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PubMed1995

Genes that control a temperature-compensated ultradian clock in Caenorhabditis elegans.

Substantial progress has been made in understanding the genetic basis of temperature-compensated circadian clocks. Ultradian rhythms, with a period shorter than 24 h, are at least as widespread as circadian rhythms. We have initiated genetic analysis of defecation behavior, which is controlled by an ultradian clock in Caenorhabditis elegans. The defecation motor program is activated every 45 sec, and this rhythm is temperature compensated. We describe mutations in 12 genes that either shorten or lengthen the cycle period. We find that most of these mutations also disrupt temperature compensation, suggesting that this process is an integral part of the clock. These genes open the way for molecular genetic dissection of this ultradian clock.

Activity Cycles↗
PubMed2006

Lupin kernel fibre foods improve bowel function and beneficially modify some putative faecal risk factors for colon cancer in men.

Consumption of some dietary fibres may benefit bowel health; however, the effect of Australian sweet lupin (Lupinus angustifolius) kernel fibre (LKFibre) is unknown. The present study examined the effect of a high-fibre diet containing LKFibre on bowel function and faecal putative risk factors for colon cancer compared to a control diet without LKFibre. Thirty-eight free-living, healthy men consumed an LKFibre and a control diet for 1 month each in a single-blind, randomized, crossover study. Depending on subject energy intake, the LKFibre diet was designed to provide 17-30 g/d fibre (in experimental foods) above that of the control diet. Bowel function self-perception, frequency of defecation, transit time, faecal output, pH and moisture, faecal levels of SCFA and ammonia, and faecal bacterial beta-glucuronidase activity were assessed. In comparison to the control diet, the LKFibre diet increased frequency of defecation by 0.13 events/d (P=0.047), increased faecal output by 21 % (P=0.020) and increased faecal moisture content by 1.6 % units (P=0.027), whilst decreasing transit time by 17 % (P=0.012) and decreasing faecal pH by 0.26 units (P<0.001). Faecal butyrate concentration was increased by 16 % (P=0.006), butyrate output was increased by 40 % (P=0.002) and beta-glucuronidase activity was lowered by 1.4 micromol/h per g wet faeces compared to the control diet (P<0.001). Addition of LKFibre to the diet incorporated into food products improved some markers of healthy bowel function and colon cancer risk in men.

Adult↗
PubMed2003

Porcine cysticercosis in village pigs of North-West Cameroon.

A study was carried out in two villages and one marketplace of the Batibo sub-division in North-West Cameroon to determine the prevalence of porcine cysticercosis. The results showed that 4.44% of 383 pigs were positive at tongue examination whereas ELISA detected circulating antigens in 27.7% of 271 pig sera. A questionnaire survey in 140 pig-raising households indicated that 59.3% of them lacked latrines while in 75.7% of the households members defecated directly into pigpens. The seroprevalence of porcine cysticercosis was significantly higher in households without latrines than in those with latrines. Similarly, significantly more seropositive pigs were present in households that defecated in the pig pens (35.5%) than in those that did not (14.4%). Although 91.4% of pig raising households did know of pig cysticercosis, only 28.6% were aware of the link with human taeniasis and only 10.7% were aware of human cysticercosis.

Animal Husbandry↗
PubMed2002

Does water-perfused catheter overdiagnose anismus compared to balloon probe?

BACKGROUND: The purpose of this study was to compare the manometric assessment of straining effort as if to defecate and rectoanal inhibitory reflex obtained with a rectosphincteric balloon probe and with a water-perfused catheter in the same subject. METHODS: Twelve healthy volunteers underwent two manometric assessments of anal sphincter function and electromyographic (EMG) surface recordings. one with a rectosphincteric balloon and one with a water-perfused catheter, 7 days apart in random order. RESULTS: Increased EMG activity in the external anal sphincter in the midst of the rectoanal inhibitory reflex (P < 0.001) and during straining for defecation (P < 0.001) was more frequently observed with the perfused system than with the balloon probe. There was a discrepancy between the EMG activity of the external anal sphincter and the anal pressures during straining recorded with the perfused system. Duration of the reflex elicited by rectal distension with 10 and 20 ml of air was significantly greater with the rectosphincteric balloon than with the perfused catheter (P = 0.02 and P = 0.05, respectively). CONCLUSION: Water instilled in the anal canal by the perfused system induces artifacts in EMG recording and active anal contractions. These artifacts and induced contractions could lead to an erroneous diagnosis of anismus, particularly if pelvic floor EMG is only taken into account for the diagnosis of anismus.

