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PubMedDate not supplied

[Use of fiber enriched biscuit in the treatment of chronic intestinal constipation].

Fiber rich cereal brans have been used for the therapeutic treatment of intestinal constipation. To improve acceptability and routine use, cookies were produced from fresh corn pericarp containing 23.3% of dietary cookies. The therapeutic effect of such cookies on simple intestinal constipation was evaluated. 8 individuals with chronic intestinal constipation and without other gastrointestinal diseases were selected. Each individual was given two diets, each of them during a seven day period: first, "normal diet" and, second, "normal" diet supplemented with 100 g of the cookies, i.e., with an increase of 23 g of dietary fiber per day. The cookies produced an increase in the frequency of evacuation (from 0.27 to 0.81 times/day), in fecal weight (from 38.3 to 117.4 g of feces/day), in water content of the feces (from 29.1 to 91.0 g of water/day), in the dry matter of the feces (from 9.1 to 26.4 g/day), and in the fiber content of the feces (from 1.59 to 8.52 g/day). As the addition of the cookies to the diet promoted increases in all fecal parameters studied, they could be considered an option in the treatment of intestinal constipation.

Chronic Disease↗
PubMed2006

Effect of a symbiotic preparation on the clinical manifestations of irritable bowel syndrome, constipation-variant. Results of an open, uncontrolled multicenter study.

AIM: Irritable bowel syndrome (IBS) is frequently associated with an imbalance in intestinal bacteria. To date, few studies have evaluated the efficacy and safety of probiotic administration in patients with constipation-variant IBS. A new agent recently available in clinical practice is a symbiotic consisting of a probiotic, Bifidobacterium longum W11, and the short chain oligosaccharide prebiotic Fos Actilight. The aim of this study was to evaluate the efficacy and safety of this symbiotic in patients with constipation-variant IBS. METHODS: A total of 636 patients (250 men, 386 women) diagnosed with constipation-type IBS according to the Roma II criteria were enrolled in 43 centers and received the symbiotic at a dose of 3 g/die for at least 36 days. A validated questionnaire investigating symptoms and stool frequency was administered before and after treatment. RESULTS: Based on patient responses to visual scale items, frequency increased significantly after treatment in the ''no symptom'' class from 3% to 26.7% for bloating and from 8.4% to 44.1% for abdominal pain (P<0.0001). In the more severe symptoms classes (moderate-severe), symptom frequency dropped significantly from 62.9% to 9.6% and from 38.8% to 4.1% for bloating and abdominal pain, respectively. Stool frequency significantly increased from 2.9+/-1.6 times/week to 4.1+/-1.6 times/ week. CONCLUSIONS: The study product can increase stool frequency in patients with constipation-variant IBS and reduce abdominal pain and bloating in those with moderate-severe symptoms.

Abdominal Pain↗
PubMed1991

Functional constipation: results of application of the colorectal laboratory.

Constipation and defaecation may be considered as the last taboo. The inability of defaecate or to achieve this only by digital evacuation has never been a popular topic among patients and doctors. Application of tests from the colorectal laboratory has made it possible to study the function of the different parts of the colon and the mechanism of continence. Two types of constipation can be distinguished: I slow transit, which is probably a systemic disease, and 2 functional colonic outlet obstruction due to abnormal pelvic floor function during defaecation straining, which is likely to be a behavioural disorder. Since 30 per cent of the patients with constipation have a normal total colonic transit time, constipation is not merely related to a low frequency of defaecation, but should be defined as a difficult and painful rectal evacuation which may even be impossible over several days.

Anal Canal↗
PubMed1991

[Constipation and incontinence: significance of colonic transit time, anorectal manometry and defecography].

Constipation and fecal incontinence are frequent motives of gastroenterological consultation. An etiological diagnosis can often be suspected from the history and can be confirmed by functional testing. We here report our experience with the measurement of colonic transit time (TTC), anorectal manometry (MAR) and defecography (D). Whilst TTC was unhelpful, MAR revealed abdomino-pelvic asynchrony (anismus) in 60 constipated patients and 7 (47%) of 15 incontinent patients. Perineal descent was suspected in 25 constipated patients and confirmed by defecography, which also revealed associated static pelvic disorders. Our experience confirms the role of functional exploration in the investigation of constipation and fecal incontinence and permits a more precise therapeutic approach.

Adult↗
PubMed1990

[Surgical therapy of severe idiopathic constipation].

Because surgery for severe idiopathic constipation is seldom indicated, careful preoperative evaluation is mandatory (colonoscopy with biopsy, whole gut transit study, evacuation proctography, electromyography, anorectal manometry) in order to classify chronic idiopathic constipation into two broad functional groups: "outlet obstruction" and "colonic inertia". Subtotal colectomy with ileorectal anastomosis yields a good outcome in 70-100% of cases with slow transit constipation. In contrast, there is a broad spectrum of surgical techniques in the treatment of outlet obstruction, among which anorectal myectomy seems to be appropriate for selected patients with good results in 54-92%. Our own small surgical experience with chronically constipated patients (n = 4, 1987-1989) is discussed and compared with the results in the literature.

