1
|
Dimas B, Hernández G, Peralta I, Godinez A, Gutierrez G, Cruz F. Case Report: Toxic megacolon secondary to chronic constipation and cocaine consumption. Front Surg 2024; 11:1434523. [PMID: 39233765 PMCID: PMC11371572 DOI: 10.3389/fsurg.2024.1434523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 08/06/2024] [Indexed: 09/06/2024] Open
Abstract
Toxic megacolon (TM) is a severe condition characterized by acute colonic dilation, with specific radiological and clinical signs. The multifactorial etiology of TM is primarily associated with inflammatory bowel disease and infections. However, TM remains a challenging complication due to its potential for rapid progression to life-threatening conditions. This report describes a rare case of TM in a 25-year-old male with a history of recurrent constipation and chronic cocaine consumption. Examination and imaging indicated acute intestinal obstruction with dilated colon segments and fecal impaction, necessitating an urgent laparotomy. Surgery revealed pan-colonic dilatation and sigmoid perforations, leading to a total colectomy and ileostomy. Chronic constipation, often perceived as benign, can escalate into a critical situation, possibly exacerbated by cocaine-induced muscle weakness and hypoxia. Evidence suggests that cocaine negatively affects the intestinal mucosa, potentially leading to ischemia. Chronic factors, including the use of enemas, may have contributed to megacolon development and perforation. Overall, this report underscores the critical elements of diagnosis and the importance of patients' medical history, particularly those with unusual risk profiles. In addition, it highlights the need for further research to fully understand the implications of these cases.
Collapse
Affiliation(s)
- Bertha Dimas
- Surgery Unit, Hospital General de México (HGM), Mexico City, Mexico
| | | | - Ivonne Peralta
- Anesthesiology Unit, Centro Médico ABC, Mexico City, Mexico
| | - Ansony Godinez
- Surgery Unit, Hospital General de México (HGM), Mexico City, Mexico
| | | | - Fernando Cruz
- Surgery Unit, Hospital General de México (HGM), Mexico City, Mexico
| |
Collapse
|
2
|
Lacy BE, Xu Y, Taylor DCA, Kosch KJ, Dobrescu R, Morlock A, Morlock R, Rooker C. Treatment for chronic idiopathic constipation: Use and satisfaction from a nationwide survey of US participants. Neurogastroenterol Motil 2024:e14885. [PMID: 39155456 DOI: 10.1111/nmo.14885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 06/20/2024] [Accepted: 07/25/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND Chronic idiopathic constipation (CIC) is a disorder of gut-brain interaction characterized by a variety of bowel movement-related and abdominal symptoms. A greater understanding of medication use and satisfaction with symptom control may provide insights to optimize patient care. Therefore, we explored these aspects of the disorder in adults with CIC. METHODS This study assessed data collected from a large nationwide survey of adult participants in the United States, querying demographics, clinical characteristics, and comorbid conditions, as well as medication use, care-seeking behaviors, and satisfaction with symptom control. Participants were grouped into the CIC cohort if they met Rome IV criteria, with controls matched 1:1 according to age, sex, race, region, and Charlson Comorbidity Index score. All data were self-reported. KEY RESULTS Two thousand five hundred and thirty-three participants with CIC were matched 1:1 to controls. In the CIC cohort, abdominal pain was the most reported symptom leading to medication use: 15.9% of respondents were receiving a prescription medication in addition to an over-the-counter medication, while 26.3% were taking neither. In addition, only one-third were satisfied with the control of their symptoms; however, satisfaction was significantly higher in respondents taking a prescription medication (p < 0.001). The proportion of reported comorbidities was significantly higher in the CIC cohort versus the control cohort, with chronic pain, anxiety, and depression among the highest (p < 0.001 for all). CONCLUSIONS AND INFERENCES This study emphasizes the need for better communication regarding prescription medications and their benefits, with the goal of further improving CIC patients' overall symptoms.
