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https://www.readbyqxmd.com/read/28405717/-differential-indications-for-ileoanal-pouch-anastomosis-ulcerative-colitis-familial-adenomatous-polyposis-synchronous-colorectal-cancer-crohn-s-disease-constipation
#1
A Fürst
Ileoanal pouch anastomosis is the procedure of choice for patients with drug refractory ulcerative colitis, indeterminate colitis and familial adenomatous polyposis (FAP). In selected patient groups this procedure is a treatment option for patients with Crohn's disease, hereditary nonpolyposis colorectal cancer (HNPCC), synchronous colorectal cancer and for severe colorectal constipation refractory to conservative drug treatment. The pouch procedure provides the opportunity to avoid a permanent ileostomy. The majority of surgeons prefer the ileal J‑pouch as the construction is the easiest to perform and complications and dysfunction rates are low...
April 12, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28386692/the-usefulness-of-mr-defecography-in-the-evaluation-of-pelvic-floor-dysfunction-our-experience-using-3t-mri
#2
Mahasen S Al-Najar, Ahmed F Ghanem, Saif Aldeen S AlRyalat, Nosaiba T Al-Ryalat, Sultan O Alhajahjeh
PURPOSE: To assess the usefulness of MR defecography in evaluating pelvic floor dysfunction, and to correlate several pelvic organ abnormalities with each other and with patients' symptoms and characteristics. METHODS: MR defecographic examinations performed in 3T MRI machine of 95 patients (70 females, 25 males; mean age 48) were retrospectively reviewed. Pelvic organ abnormalities from all three compartments were recorded, including the anorectal junction descent, anterior rectocele, and cystocele...
April 6, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28374259/anorectal-complications-after-robotic-intersphincteric-resection-for-low-rectal-cancer
#3
Li-Jen Kuo, James Chi-Yong Ngu, Yan-Jiun Huang, Yen-Kuang Lin, Chia-Che Chen, Yiu-Shun Tong, Szu-Chia Huang, Chia-Chen Hu, Shu-Hwa Tan
BACKGROUND: Robotic intersphincteric resection (ISR) has been introduced for sphincter-preservation in the treatment of low rectal cancer. However, many patients experience anorectal symptoms and defecatory dysfunction after ISR. This study aims to evaluate the anorectal complications that develop after ISR. METHODS: The medical records of 108 patients who underwent robotic ISR at Taipei Medical University Hospital, Taipei, Taiwan between December 2011 and June 2016 were retrospectively reviewed...
April 3, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28357501/robot-assisted-intersphincteric-resection-facilitates-an-efficient-sphincter-saving-in-patients-with-low-rectal-cancer
#4
Jin Cheon Kim, Jong Lyul Lee, Abdulrahman Muaod Alotaibi, Yong Sik Yoon, Chan Wook Kim, In Ja Park
PURPOSE: Few investigations of robot-assisted intersphincteric resection (ISR) are presently available to support this procedure as a safe and efficient procedure. We aimed to evaluate the utility of robot-assisted ISR by comparison between ISR and abdominoperineal resection (APR) using both robot-assisted and open approaches. METHODS: The 558 patients with lower rectal cancer (LRC) who underwent curative operation was enrolled between July 2010 and June 2015 to perform either by robot-assisted (ISR vs...
March 29, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28306603/current-treatment-of-pelvic-organ-prolapse-correlated-with-chronic-pelvic-pain-bladder-and-bowel-dysfunction
#5
Bernhard Liedl, Klaus Goeschen, Leopold Durner
PURPOSE OF REVIEW: The purpose of this review is to critically analyze the relationship between symptoms of abnormal emptying of the bladder, urgency, pelvic pain, anorectal dysfunction and pelvic organ prolapse (POP) and to present evidence in order to show how many of the above mentioned symptoms can be cured or substantially improved by repair of specific pelvic ligaments. RECENT FINDINGS: In this review, we provide evidence to show how often these dysfunctions occur and how they can be cured in 42-94% by appropriate pelvic floor surgery in the longer term, up to 2 years...
