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At least 1,549 records · Page 86Linked to original sources
PubMed1990

Constipation: pathophysiology and treatment.

Although many physicians consider constipation a trivial problem, it is one of the most frequent and chronic digestive disorders in the United States, affecting 4.53 million people and causing considerable morbidity. More than $200 million are spent for over-the-counter laxatives and untold millions of dollars are spent for prescription drugs and other medical services to manage this disorder. Successful management requires an appreciation of the magnitude of the problem, an understanding of colorectal function and a clear assessment of the causes. Careful examination of the patient's anorectal anatomy and improvement in the patient's dietary habits are the first steps in management. Therapeutic options include behavioral modification strategies, diet and lifestyle changes, pharmacologic therapy and, rarely, surgical intervention.

Cathartics↗
PubMed1990

[Diseases of the large intestine in the aged. Constipation--diverticulosis--tumors--ischemia].

In no other part of the gastrointestinal tract is there such a wide range of incidence of pathological changes and such a marked increase in incidence with increasing age as the colorectum. In view of the increasing numbers of old people in the general population, therefore, gastroenterologists are increasingly being confronted with these diseases. The most important in practical terms are constipation, colonic diverticulosis with its complications, benign and malignant tumors, and the damages to the wall of the colon resulting from deficient perfusion. In the case of geriatric patients, the evaluation of the symptomatology, so important for the diagnosis, can be difficult, since the complaints may be overemphasized owing to anxious self-observation, or, owing to a reduction in cerebral capacity, are not adequately appreciated and reported.

Aged↗
PubMed1990

Surgical aspects of severe chronic non-Hirschsprung constipation.

This paper reviews the methods available for selecting patients with disabling non-Hirschsprung constipation eligible for surgery, and the surgical methods reported. It is concluded that careful evaluation of the patient may help in selecting the most suitable treatment. The demonstration, however, of a specific morphological abnormality would, of itself, not seem to justify surgical correction. The surgical criteria remain to be defined by additional physiological research, and the outcome of the various surgical procedures is always uncertain. Surgery should only be undertaken in patients with disabling symptoms, in whom prolonged conservative treatment has failed completely.

Barium Sulfate↗
PubMedDate not supplied

Constipation among hospitalized elders.

This article presents a pilot study using a descriptive design to determine the feasibility of a major study of the prevalence of constipation among elders hospitalized in an acute care hospital. When orthopaedic nurses are aware of the altered bowel elimination patterns among elders, they can help their patients attain or maintain optimal functional goals.

Activities of Daily Living↗
PubMed1990

[Rectal myectomy in the treatment of chronic constipation in children].

Rectal myectomy was used with the positive result in 22 children. In patients with the supra-anal form of the Hirschsprung's disease, rectal myectomy was performed as an independent intervention. In patients with the residual zone of agangliosis after radical intervention, idiopathic constipation after radical myectomy, the pressure in the anal canal reduced, rectal emptying improved.

Child↗
PubMed1989

[Chronic constipation and its treatment].

Altogether 850 patients suffering from chronic constipation were examined. Of these, 80% only showed functional changes in the intestine, 5% lost the defecation reflex, and 15% manifested inflammation-induced lesions in the intestine. 80% of the patients demonstrated symptoms of dysbacteriosis. Multimodality treatment appeared to produce an appreciable effect in the majority of the patients. As a result many of the patients gave up laxatives.

Adult↗
PubMed1989

Constipation.

After years of relative neglect there is increased interest in colonic motor disorders such as constipation. A variety of aetiologies are being elucidated and separate clinical syndromes are now recognized. Newer specific prokinetic drugs may enable more effective treatment in the future for severely disabled patients. The outcome of surgery in these patients remains unpredictable.

Adult↗
PubMed1989

[Isolated rectal ectasia: a rare cause of chronic constipation. Apropos of 2 cases].

We present two patients with intractable constipation, in which investigation revealed a huge rectal ectasia without apparent other anomaly. Findings at operation are similar to those observed in the focal ectasia of the terminal bowel that we have already described in some cases of low anal deformities. As long as the physiopathology of this anomaly is not elucidated, complete amputation of the rectum seems to be the treatment of choice.

Adolescent↗
PubMed1989

[Puborectalis syndrome: a cause of obstinate constipation].

Two patients with severe chronic constipation caused by spasmodic hypertrophy of puborectalis underwent partial resection of the muscle. Pre-operative anorectal manometry showed increased length of the anal canal. Concentric electromyography showed that the puborectalis muscle failed to relax during attempted defecation and patients were unable to expel a water-filled balloon from the rectum. After surgery they have a regular defecation without difficulty. We consider that partial resection of the puborectalis muscle is a useful procedure for the puborectalis syndrome.

Aged↗
PubMed1985

Constipation during pregnancy: dietary fibre intake and the effect of fibre supplementation.

Forty women who complained of constipation during the third trimester of pregnancy completed 14-day weighed diet records and bowel function charts over a 4-week period. After 2 weeks of baseline observation the women were randomly allocated into three groups which were asked to take 10 g dietary fibre supplements per day in the form of either a corn-based biscuit (Group A), or as wheat bran (Gp B), or to continue without intervention (Gp C). Mean (+/- s.e.m.) daily dietary fibre intake in the first 2 weeks was similar to that in the general population, at 20.4 +/- 1.2 g, for the whole group, and 21.1 +/- 1.6 g for the 26 women who said they had already increased their dietary fibre intakes in attempts to relieve their symptoms. In the final 2 weeks changes in fibre intakes were: Gp A, mean increase 7.2 +/- 1.0 g per day (P less than 0.001); Gp B, mean increase 9.1 +/- 1.6 g per day (P less than 0.001); Gp C mean decrease 3.50 +/- 1.6 g per day (P less than 0.005). These changes were accompanied by an increase in the number of bowel movements and a change to a softer stool consistency in Gps A and B, with no changes in number of bowel movements or stool consistency in Gp C.

