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PubMed1992

Drug treatment of the irritable bowel syndrome.

Irritable bowel syndrome (IBS) is defined as a functional bowel disorder in which abdominal pain is associated with defecation or a change in bowel habit, and with features of disordered defecation and distension. The irritable bowel syndrome occurs in 10 to 20% of people worldwide and is very commonly encountered in clinical practice. This has encouraged the pharmaceutical industry to search for effective drug therapy. So far, a universally effective agent has not been found, and since this is a chronic, benign disorder, beginning in youth, long term drug use should be avoided. Nevertheless, if a specific IBS symptom, such as constipation or abdominal pain dominates, a specific drug may be helpful. However, tests and treatment should be minimised or even avoided in order to do no harm. A largely nonpharmaceutical approach to IBS should be taken. This approach employs drugs sparingly and then only targeted at specific and resistant symptoms.

Analgesics↗
PubMed2004

Management of irritable bowel syndrome.

Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders. The prevalence rate is 10-20% and women have a higher prevalence. IBS adversely affects quality of life and is associated with health care use and costs. IBS comprises a group of functional bowel disorders in which abdominal discomfort or pain is associated with defecation or a change in bowel habit, and with features of disordered defecation. The consensus definition and criteria for IBS have been formalized in the "Rome II criteria". Food, psychiatric disorders, and gastroenteritis are risk factors for developing IBS. The mechanism in IBS involves biopsychosocial disorders; psychosocial factors, altered motility, and heightened sensory function. Brain-gut interaction is the most important in understanding the pathophysiology of IBS. Effective management requires an effective physician-patient relationship. Dietary treatment, lifestyle therapy, behavioral therapy, and pharmacologic therapy play a major role in treating IBS. Calcium polycarbophil can benefit IBS patients with constipation or alternating diarrhea and constipation.

Adolescent↗
PubMed1997

The role of parity and hysterectomy on the development of pelvic floor abnormalities revealed by defecography.

OBJECTIVE: The purpose of our study was to assess the role of multiparity and pelvic surgery, especially hysterectomy, on pelvic floor dysfunction as diagnosed on defecography. MATERIALS AND METHODS: Three hundred fifty-four women who underwent defecography between 1986 and 1996 were asked to provide information regarding obstetric history and pelvic surgery. Responses were obtained from 272 women (response rate, 77%). Their presenting symptoms ranged from incontinence to constipation and obstructed defecation. Historical data were correlated with incidence of defecographic abnormalities that included rectocele, enterocele, rectal prolapse, incontinence, excessive pelvic floor descent, and dyskinetic puborectal muscle. RESULTS: Women with three or more birth deliveries were more likely to have incontinence (48% versus 36%, p = .05) and excessive pelvic floor descent (26% versus 17%, p = .07) than women who had delivered fewer children. Women undergoing hysterectomy before defecography were more likely to have enterocele (40% versus 25%, p = .009) and excessive pelvic floor descent (25% versus 15%, p = .04) than women who had never undergone hysterectomy. CONCLUSION: Our findings confirm the common belief that trauma from childbirth or hysterectomy contributes to the development of defecation disorders.

Defecography↗
PubMedDate not supplied

[Signs and symptoms associated with chronic constipation]

OBJECTIVE: To check whether signs and symptoms referred to by parents are associated with chronic constipation. METHODS: A comparative survey was carried out in a group of children with constipation and another group without constipation selected from a random sample. Data were collected from mothers using a structured questionnaire. Children with chronic constipation were expected to have undergone painful defecation or defecation with effort during at least thirty days with stools of hard consistency and/or bowel movements frequency below three times per week. RESULTS: An assessment was made of the variables: inappetence, abdominal distension, abdominal pain, fecal bleeding, soiling, urinary problems and vomit. Statistical differences were observed among children with and without constipation for inappetence, abdominal pain and faecal bleeding (p<0.05). CONCLUSIONS: An association was detected between the signs and symptoms analyzed and constipation. This study stresses the need to investigate accurately whether children have constipation and the extent of its relationship with those complications.

