scholarly journals Pain and discomfort in violation of bowel movements in children – an actual problem

Pain medicine ◽  
2021 ◽  
Vol 6 (3) ◽  
pp. 29-35
Author(s):  
K Dmitrieva ◽  
V Vidiscak ◽  
A Prochotsky ◽  
K Furkova ◽  
E Kovacsova ◽  
...  
Keyword(s):  
Diagnostic Procedure ◽  
Functional Constipation ◽  
Warning Signs ◽  
Organic Basis ◽  
Actual Problem ◽  
Common Cause ◽  
Bowel Movements ◽  
Difficult Defecation ◽  
Correct Technique ◽  
Civilized World

Pain and discomfort during bowel movements in children are among the most common symptoms in the modern civilized world. The most common cause of these symptoms is chronic constipation, which is often treated by a pediatrician or pediatric gastroenterologist. In differen­tial diagnosis, it is very important to distinguish between chronic symptomatic constipation and functional (without an organic basis), which are most common in childhood. Organic causes of constipation are usually dealt with in cooperation with specialized specialists. The main patho­physiological mechanisms of functional constipation are stress, pain during emptying, and fear of further painful bowel movements. The clinical picture is dominated by in­frequent and difficult defecation of a large amount of hard stools. If the history, laboratory and other additional stud­ies indicate functional constipation, and there are no warn­ing signs of chronic symptomatic constipation, complex treatment can be started. Therapy includes psychological preparation of the patient and his family, working with the correct technique of defecation, dietary and regimen mea­sures, sufficient physical activity, the use of osmotic lax­atives. The presence of warning signs requires a rational differential diagnostic procedure, which varies depending on the age of the child.

scholarly journals Severe Postoperative Chronic Constipation Related to Anorectal Malformation Managed with Osteopathic Manipulative Treatment

2020 ◽  
Vol 14 (1) ◽  
pp. 220-225
Author(s):  
Luca Vismara ◽  
Vincenzo Cozzolino ◽  
Luca Guglielmo Pradotto ◽  
Riccardo Gentile ◽  
Andrea Gianmaria Tarantino
Keyword(s):  
Pelvic Floor ◽  
Chronic Constipation ◽  
Anorectal Malformation ◽  
Bowel Movement ◽  
Functional Constipation ◽  
Good Prognosis ◽  
Osteopathic Manipulative Treatment ◽  
Severe Constipation ◽  
Bowel Movements ◽  
Functional Alteration

Constipation is frequent amongst infants who have undergone surgery for anorectal malformation (ARM). Faecal retention, due to a dysfunctional enteric reflex of defaecation, can cause abdominal cramps, pseudoincontinence and, in the worst cases, megacolon. Prokinetic protocols are used to stimulate at least 1 bowel movement per day, including laxatives, enema, stools softeners and dietary schedules. While osteopathic manipulative treatment is adopted in adults for functional constipation, it has not been described for infants. Herein, we report the case of an infant undergoing anorectoplasty for a low ARM who was referred to the osteopath 2 years after the onset of severe constipation associated with pseudoincontinence and abdominal cramps and was refractory to the prokinetic protocol. In a child with a good ARM prognosis, autonomous daily bowel movements should be achieved. In this child, the imbalanced tension of the pelvic floor and immaturity of the parasympathetic plexus led to a functional alteration of the defaecation reflex. After adjunction of osteopathic manipulative treatment (OMT) to the therapeutic panel, the constipation showed gradual remission, with acquisition of autonomous defaecation 4 months after the therapy began. This suggests the importance of investigating the efficacy of OMT inclusion in the postsurgical prokinetic protocols for ARM patients with a good prognosis.

scholarly journals Laxative Effects of Yangyin Tongmi Capsule on a Model of Diphenoxylate-Induced Constipation in Mice

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Shan Liu ◽  
Dayun Sui ◽  
Wenwen Fu ◽  
Xiaofeng Yu ◽  
Yuangeng Li ◽  
...  
Keyword(s):  
Low Dose ◽  
High Dose ◽  
Water Control ◽  
Intestinal Hormones ◽  
Expression Levels ◽  
Laxative Effects ◽  
Bowel Movements ◽  
Difficult Defecation ◽  
Underlying Mechanisms ◽  
Related Proteins

