Subcutaneous Methylnaltrexone to Restore Postoperative Bowel Function in a Long-Term Opiate User

2010 ◽  
Vol 20 (2) ◽  
pp. 308-310 ◽  
Author(s):  
Andras Ladanyi ◽  
Sarah M. Temkin ◽  
Jonathan Moss
Keyword(s):  
Bowel Function ◽  
Opiate User

Impact of temporary ileostomy on long‐term quality of life and bowel function: a systematic review and meta‐analysis

2019 ◽  
Vol 90 (5) ◽  
pp. 687-692
Author(s):  
Celia Keane ◽  
Puja Sharma ◽  
Lance Yuan ◽  
Ian Bissett ◽  
Greg O'Grady
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Meta Analysis ◽  
Bowel Function ◽  
Temporary Ileostomy

Long-Term Outcomes and Quality of Life in Patients after Soave Pull-Through Operation for Hirschsprung's Disease: An Observational Retrospective Study

2017 ◽  
Vol 28 (05) ◽  
pp. 445-454 ◽  
Author(s):  
Tania Mahler ◽  
Martine Dassonville ◽  
Dinh Truong ◽  
Annie Robert ◽  
Philippe Goyens ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Fecal Incontinence ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Bowel Function ◽  
Long Term Outcomes ◽  
Neurologic Impairment ◽  
Pull Through

Introduction Patients after pull-through operation for Hirschsprung's disease (HD) are at high risk of defecation disorders. This study aimed at investigating their long-term outcomes and quality of life (QoL) in comparison with controls. Patients and Methods Patients older than 5 years operated on for HD were interviewed to complete detailed questionnaires on bowel function. Patients without neurologic impairment were enrolled in a QoL survey to compare with controls matched for sex and age and selected randomly from the general population using sampling set in a ratio of four controls to one case of HD. Results In total, 53 operated patients were enrolled. Mean age of the patients was 16 ± 8 years, with 68% boys. Rectosigmoid aganglionosis was the most seen form of HD in 38 (72%) cases. Open Soave was performed in 40 (75.5%) cases, and minimally invasive surgery Soave (MIS Soave) in 13 (24.5%) cases. At investigation, prevalence of fecal incontinence and constipation were 22.6 and 13.2%, respectively. Regarding QoL survey, 45 patients and 180 controls were enrolled, excluding 8 patients with neurologic impairment. Thirty-seven (82.2%) patients were classified as having a good QoL (score ≥ 9 points); whereas six had a fair QoL (5–8 points) and two had a poor QoL (< 5 points). QoL score in the cases and the controls were 10.2 ± 2.5 and 11.9 ± 0.4 points, respectively. Long aganglionosis form of HD was significantly associated with a low QoL (score < 8 points), adjusted odds ratio = 9, 95% confidence interval [1.3; 64.1] (p < 0.05). In subscales analyses, the prevalence of each dimension including fecal continence, school absenteeism, unhappiness or anxiety, food restriction, and peer rejection was significantly higher in operated patients than in controls (p <0.001). Conclusion Although the QoL of patients operated on for HD in general was with good outcomes, fecal incontinence and constipation still are problematic issues and challenges in a high percentage of patients. Therefore, a long-term and multidisciplinary follow-up is essentially required for these patients.

scholarly journals A Nordic multicenter survey of long-term bowel function after transanal endorectal pull-through in 200 patients with rectosigmoid Hirschsprung disease

2017 ◽  
Vol 52 (9) ◽  
pp. 1458-1464 ◽  
Author(s):  
Kristin Bjørnland ◽  
Mikko P. Pakarinen ◽  
Pernilla Stenstrøm ◽  
Kjetil J. Stensrud ◽  
Malla Neuvonen ◽  
...  
Keyword(s):  
Hirschsprung Disease ◽  
Bowel Function ◽  
Multicenter Survey ◽  
Pull Through

scholarly journals Treatment and Patient Reported Outcome in Children with Hirschsprung Disease and Concomitant Congenital Heart Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Johan Hasserius ◽  
Josefine Hedbys ◽  
Christina Graneli ◽  
Kristine Hagelsteen ◽  
Pernilla Stenström
Keyword(s):  
Congenital Heart Disease ◽  
Congenital Heart ◽  
Hirschsprung Disease ◽  
Failure To Thrive ◽  
Bowel Function ◽  
Patient Characteristics ◽  
Patient Reported ◽  
Long Term Follow Up