Journal Article↗
PubMed2006

Combined parasacral, vaginal and endorectal approach in surgical treatment of giant rectocele.

Authors operated on their Surgical departement 67 years old women with incomplete evacuation, and digital support during defecation, giant rectocele and massive vaginal vault prolaps. Authors realized cinedefecography and detected giant rectocele, depth was 8 cm, anorectal angle was 120 degrees. They stated Resting pressure 40 cm H2O, and Maximum squeeze pressure 50cm H2O by anorectal manometry. Authors verified external anal sphincters defect by endoanal ultrasound and determined Pudendal nerve terminal motor latency (PN TML) and recorded pathologic values of n.pudendal latency ( left branch 2,7 msec., right branch 4,3 msec). In concerning massive vaginal vault prolaps, huge rerectocele and clinical incompletely evacuation with self digital support during defecation with present defect od external anal sphincters and pathologic values of PN TML, authors indicated and made combined transvaginal, endorectal and perineal reconstructive operative performance. In the present time two years after the surgery radiologic mean depth of the rectocele was significantly reduced (preoperatively 8cm; postoperatively 1 cm). Anorectal angle is 100 degrees. Values of the PN TML is normaly (left branch of n. pudendalis 1,7 msec and right branch of n. pudendalis 1,9 msec). Authors recorded Resting pressure 60 cm H2O and Maximum squeeze pressure 110 cm H2O by anorectal manometry. They didnt visualized any external anal sphincters defect by anal ultrasound. Postoperatively difficult evacuation completely disappeared and digital support was no longer necessary during evacuation.

Aged↗
PubMed2006

Evaluation of the effects of the opioid agonist morphine on gastrointestinal tract function in horses.

OBJECTIVE: To evaluate the effects of morphine administration for 6 days on gastrointestinal tract function in healthy adult horses. ANIMALS: 5 horses. PROCEDURES: Horses were randomly allocated into 2 groups in a crossover study. Horses in the treatment group received morphine sulfate at a dosage of 0.5 mg/kg, IV, every 12 hours for 6 days. Horses in the control group received saline (0.9% NaCl) solution at a dosage of 10 mL, IV, every 12 hours for 6 days. Variables assessed included defecation frequency, weight of feces produced, intestinal transit time (evaluated by use of barium-filled spheres and radiographic detection in feces), fecal moisture content, borborygmus score, and signs of CNS excitement and colic. RESULTS: Administration of morphine resulted in gastrointestinal tract dysfunction for 6 hours after each injection. During those 6 hours, mean +/- SD defecation frequency decreased from 3.1 +/- 1 bowel movements in control horses to 0.9 +/- 0.5 bowel movements in treated horses, weight of feces decreased from 4.1 +/- 0.7 kg to 1.1 +/- 0.7 kg, fecal moisture content decreased from 76 +/- 2.7% to 73.5 +/- 2.9%, and borborygmus score decreased from 13.2 +/- 2.9 to 6.3 +/- 3.9. Mean gastrointestinal transit time was also increased, compared with transit times in control horses. CONCLUSIONS AND CLINICAL RELEVANCE: Morphine administered at 0.5 mg/kg twice daily decreased propulsive motility and moisture content in the gastrointestinal tract lumen. These effects may predispose treated horses to development of ileus and constipation.

Analgesics, Opioid↗
PubMed2006

Pharmacokinetics of the opioid antagonist N-methylnaltrexone and evaluation of its effects on gastrointestinal tract function in horses treated or not treated with morphine.