Adult↗
PubMed2001

Effects of isomalto-oligosaccharides on bowel functions and indicators of nutritional status in constipated elderly men.

OBJECTIVES: To evaluate effects of isomalto-oligosaccharides (IO) on the bowel function and nutritional status of elderly men. METHODS: Seven older male subjects participated in this study that consisted of a 30-day control low fiber period followed by a 30-day IO-supplemented (10 g active components) experimental period. Bowel functions such as defecation, enema use and bloating were monitored daily. Fecal characteristics such as wet and dry stool weights, stool moisture, pH and short-chain fatty acid contents were determined on five-day fecal composites collected in each period. Feces were further fractionated into plant, bacterial and soluble fractions to determine the bases for the increase in stool weight. Nutritional status of subjects was assessed with anthropometric parameters, nutrient intake and biochemical measurements. RESULTS: Incorporation of IO significantly increased the defecation frequency, wet stool output and dry stool weight by twofold, 70% and 55%, respectively. Fecal acetate and propionate concentrations significantly increased by nearly two and a half fold with IO supplement. The increase in stool bulk was mainly attributed by increased bacterial mass. Mean serum sodium concentration decreased in the experimental period while other blood characteristics did not change significantly. Anthropometric parameters and nutrient intake remained constant throughout the study. CONCLUSIONS: Consumption of IO effectively improved bowel movement, stool output and microbial fermentation in the colon without any adverse effect observed in this study. Therefore, supplementation of IO into ordinary low fiber diets may be practical in relieving constipation in the elderly population.

Aged↗
PubMed2003

Health and social benefits from improving community hygiene and sanitation: an Indian experience.

India is a country where Atomic Age and near Stone Age people co-exist. On one hand India has achieved development in many areas, but on the other hand there is still the practice of open defecation and manual cleaning of human excreta from bucket privies by scavengers. National sanitation coverage is only about 34% meaning that 66% of the population practises open defecation. Such unhygienic conditions lead to infections and high mortality and morbidity in the community. Low sanitation coverage could be due to lack of affordable sanitation technology and awareness or motivation. Although the sewerage system was introduced in India long ago, high operational and maintenance costs have prohibited it from being implemented in most towns and cities. Similarly, the cost of a septic tank is beyond most people, and disposal of undigested sludge from septic tanks remains a problem. In contrast, the pour-flush two-pit toilet (known as Sulabh Shauchalaya) is a low cost, socially acceptable and appropriate technology that does not require scavengers to clean the pits. Sulabh has converted and constructed over 1.2 million such toilets throughout India, making 240 towns scavenger-free. Liberated scavengers are thereby available to take up vocational training in various market-oriented trades enabling self-employment. The on-site/ decentralised systems of waste management has improved community health and hygiene, particularly in socially deprived groups, and reduced the financial burden of local government.

Defecation↗
PubMed2005

A study of neonatal swimming (water therapy) applied in clinical obstetrics.

OBJECTIVE: To study the significance of some clinical parameters related to neonatal 'swimming' (water therapy) during hospitalization. METHODS: Normal newborns were randomly divided into two groups to observe their birth weight, weight before discharge,time of first defecation and meconium turning yellow. Group one was the swimming (study) group, comprising a total of 223 newborns including 127 babies delivered after spontaneous vaginal delivery and 96 babies after Cesarean section. Group two was the bathing (control) group, comprising 154 newborns including 109 babies delivered after spontaneous vaginal delivery and 45 babies after Cesarean section. RESULTS: There was no significant difference in birth weight between the two groups (p > 0.05). However, the mean weight before discharge of the babies in the study group was 3.29 + 0.35 and 3.51 + 0.40 kg, spontaneous vaginal delivery vs. Cesarean section, compared with 3.09 + 0.38 and 3.17 + 0.48 kg, respectively, in the control group (p < 0.01). The corresponding mean times of meconium turning yellow were 39.15 + 15.88 and 39.02 + 13.60 h in the study group compared with 48.01 + 19.42 and 55.67 + 25.05 h in the control group. This difference was significant (p < 0.01), as was the difference between the time of first defecation (p < 0.05). CONCLUSION: Neonatal swimming can accelerate babies' growth in the early stage.