Constipation is characterized by reduced number of bowel movements, dry stools, and difficult defecation. Yangyin Tongmi capsule (YTC), a traditional Chinese formula, is used in the treatment of constipation, while the underlying mechanisms remain unknown. Herein, this work attempted to prove the effects of YTC on constipation treatment and its possible mechanisms. KM mice were randomly divided into four groups (n = 10/group) and treated with double distilled water (Control), diphenoxylate (Model: 10 mg/kg), or diphenoxylate plus low-dose YTC (L-YTC: 0.6 g/kg) or high-dose YTC (H-YTC: 1.2 g/kg). The data indicated that YTC can significantly shorten the discharge time of the first black stool, improve intestinal propulsion rate, and increase the water content and quantity of feces in mice. ELISA suggested that YTC regulate the content of intestinal hormones and neurotransmitters, such as motilin (MTL), gastrin (GT), somatostatin (SST), substance P (SP), acetylcholine (Ach), and nitric oxide (NO). The expression levels of aquaporin 3 (AQP3) and aquaporin 8 (AQP8) in the colon were examined by immunohistochemistry. In the meantime, the expression levels of P2X2, C-kit, and stem cell factor (SCF) in the colon were examined by western blot analysis. The results of this study suggest that YTC has mitigative effects on diphenoxylate-induced constipation by regulating the content of intestinal hormones and neurotransmitters and regulating the expression of related proteins in the colon.

scholarly journals Pediatric Tuina For Functional Constipation In Children: Study Protocol For A Randomized Controlled Trail

2021 ◽  
Author(s):  
Xinghe Zhang ◽  
Luan Hu ◽  
Li Li ◽  
Yuanwang Wang ◽  
Can Zhang ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Treatment Period ◽  
Functional Constipation ◽  
Gastrointestinal Disorder ◽  
Efficacy And Safety ◽  
Clinical Trial Registry ◽  
Pediatric Tuina ◽  
Randomized Controlled ◽  
Bowel Movements

Abstract Background: Functional constipation (FC) is a common functional gastrointestinal disorder (FGID), which brings many negative impacts to the children’s daily life. Pediatric Tuina has been proved to be a potential therapy for functional constipation (FC). However, the evidence for its effectiveness and safety is insufficient due to the lack of high-quality study. This study aims to evaluate the efficacy and safety of pediatric Tuina for children with FC.Methods/design: This study is a randomized, controlled, multicentre, clinical trial. We will include 176 children with FC from five hospitals. The participants will be randomly allocated into two groups: the pediatric Tuina group and the Medilac-Vita group. This study will include a 1-week actual treatment period and a 2-week follow-up period. Primary outcomes are weekly spontaneous bowel movements (SBMs), weekly complete spontaneous bowel movements (CSBMs). The secondary outcomes are effective rate, stool form, distress sensation, and glycerine enema rate. The assessment will be performed each week. Adverse event will be monitored in treatment period and follow-up period.Discussion: This study is designed to evaluate the efficacy and safety of pediatric Tuina for children with FC, and we hypothesize that pediatric Tuina is more effective than probiotics. It will provide reliable evidence and support for the treatment of FC by pediatric Tuina.Trail registration: This protocol was registered in Chinese Clinical Trial Registry (ChiCTR2100046485).

The Effect of Lactobacillus reuteri Supplementation in Adults with Chronic Functional Constipation: a Randomized, Double-Blind, Placebo-Controlled Trial*

2014 ◽  
Vol 23 (4) ◽  
pp. 387-391 ◽  
Author(s):  
Veronica Ojetti ◽  
Gianluca Ianiro ◽  
Annalisa Tortora ◽  
Giovanna D‘Angelo ◽  
Teresa Antonella Di Rienzo ◽  
...  
Keyword(s):  
Bowel Movement ◽  
Lactobacillus Reuteri ◽  
Controlled Trial ◽  
Functional Constipation ◽  
Stool Consistency ◽  
Double Blind ◽  
Movement Frequency ◽  
Bowel Movements ◽  
Bowel Movement Frequency ◽  
The Mean

