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https://www.readbyqxmd.com/read/29662931/ulcerative-colitis-are-we-neglecting-its-progressive-character
#1
Paulo Massinha, Francisco Portela, Sara Campos, Gabriela Duque, Manuela Ferreira, Sofia Mendes, Ana Margarida Ferreira, Carlos Sofia, Luís Tomé
Introduction: Ulcerative colitis (UC) is a chronic disease but its progressive character, with structural damage, is insufficiently studied. Objectives: To analyze a group of patients without referral bias, regarding its clinical course, the morphological damage, and functional status. Methods: We evaluated UC patients diagnosed between January 1, 2000 and December 31, 2004, living in the direct referral area of the hospital and determined the medication use, colectomy rate, structural damage ("lead pipe," stenosis, pseudopolyps, fibrous bridges), and anorectal function (prospective evaluation with the Cleveland Clinic Incontinence Score [CCIS] and the Fecal Incontinence Quality of Life Scale)...
March 2018: GE Portuguese Journal of Gastroenterology
https://www.readbyqxmd.com/read/29564542/the-puborectal-continence-reflex-a-new-regulatory-mechanism-controlling-fecal-continence
#2
Paul M A Broens, Jara E Jonker, Monika Trzpis
PURPOSE: Fecal continence is maintained by voluntary and involuntary contraction of the anal sphincter, and voluntary contractions of puborectal muscle. We investigated whether the puborectal muscle can control fecal continence not only by voluntary contractions but also by involuntary contractions. METHODS: We performed anorectal function tests in 23 healthy subjects. The anorectal pressure test was used to investigate voluntary contractions of the puborectal muscle...
March 21, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29556878/effectiveness-of-pelvic-floor-rehabilitation-for-bowel-dysfunction-after-intersphincteric-resection-for-lower-rectal-cancer
#3
Hideaki Nishigori, Masayuki Ishii, Yujiro Kokado, Kouji Fujimoto, Hiroshi Higashiyama
BACKGROUND: The aim of this study was to evaluate the effectiveness of pelvic floor rehabilitation (PFR) for patients with bowel dysfunction after intersphincteric resection (ISR) and to compare the treatment response to that of patients after low anterior resection (LAR). METHODS: Thirty patients with postoperative bowel dysfunction for more than 6 months were enrolled and treated with PFR for 6 months. RESULTS: In the ISR group, significant improvements in the number of bowel movements and the use of antidiarrheal medications were observed, but no significant improvement was observed in the Wexner score (WS) and the fecal incontinence severity index (FISI)...
March 19, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29541896/outcome-of-bowel-function-following-anterior-resection-for-rectal-cancer-an-analysis-using-the-low-anterior-resection-syndrome-lars-score
#4
Juliane Kupsch, Thomas Jackisch, Klaus E Matzel, Joerg Zimmer, Andreas Schreiber, Anja Sims, Helmut Witzigmann, Sigmar Stelzner
PURPOSE: Severity of anorectal dysfunction after low anterior resection is associated with various patient- and treatment-related factors. We aimed to quantify anorectal dysfunction after treatment for rectal cancer using the low anterior resection syndrome (LARS) score. METHODS: We retrieved from a prospective database 331 eligible patients on whom anterior resection for rectal cancer had been performed from 2000 to 2014. All patients were sent a LARS score accompanied by a supplementary questionnaire...
June 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29478399/hepatic-lipidosis-clinical-review-drawn-from-collective-effort
#5
Craig B Webb
Practical relevance: Hepatic lipidosis (HL) is the most common form of liver dysfunction in cats. If recognized early and treated appropriately, the prognosis is good; if not, the prognosis is grave. Clinical challenges: Distinguishing HL as idiopathic or secondary is critical since the presence of a concurrent disease affects the therapeutic plan and the prognosis. AUDIENCE: Despite the unique and severe nature of a cat's response to anorexia and the complexity of the metabolic changes underlying this condition, the clinical acumen and technical ability to effectively diagnose and treat HL are readily available to all small animal practitioners...
March 2018: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/29464583/intestinal-involvement-in-systemic-sclerosis-a-clinical-review
#6
REVIEW
Lazaros I Sakkas, Theodora Simopoulou, Dimitrios Daoussis, Stamatis-Nick Liossis, Spyros Potamianos
Systemic sclerosis (SSc) is a chronic systemic disease characterized by microvasculopathy, autoantibodies, and extensive fibrosis. Intestinal involvement is frequent in SSc and represents a significant cause of morbidity. The pathogenesis of intestinal involvement includes vascular damage, nerve dysfunction, smooth muscle atrophy, and fibrosis, causing hypomotility, which leads to small intestinal bacterial overgrowth (SIBO), malabsorption, malnutrition, diarrhea, pseudo-obstruction, constipation, pneumatosis intestinalis, and fecal incontinence...
