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Biomedical subjects

J Frexinos

Publications and source records attributed to J Frexinos.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Colonic motility in the irritable bowel syndrome].

The importance of colonic motor disorders during the irritable bowel syndrome is recognized, but, paradoxically, their description has yet to be perfected. Among the fundamental questions that remain unanswered, three are of prime importance: a) are there one or more specific disturbances in basal colonic motility? b) can specific motor disorders be induced by certain situations, for instance, during stress? c) is there any real relationship between clinical symptoms and coexisting motor disorders? The answers to these questions are full of ambiguities; this may be explained by the difficulty with which methods of investigation are performed as well as the heterogeneous character of the disorders. Presently, recording colonic myoelectric activity over a 24 hour period or more might prove to be useful in increasing our knowledge on motor disorders. It is not at all certain that a specific basal abnormality exists and the results of the effects of stress vary according to the methods used. Segmental hyperactivity in painful constipation, abnormal colonic response to alimentation in the case of painful bloating, and propulsive hyperactivity with absence or decrease in the "sigmoid brake" during painless diarrhea have been noted on basal motor activity recordings during sleep and after meals. Myoelectric disorders, however, are seen in only two-thirds of patients with intestinal functional disorders. "Sensitivity", personality, or other disorders, and particularly, intestinal disorders, can contribute to explain the pathophysiology of "irritable bowels" in which the role of colonic disorders has yet to be shown.

Action Potentials↗
PubMed1990

[Historical viewpoint on the irritable bowel syndrome].

Contrary to common thought, the conception of the irritable bowel syndrome (IBS) is relatively old, even if the current term dates from as recently as 1944. Long ago, several ancient, and disparate terms, some of them corresponding to currently exceptional clinical pictures, were used. Does that mean that these banal complaints, currently of prime importance among the clinical signs in gastroenterology, were left aside in favor of more severe disease? Surely this is not the case because functional pain has always existed, the only problem is to know whether it was or could be recognized. It was Amboise Paré who first mentioned an ancestor to the IBS when he spoke of "windy colic" (Le Miroir de Beauté et de Santé Corporelle). The glorious kingdom of nervous, chemical, motor, buccal, and intestinal disorders predominated in Gastroenterology at the end of the nineteenth century and the two diseases suggesting functional intestinal problems, i.e. enteroptosis and chronic intestinal stasis, were relegated to second place. Mucomembraneous entercolitis represents one of the most illustrated and widely described offsprings. At the beginning of the twentieth century, progress in roentgenology has allowed to dismember the category of colitis and distinguish between functional and organic diseases. Of the many terms used, "nervous colic" and "irritable intestine" are two which suggest the pathophysiological duality of the disease. Further development of studies on colonic and intestinal motility should allow to identify the authentic motor disorders, even though some etiologies may still go recognized...

Chronic Disease↗
PubMed1989

[Colonic motility and irritable colon].

The importance of colonic motility disorders in the irritable bowel syndrome is now well accepted, but an accurate description of these abnormalities is still wanting. The insufficiency of investigational methods and, mainly, the heterogeneity of the disorders can explain this need. Twenty-four hour recordings of colonic myoelectrical activity can now provide a better knowledge of motor disturbances. No evidence of a specific basic disorder has been presented, and the effects of stress produce contradictory results depending on the method used. In contrast, motility patterns recorded during sleep and after a meal show segmental hyperactivity in painful constipation, abnormalities of the colonic response to feeding in painful abdominal distension, propulsive hyperactivity with absence or reduction of the "sigmoidal brake" in painless diarrhea. However, it appears clearly that myoelectrical activity disturbances can only be observed in two thirds of the patients presenting with functional digestive disorders. "Sensitivity" or personality disorders and disturbances of other organs can explain the physiopathology of "irritable bowels" where no evidence can be found that the colon is involved.

Animals↗
PubMed1989

Effects of sennosides on colonic myoelectrical activity in man.

