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https://www.readbyqxmd.com/read/29345097/the-diagnostic-value-of-the-functional-lumen-imaging-probe-versus-high-resolution-anorectal-manometry-in-patients-with-fecal-incontinence
#1
A M Leroi, C Melchior, C Charpentier, V Bridoux, C Savoye-Collet, E Houivet, P Ducrotté, G Gourcerol
BACKGROUND: The functional lumen imaging probe (EndoFLIP® ) is a new technology that measures the distensibility of the anal canal represented by the anal distensibility index. The aims of this study were (i) to compare the anal distensibility index to anal pressure in a cohort of patients with fecal incontinence (FI) and (ii) to compare the diagnostic value of the EndoFLIP® to that of high-resolution anorectal manometry (HRAM) in the same cohort of patients. METHODS: Eighty-three consecutive patients with FI who underwent EndoFLIP® and HRAM assessments were enrolled...
January 18, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29330765/pudendal-nerve-terminal-motor-latency-testing-does-not-provide-useful-information-in-guiding-therapy-for-fecal-incontinence
#2
Julia T Saraidaridis, George Molina, Lieba R Savit, Holly Milch, Tiffany Mei, Samantha Chin, James Kuo, Liliana Bordeianou
PURPOSE: Pudendal nerve terminal motor latency (PNTML) testing is a standard recommendation for the evaluation of fecal incontinence. Its role in guiding therapy for fecal incontinence has been previously questioned. The aim of this study was to evaluate the relationship between PNTML testing and anorectal dysfunction. METHODS: This was a retrospective analysis of data collected prospectively from patients who presented to a pelvic floor disorder center from 2007 to 2015...
January 13, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29288794/role-of-central-neurotensin-in-regulating-feeding-implications-for-the-development-and-treatment-of-body-weight-disorders
#3
REVIEW
Laura E Schroeder, Gina M Leinninger
The peptide neurotensin (Nts) was discovered within the brain over 40 years ago and is implicated in regulating analgesia, body temperature, blood pressure, locomotor activity and feeding. Recent evidence suggests, however, that these disparate processes may be controlled via specific populations of Nts neurons and receptors. The neuronal mediators of Nts anorectic action are now beginning to be understood, and, as such, modulating specific Nts pathways might be useful in treating feeding and body weight disorders...
December 27, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29239347/chronic-constipation
#4
REVIEW
Michael Camilleri, Alexander C Ford, Gary M Mawe, Phil G Dinning, Satish S Rao, William D Chey, Magnus Simrén, Anthony Lembo, Tonia M Young-Fadok, Lin Chang
Chronic constipation is a prevalent condition that severely impacts the quality of life of those affected. Several types of primary chronic constipation, which show substantial overlap, have been described, including normal-transit constipation, rectal evacuation disorders and slow-transit constipation. Diagnosis of primary chronic constipation involves a multistep process initiated by the exclusion of 'alarm' features (for example, unintentional weight loss or rectal bleeding) that might indicate organic diseases (such as polyps or tumours) and a therapeutic trial with first-line treatments such as dietary changes, lifestyle modifications and over-the-counter laxatives...
December 14, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29212617/diagnostic-role-of-anal-sphincter-relaxation-integral-in-high-resolution-anorectal-manometry-for-hirschsprung-disease-in-infants
#5
Jia-Feng Wu, Cheng-Hsun Lu, Chia-Hsiang Yang, I-Jung Tsai
OBJECTIVE: To investigate the possible diagnostic role of anal sphincter relaxation integral (ASRI) in high-resolution anorectal manometry (HRAM) for Hirschsprung disease. STUDY DESIGN: We performed conventional anorectal manometry (ARM) in 24 infants (8 with Hirschsprung disease and 16 without Hirschsprung disease) and HRAM in another 21 infants (9 with Hirschsprung disease and 12 without Hirschsprung disease) before and after October 2014. All infants underwent rectal suction biopsy for confirmation of Hirschsprung disease...