Collapse
Affiliation(s)
- Brian E Lacy
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Yanqing Xu
- AbbVie Inc., North Chicago, Illinois, USA
| | | | | | | | - Amy Morlock
- Acumen Health Research Institute, Ann Arbor, Michigan, USA
| | | | - Ceciel Rooker
- International Foundation for Gastrointestinal Disorders, Milwaukee, Wisconsin, USA
| |
Collapse
|
3
|
Lynch E, Mulligan S, Doyle SL. An exploration of fibre intake and bowel function in a sample of adults at an Irish university campus. Ir J Med Sci 2024:10.1007/s11845-024-03764-9. [PMID: 39088161 DOI: 10.1007/s11845-024-03764-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 07/22/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Bowel dysfunction can significantly impair quality of life. Adequate fibre intake is associated with good bowel health but intakes have been reported to be low in Ireland. AIM This study aimed to gather data on fibre intake and bowel habits in a cohort of adults at a university campus in Dublin, Ireland. METHODS An online questionnaire was developed by adapting validated tools to assess habitual fibre intake and bowel function. The questionnaire was circulated through mailing lists and advertised via QR codes on campus in February/March 2023. Data was analysed using SPSS, p < 0.05 was considered statistically significant. RESULTS In total, 275 valid responses were received. Low fibre intakes (< 19 g/day) were found in 50.5% of participants. A significantly higher proportion of males had low fibre intake compared to females (62.2% vs 44.8%, p = 0.039). Nearly a third (30.2%) of respondents experienced mild symptoms of bowel dysfunction, and 13.1% experienced moderate to severe symptoms. An inverse relationship was observed between fibre intake (g/day) and bowel dysfunction (p = 0.033). CONCLUSIONS In this cohort, low fibre intakes and some degree of bowel dysfunction were prevalent. Public health campaigns to increase fibre intake could prove to be a cost-effective way to improve bowel function and health amongst adults in Ireland.
Collapse
Affiliation(s)
- Ellen Lynch
- School of Biological, Health and Sports Sciences, Technological University Dublin, Grangegorman, Dublin 7, Dublin, D07 XT95, Ireland
| | - Sophie Mulligan
- School of Biological, Health and Sports Sciences, Technological University Dublin, Grangegorman, Dublin 7, Dublin, D07 XT95, Ireland
| | - Suzanne L Doyle
- School of Biological, Health and Sports Sciences, Technological University Dublin, Grangegorman, Dublin 7, Dublin, D07 XT95, Ireland.
| |
Collapse
|
4
|
Marra AA, Simonelli I, Parello A, Litta F, De Simone V, Campennì P, Ratto C. Analysis of factors that indicated surgery in 400 patients submitted to a complete diagnostic workup for obstructed defecation syndrome and rectal prolapse using a supervised machine learning algorithm. Tech Coloproctol 2024; 28:73. [PMID: 38918256 DOI: 10.1007/s10151-024-02951-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 05/25/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Patient selection is extremely important in obstructed defecation syndrome (ODS) and rectal prolapse (RP) surgery. This study assessed factors that guided the indications for ODS and RP surgery and their specific role in our decision-making process using a machine learning approach. METHODS This is a retrospective analysis of a long-term prospective observational study on female patients reporting symptoms of ODS who underwent a complete diagnostic workup from January 2010 to December 2021 at an academic tertiary referral center. Clinical, defecographic, and other functional tests data were assessed. A supervised machine learning algorithm using a classification tree model was performed and tested. RESULTS A total of 400 patients were included. The factors associated with a significantly higher probability of undergoing surgery were follows: as symptoms, perineal splinting, anal or vaginal self-digitations, sensation of external RP, episodes of fecal incontinence and soiling; as physical examination features, evidence of internal and external RP, rectocele, enterocele, or anterior/middle pelvic organs prolapse; as defecographic findings, intra-anal and external RP, rectocele, incomplete rectocele emptying, enterocele, cystocele, and colpo-hysterocele. Surgery was less indicated in patients with dyssynergia, severe anxiety and depression. All these factors were included in a supervised machine learning algorithm. The model showed high accuracy on the test dataset (79%, p < 0.001). CONCLUSIONS Symptoms assessment and physical examination proved to be fundamental, but other functional tests should also be considered. By adopting a machine learning model in further ODS and RP centers, indications for surgery could be more easily and reliably identified and shared.
