Chronic Constipation (chronic + constipation)

Distribution by Scientific Domains
Distribution within Medical Sciences


Selected Abstracts


Pathology of Chronic Constipation in Pediatric and Adult Coloproctology

HISTOPATHOLOGY, Issue 2 2006
J E Martin
No abstract is available for this article. [source]


Chronic constipation in children: Organic disorders are a major cause

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1-2 2005
BR Southwell
Abstract: Diagnostic tools for paediatric chronic constipation have been limited, leading to over 90% of patients with treatment-resistant constipation being diagnosed with chronic idiopathic constipation, with no discernible organic cause. Work in our institution suggests that a number of children with intractable symptoms actually have slow colonic transit leading to slow transit constipation. This paper reviews recent data suggesting that a significant number of the children with chronic treatment-resistant constipation may have organic causes (slow colonic transit and outlet obstruction) and suggests new approaches to the management of children with chronic treatment-resistant constipation. [source]


Clinical trial: the efficacy, impact on quality of life, and safety and tolerability of prucalopride in severe chronic constipation , a 12-week, randomized, double-blind, placebo-controlled study

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2009
E. M. M. QUIGLEY
Summary Background, Chronic constipation may result in disabling symptoms, is often unsatisfactorily treated by laxatives and negatively impacts quality of life (QoL). Aim, A randomized, double-blind, placebo-controlled, phase III trial to evaluate the efficacy and safety of a selective, high-affinity 5-HT4 receptor agonist, prucalopride, in patients with chronic constipation [,2 spontaneous complete bowel movements (SCBMs)/week]. Methods, Placebo, 2 or 4 mg prucalopride was administered orally once daily, for 12 weeks. The primary efficacy endpoint was the proportion of patients with ,3 SCBMs/week, averaged over 12 weeks. Other assessments included BM frequency, constipation-related QoL and symptoms and tolerability. Results, Among 641 patients, significantly more patients taking prucalopride 2 or 4 mg (24%) than placebo (12%), achieved the primary efficacy endpoint (,3 SCBMs/week) or an increase of ,1 SCBMs/week; 43% and 47% vs. 28% respectively. Prucalopride-treated patients also achieved significantly greater satisfaction with treatment and bowel function, and improved perception of constipation severity and constipation-related QoL, compared with placebo. Most frequent treatment-related adverse events were headache, abdominal pain, nausea and diarrhoea (mainly during day 1). There were no differences in comparison to placebo in the incidence of serious adverse effects or cardiovascular events. Conclusion, Over 12 weeks, prucalopride was effective and well tolerated in chronic constipation. [source]


Healthcare seeking for constipation: a population-based survey in the Mediterranean area of Spain

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2006
C. GÁLVEZ
Summary Background The use of healthcare resources for the management of constipation is not well-known. Aim To analyse healthcare seeking for constipation, defined by three different criteria, and its related factors and to assess the frequency of use of laxatives, suppositories and enemas for the treatment of constipation. Methods A cross-sectional study in the general community. A questionnaire comprising 21-items was developed and delivered by mail to a random sample of 506 subjects aged 18,65 years, and belonging to a Spanish population. Results Seeking of health care was high in the sample (16%) and was similar for all definitions of constipation (over 40% of constipated subjects). It was associated with female gender, a higher educational level and two symptoms, such as prolonged defecation and abdominal pain. A 14% of the sample used laxatives, and about a 25% of constipated subjects used laxatives at least once a week. Utilization was more frequent in women, with no differences by age group. Conclusions Chronic constipation is a problem that causes an important consumption of resources in our setting, derived from laxative use and the seeking of medical help to combat the problem. The use of these resources is higher in women. [source]


Review article: the role of serotonergic agents in the treatment of patients with primary chronic constipation