Baths↗
PubMedDate not supplied

Daily rhythms of food intake and feces reingestion in the degu, an herbivorous Chilean rodent: optimizing digestion through coprophagy.

Animals must match their foraging and digestion to seasonal changes in availability and quality of food. When these parameters decline, the animal's performance limits for extracting energy and nutrients may be challenged. In the laboratory, we investigated daily patterns of food processing on a low-quality (high-fiber) diet of alfalfa in an herbivorous, day-active rodent, the degu (Octodon degus), which inhabits semiarid central Chile. We manipulated timing of food availability, from continuous availability down to as little as 5 h/d. Degus maintained weight while digesting only 53% of dry-matter consumption. With food continuously available in a metabolic cage, the animals ate more food and deposited about twice as much feces in the day as at night. Continuous 24-h behavioral observation revealed that degus were actually defecating at the same rate both night and day but then ingesting most of the feces they produced at night. Further experimental treatments challenged animals with limited periods of food availability that matched natural foraging patterns. With either 11 h of daytime food availability or only 5 h (in morning and afternoon periods of 2.5 h each), degus consumed as much food as those with 24-h food availability. Continuous 24-h behavioral observations revealed in the 11-h group that nearly all feces produced at night were reingested and nearly none were reingested in the day, whereas the 5-h group resorted to further coprophagy during the 6-h midday interval with no food. Despite these differences in timing of food intake and coprophagy in response to the three experimental treatments, the degus were defecating at the same rate both night and day, which indicated a constant rate of output from the colon. This suggests a range of adjustments of digestive physiology to the timing of gut function by balancing coprophagy with ingestion of food. Overall, 38% of 24-h feces production was reingested, and 87% of this coprophagy occurred at night. The ingestion of feces during parts of the day when food is unavailable provides for continued intake into the digestive tract and appears to represent an increase in overall efficiency of gut use.

Animals↗
PubMed2003

Defecography in symptomatic older women living at home.

BACKGROUND: complaints of defecation disorders in older patients living at home is an emerging problem. Little is known about radiological examination of this population. OBJECTIVE: this study aimed to analyse the yield of defecography in women older than 75 years, living at home and complaining of defecation disorders. DESIGN AND SETTINGS: prospective study of patients referred to a radiology department in a tertiary-care medical centre in Rouen, France. SUBJECTS AND METHODS: 52 women (mean age: 78, range: 75-93) complaining of constipation, faecal incontinence or pelvic pain underwent defecography. Defecography was performed after intake of a barium meal and vaginal opacification. Radiographs were analysed accordingly with the established criteria. RESULTS: defecography showed perineal descent in 27 patients, rectocele in 29, intussusception in 33 and enterocele in 14. A combination of abnormalities was found in 40 women. Only 3 studies were normal. There was no significant association between symptoms and pelvic disorders revealed by defecography. CONCLUSIONS: defecography in symptomatic women aged 75 years and over did not raise any technical difficulty. It revealed a 77% rate of abnormalities, but there was no relationship between the symptoms and the detected abnormalities.

Aged↗
PubMed1994

The long-term effect of adjuvant postoperative chemoradiotherapy for rectal carcinoma on bowel function.