Collapse
Affiliation(s)
- A A Marra
- Proctology and Pelvic Floor Surgery Unit, Center of Excellence for Gastrointestinal and Endocrine-Metabolic Diseases, Isola Tiberina - Gemelli Isola Hospital, Via di Ponte Quattro Capi, 39, 00186, Rome, Italy
| | - I Simonelli
- Biostatistical Service, Clinical Trial Center, Isola Tiberina - Gemelli Isola Hospital, Rome, Italy
| | - A Parello
- Proctology and Pelvic Floor Surgery Unit, Center of Excellence for Gastrointestinal and Endocrine-Metabolic Diseases, Isola Tiberina - Gemelli Isola Hospital, Via di Ponte Quattro Capi, 39, 00186, Rome, Italy
| | - F Litta
- Proctology and Pelvic Floor Surgery Unit, Center of Excellence for Gastrointestinal and Endocrine-Metabolic Diseases, Isola Tiberina - Gemelli Isola Hospital, Via di Ponte Quattro Capi, 39, 00186, Rome, Italy
| | - V De Simone
- Proctology and Pelvic Floor Surgery Unit, Center of Excellence for Gastrointestinal and Endocrine-Metabolic Diseases, Isola Tiberina - Gemelli Isola Hospital, Via di Ponte Quattro Capi, 39, 00186, Rome, Italy
| | - P Campennì
- Proctology and Pelvic Floor Surgery Unit, Center of Excellence for Gastrointestinal and Endocrine-Metabolic Diseases, Isola Tiberina - Gemelli Isola Hospital, Via di Ponte Quattro Capi, 39, 00186, Rome, Italy
| | - C Ratto
- Proctology and Pelvic Floor Surgery Unit, Center of Excellence for Gastrointestinal and Endocrine-Metabolic Diseases, Isola Tiberina - Gemelli Isola Hospital, Via di Ponte Quattro Capi, 39, 00186, Rome, Italy.
- Università Cattolica del Sacro Cuore, Rome, Italy.
| |
Collapse
|
5
|
Bazzocchi G, Corazziari ES, Staiano A, Bassotti G, Bellini M, Chiarioni G, D'Alba L, Scarpato E. Position paper on transanal irrigation in chronic non-organic constipation. Dig Liver Dis 2024; 56:770-777. [PMID: 38461046 DOI: 10.1016/j.dld.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 03/11/2024]
Abstract
The practice of recto-colonic water irrigation to treat constipation has been used since ancient times with different, uncontrolled, and variably performing methods which have been considered interchangeably all alike. The use of better-performing devices with a standardized methodology is relatively recent, and the term Trans Anal Irrigation (TAI) defines a methodology performed with devices able to control the timing, volume, and pressure of the water introduced into the rectum and colon utilizing a catheter or a cone through the anus. Such practice has been implemented with favorable responses in patients with refractory chronic constipation secondary to neurological diseases. However, since the role of Trans Anal Irrigation as a therapeutic aid in chronic functional constipation and functional evacuation disorders is not yet fully clarified and standardized, a group of clinical investigators with recognized expertise in these clinical conditions intends to clarify the elements that characterize a TAI procedure that can benefit patients with functional constipation and functional defecation disorders defined according to the lastly updated Rome Diagnostic Criteria. Finally, the paper deals with adherence and practical implementation of TAI.
Collapse
Affiliation(s)
- G Bazzocchi
- Montecatone Rehabilitation Institute, Imola - University of Bologna, Italy
| | - E S Corazziari
- Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy.
| | - A Staiano
- Department of Translational Medical Science - Section Of Pediatrics, University Federico II, Naples, Italy
| | - G Bassotti
- Gastroenterology & Hepatology Section, Department of Medicine & Surgery, University of Perugia, Perugia, Italy
| | - M Bellini
- Gastrointestinal Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - G Chiarioni
- Il Centro Med Healthcare, Verona Center, Verona, Italy & UNC Center for Functional GI and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - L D'Alba
- Gastroenterology and Endoscopy Unit, San Camillo-Forlanini Hospital, Rome, Italy
| | - E Scarpato
- Department of Translational Medical Science - Section Of Pediatrics, University Federico II, Naples, Italy
| |
Collapse
|
6
|
Rolleman NH, Visser IM, Klein WM, Van Putten MJAM, De Blaauw I, Botden SMBI. Feasibility and repeatability of ultrasound-guided surface electroenterography to measure colonic slow wave motility in healthy adults. BMC Gastroenterol 2024; 24:114. [PMID: 38500056 PMCID: PMC10949649 DOI: 10.1186/s12876-024-03196-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 03/05/2024] [Indexed: 03/20/2024] Open
Abstract
Surface electroenterography is a potential non-invasive alternative to current diagnostics of colonic motility disorders. However, electrode positioning in electroenterography is often based on general anatomy and may lack generalizability. Furthermore, the repeatability of electroenterography measurements is unknown. This study aimed to evaluate ultrasound-guided electrode positioning for electroenterography measurements and to determine the repeatability of those measurements. In ten healthy adults, two electroenterography procedures were performed, consisting of fasting, ultrasound-guided electrode localization and two 20-minute electroenterography recordings separated by a meal. The dominant frequency, the mean power density (magnitude of colonic motility) and the power percent difference (relative pre- to postprandial increase in magnitude) were determined. Repeatability was determined by Lin's concordance correlation coefficient. The results demonstrated that the dominant frequency did not differ between pre- and postprandial recordings and was 3 cpm, characteristic of colonic motility. The mean power density increased between the pre- and postprandial measurements, with an average difference of over 200%. The repeatability of both the dominant frequency and power density was poor to moderate, whereas the correlation coefficient of the power percent difference was poor. Concluding, ultrasound-guided surface electroenterography seems able to measure the gastrocolic reflex, but the dissatisfactory repeatability necessitates optimization of the measurement protocol.