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11-12 2005
B. D. CASH
Summary Chronic constipation is a highly prevalent disorder that is associated with significant direct and indirect costs and has substantial impact on patient quality of life. It is more common among women and non-white populations and is evenly distributed across adult age groups. Constipation is a heterogeneous disorder associated with multiple symptoms and aetiologies. Recent research has increased our understanding of the pathogenesis of this disorder and the central role of the neurotransmitter serotonin in mediating gastrointestinal motility, secretion and sensation. Abnormal serotonin signalling and reuptake appear to play central roles in the symptoms of a subset of patients with chronic constipation. This observation provides a rationale for the use of targeted serotonergic agents for the treatment of chronic constipation. As the role of serotonin in gastrointestinal function is further elucidated and additional candidate drugs are developed, it is likely that serotonergic agents will afford additional treatment options for patients with chronic constipation. This article provides a concise review of the evidence supporting a role for serotonin in the pathogenesis of chronic constipation and a summary of the currently available evidence supporting the use of serotonergic agents for this disorder. [source]


Chronic constipation: overview and challenges

NEUROGASTROENTEROLOGY & MOTILITY, Issue 2009
I. J. Cook
Abstract, Despite its high prevalence and cost implications, our understanding of the pathophysiology of constipation remains primitive, and available therapies have limited efficacy. The purpose of this supplement is to address critically the reasons for the current lack of understanding and to propose avenues of future research to address these deficiencies. [source]


Reasons for creation of permanent ileostomy for the management of idiopathic chronic constipation

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 8 2004
AM EL-TAWIL
Abstract The aim of the present study was to examine the reasons for initiation of end ileostomy for management of intractable constipation over the last 35 years. A total of 62 patients with intractable constipation, on whom an end ileostomy was created during the period from 1966 to 2001, were recorded. The incidence of initiating a terminal ileostomy as a further surgical intervention to the total number of managed patients in examined studies varied from 2 to 25%. Preoperative unevaluated anal and rectal abnormalities formed the highest proportion compared with other reasons (65%, 40/62). A better understanding of the functional colonic and anorectal abnormalities may facilitate changes in surgical therapy. [source]


Chronic constipation in children: Organic disorders are a major cause

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1-2 2005
BR Southwell
Abstract: Diagnostic tools for paediatric chronic constipation have been limited, leading to over 90% of patients with treatment-resistant constipation being diagnosed with chronic idiopathic constipation, with no discernible organic cause. Work in our institution suggests that a number of children with intractable symptoms actually have slow colonic transit leading to slow transit constipation. This paper reviews recent data suggesting that a significant number of the children with chronic treatment-resistant constipation may have organic causes (slow colonic transit and outlet obstruction) and suggests new approaches to the management of children with chronic treatment-resistant constipation. [source]


Cows milk consumption in constipation and anal fissure in infants and young children

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 5 2003
F And
Objective: To examine daily cows milk consumption and duration of breastfeeding in infants and young children with anal fissure and constipation. Methods: Two groups of 30 consecutive children aged between 4 months and 3 years were evaluated retrospectively. Group I comprised children with chronic constipation and anal fissure in whom surgical causes were excluded, and group II comprised normal children. The daily consumption of cows milk, duration of breastfeeding and other clinical features of the children were investigated Results: The mean daily consumption of cows milk was significantly higher in group I (756 mL, range 200,1500 mL) than group II (253 mL, range 0,1000 mL) (P < 0.001). Group I children were breastfed for a significantly shorter period (5.8 months, range 0,18 months) than group II (10.1 months, range 2,24 months) (P < 0.006). The odds ratios for the two factors , children consuming more than 200 mL of cows milk per day (25 children in group I, 11 children in group II) and breastfeeding for less than 4 months (16 children in group I, 5 children in group II) , were calculated to be 8.6 (95% confidence interval [CI]: 0.23,0.74, P = 0.0005) and 5.7 (95% CI: 0.37,0.66, P = 0.007), respectively. Conclusions: Infants and young children with chronic constipation and anal fissure may consume larger amounts of cows milk than children with a normal bowel habit. Additionally, shorter duration of breastfeeding and early bottle feeding with cows milk may play a role in the development of constipation and anal fissure in infants and young children. [source]


Long-term results of subtotal colectomy for acquired hypertrophic megacolon in eight dogs

