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PubMed1985

[Anteposition of the anus. A cause of constipation in children].

Certain forms of severe constipation, unresponsive to medical treatment and classified as "idiopathic", have been thought to be anatomical anomalies due to anterior-displacement of the anus. The difficulty in defecation varies with the anal anomaly: this may range from passing of feces every 3-4 days to sub-occlusion episodes due to obstruction of the rectum from phecaloma and with sign of malnutrition, anemia and hypotrophy. Anatomically the anomaly is characterized by an anterior positioning of the anus which deviates the terminal part of the rectum in a horizontal plane creating a "cul-de-sac" which arrests normal fecal advancement. Fecal stasis in the rectal ampulla leads to an increase in the distensibility of the rectum with loss of the normal stimulus to defecate and contractile activity. Diagnosis is made by physical examination, barium enema (which reveals the rectal "cul-de-sac" and the distension of the colon) and ano-rectal manometry to rule out Hirschsprung diseases. The authors report their experience with 11 cases of anterior displacement of the anus, presenting a simple surgical treatment and the favorable results.

Anal Canal↗
PubMed1979

[Rectal tonometry in the differential diagnosis of constipation in pediatrics].

Based on the difficulties regarding the clinical, radiological, and histological diagnosis of colonic aganglionosis, we resorted the motility studies. Sixty-two children (15 days-10 years of age) were studied by means of rectal motility without knowing the results of the other auxilary methods. We obtained a clear difference between aganglionic and other group formed by constipated functional or psicogenic. We conclude that rectal motility studies have the advantage of being rapid and non-aggressive, besides avoiding rectal biopsy.

Child↗
PubMed1979

The surgical treatment of incapacitating constipation associated with idiopathic megacolon.

Results of the surgical treatment of idiopathic megacolon with incapacitating constipation in 23 patients are reviewed. The Swenson endorectal pull-through procedure, although it gave satisfactory results, was associated with high morbidity and resulted in the only death in this series. Anterior resection gave good results in six of eight patients. This procedure should give good results when the dilatation as seen on barium enema studies is confined to the rectosigmoid. However, for patients who have more extensive dilatation of the colon, extensive left hemicolectomy or total abdominal colectomy should be strongly considered, for these procedures have been associated with uniformly good results and little morbidity. There is little to recommend bilateral lumbar sympathectomy.

Adolescent↗
PubMed1982

[Treatment of chronic constipation with swelling substances].

In 20 patients with chronic constipation and, in many cases, years of laxative abuse, in a prospective and randomized study, treatment with new, specially prepared swelling substances administered at the recommended doses, was carried out after first stopping the use of laxatives. After only one week of this treatment, a marked increase in the weight of the stools, and a reduction in stool transit time (p less than 0.05 in each case) were observed.

Adult↗
PubMedDate not supplied

[Constipation in the aged--diagnosis and therapeutic aspects].

The normal stool weight is 121 +/- 25 g per day with a stool frequency of 1.1 +/- 0.9 defecation per day. A normal transit time in man of 66 +/- 23 hours has been found. These data are necessary for the diagnosis of constipation. A recommendation of a fibre-rich diet or a purified plant fibre for therapy has been made. The dosage of bassorin or bran is 0.5 g per kg/day. In older people a drug therapy can often be necessary.

Aged↗
PubMed1983

The effect of wheat bran on the intake of energy and nutrients and on serum mineral levels in constipated geriatric patients.

The total intake of energy and nutrients was recorded during 5 consecutive d in ten constipated patients in a geriatric ward. Twenty grams of ordinary or low-phytate wheat bran was then added to their diet and the 5-d food intake was recorded after 6 and 12 weeks, respectively. The intake was generally satisfactory and decreased in only two women on bran treatment. The hospital diet had a high mineral content and calcium, magnesium, zinc and iron levels in serum did not decrease when wheat bran was added to the diet. Consequently no difference was found in serum mineral levels, when ordinary wheat bran was replaced by a low-phytate bran.

Aged↗
PubMed1984

Constipation and congenital disorders of the myenteric plexus.