Collapse
Affiliation(s)
- Nick H Rolleman
- Department of Pediatric Surgery, Radboud University Medical Centre- Amalia Children's Hospital, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, Postal box 9101, The Netherlands
- Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Iris M Visser
- Department of Pediatric Surgery, Radboud University Medical Centre- Amalia Children's Hospital, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, Postal box 9101, The Netherlands
- Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Willemijn M Klein
- Department of Pediatric Surgery, Radboud University Medical Centre- Amalia Children's Hospital, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, Postal box 9101, The Netherlands
- Department of Medical Imaging, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Ivo De Blaauw
- Department of Pediatric Surgery, Radboud University Medical Centre- Amalia Children's Hospital, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, Postal box 9101, The Netherlands
| | - Sanne M B I Botden
- Department of Pediatric Surgery, Radboud University Medical Centre- Amalia Children's Hospital, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, Postal box 9101, The Netherlands.
| |
Collapse
|
7
|
Mego M, Huaman JW, Videla S, Jansana M, Tinoco K, Saperas E. Effectiveness of a high fiber diet in improving constipation in patients with defecatory dyssynergy under treatment with anorrectal biofeedback. Exploratory, randomized clinical trial. GASTROENTEROLOGIA Y HEPATOLOGIA 2023; 46:774-783. [PMID: 36731727 DOI: 10.1016/j.gastrohep.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/03/2023] [Accepted: 01/25/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Fiber is the initial treatment in chronic functional constipation. However, its role in the group of patients with defecatory dyssynergy is not well established. The objective of the study is to evaluate the efficacy and safety of a high fiber diet in patients with defecatory dyssynergy in the treatment with anorectal biofeedback. PATIENTS AND METHODS An exploratory, randomized (1:1), double-blind, controlled «add-on» clinical trial was carried out in a reference center in Spain in patients with functional constipation and defecatory dyssynergy according to the ROMEIV criteria. CONTROL GROUP treatment with biofeedback and low-fiber diet (15-20g/day). Experimental group: treatment with biofeedback and high fiber diet (25-30g/day). Analyzed: responder (primary endpoint), patient whose defecatory dyssynergy had been corrected (>20% reduction in anal pressure during the defecation maneuver and normal balloon expulsion test); anorectal parameters (anal relaxation, reduced straining); safety (abdominal symptoms: flatulence, pain, borborygmus, bloating). RESULTS A total of 44 patients were randomized: 22 per group. The percentage of responders was 75% (15/20; 95%CI: 53 89%) control group and 70% (14/20; 95%CI: 48-85%) experimental group, P=.225. Differences in favor of the control group were only observed in abdominal symptoms: flatulence (P=.028), abdominal distension (P=.041) and digestive comfort (P=.043). CONCLUSIONS In patients with defecatory dyssynergy, a high-fiber diet not only does not improve the efficacy of anorectal biofeedback but is associated with a loss of improvement in abdominal symptoms.
Collapse
Affiliation(s)
- Marianela Mego
- Servicio de Gastroenterología, Hospital Universitari General de Catalunya, Grupo QuirónSalud, Sant Cugat del Vallès, Barcelona, España
| | - José Wálter Huaman
- Servicio de Gastroenterología, Hospital Universitari General de Catalunya, Grupo QuirónSalud, Sant Cugat del Vallès, Barcelona, España; Escuela de Medicina, Universitat Internacional de Catalunya, Barcelona, España.
