SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
The author reports on self-experienced, reboxetine-induced sexual dysfunction (prolonged orgasm of reduced intensity) and seminal emission after defecation. Both disorders were accompanied by pain and ceased within two days after discontinuation of the drug.
Evacuation proctography is an important imaging method for the investigation of abnormalities of defecation. For this procedure, the most commonly carried out measurements are the ano-rectal angle and the position of the pelvic floor. The given mean values and the physiologically acceptable deviations vary just as much as the perceived clinical value of these measurements. 173 evacuation proctograms were evaluated in a prospective study; the subjective abnormalities were correlated with clinical findings. No significant correlation between the measurements from the proctograms and the clinical findings could be determined. The clinical relevance of these measurements is, therefore, uncertain.
The radiograms and videotape recordings from 32 defecographies in patients with defecation complaints were retrospectively analyzed. The patients had been examined in an upright position during stooling of a barium contrast medium. All patients had had a double contrast colon examinations which was normal. Internal procidentia was found in 20 patients, enterocele in 9 patients, proctocele in 10 patients, a defective opening of the anorectal junction which was ascribed to incoordination of the puborectal sling was present in 15 patients. Most patients had a variety of concomitant dysfunctions.
BACKGROUND: The aim of this study was to investigate the motor function of the ileoanal pouch and to evaluate its coordination with proximal small-intestine motility. METHODS: Proctocolectomy and ileal J pouch-anal anastomosis were performed in 12 dogs. Motility was recorded by serosal electrodes and strain gauge transducers. RESULTS: Transmission of the migrating motor complex (MMC) on the pouch appeared in only 37 of 109 measurements. On the ascending limb there was a constant irregular activity with no MMC detectable. Motility pattern of the pouch did not change postprandially. Spontaneous defecation always appeared independently from MMC transmission without an increase of electrical or mechanical activity or endoluminal pouch pressure. CONCLUSIONS: Ileal pouch motility is independent from motility patterns of the proximal intestine. Its random contractile activity might provide storage function and make the pouch act as a functional reservoir. Intrinsic pouch motility is not responsible for pouch evacuation under physiologic conditions.
The motor physiology of the rectum has remained largely obscure, especially concerning the mechanism of rectal motility. In the current communication we tested the possibility of characterizing the mechanism of rectal motility during filling and evacuation through the study of the rectal electric activity in 16 healthy volunteers (mean age 43.6 +/- 10.8 years; 11 men). Two monopolar silver-silver chloride electrodes were introduced per annum and fixed to the rectal mucosa by suction. The rectum was distended in 10 ml increments of water by means of a balloon-ended catheter inserted into the rectum. The rectal pressure was measured by one catheter placed above and a second one below the rectal balloon, and the 2 catheters were connected to 2 strain gauge pressure transducers. Regular triphasic slow waves or pacesetter potentials (PPs) were recorded from the 2 electrodes at rest. PPs were superimposed or followed randomly by action potentials (APs). APs but not PPs were coupled with elevated rectal pressure. Rectal distension with 10 ml of water caused no significant changes of the rectal pressure or EMG activity. Distension with a mean volume of 27.3 +/- 4.7 ml effected a significant increase (p < 0.05) of the rectal electromechanical activity proximally to the balloon and a decrease distally (p < 0.05) to it. With progressive increase of the rectal distension, the electromechanical activity continued to increase proximally and to decrease distally to the balloon, until, at a mean distending volume of 76.3 +/- 3.7 ml, the balloon was dispelled to the exterior. In conclusion, the identification of the modality of rectal motility during defecation was feasible by recording the rectal electromechanical activity. The rectal contraction is suggested to occur in a 'mass squeeze manner' which squeezes the rectal contents aborally into the anal canal. The recognition of the rectal motor modality appears to be important for the understanding of rectal motility disorders. However, further studies are required to confirm these findings.
To exert beneficial effects for the host, for example, improving the intestinal microflora, a probiotic must reach the intestine as a viable strain. These properties must be demonstrated by in vitro as well as in vivo methods. However, only a few well-designed human clinical studies have shown these properties. Lactobacillus johnsonii La1 has been shown to give many beneficial effects for the host, but it is unclear whether a viable strain of L. johnsonii La1 has the effect of improving host intestinal microflora. In the present study, a randomised double-blind placebo-controlled cross-over trial was conducted to elucidate the effect of L. johnsonii La1 on human intestinal microflora. Twenty-two young healthy Japanese women were randomly divided into two groups, and either received fermented milk with L. johnsonii La1 or a fermented milk without L. johnsonii La1 (placebo) daily for 21 d. Consumption of the fermented milk: (a) increased total Bifidobacterium and Lactobacillus, and decreased lecithinase-positive Clostridium in the faeces; (b) increased the faecal lactic acid concentrations; (c) decreased the faecal pH; (d) increased the defecation frequency. These changes were stronger than those observed with the placebo. L. johnsonii La1 was identified in all subjects only after the consumption of the fermented milk. These results suggest that L. johnsonii La1 can contribute to improve intestinal microflora with probiotic properties.
