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Anorectal physiology

Diego Pérez-Sotelo, Arturo Roca-Rivada, María Larrosa-García, Cecilia Castelao, Iván Baamonde, Javier Baltar, Ana Belen Crujeiras, Luisa María Seoane, Felipe F Casanueva, María Pardo
The secretion of the hepatokine alpha-2-Heremans-Schmid glycoprotein/Fetuin A, implicated in pathological processes including systemic insulin resistance, by adipose tissue has been recently described. Thus, we have recently identified its presence in white adipose tissue secretomes by mass spectrometry. However, the secretion pattern and function of adipose-derived alpha-2-Heremans-Schmid glycoprotein are poorly understood. The aim of this study is to evaluate the expression and secretion of total and active phosphorylated alpha-2-Heremans-Schmid glycoprotein by adipose tissue from visceral and subcutaneous localizations in animals at different physiological and nutritional status including anorexia and obesity...
October 14, 2016: Endocrine
Josephine Collins, Yoav Mazor, Michael Jones, John Kellow, Allison Malcolm
OBJECTIVE: To determine whether anorectal biofeedback therapy can improve the symptoms of fecal incontinence (FI) in patients with scleroderma when compared to patients with functional FI, and also whether there is any effect on anorectal physiology or quality of life (QOL). FI in patients with scleroderma is highly prevalent and is associated with significant loss of QOL. Biofeedback has been proven to be an effective treatment for functional FI, but there are no data to support its use in scleroderma...
December 2016: Scandinavian Journal of Gastroenterology
Wei-Cheng Liu, Song-Lin Wan, S M Yaseen, Xiang-Hai Ren, Cui-Ping Tian, Zhao Ding, Ken-Yan Zheng, Yun-Hua Wu, Cong-Qing Jiang, Qun Qian
Obstructed defecation syndrome (ODS) is a functional disorder commonly encountered by colorectal surgeons and gastroenterologists, and greatly affects the quality of life of patients from both societal and psychological aspects. The underlying anatomical and pathophysiological changes of ODS are complex. However, intra-rectal intussusception and rectocele are frequently found in patients with ODS and both are thought to play an important role in the pathogenesis of ODS. With the development of evaluation methods in anorectal physiology laboratories and radiology studies, a great variety of new operative procedures, especially transanal procedures, have been invented to treat ODS...
September 21, 2016: World Journal of Gastroenterology: WJG
Chih-Hsun Yi, Tso-Tsai Liu, Wei-Yi Lei, Jui-Sheng Hung, Chien-Lin Chen
Background. Postcolonoscopy abdominal discomfort and bloating are common. The aim of this study was to evaluate whether rectal decompression improved distension-induced abdominal symptoms and influenced anorectal physiology. Methods. In 15 healthy subjects, rectal distension was achieved by direct air inflation into the rectum by colonoscopy. Placement of rectal and sham tube was then performed in each subject on a separate occasion. The anorectal parameters and distension-induced abdominal symptoms were recorded...
2016: Gastroenterology Research and Practice
Laura Lombardi, Elena Garrisi, Matteo Ricco', Federico Marchesi, Emilio Casolari, Claudia Gatti, Carmine G Del Rossi
PURPOSE: We aimed at investigating bowel function in children and adolescents with anorectal malformations (ARMs) and assess their quality of life (QoL), in order to define a personal program of bowel management improving both clinical condition and self-confidence. METHODS: A total of 55 patients treated for ARM by Posterior Sagittal Ano-Recto-Plasty (PSARP) from 2000 to 2014 were included into the study. The parents of 41 patients answered two telephone questionnaires about the parents' self-efficacy and about QoL (GIQLI)...
September 13, 2016: Acta Bio-medica: Atenei Parmensis
Y Mazor, R Hansen, G Prott, J Kellow, A Malcolm
BACKGROUND: A subset of patients with chronic constipation display a relatively high manometric rectal pressure on strain. We hypothesized that these patients represent a unique phenotype of functional defecatory disorder (FDD) and would benefit from undergoing anorectal biofeedback (BF). METHODS: Of 138 consecutive patients with chronic constipation and symptoms of FDD, 19 were defined as having a high rectal pressure on strain, using a statistically derived cut-off of 78 mm Hg...