OBJECTIVE: The authors assessed the long-term effect of postoperative chemoradiotherapy on bowel function. SUMMARY BACKGROUND DATA: Adjuvant postoperative radiation therapy, often combined with chemotherapy, is being used increasingly often for rectal carcinoma. However, the long-term effect of this treatment on bowel function has not been investigated. METHODS: The records were reviewed of all patients undergoing anterior resection for rectal carcinoma 2 to 5 years previously. During this period, patients with Astler-Coller stage B2 or C tumors generally were given postoperative radiation therapy with chemotherapy, whereas those with earlier stage tumors were not. To minimize possible confounding factors that may have been more common in the group receiving chemoradiotherapy and that may affect bowel function, extensive exclusion criteria were used, such as invasion of contiguous organs, local or distant metastases, use of a dysfunctioning stoma, and anastomotic or pelvic complications. One hundred remaining patients were suitable for inclusion in the study and participated in a telephone questionnaire; 41 patients had postoperative chemoradiotherapy, and 59 did not. RESULTS: The two groups were well matched for sex, level of anastomosis, and length of follow-up, although the group receiving chemoradiotherapy was slightly younger. The group that had chemoradiotherapy had more bowel movements per day than the group that did not have radiation therapy (median 7 vs. median 2, p < 0.001); the former group had "clustering" of bowel movements more often (42% vs. 3%, p < 0.001), had nighttime movements more often (46% vs. 14%, p < 0.001), had occasional or frequent incontinence more often (39% and 17% vs. 7% and 0%, p < 0.001), wore a pad more often (41% vs. 10%, p < 0.001), and were unable to defer defecation for more than 15 minutes more often (78% vs. 19%, p < 0.001). The group that had chemoradiotherapy also had stool of liquid consistency, used antidiarrheal medications, had perianal skin irritation, were unable to differentiate stool from gas, and needed to defecate again within 30 minutes of a movement significantly more often than the group that did not receive chemoradiotherapy. CONCLUSION: Adjuvant postoperative chemoradiotherapy for rectal carcinoma has a major long-term detrimental effect on bowel function.

Adenocarcinoma↗
PubMedDate not supplied

MR defecography: depiction of anorectal anatomy and pathology.

With the advent of open-configuration MR systems, enabling image acquisition in a vertical patient position, MR defecography has become possible. MR defecography permits analyses of the anorectal angle, opening of the anal canal, functioning of the puborectal muscle, and descent of the pelvic floor during defecation. The rectal walls are well delineated on the GRE images, permitting visualization of intussusceptions and rectoceles. The concomitant depiction of structures surrounding the anorectal canal is helpful in the assessment of a spastic pelvic floor and the descending perineum syndrome and in permitting visualization of enteroceles. Dynamic MR defecography is an attractive alternative in the evaluation of defecation disorders.

Adult↗
PubMed1998

Voiding function in patients with the prune-belly syndrome after Monfort abdominoplasty.

PURPOSE: We reviewed our experience with patients with the prune-belly syndrome who had undergone Monfort abdominoplasty to assess whether our clinical impression of improved voiding efficiency could be demonstrated objectively. MATERIALS AND METHODS: From 1990 to 1993, 12 patients with the prune-belly syndrome underwent Monfort abdominoplasty with or without concomitant genitourinary reconstruction. All patients completed questionnaires on voiding before and after abdominoplasty, incontinence, bladder sensation, urinary flow, history of urinary tract infections and the ability to defecate. Urodynamic testing was performed in 8 patients before and after abdominoplasty. RESULTS: Subjective changes that occurred after abdominoplasty included resolution of or less double voiding in 9 patients, improved urinary continence in 7, improved bladder fullness sensation in 11, improved urinary flow in 10 and improved defecation in 5. The incidence of urinary tract infections decreased from a preoperative average of 5.7 per patient per year to 1.2 per patient per year postoperatively. Urodynamics demonstrated no significant changes in the measured urinary flow, capacity or maximal detrusor pressure. Compliance decreased on average but it remained in the compliant range. However, post-void residual volumes did significantly decrease from a preoperative average of 40.3% of bladder capacity to 13% after abdominoplasty. If the 5 patients who underwent concomitant urinary reconstruction were excluded, the reduction in average post-void residuals remained approximately the same, which was 40% of bladder capacity preoperatively to 14.3% after abdominoplasty. These data suggest that abdominoplasty alone was responsible for improved micturition. CONCLUSIONS: In addition to the cosmetic benefits and exposure provided for genitourinary reconstruction Monfort abdominoplasty seems to improve voiding efficiency.

Abdominal Muscles↗
PubMed1997

Effects of risperidone on conditioned avoidance responding in male mice.