April 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29454526/predicting-sexual-problems-in-young-adults-with-an-anorectal-malformation-or-hirschsprung-disease
#7
M J Witvliet, S van Gasteren, D van den Hondel, E Hartman, Lwe van Heurn, Afw van der Steeg
AIM: The aim of this study was to examine the prevalence of sexual dysfunction and distress and to assess whether sexual functioning could be predicted by psychosocial factors in childhood and adolescence in patients with an anorectal malformation or Hirschsprung disease. MATERIAL AND METHODS: In 1998 patients completed a psychosocial questionnaire: The Self-Perception profile. To assess the prevalence of sexual distress and sexual functioning in adulthood (2015) the Female Sexual Function Index (FSFI), The Female Sexual Distress Scale (FSDS) and the International Index of Erectile Functioning (IIEF) were used...
January 31, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29447025/anal-sphincter-dysfunction-in-patients-treated-with-primary-radiotherapy-for-anal-cancer-a-study-with-the-functional-lumen-imaging-probe
#8
Susanne Haas, Pia Faaborg, Donghua Liao, Søren Laurberg, Hans Gregersen, Lilly Lundby, Peter Christensen, Klaus Krogh
BACKGROUND: Sphincter-sparing radiotherapy or chemoradiation are standard treatments for patients with anal cancer. The ultimate treatment goal is full recovery from anal cancer with preserved anorectal function. Unfortunately, long-term survivors often suffer from severe anorectal symptoms. The aim of the present study was to characterize changes in anorectal physiology after radiotherapy for anal cancer. METHOD: We included 13 patients (10 women, age 63.4 ± 1...
April 2018: Acta Oncologica
https://www.readbyqxmd.com/read/29420431/challenges-in-transition-of-care-for-patients-with-anorectal-malformations-a-systematic-review-and-recommendations-for-comprehensive-care
#9
REVIEW
Sarah B Cairo, Alessandra Gasior, Michael D Rollins, David H Rothstein
BACKGROUND: Anorectal malformations are one of the most common congenital intestinal anomalies affecting newborns. Despite advances in neonatal care and surgical techniques, many patients with a history of anorectal malformations are affected by long-term challenges involving bowel and bladder dysfunction, sexual dysfunction, and psychosocial issues. These outcomes or challenges are additionally exacerbated by the lack of a structured transition of care from the pediatric to the adult setting...
March 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29353847/-diagnosis-and-treatment-of-six-patients-with-crohn-s-disease-complicated-by-recto-perineal-urethral-fistula
#10
Hirosuke Kuroki, Kazutaka Koganei, Kenji Tatsumi, Ryo Futatsuki, Kyoko Yamada, Katsuhiko Arai, Nao Obara, Hideaki Kimura, Akira Sugita, Tsuneo Fukushima
Recto-perineal-urethral fistula caused by Crohn's disease is a rare, for which fundamental treatment has not been established yet. We analyzed the clinical characteristics, diagnosis, treatment, and prognosis of six male patients with anorectal lesions caused by Crohn's disease. Three patients were treated with abdominoperineal resection and the other three with rectal excision without anastomosis. Excluding one case, which presented worsening immediately after surgery, symptoms of urethral fistula improved without urethral stenosis, dysuria, or sexual dysfunction...
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/29343914/symptomatic-lower-urinary-tract-dysfunction-in-sacral-agenesis-potentially-high-risk
#11
Sanjay Sinha, Mehul A Shah, Dilip M Babu
Introduction: Sacral agenesis (SA) is a caudal regression anomaly that can cause neurogenic bladder but is not generally recognized as high risk. We studied the clinical presentation, upper urinary tract, bone and spine abnormalities, and urodynamic findings in patients with SA and compared them with related high-risk conditions, anorectal malformation (ARM), and cloacal malformation. Materials and Methods: Patient records between May 2011 and December 2015 were identified and grouped into isolated SA without an overt anomaly (Group I), SA with overt caudal regression anomalies (Group II), and ARM or cloacal malformation without the SA (Group III)...
January 2018: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/29330765/pudendal-nerve-terminal-motor-latency-testing-does-not-provide-useful-information-in-guiding-therapy-for-fecal-incontinence
#12
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...