Background & Aims: There is a growing interest for the use of probiotics for chronic constipation. A recent randomized controlled trial (RCT) showed a positive effect of Lactobacillus reuteri (L. reuteri) on bowel movement frequency in infants with chronic constipation. The aim of the present study was to evaluate the effects of L. reuteri in adult patients with functional constipation.Methods: A double-blind, placebo RCT was conducted in 40 adults (18M/22F, 35±15 years) affected by functional constipation according to the Rome III criteria. Patients were randomly assigned to receive a supplementation of L. reuteri (DSM 17938), or matching placebo for 4 weeks. The increase of bowel movements/week was the primary outcome, while the improvement of stool consistency was the secondary outcome.Results: At week 4, the mean increase in bowel movements/week was 2.6 (SD±1.14, 95% CI:1.6-3.6) in the L. reuteri group and 1.0 (SD±1. 95% CI:0.12-1.88) in the placebo group (p=0.046). At the end of the treatment, the mean bowel movements/week was 5.28±1.93 in the L. reuteri group and 3.89±1.79 in the placebo group. There was a not significant difference in the stool consistency between the two groups.Conclusions: L. reuteri is more effective than the placebo in improving bowel movement frequency in adult patients with functional constipation as previously demonstrated in children, even if it seems to have no effect on stool consistency.

scholarly journals Effects of rice-based and wheat-based diets on bowel movements in young Korean women with functional constipation

2020 ◽  
Vol 74 (11) ◽  
pp. 1565-1575
Author(s):  
Su-Jin Jung ◽  
Mi-Ra Oh ◽  
Soo-Hyun Park ◽  
Soo-Wan Chae
Keyword(s):  
Fatty Acid Content ◽  
Brown Rice ◽  
Functional Constipation ◽  
Bowel Function ◽  
Colon Transit Time ◽  
Dietary Fiber Intake ◽  
Significant Difference ◽  
Before And After ◽  
Bowel Movements ◽  
Colon Transit

Abstract Background Although several studies have reported the effects that dietary fiber intake from different types of grains and fiber components have on bowel movements, insufficient attention has been paid to comparing and evaluating the effects of rice-based and wheat-based diets. This study compared and evaluated the effects of ingesting rice-based (brown rice-based diet: BRD; white rice-based diet: WRD) and wheat-based diet (WD) on the bowel movements of young women with functional constipation. Method Based on an open, randomized, controlled, and parallel design, 39 subjects were assigned to BRD, WRD, and WD groups (13 in each group). Each participant had received three types of experimental diets over the course of 4 weeks and we recommended that the subjects eat only the test diet provided during the study. Primary outcomes (total colon transit time TCTT) and secondary outcomes (bowel movements, short-chain fatty acid content, and fecal enzyme activity) were compared before and after the 4-week intervention period. Results After the 4-week study, the rice-based diet (BRD and WRD) groups and the WD group had a statistically significant difference in TCTT (p = 0.028). The TCTT of the BRD group was significantly reduced (p = 0.028) compared with the WRD group (−16.5 ± 8.1 vs +6.8 ± 2.1), and the TCTT of the WD group was also significantly reduced (p = 0.022) compared with that of the WRD group (−17.1 ± 11.9 vs +6.8 ± 2.1). Conclusion Among women with functional constipation, the BRD and WD both improved bowel function by reducing TCTT and increasing the number of bowel movements compared with the WRD group.

scholarly journals Effect of Intradermal Thumbtack Needle for Functional Constipation: Study Protocol for a Real- World Clinical Trial

2021 ◽  
Author(s):  
WenQian Zhao ◽  
Ying Xu ◽  
Jingjing Liao ◽  
Ji Li ◽  
Li Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Real World ◽  
Functional Constipation ◽  
Assessment Tools ◽  
Life Questionnaire ◽  
Self Rating ◽  
Bowel Movements