Full-thickness muscle biopsies have been taken from patients with severe disabling chronic constipation that has not responded to conservative measures. Assessment by neurohistochemical techniques has revealed that a range of neuronal dysplasias of the myenteric plexus are responsible in many cases; these include aganglionosis (Hirschsprung's disease), hypoganglionosis and hyperganglionosis. In cases considered unlikely to be Hirschsprung's disease on clinical grounds, the procedure used has often been anorectal myectomy; this has not only provided tissue for diagnosis but has also been of therapeutic value in most cases of hypoganglionosis and some cases reported as 'normal'.

Adult↗
PubMed1984

Intractable constipation in children treated by forceful anal stretch or anorectal myectomy: preliminary communication.

Sixty-one children with intractable constipation admitted between 1978-1981 under the care of the author were studied retrospectively. Ten of these patients were also studied prospectively by means of defaecating proctograms, and pre- and postoperative evoked anal potentials. It was found that 85.7% of the children who had anorectal myectomies benefited from the procedure. The possible mechanism by which the improvement is achieved is discussed.

Anal Canal↗
PubMed1984

Surgical treatment of constipation.

A 30-year retrospective review of 544,354 Seattle area hospital admissions yielded 25 patients who underwent surgical therapy for the relief of intractable idiopathic constipation. All patients were refractory to conventional medical treatment consisting of the daily use of laxatives, cathartics, emollients or enemas. Long-term follow-up was available for 13 of the 25 patients. All 13 patients had clinical improvement as a result of the operation. This confirms results reported by other authors. Subtotal colectomy and left hemicolectomy are the procedures generally favored.

Adult↗
PubMed1980

Standardized senna in the management of constipation in the puerperium: A clinical trial.

Successful treatment of constipation in the immediate postpartum period in 93% of White patients and 96% of Coloured patients was achieved in a clinical trial of standardized senna tablets (Senokot; Reckitt & Colman). This is significantly better than the success rates of 51% and 59% achieved in White and Coloured controls treated with a placebo. Minor abdominal cramps occurred in some 13% of the patients treated with standardized senna, and in 4% of the controls given the placebo. There is no evidence to suggest that standardized senna has any effect whatsoever on a breast-fed baby if taken by the mother.

Adult↗
PubMed1978

Diarrhoea, constipation and intestinal transit in a northern Nigerian population.

Healthy Nigerians from Zaria have a short intestinal transit time. It is usual for them to open their bowels daily and their concept of diarrhoea and constipation differs widely from the standard medical definition. To avoid confusion care must be taken to inquire exactly what patients mean when they present with these symptoms.

Constipation↗
PubMed1982

Adrenal insufficiency, myopathic hypotonia, severe psychomotor retardation, failure to thrive, constipation and bladder ectasia in 2 brothers: adrenomyodystrophy.

Two brothers are described who manifested primary adrenal insufficiency, dystrophic myopathy, severe psychomotor retardation, failure to thrive, fatty degeneration of the liver, megalocornea, chronic constipation, and terminal bladder ectasia until their death at 3 8/12 and 1 7/12 years, respectively. The differential diagnosis to similar syndromes is discussed. This combination of problems apparently has not yet been described. The term adrenomyodystrophy is suggested.

Adrenal Insufficiency↗
PubMed1981

[Bacterial intestinal microflora of patients with a constipation syndrome].

The authors studied the bacterial intestinal microflora (BIMF) according to Henel method in 28 patients with constipation syndrome. The following was found: --Normal ratio of BIMF in one patient; --Reduced percentage participation of anaerobic lactobacteria in 18 patients; --Increased number of Escherichia coli in 3 patients; --Proteus was over 100 000 in 1.0 feces in 6 patients or in 27 out of 28 patients dysbiosis was found. The authors explained the disturbances of the normal BIMF with the retention of feces in the large intestine, providing conditions for mass bacterial proliferation.

Adult↗
PubMed1995

[Subcutaneous cervical emphysema: complication of constipation. Review of the literature].

We report the case of a sixty-eight year old woman with chronic constipation, admitted in the emergency unit for respiratory deficiency and cervical subcutaneous emphysema. Endoscopy of the supradiaphragmatic air and digestive tracts was normal. Acutization of an abdominal syndrome required a laparotomy revealing a fissuration of the subperitoneal rectum on a fecal obstruction. This revealing complication may be explained by the topography of the cervico-thoraco-abdominal diffusion spaces.

Aged↗
PubMedDate not supplied

[Constipation in children. Value of anorectal sphincteromyectomy].