The effects of risperidone (0.1, 0.5 and 1 mg/kg) on active avoidance behaviour of BALB/C mice were explored in three acquisition sessions and in one subsequent performance session. In the acquisition phase, risperidone-treated animals showed a decrease in avoidances and in crossings in the adaptation period and in the intertrial intervals (ITIs), and an increase in non-responses; intermediate and high doses also decreased defecation. In the performance phase, 0.5 and 1 mg/kg risperidone decreased avoidance responses, crossings in the adaptation period and ITI crossing, which also decreased with 0.1 mg/kg. Moreover, 0.5 mg/kg of risperidone increased escape responses and 1 mg/kg increased non-responses and decreased defecation. The results show that risperidone has similar effects to other neuroleptics in the avoidance paradigm.

Animals↗
PubMed2001

Intrarectal injection of glycerol induces hypersensitivity to rectal distension in healthy subjects without modifying rectal compliance.

BACKGROUND: Rectal sensory thresholds are lowered in patients with irritable bowel syndrome (IBS), reflecting visceral hyperlagesia, which might be related to subclinical inflammation. AIM: To evaluate the effects of an intraluminal injection of glycerol, a mucosal irritant, on rectal tone and perception of distension in 12 healthy subjects. METHODS: Rectal tone was evaluated with a barostat. First sensation, need to defecate and pain thresholds were evaluated during isobaric phasic distensions, before and 20 and 120 min after injection of 10 ml glycerol in the rectum. RESULTS: Baseline bag volume (97.9 +/- 56.2 ml) significantly decreased 20 min (49.7 +/- 42.2 ml; P= 0.026) and 120 min (66.5 +/- 38.3 ml; P= 0.050) after injection of glycerol, indicating its hypertonic effect. The pressure defining sensory thresholds was decreased significantly 20 min after glycerol injection: first sensation, 14.6 +/- 2.9 versus 18.3 +/- 7.2 mm Hg (P = 0.01); need to defecate, 19.6 +/- 3.7 versus 26.0 +/- 6.9 mm Hg; pain, 23.8 +/- 4.5 versus 35.6 +/- 9.5 mm Hg (P = 0.001). This effect was maintained for 120 min after injection of glycerol. Slopes of the compliance curves did not differ before and after injection of glycerol. CONCLUSIONS: Intraluminal injection of glycerol significantly increases rectal tone and sensitizes healthy volunteers to rectal distension, since they show significantly lower thresholds after glycerol. This could constitute a model of visceral hypersensitivity in healthy volunteers.

Administration, Rectal↗
PubMed2003

Enteral naloxone reduces gastric tube reflux and frequency of pneumonia in critical care patients during opioid analgesia.

OBJECTIVE: Opioid analgesia impairs gastrointestinal motility. Enteral administration of naloxone theoretically allows selective blocking of intestinal opioid receptors caused by extensive presystemic metabolism. Therefore, we studied the effect of enteral naloxone on the amount of gastric tube reflux, the frequency of pneumonia, and the time until first defecation in mechanically ventilated patients with fentanyl analgesia. DESIGN: Prospective, randomized, double-blinded study. SETTING: University hospital intensive care unit. PATIENTS: Eighty-four mechanically ventilated, fentanyl-treated patients without gastrointestinal surgery or diseases. INTERVENTIONS: Patients were assigned to receive 8 mg naloxone or placebo four times daily via a gastric tube during fentanyl administration. MEASUREMENTS AND MAIN RESULTS: Thirty-eight patients received naloxone and 43 placebo; three patients were excluded because of protocol violation. Median gastric tube reflux volume (54 vs. 129 mL, p =.03) and frequency of pneumonia (34% vs. 56%, p =.04) were significantly lower in the naloxone group. In both groups, time until first defecation, ventilation time, and length of intensive care unit stay did not differ. There was no difference in fentanyl requirements between the naloxone and the placebo group (7 vs. 6.5 microg/kg/hr, p =.15). CONCLUSIONS: Our results provide evidence that the administration of enteral opioid antagonists in ventilated patients with opioid analgesia might be a simple-and possibly preventive-treatment of increased gastric tube reflux and reduces frequency of pneumonia.

Administration, Oral↗
PubMed2006

Short-term effects of magnetic sacral dermatome stimulation for idiopathic slow transit constipation: sham-controlled, cross-over pilot study.

