Constipation: Diagnosis and Management

2021 ◽  
Author(s):  
Lennox Hoyte ◽  
Renee Bassaly
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Outlet Obstruction ◽  
Functional Constipation ◽  
Vaginal Wall ◽  
The Body ◽  
Hormonal Changes ◽  
Diagnosis And Management ◽  
Functional Outlet Obstruction ◽  
Irritable Bowel

Constipation is one of the most common gastrointestinal complaints in the general population. It is associated with a diminished quality of life and increased psychological stress. Although the prevalence varies widely, the rate for chronic constipation is 15 to 20% based on epidemiologic surveys in North America. There are many causes of constipation, and its definition is imprecise and variable. Diagnosis and appropriate management are therefore difficult but extremely important. This chapter primarily focuses on the diagnosis and management of constipation as it relates to adult females. Although it is not known why more women than men experience constipation, it is possible that hormone levels, which influence the digestive system, likely contribute. Pregnancy-related constipation is also common because of both hormonal changes and pelvic floor dysfunction after pregnancy. Women also tend to experience constipation prior to menstruation. In these cases, it is most likely that fluids that would normally soften stools in the colon are retained in other parts of the body. The female anatomy may also be a factor as functional outlet obstruction can occur after changes to the pelvic floor anatomy (such as after pregnancy). Figures illustrate the Bristol Stool Chart, rectal prolapse, protrusion of the posterior vaginal wall consistent with rectocele, enterocele with vaginal prolapsed, and enterocele with bladder prolapse. Videos show rectal prolapsed, rectocele, cystocele, descended perineum, and repaired perineum. Tables list causes of functional constipation, drugs associated with constipation, diagnostic criteria for functional constipation, and Rome criteria of irritable bowel syndrome. This review contains 5 figures, 6 tables, and 99 references.

Possibilities of using neodymium laser (Nd:YAG) in patients with concomitant diseases which are accompanied by pathological discharge from the genital tract

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 75-81
Author(s):  
Olga A. Pauzina ◽  
Inna A. Apolikhina ◽  
Darya A. Malyshkina
Keyword(s):  
Drug Therapy ◽  
Pelvic Floor ◽  
Genital Tract ◽  
Vaginal Discharge ◽  
Muscle Tone ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Vaginal Wall ◽  
Neodymium Laser ◽  
Frequent Relapses

Background. Pathological vaginal discharge is the most common disorder in women after giving birth who have vaginal relaxation syndrome and vaginal wall prolapse, as well as in women during menopause. To date, there are no clear treatment regimens for mixed vulvovaginal infections, and the use of only drug therapy in patients with pelvic organ prolapse and genitourinary syndrome of menopause in combination with diseases which are accompanied by pathological vaginal discharge does not give a long lasting result and is characterized by frequent relapses. In this regard, the use of laser methods in combination with drug therapy may lead to the recovery of vaginal microbiocenosis and a decrease in the number of relapses of diseases which are accompanied by pathological discharge from the genital tract. Results. Description. This article presents a clinical case and description of the experience of using a neodymium laser for the treatment of a patient with recurrent mixed vulvovaginitis, 2nd- degree vaginal wall prolapse, loss of pelvic floor muscle tone, vaginal relaxation syndrome and sexual dysfunction using neodymium laser. The woman received 3 procedures of exposure to a neodymium laser with an interval of 2830 days. After 3 procedures of exposure to a neodymium laser, the patient has a good clinical efficacy in the recovery of vaginal microbiocenosis. Conclusions. An innovative technique of exposure to Nd:YAG neodymium laser in the practice of a gynecologist has shown high clinical efficiency in the treatment of not only pelvic floor dysfunction, but also mixed vulvovaginitis. And, despite this aspect of the use of laser technologies requires further study, we can use a neodymium laser in combination with traditional drug therapy to treat diseases which are accompanied by pathological discharge from the genital tract in cases of ineffective drug monotherapy and frequent relapses.

scholarly journals Serotonin Level and Lipid Metabolism Indices in Patients with Irritable Bowel Syndrome with Constipation Against the Background of Various Degrees of Obesity

2018 ◽  
Vol 25 (2) ◽  
Author(s):  
Vasyl Mishchuk ◽  
Galina Grygoruk
Keyword(s):  
Body Mass Index ◽  
Irritable Bowel Syndrome ◽  
Lipid Profile ◽  
Body Mass ◽  
Density Lipoprotein ◽  
Functional Constipation ◽  
The Body ◽  
Normal Body Mass Index ◽  
Serotonin Level ◽  
Irritable Bowel