OBJECTIVE: To determine the pharmacokinetics and effects of the morphine antagonist N-methylnaltrexone (MNTX) on gastrointestinal tract function in horses when administered alone and in combination with morphine. ANIMALS: 5 healthy adult horses. PROCEDURES: Horses were treated with MNTX (1 mg/kg, IV), and serial blood samples were collected for determination of drug pharmacokinetics. For evaluation of effects on the gastrointestinal tract when administered alone, MNTX was administered at a dosage of 0.75 mg/kg, IV, twice daily for 4 days. For evaluation of effects when administered concurrently with morphine, MNTX (0.75 mg/kg, IV, q 12 hours) and morphine (0.5 mg/kg, IV, q 12 hours) were administered for 6 days. Gastrointestinal variables evaluated were defecation frequency, weight of feces produced, fecal moisture content, intestinal transit time, and borborygmus scores. RESULTS: The time-concentration data for MNTX disposition best fit a 2-compartment model with a steady-state volume of distribution of 244.6 +/- 21.8 mL/kg, t1/2 of 47.04 +/- 11.65 minutes, and clearance of 11.43 +/- 1.06 mL/min/kg. Adverse effects were not observed at doses <or= 1 mg/kg. Administration of MNTX increased daily fecal weight. When administered concurrently with morphine, MNTX partially prevented the effects of morphine on the gastrointestinal tract by increasing defecation frequency, fecal weight, fecal moisture content, and borborygmus score, and by preventing increases in intestinal transit time. CONCLUSIONS AND CLINICAL RELEVANCE: Because MNTX does not cross the blood-brain barrier, administration of the drug should not alter the analgesic effects of opioids and may attenuate the adverse gastrointestinal effects associated with use of opioids in horses.

Analgesics, Opioid↗
PubMed2002

Separation anxiety syndrome in cats: 136 cases (1991-2000).

OBJECTIVE: To determine whether cats develop clinical signs typical of separation anxiety syndrome (SAS) and the type and frequency of applicable clinical signs in affected cats. DESIGN: Retrospective study. ANIMALS: 136 cats with clinical signs typical of SAS in dogs. Subjects were evaluated during home visits. PROCEDURE: Medical records of pet cats evaluated for behavior problems during a 10-year period were reviewed. Medical records of cats that displayed behaviors typical of dogs with SAS (eg, inappropriate elimination, excessive vocalization, destructiveness, or self-mutilation) were more extensively examined, and cats that displayed these behaviors only when separated from an apparent attachment figure were included in the study. RESULTS: Behavior problems triggered by separation anxiety included inappropriate urination (96 cats), inappropriate defecation (48), excessive vocalization (16), destructiveness (12), and psychogenic grooming (8). Inappropriate defecation was identified in a significantly higher percentage of the neutered females in the study than in the neutered males. Seventy-five percent of the cats that urinated inappropriately urinated exclusively on the owner's bed. Psychogenic grooming was identified in 8 of the 40 neutered females but in none of the neutered males, whereas destructiveness was observed in 12 of the 92 neutered males but in none of the neutered females. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that cats can develop SAS. Sex and breed differences in the frequency of particular signs of SAS in cats may exist. Feline SAS should be considered in the differential diagnosis of anxiety-related misbehavior in cats.

Aggression↗
PubMed2006

Outdoor fecal deposition by free-roaming cats and attitudes of cat owners and nonowners toward stray pets, wildlife, and water pollution.

OBJECTIVE: To estimate cat population size, management, and outside fecal deposition and evaluate attitudes of cat owners and nonowners to stray animal control, water pollution, and wildlife protection. DESIGN: Cross-sectional survey. SAMPLE POPULATION: 294 adult residents of Cayucos, Los Osos, and Morro Bay, Calif. PROCEDURES: Telephone survey. RESULTS: The region's cat population was estimated at 7,284 owned and 2,046 feral cats, and 38% of surveyed households owned a mean of 1.9 cats/household. Forty-four percent of cats defecated outside >75% of the time. Annual fecal deposition (wet weight) by owned cats in the 3 communities was estimated to be 77.6 tonnes (76.4 tons). Cat owners were more likely to oppose cat licensing and impounding stray cats and support trap-neuter-return for stray cats and less likely to be concerned about water pollution, than were noncat owners. CONCLUSIONS AND CLINICAL RELEVANCE: Feral cats represented a sizeable proportion (22%) of the free roaming cats in this area and could be contributing 30.0 tonnes (29.5 tons) of feces to the environment per year. However, feral cats are not the principal source of fecal loading because owned cats defecating outdoors contribute an estimated 77.6 tonnes (76.4 tons) or 72% of the annual outdoor fecal deposition.