JOURNAL OF SMALL ANIMAL PRACTICE, Issue 12 2008
T. Nemeth
Objectives: To evaluate the long-term results of subtotal colectomy for acquired hypertrophic megacolon in the dog. Methods: Eight dogs with acquired hypertrophic megacolon underwent subtotal colectomy with preservation of the ileocolic junction. Long-term follow-up was obtained by clinical records and telephone interviews with the owners. Results: Eight large-breed dogs (age range: 6 to 12 years; mean age: 10·75 years) were enrolled. The use of bone meal, low levels of exercise, chronic constipation with dyschesia and tenesmus refractory to medical management were factors predisposing dogs to acquired hypertrophic megacolon. The diagnosis was confirmed in all animals by abdominal palpation, plain radiography and postoperative histopathological findings. There were no intraoperative complications. One dog died as a result of septic peritonitis. The clinical conditions (that is, resolution of obstipation and stool consistency) of the remaining seven dogs were improved at discharge; all animals returned to normal defecation in five to 10 weeks (mean: 7·3 weeks) and were alive 11 to 48 months (mean: 40·5 months) after surgery. Clinical Significance: Predominantly bony diet and/or low levels of physical activity may predispose dogs to acquired hypertrophic megacolon. Our results emphasise the long-term effectiveness of subtotal colectomy with preservation of the ileocolic junction in this condition. [source]


Clinical trial: interferential electric stimulation in functional dyspepsia patients , a prospective randomized study

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 9 2010
S. KÖKLÜ
Aliment Pharmacol Ther,31, 961,968 Summary Background, There are several studies reporting the beneficial effects of transcutaneous electrical stimulation in patients with gastroparesis and chronic constipation. Aim, To analyse whether transcutaneous electrical stimulation is an effective procedure in functional dyspepsia patients. Methods, Functional dyspepsia patients were randomly placed in vacuum interferential current (IFC) and placebo groups. Both treatments consisted of 12 sessions administered over 4 weeks. Upper gastrointestinal system symptoms were documented at the beginning, during and after the treatment sessions. Results, Patients in therapy (23 cases) and placebo (21 cases) groups were homogeneous with respect to demographic data and upper gastrointestinal system symptoms. In the therapy group, all symptoms other than early satiation improved significantly during and after the treatment sessions, whereas in the placebo group, symptoms including heartburn and vomiting did not change significantly. IFC therapy was superior to placebo with respect to epigastric discomfort, pyrosis, bloating, early satiation and postprandial fullness during the treatment sessions. One month after the treatment sessions, vacuum IFC proved to be superior to placebo with regard to early satiation and heartburn. Conclusions, Vacuum IFC is a non-invasive and effective therapy for functional dyspepsia. Transcutaneous electrical stimulation may represent a new treatment modality for drug-refractory functional dyspepsia patients. [source]


The cost-effectiveness of macrogol 3350 compared to lactulose in the treatment of adults suffering from chronic constipation in the UK

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010
R. R. TAYLOR
Background, It is unknown whether macrogol 3350 (Movicol) affords the UK's National Health Service (NHS) a cost-effective addition to the current range of laxatives. Aim, To estimate the cost-effectiveness of macrogol 3350 compared with lactulose in the treatment of chronic constipation, from the perspective of the UK's NHS. Methods, A decision model depicting the management of chronic constipation was constructed using clinical outcomes and resource use values derived from patients suffering from chronic constipation in The Health Independent Network (THIN) database. The model was used to estimate the cost-effectiveness of a GP prescribing macrogol 3350 instead of lactulose to treat adults ,18 years of age suffering from chronic constipation. Results, Sixty-eight percent of patients given macrogol 3350 were successfully treated within 6 months after starting treatment compared to 60% of patients given lactulose.Patients' health status at 6 months was estimated to be 0.458 and 0.454 quality-adjusted life years (QALYs) in the macrogol 3350 and lactulose groups respectively. The total 6-monthly NHS cost of initially treating patients with macrogol 3350 or lactulose was estimated to be Ł420 (US $688) and Ł419 (US $686) respectively. Hence, the cost per QALY gained with macrogol 3350 was estimated to be Ł250 (US $410). Conclusion, Macrogol 3350 affords the NHS a cost-effective addition to the range of laxatives available for this potentially resource-intensive condition. Aliment Pharmacol Ther,31, 302,312 [source]


