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https://www.readbyqxmd.com/read/28185025/constipation-pathophysiology-and-current-therapeutic-approaches
#1
Amol Sharma, Satish Rao
Chronic constipation is a common, persistent condition affecting many patients worldwide, presenting significant economic burden and resulting in substantial healthcare utilization. In addition to infrequent bowel movements, the definition of constipation includes excessive straining, a sense of incomplete evacuation, failed or lengthy attempts to defecate, use of digital manoeuvres for evacuation of stool, abdominal bloating, and hard consistency of stools. After excluding secondary causes of constipation, chronic idiopathic or primary constipation can be classified as functional defecation disorder, slow-transit constipation (STC), and constipation-predominant irritable bowel syndrome (IBS-C)...
February 10, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28152894/engaging-managing-physicians-in-clinical-staging-prior-to-the-initiation-of-cancer-treatment
#2
Carol Huibregtse, Marija Bjegovich-Weidman, James L Weese
: 143 Background: Managing physicians (medical oncologist, radiation oncologist, surgeons) have a responsibility to clinically stage patients prior to the initiation of cancer treatment. Clinical staging not only directs the treatment plan, but identifies appropriate clinical trials and estimates prognosis. We sought to determine whether engagement of managing physicians would result in increased clinical staging for various types of cancer. METHODS: Baseline data on clinical staging for breast, colorectal (colon, rectal, anal, rectosigmoid junction)*, thoracic (lung esophageal)†, genitourinary (prostate, penis, testes)‡, and pancreatic primary cancers were obtained...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28144213/abdominal-approaches-to-rectal-prolapse
#3
REVIEW
Kyla Joubert, Jonathan A Laryea
Rectal prolapse is a debilitating condition with a complex etiology. Symptoms are most commonly prolapse of the rectum and pain with bowel movements or straining, with worsening fecal incontinence over time due to progressive stretching of the anal sphincters. Physical findings are fairly consistent from patient to patient-most notably diastasis of the levator ani muscles, deep pouch of Douglas, redundant sigmoid colon, a mobile mesorectum, and occasionally a solitary rectal ulcer. Evaluation includes a physical exam or imaging demonstrating the prolapse, and evaluating for other causes of pelvic floor dysfunction...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28141846/changes-in-bacterial-community-composition-of-escherichia-coli-o157-h7-super-shedder-cattle-occur-in-the-lower-intestine
#4
Rahat Zaheer, Eric Dugat-Bony, Devon Holman, Elodie Cousteix, Yong Xu, Krysty Munns, Lorna J Selinger, Rutn Barbieri, Trevor Alexander, Tim A McAllister, L Brent Selinger
Escherichia coli O157:H7 is a foodborne pathogen that colonizes ruminants. Cattle are considered the primary reservoir of E. coli O157:H7 with super-shedders, defined as individuals excreting > 104 E. coli O157:H7 CFU g-1 feces. The mechanisms leading to the super-shedding condition are largely unknown. Here, we used 16S rRNA gene pyrosequencing to examine the composition of the fecal bacterial community in order to investigate changes in the bacterial microbiota at several locations along the digestive tract (from the duodenum to the rectal-anal junction) in 5 steers previously identified as super-shedders and 5 non-shedders...
2017: PloS One
https://www.readbyqxmd.com/read/28141711/an-8-year-old-boy-with-treatment-resistant-encopresis
#5
Martin T Stein, Marc A Benninga, Barbara T Felt
Paul is an 8-year-old boy with a long-standing history of encopresis and enuresis. Potty training was initiated when he was 2 years old. At this time, his mother was absent from the home for 6 weeks when she cared for her ill father in a different city. The process of teaching Paul to use the bathroom was described as "inconsistent" due to multiple caretakers.Paul never successfully mastered bowel and bladder control. He continues to wet and soil his clothes on a daily basis at home and school. According to his parents, he does not accept responsibility and comments about his soiling such as, "I didn't do it; someone else must have put it there...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28124742/the-small-height-of-an-anastomotic-colonic-doughnut-is-an-independent-risk-factor-of-anastomotic-leakage-following-colorectal-resection-results-of-a-prospective-study-on-154-consecutive-cases
#6
François Cauchy, Solafah Abdalla, Christophe Penna, Benjamin Angliviel, Benoit Lambert, Bruno Costaglioli, Antoine Brouquet, Stéphane Benoist
PURPOSE: The aim of this prospective study was to assess the influence of morphological characteristics of anastomotic doughnuts on the risk of anastomotic leakage (AL) after double-stapled colorectal anastomosis. METHODS: This single-center prospective study enrolled all patients undergoing double-stapled colorectal anastomosis between December 2012 and December 2015. Maximal diameter and minimal and maximal heights and widths of both colonic and rectal doughnuts were measured by surgeons in the operating room...