September 20, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Tamar Nobel, Sergey Khaitov, Alexander J Greenstein
The accepted current standard for treatment of medically refractory ulcerative colitis is total proctocolectomy with an ileal pouch-anal anastomosis for restoration of continence. There are 2 techniques by which the anastomosis can be performed, including handsewn and stapled. Handsewn anastomosis with mucosectomy was the first method described; however, it has been associated with significant incontinence. The double-stapled anastomosis was developed in response to improve postoperative function. Controversy remains as to which technique is superior as both have disadvantages...
September 2016: Inflammatory Bowel Diseases
Flavio H F Galvão, Daniel R Waisberg, Victor E Seid, Anderson C L Costa, Eleazar Chaib, Rachel Rossini Baptista, Vera Luiza Capelozzi, Cinthia Lanchotte, Ruy J Cruz, Jun Araki, Luiz Carneiro D'Albuquerque
Fecal incontinence is a challenging condition with numerous available treatment modalities. Success rates vary across these modalities, and permanent colostomy is often indicated when they fail. For these cases, a novel potential therapeutic strategy is anorectal transplantation (ATx). We performed four isogeneic (Lewis-to-Lewis) and seven allogeneic (Wistar-to-Lewis) ATx procedures. The anorectum was retrieved with a vascular pedicle containing the aorta in continuity with the inferior mesenteric artery and portal vein in continuity with the inferior mesenteric vein...
2016: Scientific Reports
Satish S C Rao, Tanisa Patcharatrakul
Dyssynergic defecation is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability to coordinate the abdominal and pelvic floor muscles to evacuate stools. A detailed history, prospective stool diaries, and a careful digital rectal examination will not only identify the nature of bowel dysfunction, but also raise the index of suspicion for this evacuation disorder. Anorectal physiology tests and balloon expulsion test are essential for a diagnosis...
July 30, 2016: Journal of Neurogastroenterology and Motility
Yahya A Al-Abed, Jennifer Ayers, Abraham Ayantunde, Bandipalyam V Praveen
PURPOSE: Permacol has been gaining popularity in recent times for the treatment of fecal incontinence (FI). This study aims to evaluate the safety and efficacy of anal submucosal Permacol injection in the treatment of FI. METHODS: All consecutive patients who underwent Permacol injection for FI over a 3-year period were included. Patients' data relating to obstetric history, anorectal/pelvic operations, type of FI, preoperative anorectal physiology results and follow-up details for outcome measures were collected...
April 2016: Annals of Coloproctology
L Ambartsumyan, A Siddiqui, S Bauer, S Nurko
BACKGROUND: Children with urinary incontinence (UI) have associated functional constipation (FC) and fecal incontinence (FI). The physiology between lower urinary tract (LUT) and anorectum in children has not been elucidated. AIMS: Observe the effect of rectal distention (RD) on LUT function, and bladder filling and voiding on anorectal function. METHODS: Children with voiding dysfunction referred to Boston Children's Hospital were prospectively enrolled in combined urodynamic (UDS) and anorectal manometry (ARM)...
June 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
D C Townsend, E V Carrington, U Grossi, R E Burgell, J Y J Wong, C H Knowles, S M Scott
BACKGROUND: Fecal incontinence (FI) is a common and socially disabling condition with obstetric trauma considered the principal etiological factor. This study aimed to systematically evaluate symptom presentation and anorectal function in both females and males with FI. METHODS: One hundred males (M) and 100 age-matched females (F) with FI presenting between 2012 and 2014 were identified from a prospectively collected database. Comparison of clinical (history, symptom profile, and severity using validated questionnaires) and anorectal physiological (manometry, rectal sensory testing, endoanal ultrasonography, and evacuation proctography) data between M and F was performed...
October 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Lalit Kumar, Jorge Liwanag, Eleni Athanasakos, Amanda Raeburn, Natalia Zarate-Lopez, Anton V Emmanuel
AIM: Chronic constipation can be aetiopathogenically classified in to slow transit constipation (STC), rectal evacuation difficulty (RED) or a combination (BOTH). Although the efficacy of percutaneous tibial nerve stimulation (PTNS) in faecal incontinence has been well proven, a current literature search identifies only one study which assessed its effect on constipation. We aimed to evaluate the effectiveness of PTNS in patients with different causes of constipation. METHOD: 34 patients (30 women, median age 50 (20-79) years with constipation who had previously failed maximal laxative and biofeedback therapy participated in the study...