| | - Sebastian Videla
- Unidad de Soporte a la Investigación Clínica, Departamento de Farmacología Clínica, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España; Unidad de Farmacología, Departamento de Patología y Terapéutica Experimental, Facultad de Medicina y Ciencias de la Salud, IDIBELL, Universidad de Barcelona, Barcelona, España
| | - Marta Jansana
- Servicio de Endocrinología, Hospital Universitari General de Catalunya, Grupo QuirónSalud, Sant Cugat del Vallès, Barcelona, España
| | - Karen Tinoco
- Servicio de Medicina Interna, Hospital Universitari General de Catalunya, Grupo QuirónSalud, Sant Cugat del Vallès, Barcelona, España
| | - Esteban Saperas
- Servicio de Gastroenterología, Hospital Universitari General de Catalunya, Grupo QuirónSalud, Sant Cugat del Vallès, Barcelona, España; Escuela de Medicina, Universitat Internacional de Catalunya, Barcelona, España
| |
Collapse
|
8
|
Wu Y, Ying Q, He Y, Xie X, Yuan X, Wang M, Fei X, Yang X. Effect of external therapies of traditional Chinese medicine on constipation in patients with CRF: A meta-analysis. PLoS One 2023; 18:e0291968. [PMID: 37796899 PMCID: PMC10553223 DOI: 10.1371/journal.pone.0291968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 09/10/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the curative effect of external therapies of traditional Chinese medicine on constipation in patients with chronic renal failure and to provide scientific theoretical basis for clinical practice. METHOD We searched the English database of PubMed, EMBASE, the Cochrane Library and the Web of Science and Chinese database of CNKI, Wan fang database, VIP Database and China Biomedical Literature Database up to December 2022. Randomized controlled trials (RCTs) involving constipation in patients with CRF that compared external therapies of traditional Chinese medicine and routine treatment to routine treatment were eligible for the analysis. A meta-analysis of the outcome indicators including total efficiency, weekly defecation times, defecation time, defecation difficulty score, patient-assessment of constipation quality of life and adverse events of treatment were performed. The analysis was performed by using Review Manager version 5.3. RESULT A total of 23 studies were included, with 1764 patients. Meta-analysis results showed that compared with the control group, the test group could significantly increase weekly defecation times(MD = 0.94, 95%CI(0.70, 1.18), Z = 7.74, P < 0.00001), reduce defecation time(MD = -2.92, 95%CI(-3.69, -2.16), Z = 7.49, P < 0.00001), reduce defecation difficulty score(MD = -1.92, 95%CI(-2.45, -1.39), Z = 7.11, P < 0.00001), improve the quality of life in patients with constipation(MD = -7.57, 95%CI(-10.23, -4.91), Z = 5.58, P < 0.00001) and obtain a higher total effective rate of treatment(OR = 4.53, 95%CI(3.27, 6.29), Z = 9.07, P < 0.00001). In terms of safety, there was no statistical significance in the incidence of adverse events between two groups(OR = 0.35, 95%CI(0.04, 2.95), Z = 0.96, P = 0.34). CONCLUSION The combination of external therapies of traditional Chinese medicine and routine treatment could achieve an excellent curative effect, and there was no specific adverse event. However because of the limited level of current evidence, more high-quality trials are needed in the future.5.
Collapse
Affiliation(s)
- Yu Wu
- Department of Nephrology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qisu Ying
- Department of Nephrology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yajing He
- Department of Nephrology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiangcheng Xie
- Department of Nephrology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao Yuan
- Department of Nursing, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ming Wang
- Department of Nephrology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao Fei
- Department of Nephrology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiu Yang
- Department of Nephrology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
9
|
Al Nou'mani J, Al Alawi AM, Al-Maqbali JS, Al Abri N, Al Sabbri M. Prevalence, Recognition, and Risk Factors of Constipation among Medically Hospitalized Patients: A Cohort Prospective Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1347. [PMID: 37512158 PMCID: PMC10385149 DOI: 10.3390/medicina59071347] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/15/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023]
Abstract
Background and Objective: Constipation is a prevalent gastrointestinal condition that has a substantial impact on individuals and healthcare systems. This condition adversely affects health-related quality of life and leads to escalated healthcare expenses due to an increase in office visits, referrals to specialists, and hospital admission. This study aimed to evaluate the prevalence, recognition, risk factors, and course of constipation among hospitalized patients in medical wards. Materials and Methods: A prospective study was conducted, including all adult patients admitted to the General Medicine Unit between 1 February 2022 and 31 August 2022. Constipation was identified using the Constipation Assessment Scale (CAS), and relevant factors were extracted from the patients' medical records. Results: Among the patients who met the inclusion criteria (n = 556), the prevalence of constipation was determined to be 55.6% (95% CI 52.8-58.4). Patients with constipation were found to be older (p < 0.01) and had higher frailty scores (p < 0.01). Logistic regression analysis revealed that heart failure (Odds ratio (OR) 2.1; 95% CI 1.2-3.7; p = 0.01), frailty score (OR 1.4; 95% CI 1.2-1.5; p < 0.01), and dihydropyridines calcium channel blockers (OR 1.8; 95% CI 1.2-2.8; p < 0.01) were independent risk factors for constipation. Furthermore, the medical team did not identify constipation in 217 patients (64.01%). Conclusions: Constipation is highly prevalent among medically hospitalized patients. To ensure timely recognition and treatment, it is essential to incorporate a daily constipation assessment scale into each patient's medical records.