March 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29139310/pudendal-nerve-injury-impairs-anorectal-function-and-health-related-quality-of-life-measures-%C3%A2-2-years-after-3d-conformal-radiotherapy-for-prostate-cancer
#13
Eng Eric Yeoh, Rochelle Botten, Addolorata Di Matteo, Marcus Tippett, Jonathon Hutton, Robert Fraser, Phillip G Dinning, David Wattchow
PURPOSE: To compare GI symptoms, measures of generic and disease specific health related quality of life (HRQoL), anorectal and pudendal nerve function and anal sphincter morphology between (i) patients ≥2 years after 3D conformal radiotherapy (3D-CRT)±high dose rate (HDR) brachytherapy for carcinoma of the prostate and aged matched patients before radiotherapy and (ii) symptomatic and asymptomatic patients ≥2 years after 3D-CRT ± HDR brachytherapy. MATERIAL AND METHODS: Methodology included: (i) modified LENT-SOMA scales for GI symptoms, (ii) EORTC QLQ-C30 and EORTC QLQ-PR25 questionnaires for generic and disease specific HRQoL, (iii) anorectal manometry and terminal motor latency for anorectal and pudendal nerve function and (iv) endorectal ultrasound for anal sphincter morphology...
April 2018: Acta Oncologica
https://www.readbyqxmd.com/read/29131290/nesfatin-1-levels-in-patients-with-slow-coronary-flow
#14
Mevlüt Serdar Kuyumcu, Aliye Kuyumcu, Çağrı Yayla, Mustafa Bilal Özbay, Mehmet Alagöz, Sefa Ünal, Burak Açar, Özcan Özeke, Gülhan Samur
BACKGROUND: Nesfatin-1 is a novel anorectic neuropeptide with potent metabolic regulatory effects. AIM: We aimed to evaluate the relationship between nesfatin-1 levels and slow coronary flow (SCF). METHODS: A total of 60 consecutive patients with SCF and 60 consecutive patients with normal coronary flow (NCF) were enrolled into the study. Nesfatin-1 level was measured from blood serum samples using enzyme-linked immunosorbent assay test. RESULTS: Serum nesfatin-1 levels were significantly lower in the SCF group compared to the NCF group (p < 0...
2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29094352/anorectal-dysfunction-after-laparoscopic-low-anterior-rectal-resection-for-rectal-cancer-with-and-without-radiotherapy-manometry-study
#15
Peter Ihnát, Ivana Slívová, Lubomir Tulinsky, Lucia Ihnát Rudinská, Jan Máca, Igor Penka
BACKGROUND AND OBJECTIVES: The aim was to evaluate the impact of radiotherapy (RT) on anorectal function of patients with low rectal cancer undergoing low anterior resection (LAR). METHODS: Prospective clinical cohort study conducted to assess the functional outcome by means of high-resolution anorectal manometry and LARS score. RESULTS: In total, 65 patients were enrolled in the study (27 patients underwent LAR without RT, 38 patients underwent RT and LAR)...
November 1, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29064840/the-assessment-and-management-of-defecatory-dysfunction-a-critical-appraisal
#16
Leila Neshatian
PURPOSE OF REVIEW: To summarize the advances in diagnostic modalities and management options for defecatory dysfunction and highlight the areas in need of further research. RECENT FINDINGS: The diagnostic utility of high-resolution anorectal manometry (ARM), which has emerged as a promising tool for the diagnosis of defecatory dysfunction, appears to be questionable in differentiating disease from normal physiology. There also seems to be discrepancy between results of various tests of anorectal function in the diagnosis of defecatory dysfunction...
January 2018: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/29050194/update-on-the-pathophysiology-and-management-of-anorectal-disorders
#17
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
#18
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)...
January 29, 2018: Beneficial Microbes
https://www.readbyqxmd.com/read/29021649/follow-up-urodynamics-in-patients-with-neurogenic-bladder
#19
REVIEW
Sanjay Sinha
INTRODUCTION: Neurogenic bladder patients are at long-term risk of secondary upper urinary tract damage. Symptoms are unreliable and follow-up urodynamics is the only method of ascertaining safety of bladder pressures. This review examines the recommendations, shortcomings and utilization of existing guidelines. The evidence with regard to follow-up urodynamics in different settings relevant to neurogenic bladder is evaluated and an algorithm is proposed. METHODS: A pubmed search was conducted for studies on follow-up urodynamics in patients with neurogenic bladder...
October 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28991086/bowel-dysfunction-related-to-spina-bifida-keep-it-simple
#20
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
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