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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/28169458/outpatient-biofeedback-in-addition-to-home-pelvic-floor-muscle-training-for-stress-urinary-incontinence-a-randomized-controlled-trial
#2
Fátima Faní Fitz, Liliana Stüpp, Thaís Fonseca da Costa, Maria Augusta Tezelli Bortolini, Manoel João Batista Castello Girão, Rodrigo Aquino Castro
AIMS: To test if biofeedback (BF) added to pelvic floor muscle training (PFMT) increases the frequency of home exercises performed by women with stress urinary incontinence (SUI). METHODS: 72 incontinent women were randomized to BF (outpatient BF + home PFMT) or PFMT (outpatient PFMT + home PFMT) groups. ASSESSMENTS: baseline, after 3 months of supervised treatment, at 9-month follow-up (after six additional months of home PFMT only)...
February 7, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28144212/methods-of-evaluation-of-anorectal-causes-of-obstructed-defecation
#3
REVIEW
Anne C Fabrizio, Yewande Alimi, Anjali S Kumar
Obstructed defecation is a complex disorder that results in impaired propagation of stool from the rectum. It is one of the major subtypes of functional constipation and can be secondary to either functional or anatomic etiologies. Patients with obstructed defecation typically present with symptoms of abdominal discomfort, a sensation of incomplete evacuation and rectal obstruction, passage of hard stools, the need for rectal or vaginal digitation, excessive straining, and reduced stool frequency. Evaluation of obstructed defecation is multimodal, starting with a thorough history and physical examination with focus on the abdominal, perineal, and rectal examination...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28144209/functional-disorders-of-constipation-paradoxical-puborectalis-contraction-and-increased-perineal-descent
#4
REVIEW
Isaac Payne, Leander M Grimm
Paradoxical puborectalis contraction (PPC) and increased perineal descent (IPD) are subclasses of obstructive defecation. Often these conditions coexist, which can make the evaluation, workup, and treatment difficult. After a thorough history and examination, workup begins with utilization of proven diagnostic modalities such as cinedefecography and anal manometry. Advancements in technology have increased the surgeon's diagnostic armamentarium. Biofeedback and pelvic floor therapy have proven efficacy for both conditions as first-line treatment...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28106652/prospective-outcomes-of-a-pelvic-floor-rehabilitation-program-including-vaginal-electrogalvanic-stimulation-for-urinary-defecatory-and-pelvic-pain-symptoms
#5
Jennifer J Schmitt, Ruchira Singh, Amy L Weaver, Kristin C Mara, Randina R Harvey-Springer, Felecia R Fick, John A Occhino
OBJECTIVES: This study evaluated our experience after implementing a pelvic floor rehabilitation program including behavioral modification, biofeedback, and vaginal electrogalvanic stimulation (EGS). METHODS: This prospective cohort study evaluated outcomes of patients with pelvic floor dysfunction (urinary or defecatory dysfunction, pelvic pain/dyspareunia) who underwent pelvic floor rehabilitation. Patients received 4 to 7 sessions (1 every 2 weeks) including biofeedback and concluded with 30 minutes of vaginal EGS...
March 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28000194/-efficacy-analysis-of-acupuncture-with-biofeedback-in-the-treatment-of-patients-with-functional-anorectal-pain
#6
Ling Zheng, Shuqing Ding, Yijiang Ding, Yahong Xue, Huifen Zhou, Min Li, Jianbao Cao, Jing Wang
OBJECTIVE: To observe the short- and long-term efficacy of acupuncture combined with biofeedback in the treatment of functional anorectal pain (FARP). METHODS: Clinical data of 142 patients who met the functional gastrointestinal disorders and functional anorectal pain based on criteria of Rome III( undergoing acupuncture with biofeedback therapy from August 2010 to November 2015 in Pelvic Floor Center of The Third Affiliated Hospital of Nanjing University of Chinese Medicine were retrospectively analyzed...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27935011/electrical-stimulation-with-non-implanted-electrodes-for-overactive-bladder-in-adults
#7
REVIEW
Fiona Stewart, Luis F Gameiro, Regina El Dib, Monica O Gameiro, Anil Kapoor, Joao L Amaro
BACKGROUND: Several options exist for managing overactive bladder (OAB), including electrical stimulation (ES) with non-implanted devices, conservative treatment and drugs. Electrical stimulation with non-implanted devices aims to inhibit contractions of the detrusor muscle, potentially reducing urinary frequency and urgency. OBJECTIVES: To assess the effects of ES with non-implanted electrodes for OAB, with or without urgency urinary incontinence, compared with: placebo or any other active treatment; ES added to another intervention compared with the other intervention alone; different methods of ES compared with each other...
9, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27869312/the-effect-of-emg-biofeedback-assisted-pelvic-floor-muscle-therapy-on-symptoms-of-the-overactive-bladder-syndrome-in-women-a-randomized-controlled-trial
#8
Jeroen C Voorham, Stefan De Wachter, Tine W L Van den Bos, Hein Putter, Guus A Lycklama À Nijeholt, Petra J Voorham-van der Zalm
AIMS: The overactive bladder syndrome (OAB) is defined as urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence. Biofeedback-assisted pelvic muscle therapy (BAPFMT) is a first-line treatment option for OAB. The aims of this study were to determine the efficacy and effectiveness of BAPFMT on symptoms of OAB after 9 weeks of treatment and to detect changes EMG activity of individual pelvic floor muscles (PFM) with the MAPLe. METHODS: Patients were randomly divided into an intervention group that received BAPFMT with the MAPLe or into a control group which received only toilet behavior and lifestyle instructions...
November 21, 2016: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/27782891/evaluation-of-the-effectiveness-of-biofeedback-therapy-for-functional-constipation-in-children
#9
Dorota Jarzebicka, Joanna Sieczkowska, Maciej Dadalski, Jaroslaw Kierkus, Jozef Ryzko, Grzegorz Oracz
BACKGROUND/AIMS: Defecation disorders are one of the most common problems in pediatric gastroenterology. Treatment includes changes in the diet, pharmacotherapy, and biofeedback therapy. The aim of the present study was to evaluate the effectiveness of biofeedback therapy as assessed by clinical improvement as well as by changes in manometric parameters in children with constipation and pelvic floor dyssynergia (PFD). MATERIALS AND METHODS: A total of 44 children with constipation and PFD hospitalized between 2000 and 2015 were enrolled in this retrospective study...
September 2016: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/27557074/-incontinence-etiology-diagnostics-and-therapy
#10
Thomas Frieling
Fecal incontinence is defined by the unintentional loss of solid or liquid stool, and anal incontinence includes leakage of gas and / or fecal incontinence. Anal-fecal incontinence is not a diagnosis but a symptom. Many patients hide the problem from their families, friends, and even their doctors. Epidemiologic studies indicate a prevalence between 7-15 %, up to 30 % in hospitals and up to 70 % in longterm care settings. Anal-fecal incontinence causes a significant socio-economic burden. There is no widely accepted approach for classifying anal-fecal incontinence available...
August 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27525141/advanced-genetic-testing-comes-to-the-pain-clinic-to-make-a-diagnosis-of-paroxysmal-extreme-pain-disorder
#11
Ashley Cannon, Svetlana Kurklinsky, Kimberly J Guthrie, Douglas L Riegert-Johnson
UNLABELLED: Objective. To describe the use of an advanced genetic testing technique, whole exome sequencing, to diagnose a patient and their family with a SCN9A channelopathy. Setting. Academic tertiary care center. Design. CASE REPORT: Case Report. A 61-year-old female with a history of acute facial pain, chronic pain, fibromyalgia, and constipation was found to have a gain of function SCN9A mutation by whole exome sequencing. This mutation resulted in an SCN9A channelopathy that is most consistent with a diagnosis of paroxysmal extreme pain disorder...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27338231/the-role-of-the-defaecating-pouchogram-in-the-assessment-of-evacuation-difficulty-after-restorative-proctocolectomy-and-pouch-anal-anastomosis
#12
M E Stellingwerf, Y Maeda, U Patel, C J Vaizey, J Warusavitarne, W A Bemelman, S K Clark
AIM: Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is the most frequently performed operation for intractable ulcerative colitis (UC) and for many patients with familial adenomatous polyposis (FAP). It can be complicated by a functional evacuation difficulty, which is not well understood. We aimed to evaluate the role of defaecating pouchography in an attempt to assess the mechanism of evacuation difficulty in pouch patients. METHOD: All RPC patients who had had a defaecating pouchogram for evacuation difficulty at one hospital between 2006 and 2014 were retrospectively reviewed...
August 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27270989/diagnosis-and-treatment-of-dyssynergic-defecation
#13
REVIEW
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
https://www.readbyqxmd.com/read/27144630/functional-anorectal-disorders
#14
Satish Sc Rao, Adil E Bharucha, Giuseppe Chiarioni, Richelle Felt-Bersma, Charles Knowles, Allison Malcolm, Arnold Wald
This report defines criteria and reviews the epidemiology, pathophysiology, and management of common anorectal disorders: fecal incontinence (FI), functional anorectal pain and functional defecation disorders. FI is defined as the recurrent uncontrolled passage of fecal material for at least 3 months. The clinical features of FI are useful for guiding diagnostic testing and therapy. Anorectal manometry and imaging are useful for evaluating anal and pelvic floor structure and function. Education, antidiarrheals and biofeedback therapy are the mainstay of management; surgery may be useful in refractory cases...
