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Anorectal physiology

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https://www.readbyqxmd.com/read/29313248/functional-outcomes-with-handsewn-versus-stapled-anastomoses-in-the-treatment-of-ultralow-rectal-cancer
#1
Lisa Ramage, Paul Mclean, Constantinos Simillis, Shengyang Qiu, Christos Kontovounisios, Emile Tan, Paris Tekkis
Adequate oncological outcomes have been demonstrated with rectal resection and handsewn coloanal anastomosis (CAA) in tumours in close proximity to the internal anal sphincter. Our aim was to assess functional differences between handsewn CAA and ultralow stapled anastomosis. Participants were identified from a single-surgeon series. Included participants underwent anorectal physiology testing of anal sphincter function, in addition to completion of several questionnaires: Wexner Incontinence Score (WIS); Birmingham Bowel, Bladder and Urinary Symptom Questionnaire (BBUSQ); Low Anterior Resection Syndrome (LARS) Score; SF36...
January 8, 2018: Updates in Surgery
https://www.readbyqxmd.com/read/29288794/role-of-central-neurotensin-in-regulating-feeding-implications-for-the-development-and-treatment-of-body-weight-disorders
#2
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/29178261/an-anms-naspghan-consensus-document-on-esophageal-and-antroduodenal-manometry-in-children
#3
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/29173359/effectiveness-of-bulking-agent-solesta-therapy-in-fecal-incontinence-in-patients-refractory-to-conventional-therapies
#4
Ihsan Al-Bayati, Mohammed Saadi, Sherif Elhanafi, Richard W McCallum
BACKGROUND: Fecal incontinence is a problem that imposes considerable socioeconomic consequences. Despite many medical therapies, unmet needs remain. A new treatment option is a biocompatible bulking agent (Solesta) administered by submucosal injection in the distal rectum. The aims of this study are as follows: (1) To evaluate the efficacy and safety of this bulking agent in decreasing the severity of fecal incontinence (FI) and improving quality of life. (2) To obtain objective evidence of changes in anorectal physiology by high-resolution anorectal manometry pretreatment and posttreatment...
November 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29124885/oleoylethanolamide-the-role-of-a-bioactive-lipid-amide-in-modulating-eating-behaviour
#5
REVIEW
J Sihag, P J H Jones
Fatty acid ethanolamides are lipid mediators that regulate a plethora of physiological functions. One such bioactive lipid mediator, oleoylethanolamide (OEA), is a potent agonist of the peroxisome proliferator-activated receptor-alpha (PPAR-α), which modulates increased expression of the fatty acid translocase CD36 that enables the regulation of feeding behaviour. Consumption of dietary fat rich in oleic acid activates taste receptors in the gut activating specific enzymes that lead to the formation of OEA...
November 10, 2017: Obesity Reviews: An Official Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/29111136/factors-associated-with-response-to-biofeedback-therapy-for-dyssynergic-defecation
#6
Tanisa Patcharatrakul, Jessica Valestin, Amanda Schmeltz, Konrad Schulze, Satish S C Rao
BACKGROUND & AIMS: Biofeedback therapy (BT) is effective for dyssynergic defecation (DD), but it is not widely available or reimbursed, and is labor intensive. It is therefore important to select the appropriate patients for this treatment. We investigated symptoms and demographic, manometric, and other factors associated with outcomes of BT in patients with DD. METHODS: We performed a post-hoc analysis of 2 prospective studies of BT in 127 adult outpatients (18-75 years old, 120 female) with chronic constipation who failed to respond to treatment with dietary fiber or laxatives (>1 year) and were diagnosed with DD based on standard criteria...
October 27, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29064840/the-assessment-and-management-of-defecatory-dysfunction-a-critical-appraisal
#7
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/29053230/a-randomised-control-trial-of-four-different-regimes-of-biofeedback-program-in-the-treatment-of-faecal-incontinence
#8
Christopher J Young, Assad Zahid, Cherry E Koh, Jane M Young, Christopher M Byrne, Michael J Solomon, Jenny Rex, Janet Candido
AIM: Biofeedback is an established, effective and non-invasive treatment for faecal incontinence (FI). The aim was to compare the effectiveness of four different biofeedback treatment regimes. METHOD: Randomised control trial of patients with FI, stratified into two groups (metropolitan and rural) and then randomised into two subgroups (groups 1 and 2 within metropolitan, groups 3 and 4 within rural) with varying face-to-face and telephone biofeedback components...