The polyol isomalt (Palatinit) is a well established sugar replacer. The impact of regular isomalt consumption on metabolism and parameters of gut function in nineteen healthy volunteers was examined in a randomised, double-blind, cross-over trial with two 4-week test periods. Volunteers received 30 g isomalt or 30 g sucrose daily as part of a controlled diet. In addition to clinical standard diagnostics, biomarkers and parameters currently discussed as risk factors for CHD, diabetes or obesity were analysed. Urine and stool Ca and phosphate excretions were measured. In addition, mean transit time, defecation frequency, stool consistency and weight were determined. Consumption of test products was affirmed by the urinary excretion of mannitol. Blood lipids were comparable in both phases, especially in volunteers with hyperlipidaemia, apart from lower apo A-1 (P=0.03) for all subjects. Remnant-like particles, oxidised LDL, NEFA, fructosamine and leptin were comparable and not influenced by isomalt. Ca and phosphate homeostasis was not affected. Stool frequency was moderately increased in the isomalt phase (P=0.006) without changes in stool consistency and stool water. This suggests that isomalt is well tolerated and that consumption of isomalt does not impair metabolic function or induce hypercalciuria. In addition, the study data indicate that isomalt could be useful in improving bowel function.
Despite a hostile environment unsuited to parasite transmission, Turkana district in northwestern Kenya has the highest incidence of hydatid disease in the world. The prevalence of the disease varies ten-fold, being higher in the north than the south of the district. This study examined whether differences in man:dog contact and specific activities of dogs enhanced the transmission of Echinococcus granulosus eggs to man. A total of 24,541 observation-minutes were completed, studying 31 dogs from 20 manyattas in six locations throughout Turkana district, and in one location in neighbouring Pokot. Correlations were found between the time a dog spent in a manyatta and whether dogs were allowed to clean children, scavenge from cooking utensils and defecate within the home area. The amount of time a dog spent in a manyatta depended upon the availability of water, food and shade. The study also revealed that it is difficult to change the Turkana's behaviour and attitudes towards their dogs, despite continuous education. Therefore, in an area where home slaughter is practised, dosing of dogs with a suitable taeniacide will for many years to come remain an important component in the hydatid control programme being carried out in Turkana.
A study of the social, environmental and parasitological factors involved in the transmission of schistosomiasis among 1834 residents of a small settlement within an agricultural establishment near Yola, Nigeria, was carried out between June 1991 and May 1992. Water-contact rates and the prevalences of urinary schistosomiasis and intestinal schistosomiasis (40.0% of all contacts, 98% and 79%, respectively) were highest among children of 5-12 years, who were also the major contributors to the contamination of the Lake Geriyo environment with faeces and urine. The frequency and duration of water contact followed a seasonal pattern and seemed to be influenced by physiological and social needs such as defecation, urination and avoidance of harsh weather conditions. The interplay between a need for water contact, sanitation, freshwater snails and a supportive environment ensures a recycling of parasites within the studied community. This, in turn, helps to maintain a parasite bank from which infection is probably spread to other areas of the state. The present study is part of a series, on the dynamics of schistosomiasis transmission, which began with a study of the ecology of the freshwater snails in the same area.
Fecal incontinence is a common and important problem in the care of the elderly. An understanding of the defecation mechanism, appropriate differential diagnosis, and the best choice of treatment method are necessary to control this problem. Establishing a regular bowel program takes time and energy, but when the final result is continence, it is time and energy well spent.
To investigate the efficiency of protein and carbohydrate absorption, we studied malnourished and well-nourished subjects during the first 72 hours of tube feeding. We furthermore investigated whether differences in absorptive efficiency existed between malnourished patients with and without nongastrointestinal malignancy. Twenty-one subjects starting tube feeding without edema or major organ failure and not on antibiotics (well-nourished controls = 7; malnourished = 7; malnourished with nongastrointestinal malignancy = 7) received 50 kcal/hr Osmolite continuously for 72 hours. Twelve of these subjects completed an additional 48 hours of study where they received 125 kcal/hr continuously. We performed hydrogen breath tests to assess carbohydrate absorption and determined stool nitrogen content to assess protein absorption. We also measured frequency of defecation, stool weight, and stool moisture content. The results of these tests failed to reveal statistically significant differences between the three groups in terms of protein and carbohydrate absorption, as well as failed to demonstrate the presence of diarrhea. We conclude that patients receiving an isoosmolar diet who are malnourished, or malnourished with nongastrointestinal malignancy, absorb carbohydrate and protein as well as well-nourished patients during enteral hyperalimentation.
