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Chronic constipation

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https://www.readbyqxmd.com/read/27910115/an-expert-consensus-definition-of-failure-of-a-treatment-to-provide-adequate-relief-f-par-for-chronic-constipation-an-international-delphi-survey
#1
J Tack, H Boardman, P Layer, I Schiefke, D Jayne, C Scarpignato, M Fox, T Frieling, P Ducrotte, S Hamdy, K Gill, C Ciriza de Los Rios, R Felt-Bersma, D De Looze, V Stanghellini, A Mohr Drewes, M Simrén, C Pehl, T Hoheisel, A Leodolter, E Rey, J Dalrymple, A Emmanuel
BACKGROUND: As treatments for constipation become increasingly available, it is important to know when to progress along the treatment algorithm if the patient is not better. AIM: To establish the definition of failure of a treatment to provide adequate relief (F-PAR) to support this management and referral process in patients with chronic constipation. METHODS: We conducted an international Delphi Survey among gastroenterologists and general practitioners with a special interest in chronic constipation...
December 1, 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27895411/reoperation-in-an-adult-female-with-right-sided-hirschsprung-s-disease-complicated-by-refractory-hypertension-and-cough
#2
Zhi-Jian Wei, Lei Huang, A-Man Xu
Hirschsprung's disease (HD) is an intestinal malformation caused by the innate absence of ganglion cells in the neural plexus of the colorectal wall, and is most common in male infants. It is rare in adult, and is usually left-sided. Herein we reported based on the CARE guidelines a case of a 47-year-old adult female suffering from "right-sided" HD complicated by refractory hypertension and cough. The patient with a history of cesarean section and with digestive unfitness (abdominal pain, distention, and constipation) only since 20 years old had recurrence of HD after initial surgery due to the incomplete removal of the HD-affected bowel based on a diagnosis of "chronic ileus", leading to the relapse of the digestive symptoms and the emergence of some intractable circulatory and respiratory complications which could be hardly controlled by conservative treatment...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27891696/gender-differences-in-chronic-constipation-on-anorectal-motility
#3
M Zakari, J Nee, W Hirsch, B Kuo, A Lembo, K Staller
BACKGROUND: The epidemiology of chronic constipation (CC) skews toward female predominance, yet men make up an important component of those suffering from CC. We sought to determine whether there are sex-specific differences in symptoms and physiologic parameters on anorectal manometry (ARM). METHODS: We performed a case-control analysis of sequential men and age-matched women (2:1 ratio) presenting for ARM as part of the evaluation of CC. We collected physiologic parameters derived from 3D high-resolution ARM in addition to the ROME III constipation module and the Pelvic Floor Distress Inventory 20 (PFDI-20) questionnaires...
November 27, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27891695/downregulation-of-neuronal-vasoactive-intestinal-polypeptide-in-parkinson-s-disease-and-chronic-constipation
#4
F Giancola, F Torresan, R Repossi, F Bianco, R Latorre, A Ioannou, M Guarino, U Volta, P Clavenzani, M Mazzoni, R Chiocchetti, F Bazzoli, R A Travagli, C Sternini, R De Giorgio
BACKGROUND: Chronic constipation (CC) is a common and severe gastrointestinal complaint in Parkinson's disease (PD), but its pathogenesis remains poorly understood. This study evaluated functionally distinct submucosal neurons in relation to colonic motility and anorectal function in PD patients with constipation (PD/CC) vs both CC and controls. METHODS: Twenty-nine PD/CC and 10 Rome III-defined CC patients were enrolled. Twenty asymptomatic age-sex matched subjects served as controls...
November 27, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27890312/variables-associated-with-loss-of-ileoanal-pouches-constructed-in-childhood
#5
Khaled Abdelaal, Bruce Jaffray
AIMS: To quantify the incidence of loss of an ileoanal pouch in children and to identify variables associated this event. METHODS: Logistic regression of possible explanatory variables: age, sex, indication for procto-colectomy, pre-operative continence status, use of immunosuppressive drugs, open or laparoscopic surgery, number of stages, anastomotic leak, operative complication excluding anastomotic leak, performance of revisional surgery, albumin concentration and platelet count at time of surgery, rank order in series...