January 26, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28116474/prenatal-magnetic-resonance-and-ultrasonographic-findings-in-small-bowel-obstruction-imaging-clues-and-postnatal-outcomes
#7
Eva I Rubio, Anna R Blask, Andrea T Badillo, Dorothy I Bulas
BACKGROUND: Prenatal small-bowel obstruction can result from single or multiple atresias, and it can be an isolated abnormality or part of a syndrome. It is sometimes the first manifestation of cystic fibrosis. Accurate prediction of the level of obstruction and length of bowel affected can be difficult, presenting a challenge for counseling families and planning perinatal management. OBJECTIVE: To review the prenatal US and MRI findings of small-bowel obstruction and to assess whether fetal MRI adds information that could improve prenatal counseling and perinatal management...
January 23, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28104993/synchronous-quintuple-primary-gastrointestinal-tract-malignancies-case-report
#8
Soo-Hong Kim, Byung-Soo Park, Hyun Sung Kim, Jae Hun Kim
Multiple primary malignancy is defined as two or more malignancies detected in an individual person. In particular, synchronous quintuple primary malignancy is extremely rare. A 52-year-old male with anal pain and intermittent blood-tinged stool was diagnosed with malignancies in the stomach, jejunum, ascending colon, transverse colon and rectum. He underwent a subtotal gastrectomy, segmental resection of the jejunum and total protocolectomy with end ileostomy. The postoperative pathologic findings were moderate differentiated gastric adenocarcinoma (pT1bN0M0, pStageIA), combined adenocarcinoma and neuroendocrine carcinoma of the jejunum (pT3N0M0, pStageIIA), three mucinous adenocarcinoma of the ascending colon (pT3N0M0, pStageIIA), transverse colon (pT1N0M0, pStageI) and rectum (pT3N1aM0, pStageIIIB)...
January 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28099070/laparoscopic-rectal-dissection-assisted-by-transanal-endoluminal-videoendoscopy-through-a-blunt-tip-trocar
#9
Emanuele Asti, Andrea Lovece, Luigi Bonavina
BACKGROUND AND AIMS: Laparoscopic resection is a well-established approach for colorectal cancer surgery. In patients with rectal cancer treated by neoadjuvant chemoradiotherapy, it may be difficult to identify a clear safety margin for endostapling and subsequent anastomosis. We designed an innovative technical approach to assist colorectal anastomosis in these patients. TECHNIQUE: A four-trocar laparoscopic approach is used. After exploration of the abdominal cavity, the left colic flexure is completely mobilized...
January 18, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28078750/metabolic-adaptation-of-colonic-microbiota-to-galactooligosaccharides-a-proof-of-concept-study
#10
M Mego, C Manichanh, A Accarino, D Campos, M Pozuelo, E Varela, J Vulevic, G Tzortzis, G Gibson, F Guarner, F Azpiroz
BACKGROUND: Prebiotics have been shown to reduce abdominal symptoms in patients with functional gut disorders, despite that they are fermented by colonic bacteria and may induce gas-related symptoms. AIM: To investigate changes in the metabolic activity of gut microbiota induced by a recognised prebiotic. METHODS: Healthy subjects (n = 20) were given a prebiotic (2.8 g/day HOST-G904, HOST Therabiomics, Jersey, Channel Islands) for 3 weeks...
March 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28059915/bio-thiersch-as-an-adjunct-to-perineal-proctectomy-reduces-rates-of-recurrent-rectal-prolapse
#11
Saleh M Eftaiha, Jed F Calata, Jeremy J Sugrue, Slawomir J Marecik, Leela M Prasad, Anders Mellgren, Johan Nordenstam, John J Park
BACKGROUND: The rates of recurrent prolapse after perineal proctectomy vary widely in the literature, with incidences ranging between 0% and 50%. The Thiersch procedure, first described in 1891 for the treatment of rectal prolapse, involves encircling the anus with a foreign material with the goal of confining the prolapsing rectum above the anus. The Bio-Thiersch procedure uses biological mesh for anal encirclement and can be used as an adjunct to perineal proctectomy for rectal prolapse to reduce recurrence...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28055110/survivorship-after-lower-gastrointestinal-cancer-patient-reported-outcomes-and-planning-for-care
#12
Melissa A Frick, Carolyn C Vachani, Margaret K Hampshire, Christina Bach, Karen Arnold-Korzeniowski, James M Metz, Christine E Hill-Kayser
BACKGROUND: There is significant need for quality follow-up care to optimize long-term outcomes for the growing population of lower gastrointestinal (GI) cancer survivors. Patient-reported outcomes (PROs) provide valuable information regarding late and long-term effects (LLTEs). METHODS: A convenience sample from 1129 colon, rectal, and anal cancer survivors (n = 792; 218, and 119, respectively) who participated in an Internet-based survivorship care plan (SCP) tool between May 2010 and October 2014 was used to examine patient-reported demographics, treatment, and toxicity data...