May 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28299421/evaluation-of-sexual-dysfunction-in-female-patients-presenting-with-faecal-incontinence-or-defecation-disorder
#6
Gianluca Pellino, Lisa Ramage, Constantinos Simillis, Oliver Warren, Christos Kontovounisios, Emile Tan, Paris Tekkis
PURPOSE: Female patients with pelvic floor diseases may suffer from several sexual disorders and sexual life impairments. The aim of this manuscript was to evaluate sexual dysfunction in female patients presenting with faecal incontinence (FI) and defecation disorder (DD). METHODS: A retrospective review was performed of a prospectively collected database of sexually active women referred to the pelvic floor clinic, who completed the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-12 (PISQ-12) at first visit...
May 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28265107/use-of-sacral-nerve-stimulation-for-the-treatment-of-overlapping-constipation-and-fecal-incontinence
#7
Gouri Sreepati, Toyia James-Stevenson
BACKGROUND Fecal incontinence and constipation are common gastrointestinal complaints, but rarely occur concurrently. Management of these seemingly paradoxical processes is challenging, as treatment of one symptom may exacerbate the other. CASE REPORT A 51-year-old female with lifelong neurogenic bladder secondary to spina bifida occulta presented with progressive symptoms of daily urge fecal incontinence as well as hard bowel movements associated with straining and a sensation of incomplete evacuation requiring manual disimpaction...
March 7, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28261139/assessment-of-dysfunctional-cognitions-in-binge-eating-disorder-factor-structure-and-validity-of-the-mizes-anorectic-cognitions-questionnaire-revised-mac-r
#8
Isabelle Carrard, Stephane Rothen, Maaike Kruseman, Yasser Khazaal
Background: Dysfunctional cognitions regarding weight and shape and their implications for self-esteem are considered core features of anorexia nervosa and bulimia nervosa. However, they have also been associated with the severity of binge eating disorder (BED). Therefore, they should be screened with appropriate instruments to tailor treatment to individual patient needs. The Mizes Anorectic Cognitions-Revised (MAC-R) is a self-report questionnaire that lists dysfunctional cognitions related to three hypothesized core beliefs typical of the psychopathology of eating disorders: weight and eating as the basis of approval from others; the belief that rigid self-control is fundamental to self-worth; and the rigidity of weight- and eating-regulation efforts...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28259741/nonrelaxing-pelvic-floor-dysfunction-is-an-underestimated-complication-of-ileal-pouch-anal-anastomosis
#9
Kevin P Quinn, Chung Sang Tse, Amy L Lightner, Richard S Pendegraft, Felicity T Enders, Laura E Raffals
BACKGROUND & AIMS: Nonrelaxing pelvic floor dysfunction (N-RPFD), or dyssynergic defecation, is the paradoxical contraction and/or impaired relaxation of pelvic floor and anal muscles during defecation. Few studies have evaluated this disorder in patients with an ileal pouch-anal anastomosis (IPAA). We investigated the frequency of N-RPFD in patients with and without chronic pouchitis following IPAA and the effectiveness of biofeedback therapy within this population. METHODS: We conducted a retrospective study of all patients with an IPAA who underwent anorectal manometry between January 2000 and March 2015 (n = 111)...
March 1, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28149017/malabsorption-orocecal-transit-time-and-small-intestinal-bacterial-overgrowth-in-type-2-diabetic-patients-a-connection
#10
S V Rana, Aastha Malik, Sanjay K Bhadada, Naresh Sachdeva, Rajesh Kumar Morya, Gaurav Sharma
Type 2 diabetes mellitus consists of dysfunctions characterized by hyperglycemia and resulting from combination of resistance to insulin action and inadequate insulin secretion. Most of diabetic patients report significant gastrointestinal symptoms. Entire GI tract can be affected by diabetes from oral cavity to large bowel and anorectal region. Proteins, carbohydrates, fats, and most fluids are absorbed in small intestine. Malabsorption may occurs when proper absorption of nutrients does not take place due to bacterial overgrowth or altered gut motility...