November 13, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27860208/randomized-double-blind-trial-of-oral-methylnaltrexone-for-the-treatment-of-opioid-induced-constipation-in-patients-with-chronic-noncancer-pain
#6
Richard Rauck, Neal E Slatkin, Nancy Stambler, Joseph R Harper, Robert J Israel
BACKGROUND: Subcutaneous methylnaltrexone, a peripherally acting μ-opioid receptor antagonist, improves opioid-induced constipation (OIC) in patients with chronic noncancer pain. An oral methylnaltrexone formulation has been developed. METHODS: In this phase 3, double-blind trial, adults with chronic noncancer pain receiving opioid doses of ≥50 mg/d oral morphine equivalents with OIC were randomly assigned to oral methylnaltrexone (150 mg, 300 mg, or 450 mg) or placebo once daily (QD) for 4 weeks followed by as-needed dosing for 8 weeks...
November 17, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27857691/chemotherapy-induced-constipation-and-diarrhea-pathophysiology-current-and-emerging-treatments
#7
REVIEW
Rachel M McQuade, Vanesa Stojanovska, Raquel Abalo, Joel C Bornstein, Kulmira Nurgali
Gastrointestinal (GI) side-effects of chemotherapy are a debilitating and often overlooked clinical hurdle in cancer management. Chemotherapy-induced constipation (CIC) and Diarrhea (CID) present a constant challenge in the efficient and tolerable treatment of cancer and are amongst the primary contributors to dose reductions, delays and cessation of treatment. Although prevalence of CIC is hard to estimate, it is believed to affect approximately 16% of cancer patients, whilst incidence of CID has been estimated to be as high as 80%...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27853337/complicated-jejunal-diverticulosis-small-bowel-volvulus-with-obstruction
#8
Rommel Singh Mohi, Ashish Moudgil, Suresh Kumar Bhatia, Kaushal Seth, Tajinder Kaur
The incidence of the diverticulum of the small bowel varies from 0.2-1.3% in autopsy studies to 2.3% when assessed on enteroclysis. It occurs mostly in patients in the 6(th) decade of their life. Of all the small bowel diverticuli, jejunal diverticulum is the most common type. This rare entity is usually asymptomatic. However, they may cause chronic non-specific symptoms for a long period of time like dyspepsia, chronic postprandial pain, nausea, vomiting, borborgymi, alternating diarrhoea and constipation, weight loss, anaemia, steatorrhea or rarely lead to complications like haemorrhage, obstruction, perforation...
November 2016: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27847802/digital-rectal-examination-and-balloon-expulsion-test-in-the-study-of-defecatory-disorders-are-they-suitable-as-screening-or-excluding-tests
#9
REVIEW
Ana C Caetano, André Santa-Cruz, Carla Rolanda
Background. Rome III criteria add physiological criteria to symptom-based criteria of chronic constipation (CC) for the diagnosis of defecatory disorders (DD). However, a gold-standard test is still lacking and physiological examination is expensive and time-consuming. Aim. Evaluate the usefulness of two low-cost tests-digital rectal examination (DRE) and balloon expulsion test (BET)-as screening or excluding tests of DD. Methods. We performed a systematic search in PUBMED and MEDLINE. We selected studies where constipated patients were evaluated by DRE or BET...
2016: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27843572/utility-of-high-resolution-anorectal-manometry-and-wireless-motility-capsule-in-the-evaluation-of-patients-with-parkinson-s-disease-and-chronic-constipation
#10
Andrew Su, Rita Gandhy, Carrolee Barlow, George Triadafilopoulos
BACKGROUND: The aetiology of constipation in Parkinson's disease remains poorly understood. Defaecatory dyssynergia, anal sphincter spasticity and slow transit constipation may, individually or collectively, play a role. AIMS: In this retrospective cohort analysis of patients with Parkinson's disease and chronic constipation, we determined the utility of high-resolution anorectal manometry, balloon expulsion and wireless motility capsule testing in defining the underlying aetiology for constipation...