BACKGROUND AND AIM: An increase in recto-sigmoid colon activity through electrical stimulation of the sacral dermatomes has previously been reported. It has not been evaluated whether or not sacral dermatome stimulation has beneficial effects on constipation symptoms and anorectal function in constipated patients. Our aim was to evaluate short-term effects of magnetic stimulation of the sacral dermatomes on constipation symptoms and anorectal function in patients with idiopathic slow transit constipation. METHOD: Fourteen patients with idiopathic slow transit constipation were enrolled. Constipation symptoms, stool form and anorectal function were assessed before treatment, and at 3 and 6 weeks of treatment. Six-week treatment consisted of either a 3-week period of sham treatment or a 3-week period of magnetic stimulation of the S2-S3 dermatomes, which was performed in a randomized cross-over design. RESULTS: During the stimulation period, the frequency score of spontaneous bowel movements decreased in eight of the 14 patients (2.9 [2-3]vs 1.4 [0-2]), whose threshold volumes for urge to defecate and maximum tolerable volumes were significantly greater than those of the non-responders, and significantly decreased at the end of treatment. The degree of straining on defecation also significantly decreased in the responders. Responders had shorter right colonic transit time and longer left colonic transit time compared to the non-responders. Sham treatment did not affect constipation symptoms, stool form and rectal sensation. CONCLUSION: Sacral dermatome stimulation may offer potential for therapeutic benefit for a subset of patients with idiopathic slow transit constipation, particularly constipated patients with rectal hyposensation or hindgut dysfunction.

Adult↗
PubMed2006

Effects of magnetic stimulation in the treatment of pelvic floor dysfunction.

OBJECTIVE: To correlate, in a pilot study, the clinical results of extracorporeal magnetic innervation therapy (ExMI) of the pelvic floor muscles with functional changes in the pelvic floor musculature, urodynamics and quality of life. PATIENTS AND METHODS: In all, 74 patients (65 women and nine men) with urge incontinence, urgency/frequency, stress incontinence, mixed incontinence and defecation problems were included in a prospective study of ExMI using a 'electromagnetic chair'. All patients were treated twice weekly for 8 weeks. Digital palpation and biofeedback with a vaginal or anal probe were used for registration of the pelvic floor musculature. A urodynamic evaluation, a voiding diary, a pad-test, the King's Health Questionnaire (KHQ) and a visual analogue scale (VAS) were completed by the patient at baseline and at the end of the study. RESULTS: In the group as a whole, there were no significant differences in the voiding diary, pad-test, quality of life, VAS score, biofeedback registration and urodynamics before and after treatment. Additional stratification was applied to the total patient group, related to the pretreatment rest tone of the pelvic floor, the basal amplitude registered on electromyography, to age and to previous treatments. However, there were no significant differences in the data before and after treatment within all subgroups (stress incontinence, urge incontinence, urgency/frequency, defecation problems, overactive pelvic floor, age, previous treatments), except for the KHQ domain of 'role limitations', where there was a significant improvement in all groups. CONCLUSION: ExMI did not change pelvic floor function in the present patients. The varying outcomes of several studies on ExMI stress the need for critical studies on the effect and the mode of action of electrostimulation and magnetic stimulation. In our opinion 'the chair' is suitable to train awareness of the location of the pelvic floor. However, active pelvic floor muscle exercises remain essential.

Adult↗
PubMed1996

5-HTP induced diarrhea as a carcinoid syndrome model in mice?

Serotonin (5-HT) is present in the gastrointestinal tract and is probably one of the compounds responsible for diarrhea in patients presenting with carcinoid syndrome. Intraperitoneal administration of L-5-hydroxytryptophan (L-5-HTP) at doses of 25 to 100 mg/kg dramatically increase defecation in mice. In this new paradigm, counting fecal boli deposited is simple and the appraised or inhibition of diarrhea induced by ip 25 mg/kg of L-5-HIP is very clear, with a good reproducibility of scores. L-5-HTP needs to be metabolized into 5-HT to be active; benserazide, an inhibitor of decarboxylase, antagonized the diarrhea induced by 5-HT. Among the 5-HT antagonists used in interaction with 5-HT, only these of the 5-HT3 type (ondansetron, granisetron, tropisetron) and, to a lesser extent 5-HT2 type (ritanserin), decreased the diarrhea induced by 5-HTP. The 5-HT4 receptor agonists from the benzamide family (metoclopramide and zacopride) increased defecation in mice but the effect failed to reach statistical significance.

5-Hydroxytryptophan↗