Abstract Background: Many high-quality clinical trials have proved the efficacy of acupuncture in the improving frequency of spontaneous bowel movements, stool characteristics, and et cetera of Functional Constipation (FC) [1]. However, the high requirement of time make many patients unable to attend, this clinical trial will demonstrate the efficacy of intradermal thumbtack needle in ameliorate spontaneous bowel movement of FC.Methods: This multi-center real world clinical trial is performed involving 482 FC patients. All patients are randomly allocated into 2 group, which are group A to receive intradermal thumbtack needle twice a week for 4 weeks (intervention group n=241) or group B to take oral administration of mosapride 3 times a day for 4 weeks (control group n=241). This trial includes a 4-week treatment period and a 4-week follow-up period. The primary outcome is the number of completely spontaneous defecation per week, we use Weekly CSBMs analyze the frequency of spontaneous defecation per week during treatment and follow-up period to compared with the baseline. The secondary outcomes include FC patients’ stool consistence, gastrointestinal or anorectal symptoms, quality of life, anxiety and depression levels during treatment and follow-up period and efficacy expectations. The relevant assessment tools include: Bristol tool Form Scale (BSFS), Cleveland Constipation Score (CCS), Patient Assessment of Constipation Quality of Life Questionnaire(PAC－QOL), Self-rating Anxiety Scale (SAS) , Self-rating Depression Scale (SDS) and Efficacy Expectancy Scale. At the end, the scales filled by patients and researchers will be entered by data administrator, all the outcome assessments will be performed by independent outcome assessors and will be analyzed by professional statisticians with SPSS 25.0 software.Discussion: We hypothesize that intradermal needle is better than or equal to positive drugs in the improving frequency of spontaneous bowel movements, stool characteristics，and et cetera of FC patients . The results of this trial will provide us with a clinical basis for the application of intradermal needles in the treatment of FC.Trial registration: Chinese Clinical Trial Registry, ChinCTR2100043684.Registered on 26 February 2021.

scholarly journals The Effectiveness of Electroacupuncture for Functional Constipation: A Randomized, Controlled, Clinical Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Nili Da ◽  
Xinjun Wang ◽  
Hairong Liu ◽  
Xiuzhu Xu ◽  
Xun Jin ◽  
...  
Keyword(s):  
Functional Constipation ◽  
Needle Insertion ◽  
Controlled Clinical Trial ◽  
Large Sample Size ◽  
Randomized Controlled ◽  
Insertion Method ◽  
Bowel Movements ◽  
Long Term Observation

Background. Electroacupuncture (EA) has been reported to treat functional constipation (FC). The aim of this study was to investigate the efficacy and safety of EA with different needle insertion method for FC.Methods. Sixty-seven participants were randomly assigned to control (EA with shallow puncture) and EA (with deep puncture) groups. Every patient received 5 treatments per week in the first two weeks, then 3 treatments per week during the following six weeks. Complete spontaneous bowel movements (CSBM), spontaneous bowel movements (SBM), Bristol stool scores (BSS), and Patient Assessment of Constipation Quality of Life (PAC-QOL) were assessed.Results. Both shallow and deep EA significantly increased CSBM frequency compared to the baseline. CSBM was increased from 0.50 ± 0.59/wk to 2.00 ± 1.67/wk with deep EA and from 0.48 ± 0.59/wk to 1.33 ± 1.09/wk with shallow EA (P< 0.05, resp.). Similar finding was noted in SBM. Deep EA was more potent than shallow EA (P< 0.05) during the treatment period. No difference was found on BSS and PAC-QOL between two groups.Conclusion. It is effective and safe with EA to treat FC. Studies with large sample size and long-term observation are needed for further investigation.

Neurological etiology in structure of lameness in the pelvic limbs in dogs

2020 ◽  
Vol 1 (12) ◽  
pp. 6-11
Author(s):  
S. V. Pozyabin ◽  
◽  
N. A. Kozlov ◽  
M. D. Kachalin ◽  
A. A. Kholopova ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Procedure ◽  
Diagnostic Methods ◽  
Everyday Practice ◽  
Common Cause ◽  
Appropriate Treatment ◽  
Veterinary Surgeon ◽  
Pelvic Limb

One of the most common cause of visiting veterinarian is pelvic limb lameness in dogs. For choosing appropriate treatment, identifying cause and suitable diagnostic procedure is very important. In this article, we have described diagnostic methods and differential diagnosis of lameness in dogs as well as types of lameness which are seen in everyday practice by veterinary surgeon.