December 4, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29198537/healthcare-utilization-and-comorbidities-associated-with-anorectal-malformations-in-the-united-states
#6
Karlo Kovacic, Sravan R Matta, Katja Kovacic, Casey Calkins, Ke Yan, Manu R Sood
OBJECTIVE: To determine nationwide prevalence and healthcare utilization in children with anorectal malformations and associated anomalies over a 6-year period. STUDY DESIGN: We used the Kids' Inpatient Database for the years 2006, 2009, and 2012 for data collection. International Classification of Diseases, Ninth Revision codes were used to identify patients with anorectal malformations and associated anomalies. RESULTS: A total of 2396 children <2 years of age with anorectal malformations were identified using weighted analysis; 54...
November 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29179287/interest-of-anorectal-manometry-during-long-term-follow-up-of-patients-operated-on-for-hirschsprung-s-disease
#7
Viet Q Tran, Tania Mahler, Patrick Bontems, Dinh Q Truong, Annie Robert, Philippe Goyens, Henri Steyaert
Background/Aims: Although many advances in the management of Hirschsprung's disease have recently been achieved, postoperative outcomes of these patients remain difficult in a non-negligible number of cases. Therefore, this study aims at investigating characteristics of anorectal manometry and its relationship with postoperative outcomes during long-term follow-up in Hirschsprung patients. Methods: Patients over 4 years of age operated on for Hirschsprung's disease were interviewed to complete detailed questionnaires on bowel function...
November 25, 2017: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/29178261/an-anms-naspghan-consensus-document-on-esophageal-and-antroduodenal-manometry-in-children
#8
REVIEW
R Rosen, J M Garza, N Tipnis, S Nurko
BACKGROUND: Upper gastrointestinal symptoms in children are common and motility disorders are considered in the differential diagnosis. High resolution esophageal manometry (HRM) has revolutionized the study of esophageal physiology, and the addition of impedance has provided new insights into esophageal function. Antroduodenal motility has provided insight into gastric and small bowel function. PURPOSE: This review highlights some of the recent advances in pediatric esophageal and antroduodenal motility testing including indications, preparation, performance, and interpretation of the tests...
November 27, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29140124/apprenticeship-based-training-in-neurogastroenterology-and-motility
#9
Dipesh H Vasant, Amol Sharma, Jigar Bhagatwala, Lavanya Viswanathan, Satish S C Rao
Although neurogastroenterology and motility (NGM) disorders affect 50% of patients seen in clinics, many gastroenterologists receive limited NGM training. One-month apprenticeship-based NGM training has been provided at ten centers in the USA for a decade, however, outcomes of this training are unclear. Our goal was to describe the effectiveness of this program from a trainees perspective. Areas Covered: We describe the training model, learning experiences, and outcomes of one-month apprenticeship-based training in NGM at a center of excellence, using a detailed individual observer account and data from 12 consecutive trainees that completed the program...
November 15, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29134969/the-prevalence-and-impact-of-overlapping-rome-iv-diagnosed-functional-gastrointestinal-disorders-on-somatization-quality-of-life-and-healthcare-utilization-a-cross-sectional-general-population-study-in-three-countries
#10
Imran Aziz, Olafur S Palsson, Hans Törnblom, Ami D Sperber, William E Whitehead, Magnus Simrén
OBJECTIVES: The population prevalence of Rome IV-diagnosed functional gastrointestinal disorders (FGIDs) and their cumulative effect on health impairment is unknown. METHODS: An internet-based cross-sectional health survey was completed by 5,931 of 6,300 general population adults from three English-speaking countries (2100 each from USA, Canada, and UK). Quota-based sampling was used to generate demographically balanced and population representative samples with regards to age, sex, and education level...