Health care seeking for abdominal bloating and visible distention

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2009
X. JIANG
Summary Background, While knowledge has accumulated regarding health care seeking in several functional gastrointestinal disorders (FGIDs), little is known about health care seeking in those with bloating and distention. Aim, To identify predictors of health care seeking for bloating and distention. Methods, The validated Talley Bowel Disease Questionnaire was mailed to a cohort selected at random from the population of Olmsted County, Minnesota; 2259 subjects (53% females; mean age 62 years) answered questions about bloating and distention. The complete medical record of each respondent was reviewed. Logistic regression was used to compare consulting for bloating and distention with consulting for other GI symptoms, and nonconsulters. Results, A total of 131 (6%) subjects in the community consulted a physician for bloating or distention. Older age [odds ratio (OR), 1.8; 95% confidence interval (CI): 1.5, 2.1], higher somatic symptom scores (OR, 2.0; CI: 1.4, 2.8), lower education level (OR, 2.7; CI: 1.2, 5.6), early satiety (OR, 2.0; CI: 1.1, 3.8) and abdominal pain (OR, 2.4; CI: 1.6, 3.7) were associated with people seeking health care for bloating or distention vs. non-consulters. Similarly, older age (OR, 1.4; CI: 1.2, 1.7), chronic constipation (OR, 2.0; CI: 1.2, 3.2) and visible distention (OR, 3.0; CI: 1.8, 4.9) had greater odds of presenting for bloating or distention compared with presenting for other GI symptoms; somatic symptoms were not a predictor (OR, 1.1; CI: 0.8, 1.5). Conclusions, Factors that lead people to present for bloating and distention are similar to those for other GI symptoms visits; however, specific biological rather than somatic features may predict visits for bloating and distention. [source]


Clinical trial: the efficacy, impact on quality of life, and safety and tolerability of prucalopride in severe chronic constipation , a 12-week, randomized, double-blind, placebo-controlled study

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2009
E. M. M. QUIGLEY
Summary Background, Chronic constipation may result in disabling symptoms, is often unsatisfactorily treated by laxatives and negatively impacts quality of life (QoL). Aim, A randomized, double-blind, placebo-controlled, phase III trial to evaluate the efficacy and safety of a selective, high-affinity 5-HT4 receptor agonist, prucalopride, in patients with chronic constipation [,2 spontaneous complete bowel movements (SCBMs)/week]. Methods, Placebo, 2 or 4 mg prucalopride was administered orally once daily, for 12 weeks. The primary efficacy endpoint was the proportion of patients with ,3 SCBMs/week, averaged over 12 weeks. Other assessments included BM frequency, constipation-related QoL and symptoms and tolerability. Results, Among 641 patients, significantly more patients taking prucalopride 2 or 4 mg (24%) than placebo (12%), achieved the primary efficacy endpoint (,3 SCBMs/week) or an increase of ,1 SCBMs/week; 43% and 47% vs. 28% respectively. Prucalopride-treated patients also achieved significantly greater satisfaction with treatment and bowel function, and improved perception of constipation severity and constipation-related QoL, compared with placebo. Most frequent treatment-related adverse events were headache, abdominal pain, nausea and diarrhoea (mainly during day 1). There were no differences in comparison to placebo in the incidence of serious adverse effects or cardiovascular events. Conclusion, Over 12 weeks, prucalopride was effective and well tolerated in chronic constipation. [source]


Costs of health care for irritable bowel syndrome, chronic constipation, functional diarrhoea and functional abdominal pain

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2007
K. A. NYROP
Summary Aim To provide estimates of actual costs to deliver health care to patients with functional bowel disorders, and to assess the cost impact of symptom severity, recency of onset, and satisfaction with treatment. Methods We enrolled 558 irritable bowel (IBS), 203 constipation, 243 diarrhoea and 348 abdominal pain patients from primary care and gastroenterology clinics at a health maintenance organization within weeks of a visit. Costs were extracted from administrative claims. Symptom severity, satisfaction with treatment and out-of-pocket expenses were assessed by questionnaires. Results Average age was 52 years, 27% were males, and 59% participated. Eighty percent were seen in primary care clinics. Mean annual direct health care costs were $5049 for IBS, $6140 for diarrhoea, $7522 for constipation and $7646 for abdominal pain. Annual out-of-pocket expenses averaged $406 for treatment of IBS symptoms, $294 for diarrhoea, $390 for constipation and $304 for abdominal pain. Lower gastrointestinal costs comprised 9% of total costs for IBS, 9% for diarrhoea, 6.5% for constipation and 9% for abdominal pain. In-patient care accounted for 17.5% of total costs (15.2% IBS). Conclusion Costs were affected by disease severity (increased), recent exacerbation of bowel symptoms (increased), and whether the patient was consulting for the first time (decreased). [source]