Adult↗
PubMed1988

[A cause of terminal constipation: hypertonia of the striated pelvic muscle. Value of complementary studies].

The aim of this study was to define an other cause of idiopathic constipation with a mathematic automatic classification Fifty patients were studied by colonic transit time, anorectal manometry and defecography. Three classical causes were found: 12 patients had hypertonic upper anal pressure; 8 patients had abnormal rectonanal inhibitory reflex and 12 patients had anatomic conditions reducing stool frequencies Automatic mathematic classification coming from optimised bowls technic has led to the characterization of a new cause. Eight young women (mean age 33 years) with hypertonic striated pelvic muscles on straining were identified. Three items were significantly different: defect of sphincteric relaxation without high sphincteric pressure; closure or non opening anorectal angle, hypertonic levator ani on straining. There was a significant high frequency (p less than 0.05) of urinary disorders in this new group. All abnormalities occurred during defecation. This group can be studied with other methods: balloon expulsion, anal electromyography. Clinical identity with urinary pathology may be explained by common neurologic disorders of pelvic striated muscle innervation.

Adult↗
PubMed1987

Constipation in elderly long-stay patients: its treatment by magnesium hydroxide and bulk-laxative.

Sixty-four geriatric long-stay patients aged 65 years or older participated in the trial. All were using laxatives prior to the study. For the study laxatives the mean dose of magnesium hydroxide was 25 ml daily and for bulk-laxative 8.7 g daily. Magnesium hydroxide caused a more frequent bowel habit (13.2 vs. 10.4/4 weeks, p less than 0.001) than bulk-laxative and additional laxative bisacodyl was not needed as often as with bulk-laxative (2.3 vs. 3.3/4 weeks, p less than 0.01). Also the stool consistency was more normal during the magnesium hydroxide treatment. In two patients serum magnesium was over 1.25 mmol/l after the magnesium hydroxide treatment but there were no clinical signs of hypermagnaesemia. Our study indicated magnesium hydroxide to be more efficient than bulk-laxative in treating constipation in elderly long-stay patients.

Aged↗
PubMed1987

The surgery of idiopathic constipation.

This paper has described the methods of patient evaluation and treatment that have been developed at the Cleveland Clinic Foundation for patients with idiopathic constipation. An orderly concise work-up should identify the small group of patients that will benefit from surgical therapy and assist the surgeon in selecting the type of therapy for the greatest success. Patients with outlet obstruction appear to benefit from anorectal myectomy while those with slow colonic transit should undergo a subtotal colectomy and ileorectal anastomosis. Additional investigations will hopefully increase our knowledge of the best way to manage these patients.

Colon↗
PubMed1987

Experience of surgical treatment for chronic idiopathic constipation.

Chronic idiopathic constipation requires surgical treatment in some rare cases. Seven such patients are presented. Subtotal colectomy was performed in six of them and left hemicolectomy in one. All patients were satisfied, with 1-6 bowel movements daily, and none had complications necessitating surgery. Subtotal colectomy seems to be the preferable operation.

Adult↗
PubMed1987

[Idiopathic constipation in children. Value of treatment by biofeedback].

Anorectal manometry was used in the training by biofeedback of children with idiopathic constipation. Fourteen children 7 to 12 years old with outlet obstruction due to sphincteric disorders were submitted to a biofeedback session. There was a good improvement in 10 of the 12 children who accepted this treatment. This result is in agreement with the data published in literature. This complementary treatment appears useful when it is well accepted by the parents and the child and when the manometric signal is well understood by the child who must be also able to apply the technique at home.

Anal Canal↗
PubMed1987

Colectomy for slow transit constipation.

A series of 21 patients (18 female) whose intractable constipation was treated by colectomy between 1976 and 1985 is reported. There was no mortality attributable to surgery in this series. Total colectomy with ileorectal anastomosis was the preferred operation, but it produced a satisfactory result in only 12 patients. Five patients were treated by a permanent ileostomy, as the primary procedure in two. Megarectum did not automatically preclude a good result from ileorectal anastomosis, but a poor result was associated with failure of either a rectal stump to conduct colonic movements or of the anal sphincter to relax. Long term follow-up is necessary for assessment of results since late relapse can occur.

Chronic Disease↗
PubMed1985

Constipation. Consensual and empirical validation.

This article describes the process of consensual and empirical validation used for one nursing diagnosis, constipation. The process is illustrated with a cluster of studies, both qualitative and quantitative. Implications for practice, education, and research are described.

Aged↗
PubMed1985

[Pathophysiology and treatment of idiopathic chronic constipation with megarectum in children].

Anorectal manometry was carried out in 65 children with idiopathic chronic constipation. Forty-five had no megarectum, and 20 had megarectum. Patients without megarectum showed normal anorectal pressures, recto-anal reflex, rectal sensation and rectal compliance, but motility of the colon was disturbed in these patients. Patients with megarectum also had normal anorectal pressures, recto-anal reflex and rectal sensation, but they showed remarkably high rectal compliance, or excessive rectal reservoir. Patients without megarectum were treated with laxatives and all of them were cured within 6 months after institution of therapy. Patients with megarectum were treated with rectal washout and suppository and 14 out of 20 were cured within 10 months. Six out of 20 patients with megarectum, however, were resistant to conservative therapy and necessity of surgical treatment to reduce the excessive rectal reservoir was proposed for these patients.

Adolescent↗