OBJECTIVE: We performed a masked, randomized, 2-month crossover study with developmentally disabled children to study the tolerance of a pediatric adapted enteral formula with added soy fiber. METHODS: Twenty children and adolescents aged 1 to 17 years, requiring liquid nutrition, were fed Pediasure (PS) and Pediasure with approximately 10 g total dietary fiber/l, (PSF10) as their major source of energy and nutrient intake for 1 month each. During the two 4-week periods of the crossover study, intake, tolerance of the formula, and stool characteristics were monitored daily with diaries. Criteria for gastrointestinal tolerance were symptoms of emesis, gas, irritability or fussiness. Stool characteristics included frequency, consistency, and the need to use elimination aids to induce defecation. Following completion of the crossover study, the patients were fed PSF10 for an additional 2 months. Anthropometrics were obtained at study initiation and at each biweekly visit during the crossover phase and monthly during the follow-up phase. Bowel scintigraphy studies were conducted in patients with oral or nasogastric intake during the crossover periods. Biochemical assessments were conducted at entry, at the end of each crossover period, and at exit. RESULTS: There were no differences in any of the tolerance, stooling, growth, or biochemical measurements between the feeding regimens, in 11 children completing this phase of the study. However, there was a trend towards using less elimination aids to induce a bowel movement during the fiber supplemented formula phase. CONCLUSIONS: Pediasure with fiber is well tolerated in children with developmental disabilities.
Mass movements of the left-sided colon bring the colonic material contained in it to the sigmoid colon. The cause why the colonic contents do not pass directly to the rectum but stop short of the rectosigmoid junction (RSJ) was studied. The study comprised 10 healthy volunteers (mean age 39.2 +/- 10.2 years; 8 men, 2 women). A condomended tube was introduced into the descending colon (DC) per anum. The pressure response of the DC, sigmoid colon (SC), and RSJ to condom inflation with carbon dioxide (CO2) in increments of 10 ml was recorded by means of a three-channel microtip catheter. The responses were registered upon inflation of the upper, middle, and lower third of the DC. The test was repeated after individual anesthetization of the descending colon and the RSJ on separate days. Colonic distension with 10 and 20 ml CO2 produced no significant pressure changes in the DC, SC, and RSJ (p > .05); 30 ml distension effected a pressure rise in both the DC (p < .01) and RSJ (p < .05), but no change in the SC pressure (p > .05); and 40, 50, and 60 ml distension produced pressure changes similar to those obtained with 30 ml distension. The RSJ pressure responded to distension of the saline-injected but not of the anesthetized DC. Thus, the RSJ response to colonic distension affirms the hypothesis of the possible involvement of a reflex, which we term colo-RSJ reflex. This reflex seems to regulate the passage of stools from the colon to the rectum. Further studies are required to investigate its role in the diagnosis of defecation disorders.
Handwashing is universally promoted in health interventions. Studies in Bangladesh and elsewhere have shown a 14 - 40% reduction of diarrhoeal diseases with handwashing. The perceptions and methods related to washing of hands vary widely in Bangladesh. Socio-economic factors are also associated with methods practised. In general, the effectiveness of handwashing practices is poor. Faecal coliform bacteriological counts were reported to be high for both left and right hands. About 85% of women studied who lived in slums and 41% of rural women washed their hands using only water. However, most women rubbed their hands on the ground, or used soil, and rinsed them with water during post-defecation handwashing. Most women claimed that they could not afford to buy soap. Experimental trials showed that use of soap, ash or soil gave similar results when women washed their hands under the same conditions. The washing of both hands, rubbing of hands, and the amount and quality of rinsing water used were found to be important determinants in the reduction of bacterial counts on hands. Although handwashing messages have been revised by most of the main programmes after these studies, there is scope for further improvement, as well as evaluation of their impact.
BACKGROUND/OBJECTIVE: A study on the response of the external anal sphincter (EAS) to the passage of urine through the urethra during micturition could not be found in the literature. We investigated the hypothesis that urine passage through the urethra effects EAS contraction to guard against possible flatus or stool leakage during micturition. METHODS: The study was performed in 23 healthy volunteers (age, 38.6 +/- 10.8 [SD] years; 14 men and 9 women). The EAS electromyogram (EMG) was performed during micturition by surface electrodes applied to the EAS. Also, the EAS EMG response to urethral stimulation by a catheter-mounted electrode was registered. The test was repeated after individual anesthetization of the EAS and urethra. RESULTS: The EAS EMG recorded a significant increase (P < 0.01) during micturition and on urethral stimulation at the bladder neck. Stimulation of the prostatic, membranous, or penile urethra produced no significant change in the EAS EMG. Urethral stimulation after individual EAS and urethral anesthetization did not cause any changes in the EAS EMG. CONCLUSIONS: Urine passing through the urethra or urethral stimulation at the vesical neck produced an increase in the EAS EMG, which presumably denotes EAS contraction, which seems to guard against flatus or fecal leakage during micturition. EAS contraction on urethral stimulation is suggested to be mediated through a urethro-anal reflex. Further studies on this issue may potentially prove the diagnostic significance of this reflex in micturition and defecation disorders.