Animal Husbandry↗
PubMed1991

Open-field parameters and maze learning in aggressive and nonaggressive male mice.

Significant differences were observed in thigmotaxis, ambulation, and latency to move (time to start ambulating) between highly aggressive (TA) and low aggressive (TNA) male mice. The former displayed more thigmotaxis, ambulated more, and had a shorter latency to move than the TNA animals. Also they voided a greater number of urinary spots and defecated less than TNA. Further they were superior to the TNA mice in maze-learning capacity. The tendency to enter inner partitions of the field as well as total ambulation increased after learning by TA mice. The training toward nonaggressiveness of TA mice suppressed aggressive responses, thigmotaxis, and the number of urinary spots but enhanced defecation. All measures returned to their initial levels after one month of rest. The attacking behaviour of TA animals increased both thigmotaxis and ambulation.

Aggression↗
PubMed1997

Prepartum behavior in swine: effects of pen size.

Gravid Yorkshire sows assigned to one of three pen sizes on d 109 of gestation, were continuously observed for 72 h before parturition. Pens included a 2.1- x .7-m rectangular farrowing crate (n = 6), a small, square pen 2.1 x 2.1 m (n = 5), and a large, square pen 4.2 x 4.2 m (n = 5). Body positions were recorded at 30-s intervals. Other behaviors were recorded using the one-zero method of sampling at 1-min intervals. Sows became more active as they approached farrowing. They stood, sat, lay with legs under, changed positions, drank, urinated, defecated, rooted the floor and pipes, mouthed the waterer and pipes, and pawed the floor more (P < .05) during the 24 h before the birth of the first pig than during the previous 2 d. Position changes, rooting the floor, and pawing frequency peaked during the 6 h preceding parturition and show promise as predictors of parturition. During the 24 h preceding the birth of the first pig, farrowing crate sows stood, rooted the floor, and pawed less and sat, lay, and changed positions more than sows in either pen (P < .05). No differences (P > .05) among pens were noted for lying with legs under or out, eating, drinking, urinating, defecating, rooting the pipes, mouthing the pipes. or mouthing the waterer. Pipe biting and other behaviors commonly thought to be caused by confinement stress occurred in all three pen sizes and seem to be components of nest-building, expressed inappropriately, in a barren environment.

Animals↗
PubMed2003

Central and peripheral concentrations of tumor necrosis factor-alpha in Chinese Meishan pigs stimulated with lipopolysaccharide.

The objective of this study was to investigate the presence of tumor necrosis factor-alpha (TNF-alpha) in the central nervous system and the effects of lipopolysaccharide on central and peripheral concentrations of TNF-alpha, behavioral conditions (standing or lying), elimination scores (defecation or urination), rectal temperature, and food intake (as-fed basis) in Chinese Meishan pigs. Intravenous injections of lipopolysaccharide resulted in increased (P < 0.05) plasma concentrations of TNF-alpha and cortisol. Although urination was not affected by the administration of lipopolysaccharide, defecation was stimulated (P < 0.05). Lipopolysaccharide increased (P < 0.05) rectal temperature and standing rate, and inhibited (P < 0.05) food intake in pigs. To determine whether TNF-alpha is present in the porcine central nervous system as well as in peripheral blood, TNF-alpha and its specific transcripts in brain tissues (hypothalamus, amygdala, or hippocampus) and the pituitary were determined. The abundance of TNF-alpha messenger RNA and immunoreactive TNF-alpha were observed in all tissues, and the concentrations of TNF-alpha were increased (P < 0.05) by the intramuscular injection of lipopolysaccharide. These results suggest that TNF-alpha is present in the central nervous system, and plays some roles in its biological regulation in Chinese Meishan pigs.