Review article: the role of serotonergic agents in the treatment of patients with primary chronic constipation

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11-12 2005
B. D. CASH
Summary Chronic constipation is a highly prevalent disorder that is associated with significant direct and indirect costs and has substantial impact on patient quality of life. It is more common among women and non-white populations and is evenly distributed across adult age groups. Constipation is a heterogeneous disorder associated with multiple symptoms and aetiologies. Recent research has increased our understanding of the pathogenesis of this disorder and the central role of the neurotransmitter serotonin in mediating gastrointestinal motility, secretion and sensation. Abnormal serotonin signalling and reuptake appear to play central roles in the symptoms of a subset of patients with chronic constipation. This observation provides a rationale for the use of targeted serotonergic agents for the treatment of chronic constipation. As the role of serotonin in gastrointestinal function is further elucidated and additional candidate drugs are developed, it is likely that serotonergic agents will afford additional treatment options for patients with chronic constipation. This article provides a concise review of the evidence supporting a role for serotonin in the pathogenesis of chronic constipation and a summary of the currently available evidence supporting the use of serotonergic agents for this disorder. [source]


Linaclotide , a secretagogue and antihyperalgesic agent , what next?

NEUROGASTROENTEROLOGY & MOTILITY, Issue 3 2010
A. E. Bharucha
Abstract Ongoing clinical trials suggest that linaclotide, a first-in-class, 14-amino acid peptide guanylate cyclase-C (GC-C) receptor agonist and intestinal secretagogue is an effective treatment for chronic constipation. A study in this issue of the Journal suggests that linaclotide also has antihyperalgesic effects in three common rat models of inflammation- and stress-induced hypersensitivity (i.e., acute trinitrobenzene sulfonic acid colitis, water avoidance stress [WAS], and restraint-induced stress) but not in naďve animals. In mice, linaclotide at least partly reduces hyperalgesia via GC-C receptors. Dose,effect relationships of linaclotide were complicated and non-linear. This viewpoint discusses human clinical trials with linaclotide and the results of this study. Potential mechanisms and clinical significance of these findings are explored. Collectively, these data suggest that GC-C receptors exert other, as yet poorly understood, effects on gastrointestinal sensitivity in conditions associated with inflammation and/or stress-induced increased intestinal permeability. However, the data need to be confirmed in humans and in long-term animal models. Further studies are also necessary to elucidate the mechanisms as these effects cannot be explained by linaclotide's known effects on epithelial GC-C receptors. [source]


Psychometric performance and clinical meaningfulness of the Patient Assessment of Constipation , Quality of Life questionnaire in prucalopride (RESOLOR®) trials for chronic constipation

NEUROGASTROENTEROLOGY & MOTILITY, Issue 2 2010
D. Dubois
Abstract Background, The Patient Assessment of Constipation,Quality of Life (PAC-QOL) is a self-reported questionnaire measuring health-related quality of life (HRQL) of constipated patients and was used as secondary endpoint in three identical double-blind, randomized, placebo-controlled Phase III clinical trials. These 12-week trials in subjects with severe chronic constipation evaluated the effects of prucalopride, a selective 5-HT4 agonist given orally once daily. Methods, To consolidate the main treatment effect results observed in the prucalopride trial populations, analyses were undertaken on the pooled data of the three trials to confirm the psychometric properties of the PAC-QOL and to provide guidance for the interpretation of the clinical significance of its scores. Key Results, The evaluation of the psychometric properties confirmed the PAC-QOL reliability, validity and responsiveness to measure the impact of chronic constipation symptoms on HRQL in the prucalopride trials. The 1-point improvement in PAC-QOL scores used as target response level for the main treatment effect analyses was validated as a relevant definition of response for treatment group comparisons. Cumulative distribution curves, drawn for each treatment group to provide more complete information on treatment effects than single minimal important difference point estimates, demonstrated consistent superior effects of prucalopride over placebo on all PAC-QOL scores. Conclusions & Inferences, The PAC-QOL questionnaire is a useful measurement tool to assess, from a patient perspective, the potential therapeutic value of chronic constipation treatments in clinical trials and, by directly reflecting the patient's own perspective on constipation and its treatment, eventually also for informing daily medical practice. [source]