November 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29132530/diagnosis-and-management-of-anorectal-disorders-in-the-primary-care-setting
#11
REVIEW
Danielle Davies, Justin Bailey
Anorectal disorders are very common among a wide population of patients. Because patients may be embarrassed about the anatomic location of their symptoms, they may present to care late in the course of their illness. Care should be taken to validate patient concerns and normalize fears. This article discusses the diagnoses and management of common anorectal disorders among patients presenting to a primary care physician.
December 2017: Primary Care
https://www.readbyqxmd.com/read/29102367/-the-psychiatric-comorbidity-of-anorexia-nervosa-a-comparative-study-in-a-population-of-french-and-greek-anorexic-patients
#12
M Kountza, G Garyfallos, D Ploumpidis, E Varsou, I Gkiouzepas
OBJECTIVE: The current study had two objectives: (1) to access the psychiatric comorbidity in axis I and axis II (according to DSM-IV) of anorexia nervosa in a sample of 60 anorexic patients; (2) to compare the features of the psychiatric comorbidity between the two groups of French and Greek anorexic patients who participated in the study, as well as to compare some psychological and behavioral aspects of their anorectic psychopathology. METHOD: Sixty anorexic patients, thirty French and thirty Greek, aged between 18 and 60 years, referred for evaluation and therapy at the unit of eating disorders at the "Institut national Marcel-Rivière of the MGEN" (hôpital de La Verrière, France) and at the unit of eating disorders of the First Department of Psychiatry of EGINITIO University Psychiatric Hospital in Athens (Greece), were accessed with the Eating Attitudes Test-26 (EAT26), Eating Disorder Inventory (EDI), Symptom Checklist-90-Revised (SCL90R), Mini International Neuropsychiatric Interview, Version 5...
November 1, 2017: L'Encéphale
https://www.readbyqxmd.com/read/29068554/internal-anal-sphincter-nerves-a-macroanatomical-and-microscopic-description-of-the-extrinsic-autonomic-nerve-supply-of-the-internal-anal-sphincter
#13
S Stelzner, M Böttner, J Kupsch, W Kneist, P Quirke, N P West, H Witzigmann, T Wedel
BACKGROUND: The internal anal sphincter (IAS) contributes substantially to anorectal functions. While its autonomic nerve supply has been studied at the microscopic level, little information is available concerning the macroscopic topography of extrinsic nerve fibres. This study was designed to identify neural connections between the pelvic plexus and the IAS, provide a detailed topographical description, and give histological proof of autonomic nerve tissue. METHODS: Macroscopic dissection of pelvic autonomic nerves was performed under magnification in seven (5 males, 2 females) hemipelvises obtained from body donors (67-92 years)...
October 25, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29050194/update-on-the-pathophysiology-and-management-of-anorectal-disorders
#14
REVIEW
Tanisa Patcharatrakul, Satish S C Rao
Anorectal disorders are common and present with overlapping symptoms. They include several disorders with both structural and functional dysfunction(s). Because symptoms alone are poor predictors of the underlying pathophysiology, a diagnosis should only be made after evaluating symptoms and physiologic and structural abnormalities. A detailed history, a thorough physical and digital rectal examination and a systematic evaluation with high resolution and/or high definition three-dimensional (3D) anorectal manometry, 3D anal ultrasonography, magnetic resonance defecography and neurophysiology tests are essential to correctly identify these conditions...
October 23, 2017: Gut and Liver
https://www.readbyqxmd.com/read/29022390/randomised-double-blind-placebo-controlled-trial-on-lactobacillus-reuteri-dsm-17938-improvement-in-symptoms-and-bowel-habit-in-functional-constipation
#15
G Riezzo, A Orlando, B D'Attoma, M Linsalata, M Martulli, F Russo
Dysbiosis may contribute to constipation and its symptoms, therefore probiotic administration could improve significantly gut health and functions. The aim of the study was to investigate the effects of a long-lasting administration of Lactobacillus reuteri DSM 17938 (LR DSM 17938) on symptoms and quality of life (QoL) score in patients with functional constipation (FC). 56 FC patients with normal colonic transit time and without anorectal disorders and pelvic floor dysfunctions completed the study. LR DSM 17938 was administered for 105 days in a randomised double-blind clinical trial (28 patients per arm)...