The effects of sennosides on colonic myoelectrical activity were investigated in man. Spiking activity of the left and sigmoid colons was continuously recorded in seven constipated patients during two sessions from 5:00 PM to 9:00 AM. Each patient received orally at 7:00 PM on two consecutive days 30 mg of sennosides one day (sequence S) and placebo on the other (sequence P) in a random fashion. A significant (P less than 0.05) increase of peristaltic activity (migrating long spike bursts or MLSBs) after sennosides was observed between 1:00 and 7:00 AM, and a corresponding decrease between 7:00 and 9:00 AM. No change was noted in total short spike burst (SSB) activity or in SSBs characteristic of the rectosigmoid area. This study indicates that the main modification of colonic motility induced by sennosides was a stimulation of propulsive activity (MLSBs), which occurred between 6-12 hr after oral administration, the delay required for orocecal transit and metabolism of the drug.

Action Potentials↗
PubMed1989

Rectal potential differences in irritable bowel syndrome and in inflammatory bowel diseases in man.

We have studied rectal potential difference (pd) in 200 subjects: 30 healthy volunteers or control patients, 46 patients with irritable bowel syndrome (IBS) and painless diarrhoea (group I), 60 IBS patients without diarrhoea (group II) and 64 patients with inflammatory bowel disease (IBD) with (group III, n = 41) or without (group IV, n = 23) rectal involvement. Pd measurement used a rectal perfused probe and a subcutaneous needle both connected, via agar-KCl bridges, to calomel electrodes and a millivoltmeter. Statistical analysis used Student's t-test for paired and unpaired data and Mann-Whitney U-test as appropriate. Mean rectal pd values were, respectively -43.5 +/- 8.7 mV in control group, -32.9 +/- 10.2 mV in IBS-group I patients (P less than 0.001), -41.3 +/- 12 mV in IBS-group II patients (NS), -21.4 +/- 14.1 mV in IBD patients with rectal involvement (P less than 0.001), and -45.1 +/- 14.3 mV in IBD-group IV patients (NS). A histological examination was performed in 36 IBS patients; mean rectal pd was significantly decreased in patients showing abnormal patterns (n = 27, pd = -31.8 +/- 9 mV) compared to patients with normal mucosa (n = 9, pd = -41.1 +/- 6.5 mV; P less than 0.01). These results show that: (1) potential difference is significantly decreased in patients with ulcerative and rectal involvement; (2) in patients with Crohn's disease, normal rectal pd values do not assess the appearance of colonic mucosa above; (3) patients with IBS and diarrhoea also present a significant diminution in mean rectal pd. Although the mechanisms involved remain unclear, rectal pd measurement appears to be an objective test for intestinal mucosae weakness in functional or inflammatory diseases of the large intestine and rectum.

Adult↗
PubMed1989

[Efficacy and tolerability of enprostil in the treatment of duodenal ulcer. Comparison with cimetidine].

Enprostil, a synthetic PGE2, has been shown to have an inhibitory effect on gastric acid secretion, a mucoprotective effect and a postprandial lowering effect on gastrin. A double blind randomized study was performed in 80 patients, in order to evaluate the efficacy and safety enprostil (35 mu b.i.d) as compared to cimetidine (400 mg b.i.d) in duodenal ulcer. Healing rates after two, four and six weeks of treatment, as based on endoscopic evaluation, were 35, 72 and 83 p. 100 for enprostil and 45, 73 and 83 p. 100 for cimetidine, respectively. There were no significant differences between treatment groups. The time to relief of nighttime and daytime ulcer pain and antacid consumption were similar in the two groups. The patient's overall subjective assessment was better in the cimetidine group, but this was not confirmed by physicians' opinions. Diarrhea was observed in 7 p. 100 of patients treated by enprostil compared with 5 p. 100 for patients treated by cimetidine. One enprostil treated patient withdrew from the trial prematurely because of abdominal pain. This study demonstrates the efficacy and safety of enprostil in the treatment of active duodenal ulcer at the dosage of 35 micrograms twice daily.

Adult↗
PubMed1989

[Functional study, in man, of congestive gastropathy in cirrhosis by measurement of potential difference].

