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Anorectal physiology

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https://www.readbyqxmd.com/read/29124885/oleoylethanolamide-the-role-of-a-bioactive-lipid-amide-in-modulating-eating-behaviour
#1
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
#2
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
#3
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...
October 23, 2017: 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
https://www.readbyqxmd.com/read/28589452/on-demand-microbicide-products-design-matters
#17
REVIEW
Sravan Kumar Patel, Lisa Cencia Rohan
Sexual intercourse (vaginal and anal) is the predominant mode of human immunodeficiency virus (HIV) transmission. Topical microbicides used in an on-demand format (i.e., immediately before or after sex) can be part of an effective tool kit utilized to prevent sexual transmission of HIV. The effectiveness of prevention products is positively correlated with adherence, which is likely to depend on user acceptability of the product. The development of an efficacious and acceptable product is therefore paramount for the success of an on-demand product...
December 2017: Drug Delivery and Translational Research
https://www.readbyqxmd.com/read/28588875/management-of-chronic-constipation-in-adults
#18
REVIEW
K Krogh, G Chiarioni, W Whitehead
Chronic constipation (CC) is an extremely common condition with an estimated prevalence of up to 24%. Most patients with CC should be treated in primary care. Changes in lifestyle, including increased intake of dietary fibre, fluid, and exercise, should be attempted in most patients. Osmotic or stimulant laxatives are indicated if there are insufficient effects of lifestyle changes. Prokinetics and secretagogues should be restricted to those not responding to basic treatment. Anorectal physiology tests and assessment of colorectal transit time are indicated if medical treatment fails or if symptoms indicate severely obstructed defecation...
June 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28547814/electrical-stimulation-structurally-affects-the-tissues-of-the-rectum-and-anus-of-nulliparous-rats
#19
Hugo Alves de Sousa, Maria da Glória da Silva, Keyla de Paula Barbosa, Leonora Maciel de Souza Vianna, Yolanda Galindo Pacheco, José Roberto Pimenta de Godoy, Selma Aparecida Souza Kuckelhaus
Considering that the muscles of the anus perform a critical role in maintaining continence, losses in their structure can negatively affect the physiological control of the intestinal contents. Anorectal electro-stimulation (ARES) has been reported to have a positive effect on the functionality of treated patients, but how ARES affects the structural tissues of the anorectal segment remains unknown. Because the study of how ARES structurally affects human tissues is not possible, this study aimed to clarify these effects in a murine model, which has a similar anorectal segment (structure and physiology) to humans...
May 26, 2017: Journal of Anatomy
https://www.readbyqxmd.com/read/28484364/energy-homeostasis-in-monotremes
#20
REVIEW
Stewart C Nicol
In 1803, the French anatomist Étienne Geoffroy Saint-Hilaire decided that the newly described echidna and platypus should be placed in a separate order, the monotremes, intermediate between reptiles and mammals. The first physiological observations showed monotremes had low body temperatures and metabolic rates, and the consensus was that they were at a stage of physiological development intermediate between "higher mammals" and "lower vertebrates." Subsequent studies demonstrated that platypuses and echidnas are capable of close thermoregulation in the cold although less so under hot conditions...
2017: Frontiers in Neuroscience
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