Anal Canal↗
PubMed1989

[Treatment of chronic functional constipation in children by administration of vegetable fiber (Dicoman 5)].

Chronic functional constipation is a common clinical disorder in pediatric age. Thirteen children with functional constipation were treated by administration of vegetable fibres together with a toilet training program, for two months. In each patient anorectal manometry showed presence of inhibitory anal reflex and diagnosis of constipation was confirmed by a prolonged gastrointestinal transit time measured by radio-opaque markers. In all patients there was a significant improvement in both stool frequency and intestinal transit time; furthermore, a normalization of anorectal motility variables was observed at rectal manometry. No changes in the blood levels of nutritional parameters were seen in any patient. It is concluded that vegetable fibres represent an effective treatment of functional chronic constipation in children.

Child↗
PubMed1989

[Surgical treatment of severe constipation].

Severe constipation may be treated surgically provided precise evaluation of colon-transit-time and rectal evacuation can be performed. Colon-transit-time may be studied by straight X-ray of the abdomen after oral intake of small plastic markers, and rectal evacuation may be evaluated by defecography. In patients, where Hirschsprung's disease with a short aganglionic segment is suspected, ano-rectal manometry with evaluation of the recto-anal reflex must be performed. Furthermore, electromyography of the external anal sphincter and puborectal muscle during simulated defecation will be necessary in order to evaluate whether obstructed defecation is due to a spastic condition in the anal sphincter or pelvic floor muscles (anismus). Surgical treatment of obstructed defecation depends on the specific pathology, while treatment of slow transit constipation is subtotal colectomy and ileo-rectal anastomosis. In patients, where constipation is based on a combination of obstructed defecation and prolonged colon-transit-time, surgery for obstructed defecation should be carried out first. In patients, where the constipation is due to prolonged colon-transit-time and an adynamic rectum (rectal inertia) without anatomical abnormalities the only possibility of surgical treatment is total colectomy with an ileo-anal pouch.

Constipation↗
PubMed1988

Studies of manometric abnormalities of the rectoanal region during defecation in constipated and soiling children: modification through biofeedback therapy.

Anorectal manometry was performed on 12 normal children and 18 patients suffering from constipation and soiling. In both groups, the results of the rectoanal inhibitory reflex and the squeezing anal pressure were similar. The pressure recording in all the normal children showed that the anal canal relaxed during defecation. Fourteen (78%) constipated children closed the anal canal while straining by contracting the anal sphincter. This paradoxical contraction appears to be the cause of chronic constipation. Twelve children with paradoxical anal closure were treated by biofeedback therapy. The results show that all these children were successfully conditioned to relax their anal sphincter during defecation. This therapy improved their bowel habits and relieved them from constipation and soiling. It is proposed that the paradoxical anal closure itself is the result of a self-conditioning process. In this process, the patient learns to paradoxically contract the external anal sphincter in response to the urge and the act of defecation. Biofeedback therapy seems to be the appropriate treatment in such cases.

Anal Canal↗
PubMed1986

Constipation and meconium ileus equivalent in patients with cystic fibrosis.

Constipation and its complications, particularly meconium ileus equivalent, may become management problems in patients with cystic fibrosis. The medical records of 168 patients with cystic fibrosis were reviewed for the prevalence of constipation and meconium ileus equivalent. Of 168 patients, 54 (32%) had experienced at least one episode of constipation which responded to oral or rectal laxative therapy. In 16 of the study group (9%) meconium ileus equivalent developed. Patients younger than 5 years of age had a lower prevalence and those older than 30 years of age had a much higher prevalence of both conditions. Those with prolonged histories of inadequately controlled steatorrhea appeared to be at higher risk for the eventual development of meconium ileus equivalent. Recurrences and complications of constipation may be avoided by instituting early and aggressive therapy.

Adolescent↗
PubMed1986

[Severe constipation indicative of pseudohypoparathyroidism and resolved after normalization of the blood calcium].

Hypocalcemia does not appear among the endocrine and metabolic causes of constipation. The work-up of a severe constipation has disclosed a pseudo-hypoparathyroidism according to the clinical picture described by Albright, associating signs of hypo-parathyroidism, a characteristic dysmorphic syndrome, mental deficiency and normal PTH dosages. The resolve of the constipation along with the return to a normal calcemia suggests that hypocalcemia should be added to the long list of endocrine and metabolic causes of constipation.