Effectiveness of Probiotics in the Management of Functional Constipation in Children: A Randomized, Double-Blind, Placebo-Controlled Trial

2020 ◽  
Vol 15 (1) ◽  
pp. 1-6
Author(s):  
Tjokronegoro Srihati Dyah Permatasari ◽  
Advani Najib ◽  
Firmansyah Agus
Keyword(s):  
Placebo Group ◽  
Controlled Trial ◽  
Functional Constipation ◽  
Parent Report ◽  
Number Needed To Treat ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Bowel Movements ◽  
Rome Iii ◽  
Constipation Severity

A randomized, double-blind, placebo-controlled trial was conducted to assess the efficacy of probiotics (L. acidophilus, B. longum, and S. thermophylus 2 × 109 cfu/day) in 78 children aged 4–10 years old with functional constipation (Rome III criteria) at several schools in Jakarta, Indonesia. The case finding used a validated parent-report questionnaire. Subjects were randomly assigned to receive either oral probiotics (L. acidophilus, B. longum, and S. thermophylus 1 × 109 cfu/day) or placebo twice a day for 4 weeks. There were more subjects in the probiotics group who had improvement in stool consistency (P = 0.022) and difficulty/painful defecation (P = 0.009) than in the placebo group. Other symptoms (frequency of bowel movements, withholding behavior, fecal incontinence, and presence of stool mass in abdomen) also improved, but no statistically significant differences were found. Constipation severity significantly improved in the probiotics group (P = 0.026). Overall improvement (defined as decrease of constipation severity score >60% at the end of evaluation) was higher in the probiotics group than the placebo group (31/39 versus 18/39, P = 0.002) with number needed to treat (NNT) of 3 (95%CI 2;8). The present study shows that probiotics (L. acidophilus, B. longum, and S. thermophylus 2 × 109 cfu/day) are effective in the management of functional constipation in children.

scholarly journals Initial Effects of Electroacupuncture for Chronic Severe Functional Constipation and the Potential Underlying Factors: Secondary Analysis of a Randomized Controlled Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Yuxiao Zeng ◽  
Yan Liu ◽  
Sixing Liu ◽  
Zhishun Liu
Keyword(s):  
Randomized Controlled Trial ◽  
Clinical Response ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Functional Constipation ◽  
Initial Response ◽  
Randomized Controlled ◽  
Younger Age ◽  
Multicenter Randomized Controlled Trial ◽  
Bowel Movements

Background. Electroacupuncture (EA) has been found to be effective for treating chronic severe functional constipation (CSFC). However, the initial effects of treatment usually affect the acceptability and compliance of patients with chronic disease in particular. Which class of CSFC patients will have a better initial response to EA remains uncertain and requires investigation. Methods. This was a secondary analysis of an original multicenter randomized controlled trial in which patients with CSFC were randomly assigned to receive 28 sessions of EA or sham electroacupuncture (SA) over 8 weeks with 12 weeks of follow-up. The primary outcome, namely, response with complete spontaneous bowel movements (CSBMs), required participants to have ≥ 3 CSBMs and an increase of ≥ 1 CSBM from the baseline over the first week of treatment. Logistic regression analysis with bootstrapping techniques was performed to determine independent factors related to the response. Results. A total of 1051 eligible patients were included in this study of whom 161 patients were classified as responders at week 1. The CSBM response rate was higher in the EA group (17.5%) than in the SA group (13.2%). And the proportion of these 1-week early responders remained to have higher clinical response at the end of 8-week treatment and 12 weeks after treatment. Age and higher baseline CSBMs were related to CSBM response within the first week: with every 1-year increase in age, the likelihood of clinical response was reduced by 1.7% (odds ratio [OR] 0.983, 95% confidence interval [CI] 0.972 to 0.993; P=0.001). The odds of a CSBM response in patients with 1< CSBMs ≤ 2 at baseline were 4.64 times higher than that in patients with CSBMs ≤ 1 (OR 4.64, 95%CI 4.01 to 5.27). Conclusions. EA produced its initial effects within the first week of treatment. And the effects could last until week 8 and week 20. A younger age and higher number of CSBMs at baseline may increase likelihood of a response.

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