The morphologic features of the gastric mucosa in patients with cirrhosis have been well investigated. The aim of this study was to evaluate its functional disruption by measuring the gastric potential difference. Forty patients were investigated, 12 control subjects and 28 consecutive cirrhotic patients with endoscopically proved congestive gastropathy. Potential difference was measured the morning, on an empty stomach, at least 3 days after endoscopy; the method used a double channel gastric perfused probe placed under fluoroscopy 10 cm above the cardia, and a subcutaneous reference, both connected to a millivoltimeter via gelose agar-KCl bridges. Potential difference was recorded in each case 20 min before (baseline) and after local instillation of lysine acetylsalicylate (500 mg) as a provocative test. Cirrhotic patients had significantly lower basal potential difference than controls (-28.3 +/- 1.5 mV vs -33.8 +/- 1.3mV, p = 0.007). Potential difference was significantly lower in patients with severe gastropathy than in patients with mild gastropathy (-20.5 +/- 2.1 and -28.9 +/- 1.6 mV, respectively, p less than 0.01). After stimulation with acetylsalicylate, the area under curve and the irritability index were greater in patients with gastropathy (81.4 +/- 12.8 vs 41.2 +/- 8.6 mV.min, p = 0.032 and 0.935 +/- 0.19 vs 0.290 +/- 0.07 mV.mV.min, p = 0.022, respectively). These differences were explained by a higher drop in potential difference (delta DPmax/baseline; 28.1 +/- 3 vs 16.1 +/- 3 p. 100, p = 0.006) whereas basal return time remained unchanged (16.2 +/- 2.1 vs 13.7 +/- 2.2 min).(ABSTRACT TRUNCATED AT 250 WORDS)

Aspirin↗
PubMed1989

[Effects of corticoids, 5-aminosalycilic acid and sucralfate on the potential difference of the rectum in inflammatory colitis in man].

Glucocorticoids are able to increase ionic transport across the rectal mucosa and improve the potential difference (PD) which is known to be decreased in inflammatory bowel diseases in man. The aim of this study was to evaluate the effects of therapeutic enemas or parenteral drugs used in the treatment of inflammatory colitis, by means of rectal PD variations. Seventeen patients (10 women, 7 men, mean age 47 +/- 16 years) with chronic colitis and rectal involvement were studied (ulcerative colitis: n = 12, Crohn's disease n = 4, radiation proctocolitis : n = 1). In each patient, mean PD basal value was measured before treatment for 30 min; a few days later PD measurements were performed 5 h after either intravenous administration of hydrocortisone (HC i.v.: 100 mg) or local administration of therapeutic enemas: 5-aminosalicylate acid (5-ASA: 4 g), hydrocortisone (HC L: 100 mg) or sucralfate (S: 1 g). Statistical analysis used Student's T test for paired or unpaired data, the Mann-Whitney U or Wilcoxon test. PD increased from: - 30.7 mV to - 45.6 mV after HC i.v. (p less than 0.001), - 31.8 mV to - 48.7 mV after HC L (p = 0.01), - 29.8 mV to - 39.8 mV after 5-ASA (p less than 0.01) and - 20.6 mV to - 24.9 mV after sucralfate (NS) respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1988

Inhibition of the colonic motor response to eating by pinaverium bromide in irritable bowel syndrome patients.

The effect of pinaverium bromide on the colonic motor response to eating was investigated in 10 irritable bowel syndrome patients, by means of an intraluminal probe supporting 8 groups of electrodes. At each site examined from transverse to sigmoid colon, the electromyograms exhibited 2 kinds of spike bursts: short spike bursts (SSB) localized at one electrode, and long spike bursts (LSB), isolated, propagated orally or aborally over a few centimeters, or aborally propagated over the whole length of the colon investigated (migrating long spike bursts, MLSB). Recordings were continuously performed over 24 hr. Each patient received at 7.00 p.m. on day 1 and at noon on day 2 an 800-1000 Kcal meal preceded by IV administration of pinaverium bromide (4 mg) or placebo. After placebo administration, the duration of LSB activity and the number of MLSB were significantly increased over 3 postprandial hr by comparison with the 2 hr preceding the meal. After pinaverium injection no significant postprandial change in LSB and MLSB activity was noted. The SSB activity was not modified after the meals preceded by placebo or pinaverium injection. These results suggest that the inhibitory action of pinaverium bromide on postprandial colonic motility may support the clinical efficacy of this agent in the treatment of the irritable bowel syndrome.