March 2017: Indian Journal of Clinical Biochemistry: IJCB
https://www.readbyqxmd.com/read/28130409/reduced-metabolism-in-the-hypothalamus-of-the-anorectic-anx-anx-mouse
#11
Ulrika Bergström, Charlotte Lindfors, Marie Svedberg, Jeanette E Johansen, Jenny Häggkvist, Martin Schalling, Rolf Wibom, Abram Katz, Ida A K Nilsson
The anorectic anx/anx mouse exhibits a mitochondrial complex I dysfunction that is related to aberrant expression of hypothalamic neuropeptides and transmitters regulating food intake. Hypothalamic activity, i.e. neuronal firing and transmitter release, is dependent on glucose utilization and energy metabolism. To better understand the role of hypothalamic activity in anorexia, we assessed carbohydrate and high-energy phosphate metabolism, in vivo and in vitro, in the anx/anx hypothalamus. In the fasted state, hypothalamic glucose uptake in the anx/anx mouse was reduced by ~50% of that seen in wild-type (wt) mice (P < 0...
April 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/28116695/update-on-the-management-of-chronic-constipation
#12
REVIEW
Jenna Koliani-Pace, Brian E Lacy
Chronic constipation (CC) is a highly prevalent disorder encountered by health care providers of all specialties. The diagnosis can be confidently made by taking a careful history, evaluating for warning signs and symptoms, performing an examination, including a digital rectal exam, and using the Rome IV criteria. Treatment should begin at the first visit; most patients require few diagnostic tests to make, or confirm, the diagnosis of CC. Assuming that the patient has persistent symptoms of constipation, despite using traditional therapy (fiber, osmotic agents), then patients should be offered one of the newer treatments, rather than repeating prior treatments, which is a common practice...
March 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28110485/are-obese-patients-at-an-increased-risk-of-pelvic-floor-dysfunction-compared-to-non-obese-patients
#13
Isaac José Felippe Corrêa Neto, Rodrigo Ambar Pinto, José Marcio Neves Jorge, Marco Aurélio Santo, Leonardo Alfonso Bustamante-Lopez, Ivan Cecconello, Sérgio Carlos Nahas
PURPOSE: Factors associated with increased intra-abdominal pressure such as chronic cough, morbid obesity, and constipation may be related to pelvic floor dysfunction. In this study, we compared anorectal manometry values and clinical data of class II and III morbidly obese patients referred to bariatric surgery with that of non-obese patients. METHODS: We performed a case-matched study between obese patients referred to bariatric surgery and non-obese patients without anorectal complaints...
January 21, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28101937/methods-of-anorectal-manometry-vary-widely-in-clinical-practice-results-from-an-international-survey
#14
E V Carrington, H Heinrich, C H Knowles, S S Rao, M Fox, S M Scott
BACKGROUND: Ano-rectal manometry (ARM) is the most commonly performed investigation for assessment of anorectal dysfunction. Its use is supported by expert consensus documents and international guidelines. Variation in technology, data acquisition, and analysis affect results and clinical interpretation. This study examined variation in ARM between institutions to establish the status of current practice. METHODS: A 50-item web-based questionnaire assessing analysis and interpretation of ARM was distributed by the International Anorectal Physiology Working Group via societies representing practitioners that perform ARM...
January 18, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28097524/pubovisceralis-muscle-fiber-architecture-determination-comparison-between-biomechanical-modeling-and-diffusion-tensor-imaging
#15
Sofia Brandão, Marco Parente, Elisabete Silva, Thuane Da Roza, Teresa Mascarenhas, João Leitão, João Cunha, Renato Natal Jorge, Rita Gouveia Nunes
Biomechanical analysis of pelvic floor dysfunction requires knowledge of certain biomechanical parameters, such as muscle fiber direction, in order to adequately model function. Magnetic resonance (MR) diffusion tensor imaging (DTI) provides an estimate of overall muscle fiber directionality based on the mathematical description of water diffusivity. This work aimed at evaluating the concurrence between pubovisceralis muscle fiber representations obtained from DTI, and the maximum principal stress lines obtained through the finite element method...