1,4,5-trisphosphate (IP(3))-dependent Ca(2+) signaling regulates gonad function, fertility, and rhythmic posterior body wall muscle contraction (pBoc) required for defecation in Caenorhabditis elegans. Store-operated Ca(2+) entry (SOCE) is activated during endoplasmic reticulum (ER) Ca(2+) store depletion and is believed to be an essential and ubiquitous component of Ca(2+) signaling pathways. SOCE is thought to function to refill Ca(2+) stores and modulate Ca(2+) signals. Recently, stromal interaction molecule 1 (STIM1) was identified as a putative ER Ca(2+) sensor that regulates SOCE. We cloned a full-length C. elegans stim-1 cDNA that encodes a 530-amino acid protein with approximately 21% sequence identity to human STIM1. Green fluorescent protein (GFP)-tagged STIM-1 is expressed in the intestine, gonad sheath cells, and spermatheca. Knockdown of stim-1 expression by RNA interference (RNAi) causes sterility due to loss of sheath cell and spermatheca contractile activity required for ovulation. Transgenic worms expressing a STIM-1 EF-hand mutant that constitutively activates SOCE in Drosophila and mammalian cells are sterile and exhibit severe pBoc arrhythmia. stim-1 RNAi dramatically reduces STIM-1GFP expression, suppresses the EF-hand mutation-induced pBoc arrhythmia, and inhibits intestinal store-operated Ca(2+) (SOC) channels. However, stim-1 RNAi surprisingly has no effect on pBoc rhythm, which is controlled by intestinal oscillatory Ca(2+) signaling, in wild type and IP(3) signaling mutant worms, and has no effect on intestinal Ca(2+) oscillations and waves. Depletion of intestinal Ca(2+) stores by RNAi knockdown of the ER Ca(2+) pump triggers the ER unfolded protein response (UPR). In contrast, stim-1 RNAi fails to induce the UPR. Our studies provide the first detailed characterization of STIM-1 function in an intact animal and suggest that SOCE is not essential for certain oscillatory Ca(2+) signaling processes and for maintenance of store Ca(2+) levels in C. elegans. These findings raise interesting and important questions regarding the function of SOCE and SOC channels under normal and pathophysiological conditions.
The effect of cellulose purified from wood pulp on wet and dry stool weights, gastrointestinal transit time (TT), frequency of defecation, and calcium and magnesium balances was tested. Seven healthy women consumed a low fiber diet of constant composition (percentage of total kcal: 23% protein, 30% fat, 47% carbohydrate) and the same metabolically controlled diet to which 16 g of refined cellulose (Solka Floc) was added. Each diet was consumed for approximately one month. The neutral detergent fiber contents of the two diets were 9.5 and 23.5 g, respectively. Cellulose consumption significantly increased mean daily wet stool weight from 74.6 +/- 23.4 (SD) to 130.5 +/- 29.4 g, mean daily dry fecal weight from 19.1 +/- 4.2 to 39.5 +/- 7.7 g, and frequency of defecatin from 0.85 +/- 0.2 to 1.10 +/- 0.29/day. Cellulose effectively shortened TT of two subjects with initially slow TT (7 days), but mean TT of all subjects was not significantly affected when fiber was added to the diet. Fecal excretions of calcium and magnesium were significantly greater when the diet containing cellulose was fed, and only calcium balance was significantly more negative. These results suggest that moderate levels of refined cellulose adversely increased fecal losses of calcium and magnesium. All other indices of bowel function remained within normal ranges.
The two aims of these experiments were first, to examine the relationships between mean daily stool weight, mean weight per stool, frequency of defecation, dye transit time, dietary fiber intake, and transit time of small radiopaque pellets, and second, to determine the ability of these measures of bowel function, singly or in combination, to predict gastrointestinal transit time of the pellets. Variables were observed simultaneously in 13 healthy women consuming controlled low and high cellulose diets. All except one of the correlation coefficients between the measures of bowel function were significant. Stepwise regression analysis retained log stool weight, fiber and dye transit to predict log of the mean transit time of all pellets (R2 = 71.3); the same three variables were selected to predict log of the transit time of 80% of the pellets (R2 = 59.4). Mean daily stool weight explained about 50% of the variation for both measures of transit, while dye transit and dietary fiber explained the rest. Log transformation of either stool weight or pellet transit time or both variables improved the prediction of about 10%. These results suggest that prediction of pellet gastrointestinal transit time from other measures of bowel function may be limited and is influenced significantly by the fiber level of the diet.