1,721,018 research outputs found
Use of low dose polyethylene glycol solutions in the treatment of functional constipation
No full textA brief review is made of trials which used low doses of polyethylene glycol (13-30 g/day) solutions (125-500 ml/day) in rite treatment of chronic functional constipation. Most of these were short-run studies, and confirmed that polyethylene glycol solution increased bowel frequency, improved defaecation and decreased stool consistency. Three studies reported that polyethylene glycol electrolyte solution accelerated transit through the large bowel. One long-term study observed remission of constipation-related symptoms in more than 70% of the polyethylene glycol electrolyte solution treated patients, and the efficacy of the treatment was maintained over a 6-month period, despite progressive reduction of daily dosage
Management of lower gastrointestinal tract dysfunctions in patients with spinal cord injury.
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Chronic neurogenic lesions of the external anal sphincter and abdomino-pelvic dyssynergia in chronic constipation.
No full textBackground. Neuropathy of the pudendal nerves which may be found in constipated patients has been considered the result of pelvic floor descent due to the repetitive acts of straining at stool. However the relationship between abdominopelvic dyssynergia, which may lend to repetitive acts of straining and neurophysiopathologic alterations of the pelvic floor has not yet been fully elucidated. Aim of this study was to assess the relationship between neurophysiologic alterations of the external anal sphincter; patterns of altered evacuation and defaecographic pelvic floor physiology in 32 patients with chronic idiopathic constipation. Results. Ar electromyography partial muscle denervation, identified as chronic neurogenic lesions of the external anal sphincter were found in 19% and dyssynergia (co-contraction of external anal sphincter and abdominal muscles) in 34% of the investigated subjects. Patients with different electromyography patterns did not differ as far as concerns symptoms of altered evacuation, bowel frequency, use of digital manoeuvres, age, and duration of symptoms. The presence of neurophysiologic alterations was significantly associated with altered defaecographic findings: reduced ano-rectal angle at rest in chronic neurogenic lesions and abdomino-pelvic dyssynergia (p<0.01); excessive pelvic floor descent in the presence of chronic neurogenic lesions (p<0.05). Conclusions. In chronically constipated patients symptoms of altered defaecation do not appear to be related to abdomino-pelvic dyssynergia and/or chronic neurogenic lesion of the external anal sphincter and do not show any association with defaecographic alterations. These results suggest that straining at. evacuation can be induced by additional factors other than abdomino-pelvic dyssynergia and chronic neurogenic lesions and that these two alterations have different pathogenetic mechanisms
EFFECT OF ENDOGENOUS CHOLECYSTOKININ ON POSTPRANDIAL GALLBLADDER - REFILLING ULTRASONOGRAPHIC STUDY IN HEALTHY-SUBJECTS AND IN GALLSTONE PATIENTS
No full textThe postprandial release of cholecystokinin (CCK) regulates gallbladder (GB) contraction but little is known about the role, if any, of the still-elevated CCK blood levels on subsequent GB refilling. To assess the role of CCK in GB refilling, a CCK-receptor antagonist, loxiglumide, or saline were infused intravenously in a random double-blind fashion after the ingestion of a liquid test meal in 16 healthy subjects. An identical study protocol was performed in 10 GB ''contractor'' patients with radiolucent stones to ascertain whether the reported reduced CCK effect on GB emptying also affects GB refilling. GB volumes were assessed ultrasonographically in the fasting state and for 150 min at 15-min intervals after meal ingestion. GB volumes during postprandial refilling were significantly greater during loxiglumide than placebo infusion (P < 0.01), but they did not differ between gallstone and control subjects. In conclusion, postprandial endogenous CCK has a relevant role in delaying GB refilling, and this effect is not altered in patients with radiolucent gallstones
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