Collapse
Affiliation(s)
- Jawahar Al Nou'mani
- Internal Medicine Residency Training Program, Oman Medical Specialty Board, Muscat 130, Oman
| | - Abdullah M Al Alawi
- Internal Medicine Residency Training Program, Oman Medical Specialty Board, Muscat 130, Oman
- Department of Medicine, Sultan Qaboos University Hospital, Muscat 123, Oman
| | - Juhaina Salim Al-Maqbali
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat 123, Oman
- Department of Pharmacology and Clinical Pharmacy, Sultan Qaboos University, Muscat 123, Oman
| | - Nahid Al Abri
- College of Medicine and Health Science, Sultan Qaboos University, Muscat 123, Oman
| | - Maryam Al Sabbri
- College of Medicine and Health Science, Sultan Qaboos University, Muscat 123, Oman
| |
Collapse
|
10
|
Zheng C, Yang Z, Kong L, Gao Z, Lu T, Zhang H. Psychometric evaluation of the Chinese version of the Elderly-Constipation Impact Scale: a translation and validation study. BMC Public Health 2023; 23:1345. [PMID: 37438713 DOI: 10.1186/s12889-023-16231-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/02/2023] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVE The objective of this study was to translate the Elderly-Constipation Impact Scale into Chinese and to examine its reliability and validity in a population of older people suffering from chronic constipation. METHODS In this study, the scale was paraphrased, back-translated, cross-culturally adapted and pre-experimented using the Brislin double translation-back-translation method to create the initial Chinese version of the Elderly-Constipation Impact Scale. A convenience sampling method was used to select 564 study participants who met the inclusion and exclusion criteria in Liaoning and Shanxi, China, to evaluate the reliability and validity of the scale. General information about the study population was using descriptive statistics; item analysis was used to screen the items of the scale. Content validity, exploratory factor analysis, and validation factor analysis were chosen to validate the scales; internal consistency, spilt-half reliability and retest reliability were used determine the reliability of the measurement scales. RESULTS The Chinese version of the Elderly-Constipation Impact Scale contains 7 dimensions and 21 items. The Cronbach's alpha coefficient for the total scale was 0.901 and the range of Cronbach's alpha values for each dimension was 0.707 to 0.918. The split-half reliability of the scale was 0.736 and the retest reliability was 0.763. The exploratory factor analysis showed a KMO value of 0.873 and a Bartlett's spherical test X2 value of 3499.978 (p < 0.001). A total of seven common factors were extracted, namely daily activities, treatment satisfaction, lack of control of bodily function, diet restriction, symptom intensity, anxiety and preventive actions, with a cumulative variance contribution of 77.813%. Each item had a loading value > 0.4 on its common factor. In the validation factor analysis, the model fit results were X2 / df = 1.886, GFI = 0.910, AGFI = 0.874, PGFI = 0.654, IFI = 0.955, TLI = 0.942, CFI = 0.954, RMSEA = 0.056 and PNFI = 0.718. The model fit indicators were all within acceptable limits. CONCLUSION The Chinese version of the E-CIS has good reliability and validity in the chronic constipation population of elderly individuals. The results of the questionnaire can effectively and comprehensively reflect the impact of chronic constipation on the quality of life of elderly individuals. It provides a meaningful reference for identifying targets for intervention.
Collapse
Affiliation(s)
- Chen Zheng
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Liaoning Province, Jinzhou City, P.R. China
| | - Zhen Yang
- School of Nursing, China Medical University, 77 Puhe Road, Shenyang New District, Shenyang, Liaoning Province, P.R. China
| | - Linghui Kong
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Liaoning Province, Jinzhou City, P.R. China
| | - Ziyun Gao
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Liaoning Province, Jinzhou City, P.R. China
| | - Tingting Lu
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Liaoning Province, Jinzhou City, P.R. China
| | - Huijun Zhang
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Liaoning Province, Jinzhou City, P.R. China.