Anorectal sphincteromyectomy is a suitable answer to the problem of the chronic constipation in childhood. It took a long time to be recognized beside others methods as biofeedack. This surgical procedure has been described for the first time by B. Duhamel in 1965; we still remained faithful and proud of this idea. We wanted to understand and to explain the basis of the conception of anorectal achalasia. Several works about the fetal development of the anorectal sphincter tried to explain it. A good exposition makes the technique less difficult and the dissection of the internal sphincter easier. We have analysed our 22 recent children. In 21 cases, we noticed a good result. The histological study of the fragment of the myomectomy showed a normal cytology of the smooth muscular tissue, a normal intrinsic innervation and arterial vascularisation. The surgical procedure is efficient because it relieves the functional disorder of the internal anal sphincter. It is a mechanical action; the external sphincter finds again its normal function, or is allowed to be reeducated.

Adolescent↗
PubMed1995

Lower gastrointestinal tract. 1. Constipation.

An accurate diagnosis is of primary importance in lower gastrointestinal problems in the elderly. Reversible causes should be treated specifically whenever possible, but symptomatic treatment can be a useful adjunct or a mainstay if no cause can be found. For constipation symptomatic treatment should proceed stepwise, commencing with increase in dietary fibre content. Only if this approach fails should laxatives (osmotic) be used. Stimulant laxatives and paraffin are best used intermittently, if at all, because of their side effects.

Aged↗
PubMed1994

[Effectiveness of plantago seed husks in comparison with wheat brain on stool frequency and manifestations of irritable colon syndrome with constipation].

BACKGROUND AND AIM: The importance of dietary fibres in treatment of irritable bowel syndrome increased during the last years. Yet the results of clinical studies on the different dietary fibres are not consistent. Therefore we decided to perform a controlled trial with a well defined group of patients to compare the effectiveness of wheat bran to psyllium seeds. PATIENTS AND METHODS: Thirty patients each with irritable bowel syndrome group II to III were treated in an open, not controlled study design either with 3 times 3.25 g psyllium seeds or 3 times 7 g wheat bran daily. All patients entering the study had not been treated for at least 3 weeks before. The study comprised two treatment phases of two weeks each, separated by two weeks without any treatment, thus leading to a study duration of 6 weeks altogether. Parameters for evaluation were stool frequency and consistency and the symptoms pain and abdominal distention, measured by a score (1 to 4). RESULTS: In both treatments groups stool frequency and consistency improved apparently compared to the starting point or the two weeks treatment free time in between. The improvement of stool frequency was statistically significant (p < 0.0001) for both substances. Furthermore the effect of psyllium seeds exceeded that of wheat bran statistically significant in week 1, 2, 3, 5 and 6 (p < 0.005). Other symptoms such as abdominal pain improved too by therapy, psyllium seeds again tending to show better results. A significant difference between both substances could be observed on the symptom abdominal distension. Whereas abdominal distension decreased under treatment with psyllium seeds it increased with wheat brain. This lead to discontinuation of the study in 5 cases, 3 of which could be changed successfully to psyllium seeds. The difference between psyllium seeds and wheat bran concerning the occurrence of abdominal distension was statistically significant (p < 0.01). CONCLUSION: The results of this study demonstrate the effectiveness of psyllium seeds and wheat bran on stool frequency and consistency of patients with irritable bowel syndrome. Psyllium seeds showed to be superior to wheat brain with respect to stool frequency and abdominal distension so that it should be preferred in treatment of irritable bowel syndrome and constipation.

Adult↗
PubMed1994

A patient with localized megacolon and intractable constipation: evidence for impairment of colonic muscle tone.

There have been descriptions of a variety of abnormalities in motor function in patients with megacolon; however, colonic tone in megacolon has not been measured to date. Recent data suggest that colonic hypertonicity of carcinoid diarrhea is measurable with an electronic barostat. Using a barostat method, we have evaluated colonic transit, motility, and tone in a patient with severe constipation and localized chronic megacolon. Transit measurements showed a significant delay beyond the mid transverse colon; motility studies in the dilated region of colon showed abnormally low tone but normal phasic contractility, as measured by the barostat. In contrast, manometry showed low amplitude contractions relative to control data; this discrepancy probably results from the large capacity of the segment of colon examined. Chronic megacolon can be associated with abnormal colonic tone, which can be measured by means of an electronic barostat.

Aged↗