October 12, 2017: Beneficial Microbes
https://www.readbyqxmd.com/read/28991086/bowel-dysfunction-related-to-spina-bifida-keep-it-simple
#16
Charlène Brochard, Benoît Peyronnet, Anne Dariel, Hélène Ménard, Andréa Manunta, Alain Ropert, Michel Neunlist, Guillaume Bouguen, Laurent Siproudhis
BACKGROUND: Although care of urological disorders in spina bifida is well established, there is yet no agreement on a standardized approach to bowel dysfunction in this population. OBJECTIVE: The purpose of this study was to assess bowel dysfunction using validated instruments and the risk factors in adults with spina bifida. DESIGN: A multidisciplinary team prospectively collected patient data, focusing on anorectal and urological symptoms...
November 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28922706/functional-outcome-of-low-rectal-resection-evaluated-by-anorectal-manometry
#17
Peter Ihnát, Petr Vávra, Jiří Prokop, Anton Pelikán, Lucia Ihnát Rudinská, Igor Penka
BACKGROUND: Low anterior resection syndrome (LARS) covers disordered bowel function after rectal resection, leading to deterioration in patients' quality of life. The aim of this study was to evaluate anorectal function after laparoscopic low anterior resection (LAR) by means of standardized instruments. METHODS: This was a prospective clinical cohort study conducted in a single institution to assess functional outcome of patients 1 year after laparoscopic LAR by means of LARS score and high-resolution anorectal manometry...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28893560/emr-is-superior-to-rectal-suction-biopsy-for-analysis-of-enteric-ganglia-in-constipation-and-dysmotility
#18
Kenneth Barshop, Field F Willingham, William R Brugge, Lawrence R Zukerberg, Braden Kuo
BACKGROUND AND AIMS: Patients with chronic constipation or motility disorders may be referred for rectal suction biopsy (RSB) to rule out Hirschsprung's disease (HD). RSB may not be successful beyond infancy because of the increased thickness of the rectal mucosa. EMR could improve the diagnostic yield for HD when compared with traditional RSB because larger and deeper samples are acquired for analysis. METHODS: In this prospective, single-center study, patients referred for RSB were offered enrollment for concurrent EMR...
September 8, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28873483/a-rare-case-of-amelanotic-anorectal-melanoma
#19
Nicole A Negbenebor, Edward Feller
We report an exceedingly rare case of amelanotic anorectal melanoma misdiagnosed as hemorrhoids. A 74-year-old man presented with a week's history of "blood on toilet tissue" without bowel complaints or history of cutaneous melanoma. Skin evaluation was normal. Rectal exam was negative for blood, but revealed an anal nodule, interpreted as a hemorrhoid. Hemoglobin was normal; bleeding persisted. After one month, colonoscopy detected a non-pigmented anal lesion. Biopsy showed melanoma. Noncutaneous mucosal melanoma represents 0...
September 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28871380/mri-of-anal-canal-common-anal-and-perianal-disorders-beyond-fistulas-part-2
#20
REVIEW
Ayşe Erden
A broad spectrum of disease, from benign processes to life-threatening pathologies, can cause anal pain. MR imaging (MRI) has become increasingly widely used method over the past two decades for the evaluation of individuals with anorectal symptoms. Although imaging is rarely necessary to determine the etiology of the majority of cases, MRI is particularly useful as a noninvasive method of excluding severe neoplastic conditions. In this article, MRI findings of a number of pathologies such as anal and perianal neoplasms, hemorrhoidal disease, arteriovenous malformation of the perianal region, and anal sphincter lesions (defects, scarring, atrophy) which may lead to fecal incontinence are presented...
September 4, 2017: Abdominal Radiology
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