Adult↗
PubMed1988

Changes in colonic motility induced by sennosides in dogs: evidence of a prostaglandin mediation.

The effects of sennosides on colonic motility were investigated in eight conscious dogs chronically fitted with two strain gauge transducers in the proximal colon, an intracolonic silicone catheter and a polyethylene catheter implanted in a branch of the right colonic artery. Oral sennosides (30 mg/kg) inhibited colonic motility for 12 to 18 h after a three to six hours delay, and associated with giant contractions and diarrhoea. The minimal oral dose of sennosides to produce such changes varied from 5 to 15 mg/kg. Intracolonic sennosides at the minimal effective dose and at 30 mg/kg reproduced the effects of oral sennosides, but with a shorter latency (0.5-1.5 h). Intracolonic PGE2 (100 micrograms/kg) in viscous gel medium or intra-arterial PGE2 (10 micrograms/h) inhibited colonic motility and induced giant contractions often associated with defecation. The colonic motor changes induced by intracolonic sennosides at the minimal effective dose, but not those induced by intracolonic PGE2, were blocked by intra-arterial indomethacin (10 micrograms/h) or piroxicam (5 micrograms/h). These results suggest that colonic motor actions of sennosides are mediated through a local prostaglandins synthesis, as they were blocked by cyclooxygenase inhibitor and reproduced by PGE2.

Animals↗
PubMed1988

Role of motility in pathogenesis of constipation and diarrhea.

Several attempts have been made in order to classify the gastrointestinal motility disorders; they are mainly based upon the type of disorder in transit and the region of the gastrointestinal tract affected. Many digestive motor disturbances do not constitute entities, but are pathophysiologic mechanisms that may contribute to the production of symptoms and signs of various diseases. The abnormal interdigestive motility pattern or the migrating motor complex often corresponds to the absence of phase 3 and several observations strongly suggest that this disordered motility pattern is the cause rather than the consequence of intestinal bacterial overgrowth. Disturbances of colonic motility are often associated with diarrhea; however, the nature of motor alterations depends on the diarrheal disease (episodic, continuous with or without pain). Finally, both gastrointestinal and colonic motor disturbances may contribute to the pathogenesis of constipation and diarrhea; however, several findings suggest that colonic motor alterations are the consequence rather than the cause of changes in bowel habits.

Animals↗
PubMed1988

Sennosides and human colonic motility.

The effects of stimulant laxatives on colonic motility in man still remain controversial. Stimulation of peristalsis or a decrease of intraluminal pressure has been described manometrically after intraluminal administration of laxatives including senna. In contrast to manometry, electromyographic methods using an endoluminal probe enable continuous colonic motor recordings over a long colonic segment for at least 24 h, and consequently studies following the course of laxative effects after oral administration, the classical therapeutic route, are possible. Preliminary results using sennosides obtained with few subjects provide evidence for an increase in propulsive activity expressed as an increased number of migrating long-spike bursts in the left and sigmoid human colon. This motor colonic pattern seems to be a common feature in nonspecific or induced diarrhoea.

Anthraquinones↗
PubMed1988

Effect of Carbolevure on intestinal fermentation induced by the ingestion of lactulose.

A double-blind trial involving two parallel groups of healthy volunteers was carried out in order to determine whether Carbolevure was capable of decreasing the over-production of intestinal gas induced by the ingestion of 15 ml of lactulose, a synthetic disaccharide not absorbed by the small intestine. Catabolism of this substrate by the anaerobic bacterial flora produces hydrogen, a constant fraction of which diffuses from the intestinal lumen into the blood, later to be excreted in expired air. Hydrogen levels were measured in air samples collected at the end of forced expiration. This hydrogen respiratory test was carried out before and after administration of Carbolevure to 17 volunteers or of a placebo to 15 volunteers, at a dose of three capsules morning and evening for seven days. Comparison of measurements of expired hydrogen by the subjects before and after administration showed a decrease in both groups. However, this decrease was statistically significant only in the group of volunteers having received Carbolevure.

Administration, Oral↗