January 5, 2017: Cancer
https://www.readbyqxmd.com/read/28013111/risk-of-rectal-cancer-after-colectomy-for-patients-with-ulcerative-colitis-a-national-cohort-study
#13
Maie Abdalla, Kalle Landerholm, Peter Andersson, Roland E Andersson, Pär Myrelid
BACKGROUND & AIMS: Patients with ulcerative colitis (UC) have an increased risk of rectal cancer, so reconstruction with an ileal pouch anal anastomosis (IPAA) is generally preferred to an ileo-rectal anastomosis (IRA) after subtotal colectomy. Similarly, completion proctectomy is recommended for patients with ileostomy and diverted rectum, although this approach has been questioned because anti-inflammatory agents might reduce cancer risk. We performed a national cohort study in Sweden to assess the risk of rectal cancer in patients with UC who have an IRA, IPAA, or diverted rectum after subtotal colectomy...
December 21, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28000187/-evaluation-of-test-methods-for-defecation-disorders
#14
Zhihui Huang, Ning Dai
Defecation disorders is a common gastrointestinal disease characterized by slow colonic transit and/or paradoxical anal contraction. Gastrointestinal motility test plays an important role in the diagnosis, classification and treatment of defecation disorders. Anorectal manometry (ARM) provides comprehensive information about rectal and anal sphincter function, including resting anal sphincter pressure, squeeze anal sphincter pressure, the rectal and anal sphincter pressure changes during an attempted defecation, rectal sensory testing, rectoanal inhibitory reflex and rectal compliance...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27991017/-proctocolectomy-with-j-pouch-ileo-anal-anastomosis-performed-with-pph-stapler-our-experiences-after-88-cases
#15
Csaba Berki, Elemér Mohos, György Réti, Tamás Kovács, Zoltán Jánó, József Mohay, Sándor Horváth, Gábor Bognár, Krisztina Bene, Myroslav Horzov, Gábor Sándor, Gábor Tornai, Petra Mohos, Péter Szenkovits, Tibor Nagy, Csaba Orbán, Vivien Herpai, Attila Nagy
AIM: Ulcerative colitis (CU) or Familiar Polyposis (FAP) can be the indication for proctocolectomy reconstructed with J pouch. The complete removal of the colon mucosa is essential regarding the late complications and at the same time the atraumatic surgical technique is very important concerning on the long term functional results. Both aspects seems to be answered by the stapled ileo-anal anastomosis using a "procedure for prolaps and haemorrhoids (PPH)" stapler applied by us since 2000...
December 2016: Magyar Sebészet
https://www.readbyqxmd.com/read/27934790/abdomino-endoscopic-perineal-excision-of-the-rectum-for-benign-and-malignant-pathology-technique-considerations-for-true-transperineal-verus-transanal-total-mesorectal-excision-endoscopic-proctectomy
#16
Hazar Al Furajii, Niall Kennedy, Ronan A Cahill
PURPOSE: Transanal minimally invasive surgery using single port instrumentation is now well described for the performance of total mesorectal excision with restorative colorectal/anal anastomosis most-often in conjunction with transabdominal multiport assistance. While non-restorative abdomino-endoscopic perineal excision of the anorectum is conceptually similar, it has been less detailed in the literature. METHODS: Consecutive patients undergoing non-restorative ano-proctectomy including a transperineal endoscopic component were analysed...
January 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27926556/natural-orifice-specimen-extraction-with-single-stapling-colorectal-anastomosis-for-laparoscopic-anterior-resection-feasibility-outcomes-and-technical-considerations
#17
Bansal Saurabh, Sheng-Chi Chang, Tao-Wei Ke, Yu-Chun Huang, Takashi Kato, Hwei-Ming Wang, William Tzu-Liang Chen, Abe Fingerhut
BACKGROUND: Double and triple stapling techniques to close the rectal stump in laparoscopic anterior resection are fraught with technical drawbacks that could possibly be avoided with the use of the single stapling technique. However, little is known of its safety in laparoscopic surgery or outcomes when combined with natural orifice specimen extraction. OBJECTIVE: This study aims to analyze the feasibility and the operative and immediate postoperative outcomes of single-stapled anastomosis and natural orifice specimen extraction with conventional techniques...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27882164/inflammatory-bowel-disease-in-chinese-children-a-retrospective-analysis-of-49-cases
#18
Ying Zhou, Ying Huang
To present study reports the clinical characteristics, diagnosis and management of pediatric patients with inflammatory bowel disease (IBD) in China. Clinical records of 49 pediatric patients with IBD at Fudan University Children's Hospital (Shanghai, China) between July 2001 and May 2012 were reviewed. Of 49 patients (30 males and 19 females), 8 patients had ulcerative colitis (UC) and 41 patients had Crohn's disease (CD). The mean age was 10.4 years in patients with UC and 10.1 years in patients with CD. The percentages of patients with UC with abdominal pain, diarrhea or rectal bleeding were 62...
November 2016: Experimental and Therapeutic Medicine
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
#19
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/27836884/should-rectal-cancer-located-10-15cm-from-the-anal-verge-be-defined-as-colon-cancer
#20
M Swets, A J Breugom, H Gelderblom, C J H van de Velde
No abstract text is available yet for this article.
November 10, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
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