Translating 5-HT4 receptor pharmacology

NEUROGASTROENTEROLOGY & MOTILITY, Issue 12 2009
G. J. Sanger
Abstract, Since metoclopramide was first described (in 1964) there have been several attempts to develop compounds which retained gastrointestinal prokinetic activity (via 5-HT4 receptor activation) but without the limiting side effects associated with dopamine D2 receptor antagonism. Early compounds (mosapride, cisapride, renzapride, tegaserod) were identified before several of the 5-HT receptors were even described (including 5-HT4 and 5-HT2B), whereas prucalopride came later. Several compounds were hampered by non-selectivity, introducing cardiac liability (cisapride: activity at human Ether-a-go-go Related Gene) or potentially, a reduced intestinal prokinetic activity caused by activity at a second 5-HT receptor (renzapride: antagonism at the 5-HT3 receptor; tegaserod: antagonism at the 5-HT2B receptor). Poor intrinsic activity at gastrointestinal 5-HT4 receptors has also been an issue (mosapride, tegaserod). Perhaps prucalopride has now achieved the profile of good selectivity of action and high intrinsic activity at intestinal 5-HT4 receptors, without clinically-meaningful actions on 5-HT4 receptors in the heart. The progress of this compound for treatment of chronic constipation, as well as competitor molecules such as ATI-7505 and TD-5108, will now be followed with interest as each attempts to differentiate themselves from each other. Perhaps at last, 5-HT4 receptor agonists are being given the chance to show what they can do. [source]


From the bench to the ,crib'-side: implications of scientific advances to paediatric neurogastroenterology and motility

NEUROGASTROENTEROLOGY & MOTILITY, Issue 4 2006
D. K. Chitkara
Abstract, Paediatric gastrointestinal motility disorders may present in the neonatal period as the result of a congenital insult that occurred during embryonic development or as a manifestation of an abnormal genetic background. Functional gastrointestinal and motility disorders may also be acquired and present during childhood as the first presentation of a condition that can persist or re-occur throughout adolescence and adulthood. These disorders can have a significant psychological and financial impact on the lives of the affected children and their families.1,2 Recently, enteric neuroscience research has advanced the understanding of the pathogenesis and treatment of uncommon congenital or developmental gastrointestinal motility disorders such as Hirschsprung disease and chronic intestinal pseudo-obstruction. In addition, research has contributed to improvements in the understanding of more prevalent functional gastrointestinal disorders in children, such as chronic constipation and functional abdominal pain syndromes. The purpose of this review is to highlight these advances with particular regard to the clinical impact they have in the understanding and management of disorders in the field of paediatric neurogastroenterology and motility. [source]


Activation of peripheral 5-HT4 receptors attenuates colonic sensitivity to intraluminal distension

NEUROGASTROENTEROLOGY & MOTILITY, Issue 1 2006
B. Greenwood-van Meerveld
Abstract, Tegaserod is a 5-HT4 receptor partial agonist approved for the treatment of irritable bowel syndrome in women with constipation and in both men and women with chronic constipation. The efficacy of tegaserod is based on the importance of 5-HT4 receptors regulating intestinal peristalsis and secretion, and possibly visceral sensory pathways. Our aim was to investigate the effect of tegaserod on colorectal sensitivity using models of normal and exaggerated responsiveness to colorectal distension (CRD). The visceromotor responses (VMR) to CRD at graded pressures (0,60 mmHg) were measured by the number of reflex abdominal contractions. Acute colorectal hypersensitivity was induced by intracolonic infusion of dilute acetic acid. Chronic hypersensitivity was observed in rats following spontaneous resolution of trinitrobenzenesulfonic acid-induced colitis. Rats with normosensitive colons served as controls. Tegaserod (0.1,10 mg kg,1) caused dose-dependent reduction of the VMR to CRD in control rats and in those with colonic hypersensitivity. 5-HT4 antagonists reversed the effects of tegaserod in rats with normosensitive colons, and partially inhibited effects in rats with colonic hypersensitivity. Central administration of tegaserod had no inhibitory effect. These results support the assumption that colonic hypersensitivity could be normalized by tegaserod acting, at least in part, through peripheral 5-HT4 receptors. [source]


