","author":"Botten","year":"2013","journal-title":"Int J Radiol Biol Phys"},{"key":"2025090709255843000_6.1.53.24","doi-asserted-by":"crossref","first-page":"358","DOI":"10.12968\/bjcn.2007.12.8.24365","article-title":"Managing a common dermatological problem: incontinence dermatitis","volume":"12","author":"Nazarko","year":"2007","journal-title":"Br J Community Nurs"},{"key":"2025090709255843000_6.1.53.25","unstructured":"The Royal Marsden NHS Foundation Trust. The Royal Marsden Hospital Manual of Clinical Procedures. 8th edn. Dougherty L Lister S . eds. Chapter 19. Wound Management: Radiotherapy skin reactions:1180\u20133."},{"key":"2025090709255843000_6.1.53.26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00640.x"},{"key":"2025090709255843000_6.1.53.27","doi-asserted-by":"publisher","DOI":"10.1586\/egh.09.10"}],"container-title":["Frontline Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/flgastro-2014-100468","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T16:26:03Z","timestamp":1757262363000},"score":1,"resource":{"primary":{"URL":"https:\/\/fg.bmj.com\/lookup\/doi\/10.1136\/flgastro-2014-100468"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,6,17]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2014,12,5]]},"published-print":{"date-parts":[[2015,1]]}},"alternative-id":["10.1136\/flgastro-2014-100468"],"URL":"https:\/\/doi.org\/10.1136\/flgastro-2014-100468","relation":{},"ISSN":["2041-4137","2041-4145"],"issn-type":[{"value":"2041-4137","type":"print"},{"value":"2041-4145","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,6,17]]}}}