May 20, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Vicki Patton, Earl Abraham, David Z Lubowski
BACKGROUND: Most studies on sacral nerve stimulation (SNS) are either single-centre with small numbers of patients or multi-centre studies. We present the medium-term follow-up results from a single centre for 127 patients undergoing SNS. METHODS: Consecutive patients treated with SNS for faecal incontinence had preoperative baseline St Mark's continence scores, faecal incontinence quality of life (FIQL) measures and anorectal physiology studies. Follow-up was a postal questionnaire concerning continence, FIQL, patient-perceived change in bowel control (-5 to +5 where 0 is no change), overall satisfaction (0-10 visual analogue scale) and use of medications...
May 19, 2016: ANZ Journal of Surgery
Y Mazor, M Jones, A Andrews, J E Kellow, A Malcolm
STUDY DESIGN: A case-control study of prospectively collected data was performed. OBJECTIVES: To compare anorectal biofeedback (BF) outcomes in patients with incomplete motor spinal cord injury (SCI) and neurogenic bowel dysfunction (NBD) with a group of functional anorectal disorder-matched control patients. SETTING: Neurogastroenterology Unit affiliated with a Spinal Injury Unit in a tertiary referral centre in Sydney, Australia. METHODS: All consecutive patients with SCI and NBD referred for anorectal manometry and BF were matched in a 1:2 ratio with age, gender, parity and functional anorectal disorder-matched control patients...
May 17, 2016: Spinal Cord
Takeshi Iwasa, Toshiya Matsuzaki, Altankhuu Tungalagsuvd, Munkhsaikhan Munkhzaya, Maira Yiliyasi, Takeshi Kato, Akira Kuwahara, Minoru Irahara
The actions and responses of hypothalamic appetite regulatory and factors change markedly during the neonatal to pre-pubertal period. Pituitary adenylate cyclase-activating polypeptide (PACAP) has been found to play pivotal roles in the regulation of metabolic and nutritional status through its specific receptor PAC1. PACAP/PAC1 have anorectic roles, and their functions are regulated by leptin in adulthood. In the present study, we showed that hypothalamic PACAP mRNA expression decreases during the neonatal to pre-pubertal period (from postnatal day 10-30) in both male and female rats...
August 2016: International Journal of Developmental Neuroscience
Ting Yu, Dong Qian, Yongping Zheng, Ya Jiang, Ping Wu, Lin Lin
The physiological mechanism of functional constipation (FC) includes defecatory disorders and delayed colon transit. About 18% to 68% constipated patients may have rectal hyposensitivity (RH). We performed this study to investigate the association between RH and functional defecatory disorder (FDD) as well as that between RH and delayed colon transit in FC patients.A total of 218 FC patients were enrolled. The constipation severity instrument (CSI) was used to assess constipation symptoms. High-resolution anorectal manometry (HR-ARM), defecography, balloon expulsion tests, and colon transit studies were performed for each patient...
May 2016: Medicine (Baltimore)
V Passananti, A Wilton, G Preziosi, J B Storrie, A Emmanuel
BACKGROUND: Multiple sclerosis (MS) is the commonest disabling neurological disease in young adults. A majority of patients experience bowel dysfunction, reporting a wide spectrum of bowel symptoms that significantly negatively impact social activities and emotional state. Transanal irrigation (TAI) is a method of managing such bowel symptoms. We aimed to investigate long-term efficacy of TAI, to measure health status-related quality of life and identify factors predictive of TAI outcome...
September 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Tomasz Zieliński, Piotr Czyżewski, Marek Szczepkowski
UNLABELLED: The operation to restore the continuity of the gastrointestinal tract is another surgical intervention in a given patient, which directly translates into an increased risk of complications during and after surgery. That is why proper qualification is important for the operation to restore the continuity of the gastrointestinal tract in terms of performance and efficiency of the anal sphincter apparatus, among other things. The aim of the study was to evaluate the effect of restoring physiological defecation routes on the sphincter function and to observe the parameters of anorectal manometry in patients before and after surgery to restore the continuity of the gastrointestinal tract...
January 1, 2016: Polski Przeglad Chirurgiczny
A J Hainsworth, A M P Schizas, S Brown, A B Williams
AIM: The study aimed to determine the current state of UK pelvic floor services and to discuss future strategies. METHOD: A questionnaire developed by The Pelvic Floor Society was sent in 2014 to the 175 colorectal units recognised by the Association of Coloproctology of Great Britain and Ireland. Questions included type of centre, frequency of pelvic floor clinics/ inter-disciplinary joint pelvic floor clinics/ multidisciplinary meeting (MDM) and workload. RESULTS: sixty seven (38%) centres replied including 75% of units with a consultant who was as member of the Pelvic Floor Society...
March 30, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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