2016: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/27832472/oxycodone-deterx-%C3%A2-er-capsules-a-review-in-severe-chronic-pain
#11
Yvette N Lamb, Karly P Garnock-Jones, Susan J Keam
Oxycodone DETERx (®) extended-release (ER) capsules (Xtampza(®) ER), an abuse-deterrent formulation of oxycodone as the myristate salt, are approved in the USA for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. This narrative review discusses the clinical efficacy and tolerability of the oxycodone DETERx (®) ER capsule formulation in the management of severe pain, and provides an overview of pharmacokinetics, abuse-deterrent properties and alternative administration options...
November 10, 2016: Drugs
https://www.readbyqxmd.com/read/27832323/deep-pelvic-endometriosis-a-radiologist-s-guide-to-key-imaging-features-with-clinical-and-histopathologic-review
#12
REVIEW
Ayeh Darvishzadeh, Wendaline McEachern, Thomas K Lee, Priya Bhosale, Ali Shirkhoda, Christine Menias, Chandana Lall
While endometriosis typically affects the ovaries, deep infiltrating endometriosis can affect the gastrointestinal tract, urinary tract, and deep pelvis, awareness of which is important for radiologists. Symptoms are nonspecific and can range from chronic abdominal and deep pelvic pain to nausea, vomiting, diarrhea, constipation, hematuria, and rectal bleeding. Ultrasound and computed tomography may show nonspecific soft-tissue density masses causing bowel obstruction and hydronephrosis. This constellation of presenting symptoms and imaging evidence is easily mistaken for other pathologies including infectious gastroenteritis, diverticulitis, appendicitis, and malignancy, which may lead to unnecessary surgery or mismanagement...
November 10, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27831985/randomized-double-blind-placebo-controlled-phase-iii-trial-of-duloxetine-monotherapy-in-japanese-patients-with-chronic-low-back-pain
#13
Shinichi Konno, Natsuko Oda, Toshimitsu Ochiai, Levent Alev
STUDY DESIGN: A 14-week, randomized, double-blind, multicenter, placebo-controlled study of Japanese patients with chronic low back pain (CLBP) who were randomized to either duloxetine 60 mg once daily or placebo. OBJECTIVE: This study aimed to assess the efficacy and safety of duloxetine monotherapy in Japanese patients with CLBP. SUMMARY OF BACKGROUND DATA: In Japan, duloxetine is approved for the treatment of depression, diabetic neuropathic pain, and pain associated with fibromyalgia; however, no clinical study of duloxetine has been conducted for CLBP...
November 15, 2016: Spine
https://www.readbyqxmd.com/read/27830103/a-case-of-stercoral-perforation-detected-on-ct-requiring-proctocolectomy-in-a-heroin-dependent-patient
#14
William H Seligman, Fahreyar Alam, Andy Planner, Roderick J Alexander
Stercoral perforation of the colon is rare but carries with it significant morbidity and mortality. Stercoral perforation usually occurs in elderly, immobile patients with chronic constipation. In this manuscript, we report the case of stercoral perforation in a patient due to chronic heroin dependence. We report the case of a 56-year-old male patient with stercoral perforation, diagnosed by computed tomography, secondary to heroin dependence, requiring proctocolectomy and an end ileostomy. There are very few reports in the literature describing cases of stercoral perforation and questions have been asked about the importance of preoperative cross-sectional imaging...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27826213/management-of-moderate-to-severe-chronic-low-back-pain-with-buprenorphine-buccal-film-using-novel-bioerodible-mucoadhesive-technology
#15
REVIEW
Joseph V Pergolizzi, Robert B Raffa, Charles Fleischer, Gianpietro Zampogna, Robert Taylor
With a global prevalence of ~9%-12%, low back pain (LBP) is a serious public health issue, associated with high costs for treatment and lost productivity. Chronic LBP (cLBP) involves central sensitization, a neuropathic pain component, and may induce maladaptive coping strategies and depression. Treating cLBP is challenging, and current treatment options are not fully satisfactory. A new BioErodible MucoAdhesive (BEMA(®)) delivery system for buprenorphine has been developed to treat cLBP. The buccal buprenorphine (BBUP) film developed for this product (Belbuca™) allows for rapid delivery and titration over a greater range of doses than was previously available with transdermal buprenorphine systems...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27822226/somatic-comorbidity-in-chronic-constipation-more-data-from-the-gecco-study
#16
Paul Enck, Johannes Leinert, Menno Smid, Thorsten Köhler, Juliane Schwille-Kiuntke
Background. Comorbidity in chronic constipation has rarely been investigated, despite the fact that constipation can occur as one symptom in a number of neurological, systemic, and other nonintestinal and intestinal disorders. Methods. Of 1037 individuals with constipation identified during a telephone survey, 589 returned a postal questionnaire with valid data, asking for sociographic data, clinical symptoms, comorbid conditions, medication intake, and health care behavior related to constipation. Among them, 245 reported some somatic diagnoses and another 120 regular medication intake...