Rectal sensorimotor characteristics in female patients with idiopathic constipation with or without paradoxical sphincter contraction

NEUROGASTROENTEROLOGY & MOTILITY, Issue 2 2003
C. E. J. Sloots
Abstract, Patients with chronic constipation fulfilling the Thompson criteria can show paradoxical sphincter contraction. Aim of this study was to evaluate rectal sensorimotor characteristics in patients with constipation with or without paradoxical sphincter contraction. Thirty female patients with chronic constipation and 22 female controls were investigated with anal manometry and rectal barostat. Paradoxical sphincter contraction was shown with manometry as a paradoxical increase of anal pressure during straining. Visceral sensitivity and compliance were tested by intermittent and continuous pressure-controlled distension. Patients were classified according to their sensations and compliance into normal, hypersensitive, reduced compliant, insensitive or excessive compliant rectum. Postprandial rectal response (PRR) and phasic volume events (PVEs) were registered for 1 h after a 600-kCal meal. Paradoxical sphincter contraction was found in 13 (43%) patients. In these patients, rectal sensitivity scores were higher (P = 0.045) than in patients without paradoxical contractions, but rectal compliance was not different. In 90% of patients an abnormal rectal sensitivity or compliance was found: excessively compliant in 35%, reduced compliant in 10%, hypersensitive in 27% and hyposensitive in 17%. Both patients with constipation (11%; P = 0.042) and controls (25%; P = 0.002) exhibited the presence of a postprandial rectal response. This response was not significantly different between idiopathic constipation, paradoxical sphincter contraction and controls. Patients with rectal hypersensitivity had lower response than other patients (P = 0.04). Patients with constipation had fewer basal PVEs compared controls (P = 0.03). Postprandial PVEs increased in both patients (P = 0.014) and controls (P < 0.001). Postprandial rectal response and PVE were not different in patients with or without paradoxical sphincter contraction. A total of 90% of female patients with idiopathic constipation show an abnormality in rectal sensation or compliance. The postprandial rectal response was comparable between patients with constipation and controls, however, PVEs were diminished. Patients with paradoxical sphincter contraction had higher rectal sensitivity but an unaltered compliance and postprandial rectal response. Future trials should investigate whether the classification of rectal abnormalities in patients with constipation has clinical importance. [source]


Factors related to lower urinary tract symptoms among a sample of employed women in Taipei,,§

NEUROUROLOGY AND URODYNAMICS, Issue 1 2008
Yuan-Mei Liao
Abstract Aim To identify factors associated with lower urinary tract symptoms (LUTS) among female elementary school teachers in Taipei. Methods This study is a cross-sectional, descriptive study. A total of 520 surveys were distributed to 26 elementary schools in Taipei. Logistic regression was used to identify possible factors related to individual LUTS. Results Study results were based on the information provided by 445 participants. Of the 445 teachers, 293 (65.8%) experienced at least one type of LUTS. Factors associated with urinary incontinence were body mass index (BMI), vaginal delivery, obstetric and/or gynecological surgery, bladder habits, and job control. Increased daytime urinary frequency was associated with chronic cough and chronic constipation. Bladder habits, straining to lift heavy objects at work and chronic constipation were associated with urgency. Nocturia was associated with age and caffeine consumption while intermittent stream was associated with the presence of a family history of LUTS and chronic constipation. Bladder habits and regular exercise were associated with weak urinary stream. Incomplete emptying was more likely to occur in teachers with chronic constipation and in those who did not exercise regularly. Conclusion All the LUTS under logistic regression analyses were associated with 1,3 modifiable factors. Identification of these modifiable contributing factors may be useful to health care providers. Education of women may include the importance of maintaining normal body weight, good bladder/bowel habits, and regular exercise, treating chronic cough, decreasing daily caffeine consumption, and implementing feasible environmental modifications in employment settings. Neurourol. Urodynam. © 2007 Wiley-Liss, Inc. [source]