Animals↗
PubMed1985

Social facilitation of feeding and time budgets in stabled ponies.

Eight pairs of pony mares were observed. Members of a pair were housed in adjacent stalls and fed hay ad libitum. The behavior of both ponies was recorded simultaneously in the morning (1000 to 1200 h) and afternoon (1400 to 1600 h) for a total of 117 h. The time budget was: 70.1 +/- 8.6% eating; 17.8 +/- 7.4% standing (including stand rest, stand alert and stand nonalert); 5.2 +/- 7.0% pushing hay; 2.9 +/- 1.2% walking; 1.9 +/- 2.9% drinking; 1.3 +/- 1.1% self-grooming; .2 +/- .3% defecating; .06 +/- .1% chewing nonfood items; .06 +/- .03% urination; .06 +/- .1% licking salt; .07 +/- .1% pawing hay; .6 +/- .7% lying and .07 +/- .08% stretching the neck over the stall wall dividing the ponies. While eating, the ponies lifted their heads 25.4 +/- 11.0 times/h. In less than one-half of the occasions when urination or defecation was observed, the ponies walked away from the spot where they had been eating to eliminate. During one-half of the observations, visual contact between the ponies was prevented by a solid partition between the stalls. The ponies spent significantly more time standing nonalert when the partition prevented visual contact (12 +/- 7%) than when visual contact could take place (6 +/- 3%, P less than .05). When fresh hay was supplied in the mornings, the ponies spent similar amounts of time eating whether visual contact was allowed or not, but in the afternoon significantly more time was spent feeding when visual contact was allowed (73 +/- 4%) than when it was not (60 +/- 7%).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

The influence of ispaghula husk and lactulose on the in vivo and the in vitro production capacity of short-chain fatty acids in humans.

To evaluate factors influencing the short-chain fatty acid (SCFA) concentrations in stools, three different experiments were performed: faecal concentrations of SCFA at defecation were determined by gas liquid chromatography in nine healthy volunteers on a free diet. SCFAs were 114 +/- 15.0 mmol/l (means +/- SD). The coefficient of variation (CV) of the assay was 4-15%, the intraindividual CV 12-33%, and the interindividual CV 11-29%. On incubation of faeces at 37 degrees C concentrations of SCFA doubled in 6 h and rose fourfold in 72 h. In three volunteers the experiments were extended by adding ispaghula husk or lactulose to the diet for two 14-day periods each; no change in faecal SCFA concentrations was seen, either at defecation or after incubation. When ispaghula husk or lactulose was added to faeces in an in vitro incubation system, the concentrations of SCFA were five times higher than those of controls. We conclude that instant handling of faeces is essential for determinations of SCFA concentrations to obtain interpretable and comparable results; that determination of total SCFA output is of limited value; that addition of fibre to the diet does not influence faecal SCFA concentrations; and that the capacity for SCFA production in faeces is large provided a sufficient amount of substrate is available.

Adult↗
PubMed1994

Influence of partially hydrolyzed guar gum on constipation in women.

A partially hydrolyzed guar gum preparation (PHGG, average molecular weight: 20,000), obtained as a water-soluble dietary fiber by digestion of guar gum with beta-D-endomannanase, was administered as a beverage (11 g a day, bid) to 15 constipated women for 3 weeks. Defecating frequency, pH, weight, moisture, and bacterial flora of the feces were investigated and compared with the control periods. Average total dietary fiber taken from food was 9.7 +/- 0.1 g/day during the experiment. PHGG caused an increase in the defecating frequency from 0.46 +/- 0.05 (frequency/day, M +/- SE) to 0.63 +/- 0.05. Fecal moisture significantly increased from 69.1% in the control period to 73.8% by ingestion of PHGG. Fecal moisture content also increased consistent with lowering the pH of feces (r = -0.478). The frequency of Lactobacillus spp. occurrence in feces significantly increased (p < 0.05) compared with the control period. These results clearly indicate that PHGG softens and improves the output of feces.