| |
Collapse
|
11
|
Maqoud F, Tricarico D, Mallamaci R, Orlando A, Russo F. The Role of Ion Channels in Functional Gastrointestinal Disorders (FGID): Evidence of Channelopathies and Potential Avenues for Future Research and Therapeutic Targets. Int J Mol Sci 2023; 24:11074. [PMID: 37446251 DOI: 10.3390/ijms241311074] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
Several gastrointestinal (GI) tract abnormalities, including visceral hypersensitivity, motility, and intestinal permeability alterations, have been implicated in functional GI disorders (FGIDs). Ion channels play a crucial role in all the functions mentioned above. Hormones and natural molecules modulate these channels and represent targets of drugs and bacterial toxins. Mutations and abnormal functional expression of ion channel subunits can lead to diseases called channelopathies. These channelopathies in gastroenterology are gaining a strong interest, and the evidence of co-relationships is increasing. In this review, we describe the correlation status between channelopathies and FGIDs. Different findings are available. Among others, mutations in the ABCC7/CFTR gene have been described as a cause of constipation and diarrhea. Mutations of the SCN5A gene are instead associated with irritable bowel syndrome. In contrast, mutations of the TRPV1 and TRPA genes of the transient receptor potential (TRP) superfamily manifest hypersensitivity and visceral pain in sensory nerves. Recently, mice and humans affected by Cantu syndrome (CS), which is associated with the mutations of the KCNJ8 and ABCC9 genes encoding for the Kir6.1 and SUR2 subunits, showed dysfunction of contractility throughout the intestine and death in the mice after the weaning on solid food. The discovery of a correlation between channelopathies and FIGD opens new avenues for discovering new direct drug targets for specific channelopathies, leading to significant implications for diagnosing and treating functional GI diseases.
Collapse
Affiliation(s)
- Fatima Maqoud
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "Saverio de Bellis", Castellana Grotte, 70013 Bari, Italy
| | - Domenico Tricarico
- Section of Pharmacology, Department of Pharmacy-Pharmaceutical Sciences, University of Bari Aldo Moro, 70125 Bari, Italy
| | - Rosanna Mallamaci
- Department of Biosciences, Biotechnologies and Environment University of Bari Aldo Moro, 70125 Bari, Italy
| | - Antonella Orlando
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "Saverio de Bellis", Castellana Grotte, 70013 Bari, Italy
| | - Francesco Russo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "Saverio de Bellis", Castellana Grotte, 70013 Bari, Italy
| |
Collapse
|
12
|
Ma T, Yang N, Xie Y, Li Y, Xiao Q, Li Q, Jin H, Zheng L, Sun Z, Zuo K, Kwok LY, Zhang H, Lu N, Liu W. Effect of the probiotic strain, Lactiplantibacillus plantarum P9, on chronic constipation: a randomized, double-blind, placebo-controlled study. Pharmacol Res 2023; 191:106755. [PMID: 37019193 DOI: 10.1016/j.phrs.2023.106755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/20/2023] [Accepted: 04/02/2023] [Indexed: 04/05/2023]
Abstract
Chronic constipation (CC) is a common gastrointestinal condition associated with intestinal inflammation, and the condition considerably impairs patients' quality of life. We conducted a large-scale 42-day randomized, double-blind, placebo-controlled trial to investigate the effect of probiotics in alleviating CC. 163 patients diagnosed with CC (following Rome IV criteria) were randomly divided into probiotic (n = 78; received Lactiplantibacillus plantarum P9 [P9]; 1×1011 CFU/day) and placebo (n = 85; received placebo material) groups. Ingesting P9 significantly improved the weekly mean frequency of complete spontaneous bowel movements (CSBMs) and spontaneous bowel movements (SBMs), while significantly reducing the level of worries and concerns (WO; P < 0.05). Comparing with the placebo group, P9 group was significantly enriched in potentially beneficial bacteria (Lactiplantibacillus plantarum and Ruminococcus_B gnavus), while depriving of several bacterial and phage taxa (Oscillospiraceae sp., Lachnospiraceae sp., and Herelleviridae; P < 0.05). Interesting significant correlations were also observed between some clinical parameters and subjects' gut microbiome, including: negative correlation between Oscillospiraceae sp. and SBMs; positive correlation between WO and Oscillospiraceae sp., Lachnospiraceae sp. Additionally, P9 group had significantly (P < 0.05) more predicted gut microbial bioactive potential involved in the metabolism of amino acids (L-asparagine, L-pipecolinic), short-/medium-chain fatty acids (valeric acid and caprylic acid). Furthermore, several metabolites (p-cresol, methylamine, trimethylamine) related to the intestinal barrier and transit decreased significantly after P9 administration (P < 0.05). In short, the constipation relief effect of P9 intervention was accompanied by desirable changes in the fecal metagenome and metabolome. Our findings support the notion of applying probiotics in managing CC.