Recent research shows that the number of diseases associated with obesity has been increasing. In obese persons, association with functional constipation is noted in 24.0% of cases, and obesity is recorded in 60.0% of patients with functional constipation. Among the possible mechanisms for the development of such a combination are changes in serotonin level in the blood, although the existing data are ambiguous and sometimes controversial.The objective of the study is to investigate the changes in serotonin level in the blood of obese patients in combination with constipation and its relationship with the lipid profile of the blood.Materials and methods. 63 patients with obesity in combination with irritable bowel syndrome with constipation (IBSc), 24 patients with normal body mass index and 10 practically healthy people were examined. 25 patients with obesity and constipation had a body mass index of 32.8±0.24kg/m2, 28 patients – 37.8±kg/m2, and 10 patients – 42.6±0.5kg/m2. In patients with irritable bowel syndrome without obesity, the body mass index was 21.7±0.4kg/m2. The blood serotonin level and lipid profile of the blood was determined in all patients.Results. It was deermined that in case of irritable bowel syndrome with constipation, serotonin level in the blood was reduced. In obesity with IBSc, the concentration of serotonin, on the contrary, was elevated. All patients with IBSc and obesity were marked an elevated level of total cholesterol and triglycerides. A direct correlation between high levels of triglycerides and serotonin concentration in serum of such comorbid patients was detected. The increase in the degree of obesity in the presence of IBSc was accompanied by a decrease in the concentration of cholesterol of high density lipoprotein. Patients with IBSc without excessive body weight had no such deviations.Conclusions. With an increase in the degree of obesity, serotonin level in the blood increases and the lipid blood spectrum worsens.

Developing evidence-based standards for diagnosis and management of lower urinary tract or pelvic floor dysfunction

2012 ◽  
Vol 31 (5) ◽  
pp. 621-624 ◽  
Author(s):  
Peter F.W.M. Rosier ◽  
Dirk de Ridder ◽  
Jane Meijlink ◽  
Ralph Webb ◽  
Kristene Whitmore ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Pelvic Floor ◽  
Lower Urinary Tract ◽  
Pelvic Floor Dysfunction ◽  
Evidence Based ◽  
Diagnosis And Management ◽  
Lower Urinary

Female Pelvic Pain: Assessment

2020 ◽  
Author(s):  
Mario Castellanos ◽  
Louise P King
Keyword(s):  
Irritable Bowel Syndrome ◽  
Pelvic Floor ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Visceral Pain ◽  
Pelvic Floor Dysfunction ◽  
Pudendal Neuralgia ◽  
Somatic Pain ◽  
Irritable Bowel ◽  
Over Time

Chronic pelvic pain (CPP) in women is responsible for greater than 10% of referrals to gynecologists. A majority of them will remain undiagnosed or inadequately treated. Over time, CPP may lead to a syndrome that results in disability, loss of employment, and discord within relationships. This review discusses how to achieve a comprehensive assessment of CPP from a variety of causes. This review contains 13 figures, 5 tables and 60 references Key Words: dysmenorrhea, dyspareunia, endometriosis, interstitial cystitis, irritable bowel syndrome, pelvic floor dysfunction, pelvic pain, pudendal neuralgia, somatic pain, visceral pain

scholarly journals Comprehensive assessment of the pelvic floor in women: new approaches to the prediction of pelvic organ prolapse

2020 ◽  
Vol 69 (3) ◽  
pp. 13-16
Author(s):  
Ilnur I. Musin
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Genital Prolapse ◽  
Risk Groups ◽  
Vaginal Wall ◽  
Pelvic Floor Muscles ◽  
Comprehensive Assessment ◽  
Reproductive Age ◽  
Blood Microcirculation ◽  
The Future

Hypothesis/aims of study. Despite the growing prevalence of pelvic floor dysfunction in women in the postpartum period, there is still no consensus on its etiology and pathogenesis. The prerequisite for serious disorders to occur in the future is the initial stages of pelvic floor dysfunction after childbirth, despite the fact that they occur without severe symptoms and, remaining undiagnosed in a timely manner, further reduce the quality of life of women. Despite the availability of information on causal relationships between childbirth and the appearance of pelvic floor dysfunctions, this knowledge among women of reproductive age is still limited, which warrants further study. A number of methods have been developed to assess the pelvic floor, among which are non-invasive techniques, including a quantitative assessment of the strength of contractions of the pelvic floor muscles, as well as techniques that assess the microcirculation of the vaginal wall. The aim of this study was to evaluate the parameters of the strength of contractions of the pelvic floor muscles and to identify possible correlations between the obtained parameters. Study design, materials and methods. The study was carried out using methods for measuring the blood microcirculation of the vaginal wall using laser Doppler blood flowmetry in women after the first birth. Results. We obtained indicators of the strength of contractions of the pelvic floor muscles and indicators of the blood microcirculation of the vaginal wall in primary women, and we revealed the dependence of the obtained indicators on the weight and age of the mother, as well as the weight of the fetus at birth. Conclusion. The obtained indicators will allow a comprehensive assessment of the pelvic floor in primiparous women, as well as to identify possible risk groups for genital prolapse development in the future.

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