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

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.

Rectal metastasis from bladder urothelial carcinoma: a case report

Background Urothelial carcinoma arises from transitional cells in the urothelial tract. In advanced cases, it can metastasize locally to surrounding organs or distally to organs such as the lungs, bones, or liver. Here we describe a case of rectal metastasis from urothelial carcinoma treated with multiple sessions of transurethral resection of bladder tumor (TURBT). Case presentation A 72-year-old woman presented to our department with abdominal bloating andobstructed defecation. She had undergone two sessions of TURBT for early urothelial carcinoma in another hospital at 64 and 65 months ago, respectively. Cystoscopy at 3 months after the second TURBT session had indicated disease recurrence, and thus, she had been referred to our hospital for further examination, followed by TURBT for the third time at 59 months ago and for the fourth time at 48 months ago; thereafter, she had been followed up with cystoscopy every 6 months without any recurrence. However, she returned to our hospital, complaining of difficult defecation. Subsequent colonoscopy demonstrated an obstructive tumor in the rectum, which was pathologically diagnosed as metastatic urothelial carcinoma of the bladder. Laparoscopic examination revealed two small areas of peritoneal dissemination in the pelvis. A sigmoid colostomy was performed without rectal tumor resection. She has been receiving chemotherapy and is still alive 10 months after surgery. Conclusions Rectal metastasis is a rare site of metastasis for urothelial carcinomas. It is important to consider the possibility of annular rectal constriction caused by infiltrating or metastasizing urothelial carcinoma when managing patients with urothelial carcinoma and with difficult defecation.

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

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.

Gambaran Kebiasaan Ibu Hamil Dalam Mengatasi Ketidaknyamanan Selama Kehamilan Di RSUD R. Syamsudin, SH

Pregnancy is a natural and normal process in reproductive period of women life. Discomfort of pregnancy period is common thing. During 9 months or at the 3 trimesters of pregnancy, pregnant women suffered physical change and also with her psychological to prepare herself for the growth period of the fetus, during labor, and breastfeeding. The such changes can cause interference and obstacles in pregnancy. The purpose of research is to describe the habits of pregnant women how to resolve discomfort condition at R. Syamsudin, SH Hospital in May 2014. This research used descriptive method with cross sectional approach by using 30 respondents as samples. For statistical analysis used is univariate. Results of research are for first trimester are nausea and vomiting (100%); second trimester are difficult defecation, bloating, and heartburn (50%), third trimester is frequent urination (100%). Base on the discomfort condition that happened, commonly practice by pregnant women is waiting for the discomfort goes away by itself. The conclusions of research are the habit that did by pregnant women to resolve discomfort conditions is waiting for the discomfort goes away by itself.

Ewing’s sarcoma/primitive neuroectodermal tumor of the prostate a case report and literature review

We present a case of Ewing’s sarcoma (ES) and primitive neuroectodermal tumor (PNET) of prostate. A 29-year-old male presented with difficult defecation and anus distention and was found on magnetic resonance imaging (MRI) scan of the pelvis to have a prostate tumor. A transrectal ultrasound guided needle biopsy confirmed the diagnosis. The patient underwent cystoprostatectomy and replacement ileocystoplasty and was followed by multiagent chemotherapy. PNET/EWS of the prostate is an extremely rare neoplasm. And the prognosis is very poor, so we should pay enough attention to the differential diagnosis and treatment.