Purpose. Congenital heart disease (CHD) is reported to be associated with Hirschsprung disease (HD). The aim was to evaluate any differences between children with HD with and without CHD, respectively, with regard to patient characteristics, medical care, and patient reported bowel function. Method. This is a retrospective chart study and a cross-sectional long-term follow-up of patients older than 4 years old, including all children with HD operated on with transanal endorectal pull-through (TERPT) at a tertiary center of pediatric surgery. Information about patient characteristics, diagnostics, surgery, and medical care was compiled. At long-term follow-up, bowel function was assessed by Bowel Function Score. Results. Included were 53 HD-patients, 13 with CHD and 40 without CHD. Children with CHD more commonly presented with failure to thrive; 4 (23%) compared to those without CHD (0%) (p<0.01). In the long-term follow-up, including 32 patients (6 with CHD), constipation was more commonly reported by children with CHD 5 (83%) than by children without CHD 4 (27%) (p=0.01). No differences were shown in the other parameters such as fecal control and incontinence. Conclusion. HD-patients with CHD more commonly presented with failure to thrive and more frequently reported constipation than HD-patients without CHD. The findings indicate that HD-patients with CHD might need special consideration in their initial care and long-term follow-up.

scholarly journals Long-Term Bowel Function and Fate of the Ileal Pouch After Restorative Proctocolectomy in Patients With Crohn’s Disease: A Systematic Review With Meta-Analysis and Metaregression

2019 ◽  
Vol 14 (3) ◽  
pp. 418-427 ◽  
Author(s):  
Gianluca Pellino ◽  
Danilo Vinci ◽  
Giuseppe Signoriello ◽  
Christos Kontovounisios ◽  
Silvestro Canonico ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Ileal Pouch ◽  
Meta Analysis ◽  
Bowel Function ◽  
Age At Surgery ◽  
Secondary Endpoints ◽  
Grade Failure

Abstract Background and Aims Debate exists on whether ileal pouch anal anastomosis [IPAA] can be safely offered to patients diagnosed with Crohn’s disease [CD]. Our aim was to assess the outcome of IPAA for CD vs ulcerative colitis [UC]. Methods We used a PRISMA/MOOSE-compliant meta-analysis. Studies published between 1993 and 2018 were retrieved. Primary end points included complications. Secondary endpoints included functional outcome. The time of CD diagnosis was considered [intentional vs incidental IPAA]. Results Eleven studies comprising 6770 patients [CD = 352, UC = 6418] were included, with 44–120 months of follow-up. Pouch fistulae were more common in CD (CD vs UC; odds ratio (OR) 6.08; p = 0.0003, GRADE+++), as were strictures [OR 1.82; p = 0.02, GRADE+++] and failure [OR 5.27; p &lt; 0.0001, GRADE++++]. Compared with UC, postoperative CD diagnosis was associated with a much higher risk of fistulae [OR 6.23; p = 0.006, GRADE+++] and failure [OR 8.53; p &lt; 0.0001, GRADE++++] than intentional IPAA in CD [fistula: OR 4.17; p = 0.04, GRADE+++; failure: OR 2.48; p = 0.009, GRADE++++]. Age at surgery was positively associated with failure in CD [p = 0.007]. Obstruction was more common after intentional IPAA for CD. The risk of pouchitis did not differ between CD and UC [OR 1.07, p = 0.76, GRADE+++]. CD patients were at a higher risk of seepage [OR 2.27; p = 0.010, GRADE++]. Conclusions Patients with CD have 5-fold higher risk of failure, and a 2-fold risk of strictures after IPAA compared with UC. The risk is much higher if diagnosis is performed after IPAA. Function in those who retain the pouch seemed similar to that of patients with UC. CD does not increase the risk of pouchitis. IPAA could be offered to a selected population of CD patients after proper preoperative counselling. [PROSPERO registry 116811]

Radio-Nucleotidic Study of the Functional Aspect of the Bowels after Ileal Resection

1992 ◽  
Vol 59 (2) ◽  
pp. 32-34
Author(s):  
A. Fandella ◽  
M. Mangano ◽  
L. Maccatrozzo ◽  
F. Merlo ◽  
P. Checchin ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Bowel Function ◽  
Intestinal Malabsorption ◽  
Term Study ◽  
Medical Test ◽  
Ileal Resection ◽  
Long Term Study ◽  
Taurine Conjugate ◽  
Selenium 75

SeHCAT (a taurine conjugate of a synthetic bile acid-homotaurocholate-containing the isotope selenium 75) has been used by the Authors to study the effects of extensive ileal resection on bowel function. 12 patients with ileal bladder were investigated 6–12 months following the operation; 4 of them also underwent the medical test prior to the operation, to ascertain integrity of the enterohepatic circle. 7 patients showed a failure of the enterohepatic circle, 3 patients were borderline, and the last 2 were normal. However none of them had clinical symptoms. On the basis of our data SeHCAT may be used for long-term study of patients with ileal bladder, and in the case of poor symptomatic situations the nutritional future of these patients can be monitored. The present method can be applied to selecting candidates for orthotopic bladder, since patients with intestinal malabsorption should be excluded from this type of ileal bladder diversion.

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