May 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28062871/-chronic-diarrhea-in-the-diabetic-a-review-of-the-literature
#16
Juan Sebastián Frías Ordoñez, William Otero Regino
The association of diarrhea with diabetes mellitus has been known for more than 70 years. In diabetic patients its prevalence is around 20%.Its clinical manifestations are diverse, and represents a diagnostic and therapeutic challenge.There are certain diagnoses of higher prevalence in diabetic patients than in the general population.The different related etiologies can be adequately diagnosed through the clinical history and complementary diagnostic tests.The medications used by the diabetic patient to manage their disease often cause chronic diarrhea, so the pharmacological background should be studied at the time of the study of diarrhea...
October 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28058590/sphincter-saving-resection-by-cluneal-arched-skin-incision-for-a-gastrointestinal-stromal-tumor-gist-of-the-lower-rectum-a-case-report
#17
Hirofumi Tazawa, Yuzo Hirata, Yoshio Kuga, Toshihiro Nishida, Hideto Sakimoto
BACKGROUND: Planning the surgical strategy for a gastrointestinal stromal tumor (GIST) at the posterior wall of the lower rectum is difficult, as the procedures for the lower rectum are hampered by poor visualization and may cause anal dysfunction or discomfort. We report a novel procedure to resect a submucosal tumor of the rectum. CASE PRESENTATION: A 75-year-old woman presented with metrorrhagia. Endovaginal ultrasonography showed a low echoic tumor. Computed tomography showed an enhanced tumor, measuring 5...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28042962/analysis-of-recurrent-sacrococcygeal-teratoma-in-children-clinical-features-relapse-risks-and-anorectal-functional-sequelae
#18
Yi Wang, Yeming Wu, Lifeng Wang, Xiaojun Yuan, Mawei Jiang, Yuhua Li
BACKGROUND Sacrococcygeal teratoma (SCT) is a relatively uncommon tumor. Recurrence with poor survival and anorectal dysfunction are the 2 leading problems for patients. Here, we would review the clinic features of patients with SCTs in our hospital to identify risk factors of recurrent SCTs and to analyze anorectal functional sequelae. MATERIAL AND METHODS A retrospective review of all patients with SCTs in our center between 2007 and 2013 was performed. We analyzed the recorded data on each patient and performed follow-up through phone calls...
January 2, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28040503/are-interferential-electrical-stimulation-and-diaphragmatic-breathing-exercises-beneficial-in-children-with-bladder-and-bowel-dysfunction
#19
Vesna D Zivkovic, Ivona Stankovic, Lidija Dimitrijevic, Mirjana Kocic, Hristina Colovic, Marina Vlajkovic, Andjelka Slavkovic, Milica Lazovic
OBJECTIVE: To evaluate the effects of interferential current (IC) stimulation and diaphragmatic breathing exercises (DBEs) in children with bladder and bowel dysfunction. PATIENTS AND METHODS: Seventy-nine children with dysfunctional voiding and chronic constipation who were failures of primary care interventions were included in the prospective clinical study. All the children were checked for their medical history regarding lower urinary tract symptoms and bowel habits...
December 28, 2016: Urology
https://www.readbyqxmd.com/read/28013205/clinical-correlates-of-faecal-incontinence-in-systemic-sclerosis-identifying-therapeutic-avenues
#20
Nicolas Richard, Marie Hudson, Geneviève Gyger, Murray Baron, Evelyn Sutton, Nader Khalidi, Janet E Pope, Nathalie Carrier, Maggie Larché, Alexandra Albert, Paul R Fortin, Carter Thorne, Ariel Masetto
Objectives.: The aim was to establish the prevalence and severity of faecal incontinence (FI) in SSc, its association with other intestinal manifestations and potential predictors of FI, and its impact on quality of life. Methods.: A multicentre, cross-sectional study of 298 SSc subjects followed in the Canadian Scleroderma Research Group cohort was performed using validated questionnaires: Jorge-Wexner score (an FI severity scale), Bristol stool scale (a visual scale of stool consistency) and FI Quality-of-Life scale...
April 1, 2017: Rheumatology
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