Lactobacillus casei rhamnosus Lcr35 in children with chronic constipation

PEDIATRICS INTERNATIONAL, Issue 4 2007
LING-NAN BU
Abstract Background: The purpose of the present paper was to evaluate the efficacy of probiotics (Lactobacillus casei rhamnosus, Lcr35) for treating children with chronic constipation and to compare its effect with magnesium oxide (MgO) and placebo. Methods: This double-blind placebo-controlled, randomized study enrolled 45 children under 10 years old with chronic constipation. They were randomly assigned to receive Lcr35 (8 × 108 c.f.u./day; n = 18), MgO (50 mg/kg/day; n = 18), or placebo (n = 9) orally twice daily for 4 weeks. Lactulose use (1 mL/kg per day) was allowed when no stool passage for 3 days was noted. Glycerin enema was used only when no defecation was noted for >5 days or abdominal pain was suffered due to stool impaction. Bacterial cultures of stool were performed before and after treatment to evaluate the change of intestinal flora. Comparisons of the frequency of defecation, consistency of stool and the use of lactulose or enema during the period of treatment were made among the three groups. Results: The patients who received MgO or probiotics had a higher defecation frequency (P = 0.03), higher percentage of treatment success (P = 0.01), less use of glycerin enema (P = 0.04) and less hard stool (P = 0.01) than the placebo group. There was no significant difference between MgO and probiotic groups in the aforementioned comparisons. The first effect of MgO (second week) on constipation was slightly earlier than that of probiotic (second to third week). Abdominal pain occurred less frequently in the probiotic group than in both the MgO and the placebo groups (P = 0.03). There was no statistically significant difference among the three groups in the use of lactulose, episodes of fecal soiling, and change of appetite. No adverse effect was noted in probiotic and placebo groups. Only one patient in the MgO group suffered from mild diarrhea. Conclusion: Lcr35 was effective in treating children with chronic constipation. There is no statistically significant difference in efficacy between MgO and Lcr35, but less abdominal pain occurred when using Lcr35. Study with larger case number and longer follow up is needed in the future. [source]


Prucalopride (Resolor): new treatment for chronic constipation

PRESCRIBER, Issue 11 2010
MRPharmS, Steve Chaplin MSc
Prucalopride (Resolor) is a new treatment for women with chronic constipation who have not responded to conventional laxatives. In our New products review, Steve Chaplin presents the data relating to its efficacy and adverse effects and Drs Paul Blaker and Mark Wilkinson comment on its place in the treatment of constipation. Copyright © 2010 Wiley Interface Ltd [source]


Childhood chronic constipation: An innovative community-based parent education group program

AUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 4 2007
Dianne Rae Collis
No abstract is available for this article. [source]


Reduced quality of life in children with Gastro-oesophageal reflux disease

ACTA PAEDIATRICA, Issue 3 2010
M Marlais
Abstract Aim:, To assess self-reported Quality of life (QoL) in children with Gastro-oesophageal reflux disease (GORD) aged 5,18 and compare this with both disease and healthy control children in a prospective consecutive sample. Methods:, All children attending a tertiary paediatric gastroenterology clinic from February 2009 to May 2009 with GORD, chronic constipation and inflammatory bowel disease (IBD) were asked to complete the validated PedsQL generic QoL assessment (self-report) at their clinic appointment. The PedsQL considers physical, emotional, social and school domains and is scored from 0 to 100. Healthy children were also recruited from the same site. Groups were compared using the independent samples Student's t -test. Results:, A total of 184 children completed the assessment [103 (56%) male, mean age 10.7 years ± 3.3] including 40 children with GORD, 44 with chronic constipation, 59 with IBD and 41 healthy children. QoL was significantly lower in the GORD group compared with both children with IBD (74 vs. 82) and healthy children (74 vs. 84), and was comparable to that of children with chronic constipation (74 vs. 74). Conclusions:, Self-reported QoL in children with GORD attending a tertiary paediatric gastroenterology clinic is significantly reduced compared with both healthy children and children with IBD. [source]


Pathology of chronic constipation in pediatric and adult coloproctology

ACTA PAEDIATRICA, Issue 12 2005
Bo Lindquist
No abstract is available for this article. [source]