Adolescent↗
PubMed1999

Colonic transit patterns and plasma cholecystokinin levels in children with recurrent abdominal pain.

Plasma cholecystokinin levels were measured in children with recurrent abdominal pain to investigate the relationship of plasma cholecystokinin levels with colonic transit patterns and clinical symptoms. Subjects consisted of 120 children (mean age 9.6 +/- 2.6 years) for whom colonic transit study had also been done. Plasma cholecystokinin levels were 79.2 +/- 58.7 pg/mL in children with colonic inertia, 70.7 +/- 47.0 pg/mL in hindgut dysfunction, 57.4 +/- 53.1 pg/mL in pelvic outlet obstruction, and 67.6 +/- 47.9 pg/mL in normal colonic transit. These data showed that there was a tendency of increasing plasma cholecystokinin levels in children with proximal colon transit delay, although there was no significant difference among four groups. Plasma cholecystokinin levels in children of 10 years of age and under (54.5 +/- 40.4 pg/mL) were significantly lower (p = 0.01) than in children over 10 years (79.1 +/- 59.8 pg/mL). Plasma cholecystokinin levels based on colonic transit patterns, however, were not significantly different between the two age groups. There was no significant difference in plasma cholecystokinin levels between groups based on defecation frequency per week, presence of defecation pain, symptoms of milk intolerance, or the presence of emotional stress. These results suggested that there was a tendency of increasing plasma cholecystokinin levels in the younger age group and in children with delay in proximal colonic transit, but further study is required in relation to plasma cholecystokinin levels based on colonic transit patterns in a large number of patients.

Abdominal Pain↗
PubMed2003

Visceral hypersensitivity and altered colonic motility after subsidence of inflammation in a rat model of colitis.

AIM: Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by visceral hypersensitivity and altered bowel motility. There is increasing evidence suggesting the role of inflammation in the pathogenesis of IBS, which addresses the possibility that formerly established rat model of colitis could be used as an IBS model after the inflammation subsided. METHODS: Colitis was induced by intracolonic instillation of 4% acetic acid in male Sprague-Dawley rats. The extent of inflammation was assessed by histological examination and myeloperoxidase (MPO) activity assay. After subsidence of colitis, the rats were subjected to rectal distension and restraint stress, then the abdominal withdrawal reflex and the number of stress-induced fecal output were measured, respectively. RESULTS: At 2 days post-induction of colitis, the colon showed characteristic inflammatory changes in histology and 8-fold increase in MPO activity. At 7 days post-induction of colitis, the histological features and MPO activity returned to normal. The rats at 7 days post-induction of colitis showed hypersensitive response to rectal distension without an accompanying change in rectal compliance, and defecated more stools than control animals when under stress. CONCLUSION: These results concur largely with the characteristic features of IBS, visceral hypersensitivity and altered defecation pattern in the absence of detectable disease, suggesting that this animal model is a methodologically convenient and useful model for studying a subset of IBS.

Acetic Acid↗
PubMed2005

[The effects of abdominal meridian massage on constipation among CVA patients].

PURPOSE: This study was aimed at developing an efficient nursing method for the management of constipation by comparing the effects of abdominal meridian massage on the symptoms of constipation. METHOD: The subjects were determined by the Rome II criteria and the Constipation Assessment Scale from Aug 30 through Sep 26, 2002. They were randomly divided into two groups: one experimental group of 16, another control group of 15. Abdominal meridian massage was given to the experimental group and no massage was given to the control group. The frequency of defecation and severity of constipation by CAS were measured. The data was analyzed with the t-test, chi(2)-test, and repeated measures ANOVA. RESULTS: There was a significant improvement in frequency of defecation, and severity of constipation in the experimental group compared to the control group. CONCLUSION: Abdominal meridian massage can be considered an effective nursing method for the management of constipation among CVA patients.

Abdomen↗