Adult↗
PubMedDate not supplied

[Constipation caused by colonic inertia and distal obstruction: electromyographic study].

Colonic motility was evaluated in 15 patients with chronic constipation and 12 healthy subjects by both measuring the transit time of 20 radiopaque markers and recording the colonic myoelectric signals by means of a silastic tube equipped with 4 ring contact electrodes. The tube was introduced by flexible sigmoidoscopy so as the electrodes be located at 50, 40, 30 and 20 cm from the anal verge. Constipation resulted from colonic inertia in 7 patients, the markers being delayed over the whole length of the colon. In the 8 other patients, constipation was due to distal obstruction, the markers accumulating electively in the rectum. The myoelectric tracings showed in the control subjects, on one hand rhythmical stationary spike potentials that occurred at only one electrode site at a mean rate of 10 per minute; on the other hand sporadic (non-rhythmic) spike potentials that were either propagating over the colonic segment (sporadic propagating potentials) or not (sporadic non-propagating potentials). In the constipated patients, the following changes were observed: 1) the number of sporadic propagating potentials was significantly decreased in colonic inertia (2.5 +/- 1.3 bursts of spikes per hour) compared to the controls (8.5 +/- 1.1 bursts/h) or distal obstruction (7.9 +/- 1.3 bursts/h); 2) sporadic propagating potentials usually moved aborally; however, 19.8 +/- 0.9 p. 100 moved orally in colonic obstruction, while 4.6 +/- 0.2 p. 100 in the controls and 4.7 +/- 0.1 p. 100 in colonic inertia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

Chronic constipation in children: can it be managed by diet alone?

Chronic constipation is a common childhood problem. In a study of 60 children aged 2 to 12 years, a special diet that involved daily intake of raw bran and high-fiber foods and exclusion of milk and other constipating foods was found to be successful. Within six weeks, the problem resolved in all 60 patients. Milk and other restricted foods were returned slowly to the diet if they were found not to be a contributing factor to constipation. We believe our clinical observations support the prescription of a special diet for childhood constipation. For patients in whom specified organic causes have been excluded, we recommend a trial of this diet before other, more complex therapeutic efforts are undertaken. Implementation of the diet necessitates careful explanation to the child and family, as well as long-term follow-up.

Child↗
PubMed1983

Constipation in the elderly.

Constipation is a common problem that affects not only the young, but the elderly as well. Treatment in the elderly, however, may cause more problems than the constipation itself. A review of the prevalence of constipation in the elderly and its etiology and suggestions for treatment are presented. Some of the complications that may result from constipation or its treatment are described.

Aged↗
PubMed1982

Dexpanthenol (Ro 01-4709) in the treatment of constipation.

Functional constipation is not a life-threatening disease, but as a chronic state it worries the patient and causes him discomfort and often leads him to self-medication with potentially dangerous drugs. Ro 01-4709 contains as active substance dexpanthenol, which is the alcohol of pantothenic acid, a vitamin of the B-complex. In the cells, dexpanthenol is readily oxidized to pantothenic acid, which stimulates peristalsis when administered in therapeutically effective doses. Ro 01-4709 has already proven its efficacy in the prevention and treatment of adynamic ileus. Recently, several open and two double-blind studies have been carried out, investigating the efficacy of oral Ro 01-4709 in the treatment of chronic functional constipation. The two double-blind studies showed Ro 01-4709 to be superior to placebo in all parameters measured. The studies with an open design also demonstrated a favourable effect of Ro 01-4709 in the treatment of chronic functional constipation. Owing to its physiological action-which is in a favourable contrast to that of normal laxatives. Ro 01-4709 can be recommended for the treatment of functional constipation in pregnant women, children and the elderly.

Abdomen↗
PubMed1981

[Interest of the sphincteromyectomy in the treatment of idiopathic constipation and short-segment Hirschsprung's disease (author's transl)].

During last 10 years, 33 children presenting with a severe constipation (19 of them with subobstruction episodes) have been treated with sphincteromyectomy at ages varying from 3 m. to 13 y. The aetiologic study of the constipation includes a barium enema, a manometric study (for the cases treated since 1975) and a histologic study of the muscular strip obtained during the sphincteromyectomy. The barium enema does not show any specific pattern of Hirschsprung's disease, on the other hand, the manometric study brings more constant arguments to distinguish the idiopathic constipation from the short-segment Hirschsprung's disease. The sphincteromyectomy is done by anal approach (28 times) or by posterior approach (6 times). One patient has had 2 sphincteromyectomies. 14 patients had a Hirschsprung's disease and we find among them 9 very good or good results. 5 failures needed a rectal resection by the Swenson's technique. 19 children had an idiopathic constipation. 2 have not been reviewed. Among the 17 others, we find 11 very good results. No postoperative complications have been observed particularly not any incontinence.