October 20, 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
#9
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/29040444/re-establishment-of-energy-balance-in-a-male-mouse-model-with-pomc-neuron-deletion-of-bmpr1a
#10
Kristy L Townsend, Christopher Madden, Magdalena Blaszkiewicz, Lindsay McDougall, Domenico Tupone, Matthew D Lynes, Yuji Mishina, Paul Yu, Shaun Morrison, Yu-Hua Tseng
The regulation of energy balance involves complex processes in the brain, including coordination by hypothalamic neurons that contain pro-opiomelanocortin (POMC). We previously demonstrated that central bone morphogenetic protein 7 (BMP7) reduces appetite. Now we show that a type 1 BMP receptor, BMPR1A, is co-localized with POMC neurons and POMC-BMPR1A-KO mice are hyperphagic, revealing physiological involvement of BMP signaling in anorectic POMC neurons in the regulation of appetite. Surprisingly, the hyperphagic POMC-BMPR1A-KO mice exhibit a lack of obesity, even on a 45% high-fat diet...
October 9, 2017: Endocrinology
https://www.readbyqxmd.com/read/29022787/does-a-missed-obstetric-anal-sphincter-injury-at-time-of-delivery-affect-short-term-functional-outcome
#11
L Ramage, C Yen, S Qiu, C Simillis, C Kontovounisios, E Tan, P Tekkis
Introduction This study aimed to ascertain whether missed obstetric anal sphincter injury at delivery had worse functional and quality of life outcomes than primary repair immediately following delivery. Materials and methods Two to one propensity matching was undertaken of patients presenting to a tertiary pelvic floor unit with ultrasound evidence of missed obstetric anal sphincter injury within 24 months of delivery with patients who underwent primary repair at the time of delivery by parity, grade of injury and time to assessment...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28951737/efficacy-and-predictors-for-biofeedback-therapeutic-outcome-in-patients-with-dyssynergic-defecation
#12
Ting Yu, Xiaoxue Shen, Miaomiao Li, Meifeng Wang, Lin Lin
AIM: To evaluate the short-term efficacy of biofeedback therapy (BFT) for dyssynergic defecation (DD) and to explore the predictors of the efficacy of BFT. METHODS: Clinical symptoms, psychological state, and quality of life of patients before and after BFT were investigated. All patients underwent lifestyle survey and anorectal physiology tests before BFT. Improvement in symptom scores was considered proof of clinical efficacy of BFT. Thirty-eight factors that could influence the efficacy of BFT were studied...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28950040/fecal-incontinence-in-patients-with-spina-bifida-the-target-is-the-rectum
#13
Charlène Brochard, Alain Ropert, Benoît Peyronnet, Hélène Ménard, Andréa Manunta, Michel Neunlist, Guillaume Bouguen, Laurent Siproudhis
AIMS: The prevalence rate of severe fecal incontinence (FI) in adults with spina bifida (SB) is high. The physiological basis of FI in SB has not been clearly established, which contributes to inadequate care. The aim was to better characterize a large cohort of adults with special consideration of anorectal physiology. METHODS: A multidisciplinary team from a French referral centre for SB prospectively collected data on patients who had an anorectal manometry. Factors associated with severe FI (Cleveland clinical incontinence score ≥ 9) were assessed in a multivariate analysis model...
September 26, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28935264/a-potent-neuromedin-u-receptor-2-selective-alkylated-peptide
#14
Naoki Nishizawa, Yoko Kanematsu-Yamaki, Masaaki Funata, Hiroaki Nagai, Ayako Shimizu, Hisashi Fujita, Junichi Sakamoto, Shiro Takekawa, Taiji Asami
Neuromedin U (NMU) mediates various physiological functions via NMUR1 and NMUR2 receptors. NMUR2 has been considered a promising treatment option for diabetes and obesity. Although NMU-8, a shorter peptide, has potent agonist activity for both receptors, it is metabolically unstable. Therefore, NMU-8 analogs modified with long-chain alkyl moieties via a linker were synthesized. An octadecanoyl analog (17) with amino acid substitutions [αMePhe(19), Nle(21), and Arg(Me)(24)] and a linker [Tra-γGlu-PEG(2)] dramatically increased NMUR2 selectivity, with retention of high agonist activity...
October 15, 2017: Bioorganic & Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/28844157/validation-of-genetic-predictors-of-late-radiation-induced-morbidity-in-prostate-cancer-patients
#15
Line M H Schack, Stine E Petersen, Steffen Nielsen, Lilly Lundby, Morten Høyer, Lise Bentzen, Jens Overgaard, Christian N Andreassen, Jan Alsner
INTRODUCTION: Normal tissue morbidity sets the dose limit for radiotherapy (RT) in cancer treatment and has importance for quality of life for cancer survivors. A previous study of prostate cancer patients treated with RT generated clinical data for radiation-induced morbidity measured by anorectal physiological methods and validated questionnaires. Other studies have identified genetic predictors associated with late radiation-induced morbidity outcome. We have expanded biobank material aiming to validate single nucleotide polymorphisms (SNPs) and a gene expression classifier with endpoints on patient-reported outcomes and biomechanical properties of the anorectum from our cohort matching originally published endpoints...