March 25, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27054793/effect-of-supervised-pelvic-floor-biofeedback-and-electrical-stimulation-in-women-with-mixed-and-stress-urinary-incontinence
#15
Cherrilyn F Richmond, Deanna K Martin, Sallis O Yip, Madeline A Dick, Elisabeth A Erekson
OBJECTIVE: The aim of this study was to compare the symptomatic change in urinary symptom distress before and after treatment with pelvic floor biofeedback and electrical stimulation in women with mixed urinary incontinence (MUI) and stress urinary incontinence (SUI). METHODS: We conducted a retrospective cohort study of women who underwent supervised pelvic floor biofeedback therapy and electrostimulation for the treatment of MUI and SUI. Our primary outcome was change in the Urinary Distress Inventory-6 (UDI-6) score before and after therapy...
September 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27033126/diagnosis-and-management-of-chronic-constipation-in-adults
#16
REVIEW
Satish S C Rao, Kulthep Rattanakovit, Tanisa Patcharatrakul
Constipation is a heterogeneous, polysymptomatic, multifactorial disease. Acute or transient constipation can be due to changes in diet, travel or stress, and secondary constipation can result from drug treatment, neurological or metabolic conditions or, rarely, colon cancer. A diagnosis of primary chronic constipation is made after exclusion of secondary causes of constipation and encompasses several overlapping subtypes. Slow-transit constipation is characterized by prolonged colonic transit in the absence of pelvic floor dysfunction...
May 2016: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/26851599/nonantimuscarinic-treatment-for-overactive-bladder-a%C3%A2-systematic-review
#17
REVIEW
Cedric K Olivera, Kate Meriwether, Sherif El-Nashar, Cara L Grimes, Chi Chiung Grace Chen, Francisco Orejuela, Danielle Antosh, Jon Gleason, Shunaha Kim-Fine, Thomas Wheeler, Brook McFadden, Ethan M Balk, Miles Murphy
The purpose of the study was to determine the efficacy and safety of nonantimuscarinic treatments for overactive bladder. Medline, Cochrane, and other databases (inception to April 2, 2014) were used. We included any study design in which there were 2 arms and an n > 100, if at least 1 of the arms was a nonantimuscarinic therapy or any comparative trial, regardless of number, if at least 2 arms were nonantimuscarinic therapies for overactive bladder. Eleven reviewers double-screened citations and extracted eligible studies for study: population, intervention, outcome, effects on outcome categories, and quality...
July 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26701107/the-role-of-urinary-nerve-growth-factor-for-the-diagnosis-and-assessment-of-the-biofeedback-success-in-children-with-dysfunctional-voiding
#18
Giray Ergin, Yusuf Kibar, Turgay Ebiloğlu, H Cem Irkılata, Burak Kopru, Engin Kaya, Metin Uyanık, Serkan Tapan, M Murat Dayanc
INTRODUCTION: Dysfunctional voiding (DV) occurs in neurologically normal children who are not able to establish brain control on detrusor muscle contractions (DMCs). It is also reported to be the result of incorrect voiding habits during toilet training. Children contract pelvic floor muscles (PFMs) to suppress DMC and DV begins. Urinary nerve growth factor (uNGF) is necessary for the synthesis and regulation of neurotransmitters, development of dorsal root ganglia (sensory neurons), and development of sympathetic cells during embryonic and post-natal life...
April 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/26603727/pelvic-floor-dysfunction-in-inflammatory-bowel-disease
#19
REVIEW
A Bondurri, A Maffioli, P Danelli
Advances in tailored medical therapy and introduction of biologic agents for inflammatory bowel disease (IBD) treatment have ensured long-term disease remission. Some patients, however, still report defecatory symptoms. Patients present with a wide spectrum of conditions - anal incontinence, obstructed defecation and pelvic pain among the most frequent - that have a great impact on their quality of life. Due to IBD diagnosis, little relevance is attributed to this type of symptoms and their epidemiologic distribution is unknown...
December 2015: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/26439772/re-dijkstra-eshuis-j-van-den-bos-tw-splinter-r-bevers-rf-zonneveld-wc-putter-h-pelger-rc-voorham-van-der-zalm-pj-effect-of-preoperative-pelvic-floor-muscle-therapy-with-biofeedback-versus-standard-care-on-stress-urinary-incontinence-and-quality-of-life-in-men
#20
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