Adolescent↗
PubMed1995

Functional colonic and anorectal disorders. Detecting and overcoming causes of constipation and fecal incontinence.

Evaluation of constipation and fecal incontinence begins with comprehensive history taking, which may include overcoming a significant psychosocial barrier. Before functional anorectal diseases can be controlled, the fundamental cause must be determined and any underlying disorder corrected. In constipation, a colonic or anorectal motility disorder is often the cause; about half of refractory cases are the result of obstructive defecation. In fecal incontinence, dysfunction of several anatomic or physiologic mechanisms may be the cause. Anorectal manometry is useful in assessment in both disorders. Other helpful tests are colonic-transit measurement in constipation and electrophysiologic tests and defecography in fecal incontinence. Treatment of constipation often includes dietary measures and use of laxatives or prokinetic agents; fecal incontinence may respond to bulking or antidiarrheal agents. In both disorders, some patients have responded to the recently described technique of neuromuscular conditioning with biofeedback. In some cases, surgical repair must be considered.

Constipation↗
PubMed1995

Biofeedback treatment for chronic constipation and encopresis in childhood: long-term outcome.

OBJECTIVE: Abnormal defecation dynamics often are present in children with chronic constipation and encopresis. Patients who learned normal defecation dynamics with biofeedback treatment had improved short-term outcome. The aim of our research was to evaluate if biofeedback treatment improved long-term outcome. DESIGN: One hundred twenty-nine children with constipation, encopresis, and abnormal defecation dynamics were treated conventionally; 63 of them received additional biofeedback training directed towards teaching normal defecation dynamics. RESULTS: At follow-up (4.1 +/- 1.5 years), 86% of conventionally treated patients and 87% of biofeedback-treated patients had improvement in encopresis; 62% of conventionally treated patients, 50% of successful biofeedback-treated patients, and 23% of unsuccessful biofeedback-treated patients had recovered from chronic constipation and encopresis. Recovery rates were similar for conventionally treated patients and biofeedback-treated patients who learned normal defecation dynamics (P > .2) but significantly lower for unsuccessful biofeedback-treated patients (P < .02). Length of follow-up was significantly related to recovery (P < .01). CONCLUSION: Learning normal defecation dynamics with biofeedback training did not increase long-term recovery rates in children with chronic constipation, encopresis, and abnormal defecation dynamics above those achieved with conventional treatment alone.

Adolescent↗
PubMed1995

Peptic ulcer disease, irritable bowel syndrome and constipation in two populations in Iran.

OBJECTIVE: To determine the prevalence of peptic ulcer disease, irritable bowel syndrome (IBS) and chronic constipation in two Iranian populations (pastoral nomads and industrial labourers) with different life styles, and to evaluate the risk factors associated with these diseases. SUBJECTS: A total of 455 randomly selected pastoral nomads and 492 industrial labourers (all male) aged between 35-55 years. METHODS: Demographic and social data were obtained by interviews. An upper gastrointestinal tract endoscopy was performed and biopsy specimens were taken from subjects complaining of abdominal symptoms and randomly selected asymptomatic subjects. A urease test was performed on antral specimens. Serum pepsinogen I concentrations and Helicobacter pylori antibody titres were measured by radioimmunoassay and immunoglobulin (Ig) G enzyme-linked immunosorbent assay tests, respectively. RESULTS: Serum pepsinogen I concentrations were similar in both nomads and industrial labourers, and the percentage with positive antibody titres for H. pylori was high in both populations (86.3 and 91% in nomads and industrial labourers, respectively). Industrial labourers were twice as likely to have duodenal ulcer (P < 0.05) than nomads. The prevalence of duodenal ulcer disease and gastric ulcer was 4.6 and 0.6% in nomads and 10.3 and 0.4% in industrial labourers, respectively. The prevalence of IBS was similar in nomads (3.1%) and industrial labourers (3.6%). Fewer nomads (1.4%) than industrial labourers (3.3%) had chronic constipation. Logistic regression analysis showed that being an industrial labourer, or smoker and having undergone previous non-gastric surgery were risk factors for duodenal ulcer disease. When the variable 'urease test' was included in the logistic regression analysis, smoking, a positive urease test and the quantity of fruit eaten per week were associated risk factors. The risk factors associated with IBS were the use of analgesics and back pain. The only risk factor associated with chronic constipation was being an industrial labourer. CONCLUSIONS: Industrial labourers were twice as likely to have duodenal ulcer disease as nomads. The prevalence of IBS and chronic constipation in the two male Iranian populations was lower than that found in western countries. Duodenal ulcer disease was associated with H. pylori colonization but not with a positive serum antibody titre for H. pylori. H. pylori colonization of the antral mucosa and smoking are causative factors for duodenal ulcer disease and fruit intake is possibly an associated factor.

Adult↗