2016: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/27818596/epidemiological-study-correlation-between-diet-habits-and-constipation-among-elderly-in-beijing-region
#17
Xiao-Jiao Yang, Mei Zhang, Hong-Ming Zhu, Zhe Tang, Dan-Dan Zhao, Bang-Yi Li, Amanda Gabriel
AIM: To investigate correlations between diet and prevalence of constipation among elderly people in Beijing. METHODS: A total of 2776 (≥ 60 years) were selected in Beijing region for investigation. Data regarding constipation and diet habits was collected via hierarchical status, segmentation and random cluster sampling. Investigation included constipation-related demographic indicators and diet habits. Door-to-door questionnaires and surveys included daily staple food intakes, frequency of fish, egg, fruits and vegetables consumption...
October 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27815511/lorcaserin-for-smoking-cessation-and-associated-weight-gain-a-randomized-12-week-clinical-trial
#18
William R Shanahan, Jed E Rose, Alan Glicklich, Scott Stubbe, Matilde Sanchez-Kam
INTRODUCTION: Lorcaserin is a selective serotonin 2C receptor agonist approved by the FDA for chronic weight management. Preclinical data suggest that it may also be effective in smoking cessation through modulation of the dopaminergic reward system. METHODS: This was a 12-week, randomized, double-blind, placebo-controlled trial conducted in 30 centers in the United States. 603 adult smokers with a Body Mass Index (BMI) of 18.5-35 kg/m(2), averaging at least 10 cigarettes/day with no period of abstinence >3 months for the past year were randomized to lorcaserin 10 mg QD, 10 mg BID or placebo; all received standardized smoking cessation counseling weekly...
November 4, 2016: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/27815136/phenylquinoxalinone-cftr-activator-as-potential-prosecretory-therapy-for-constipation
#19
Onur Cil, Puay-Wah Phuan, Jung-Ho Son, Jie S Zhu, Colton K Ku, Niloufar Akhavan Tabib, Andrew P Teuthorn, Loretta Ferrera, Nicholas C Zachos, Ruxian Lin, Luis J V Galietta, Mark Donowitz, Mark J Kurth, A S Verkman
Constipation is a common condition for which current treatments can have limited efficacy. By high-throughput screening, we recently identified a phenylquinoxalinone activator of the cystic fibrosis transmembrane conductance regulator (CFTR) chloride channel that stimulated intestinal fluid secretion and normalized stool output in a mouse model of opioid-induced constipation (Cil et al Cell Mol Gastroenterol Hepatol 2:317-327, 2016). Here, we report phenylquinoxalinone structure-activity analysis, mechanism of action, animal efficacy data in acute and chronic models of constipation, and functional data in ex vivo primary cultured human enterocytes...
October 15, 2016: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/27807793/opioids-and-gi-motility-friend-or-foe
#20
REVIEW
Allen A Lee, William L Hasler
The use of opioids for the treatment of chronic non-cancer pain is growing at an alarming rate. Opioid-induced bowel dysfunction (OBD) is a common adverse effect of long-term opioid treatment manifesting as constipation, nausea, and vomiting. These effects are primarily mediated by peripheral μ-opioid receptors with resultant altered GI motility and function. As a result, patients may present with opioid-induced constipation (OIC), opioid-induced nausea and vomiting (OINV), and/or narcotic bowel syndrome (NBS)...
November 2, 2016: Current Treatment Options in Gastroenterology
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