November 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28792489/l-phenylalanine-modulates-gut-hormone-release-and-glucose-tolerance-and-suppresses-food-intake-through-the-calcium-sensing-receptor-in-rodents
#16
A Alamshah, E Spreckley, M Norton, J S Kinsey-Jones, A Amin, A Ramgulam, Y Cao, R Johnson, K Saleh, E Akalestou, Z Malik, N Gonzalez-Abuin, A Jomard, R Amarsi, A Moolla, P R Sargent, G W Gray, S R Bloom, K G Murphy
OBJECTIVE: High-protein diets (HPDs) are associated with greater satiety and weight loss than diets rich in other macronutrients. The exact mechanisms by which HPDs exert their effects are unclear. However, evidence suggests that the sensing of amino acids produced as a result of protein digestion may have a role in appetite regulation and satiety. We investigated the effects of l-phenylalanine (L-Phe) on food intake and glucose homeostasis in rodents. METHODS: We investigated the effects of the aromatic amino-acid and calcium-sensing receptor (CaSR) agonist l-phenylalanine (L-Phe) on food intake and the release of the gastrointestinal (GI) hormones peptide YY (PYY), glucagon-like peptide-1 (GLP-1) and ghrelin in rodents, and the role of the CaSR in mediating these effects in vitro and in vivo...
November 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28767804/partial-stapled-hemorrhoidopexy-clinical-aspects-and-impact-on-anorectal-physiology
#17
Marllus Braga Soares, Marcos Bettini Pitombo, Francisco Lopes Paulo, Paulo Cezar de Castro, Júlia Resende Schlinz, Annibal Amorim, Karin Guterres Lohmann Hamada
Objective: to evaluate the impact of partial stapled hemorrhoidopexy on anorectal physiology, the complications related to this surgical technique, pain, postoperative bleeding and recurrence of hemorrhoidal disease one year after surgery. Methods: this is a prospective, descriptive study in consecutive patients with mixed or internal hemorrhoidal disease, the internal component being classified as grade III or IV, undergoing partial stapled hemorrhoidopexy. Results: we studied 17 patients, 82% of them with internal hemorrhoids grade III and 18% grade IV...
May 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28757640/effects-of-peripheral-administration-of-a-neuromedin-u-receptor-2-selective-agonist-on-food-intake-and-body-weight-in-obese-mice
#18
T Kaisho, H Nagai, T Asakawa, N Suzuki, H Fujita, K Matsumiya, N Nishizawa, Y Kanematsu-Yamaki, K Dote, J-I Sakamoto, T Asami, S Takekawa
BACKGROUND: Neuromedin U (NMU) is a neuropeptide with various physiological functions including regulation of smooth-muscle contraction, blood pressure, stress responses, and feeding behaviors. NMU activates two distinct receptors, NMUR1 and NMUR2, which are predominantly expressed in peripheral tissues and the central nervous system, respectively. It is reported that the NMU signaling system regulates food intake and body weight via NMUR2, suggesting that an NMUR2 agonist exhibiting anorectic effects would be a potential therapy for obesity...
July 31, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28730167/the-clinical-characteristics-of-patients-with-chronic-idiopathic-anal-pain
#19
Weiming Mao, Xiujun Liao, Wenjing Wu, Yanyan Yu, Guangen Yang
The aim of this study was to investigate the clinical characteristics, treatment outcomes and psychological distress in patients with chronic idiopathic anal pain. The study was conducted on patients referred to Hangzhou Third Hospital for chronic anal pain from January, 2010 to December, 2014. Patient demographics, clinical history, anorectal physiology, and radiological imaging data were recorded for all patients. The treatment outcome was noted for patients treated and followed up for more than 6 month at the present unit...
2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/28660835/rectal-foreign-body-insertion-as-a-rare-cause-of-persistent-lumbosacral-plexus-injury
#20
F A Meister, I Amygdalos, U P Neumann, G Lurje
Rectal foreign body insertion is a common condition in emergency surgery, which often requires surgical intervention. Here we report a clinical case of rectal foreign body insertion as a rare cause of persistent lumbosacral plexus injury. A 72-year-old man presented to the emergency department complaining of acute bilateral paraplegia with loss of sensation in both legs, as well as total urinary retention. The patient underwent abdominal computed tomography, which showed a rectal foreign body measuring 13 × 11...
July 2017: Annals of the Royal College of Surgeons of England
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