Collapse
|
13
|
UMEDA K, IKEDA A, UCHIDA R, SASAHARA I, MINE T, MURAKAMI H, KAMEYAMA K. Combination of poly-γ-glutamic acid and galactooligosaccharide improves intestinal microbiota, defecation status, and relaxed mood in humans: a randomized, double-blind, parallel-group comparison trial. BIOSCIENCE OF MICROBIOTA, FOOD AND HEALTH 2023; 42:34-48. [PMID: 36660591 PMCID: PMC9816053 DOI: 10.12938/bmfh.2021-084] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/30/2022] [Indexed: 01/22/2023]
Abstract
The genus Bifidobacterium comprises beneficial intestinal bacteria that play a crucial role in the regulation of human health. Traditional prebiotics are known to increase intestinal bifidobacteria by supplying a carbon source necessary for their growth. However, intestinal bifidobacteria need not only a carbon source but also a nitrogen source for growth. Moreover, the growth of bifidobacteria is known to be inhibited in a culture medium that does not contain glutamic acid. Based on these reports, we hypothesized that the combined intake of traditional prebiotics and glutamic acid would be beneficial for growth of bifidobacteria in the gut. In this study, we investigated the effects of the combination of galactooligosaccharide (GOS; traditional prebiotic material) and poly-γ-glutamic acid (γ-PGA; source of glutamic acid) and only GOS on the intestinal microbiota and health conditions (including intestinal regulation, mood status, gastrointestinal condition, skin condition, and sleep quality) in a randomized, double-blind, parallel-group comparison trial in healthy subjects. The combined intake of GOS and γ-PGA significantly increased the prevalence of B. longum compared to the intake of GOS alone. A minimum effective dose of 2.0 g GOS and 0.3 g γ-PGA improved defecation and mood status. We revealed the combined effects of GOS and γ-PGA on intestinal microbiota as well as physical condition and concluded that the delivery of glutamic acid to the large intestine with traditional prebiotics is useful as an advanced prebiotic.
Collapse
Affiliation(s)
- Kentaro UMEDA
- Institute of Food Sciences and Technologies, Ajinomoto Co.,
Inc., 1-1 Suzuki-cho, Kawasaki-ku, Kawasaki-shi 210-8681, Japan
| | - Atsuko IKEDA
- Institute of Food Sciences and Technologies, Ajinomoto Co.,
Inc., 1-1 Suzuki-cho, Kawasaki-ku, Kawasaki-shi 210-8681, Japan
| | - Ryo UCHIDA
- Institute of Food Sciences and Technologies, Ajinomoto Co.,
Inc., 1-1 Suzuki-cho, Kawasaki-ku, Kawasaki-shi 210-8681, Japan
| | - Ikuko SASAHARA
- Institute of Food Sciences and Technologies, Ajinomoto Co.,
Inc., 1-1 Suzuki-cho, Kawasaki-ku, Kawasaki-shi 210-8681, Japan
| | - Tomoyuki MINE
- Research & Business Planning Department, Ajinomoto Co.,
Inc., 1-15-1 Kyobashi, Chuo-ku, Tokyo 104-8315, Japan
| | - Hitoshi MURAKAMI
- Institute of Food Sciences and Technologies, Ajinomoto Co.,
Inc., 1-1 Suzuki-cho, Kawasaki-ku, Kawasaki-shi 210-8681, Japan
| | - Keishi KAMEYAMA
- Institute of Food Sciences and Technologies, Ajinomoto Co.,
Inc., 1-1 Suzuki-cho, Kawasaki-ku, Kawasaki-shi 210-8681, Japan,aThese authors have contributed equally to this work.
| |
Collapse
|
14
|
Neyrinck AM, Rodriguez J, Taminiau B, Herpin F, Cani PD, Daube G, Bindels LB, Delzenne NM. Constipation Mitigation by Rhubarb Extract in Middle-Aged Adults Is Linked to Gut Microbiome Modulation: A Double-Blind Randomized Placebo-Controlled Trial. Int J Mol Sci 2022; 23:ijms232314685. [PMID: 36499011 PMCID: PMC9738964 DOI: 10.3390/ijms232314685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/17/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
Gut microbiota alterations are intimately linked to chronic constipation upon aging. We investigated the role of targeted changes in the gut microbiota composition in the relief of constipation symptoms after rhubarb extract (RE) supplementation in middle-aged volunteers. Subjects (95% women, average 58 years old) were randomized to three groups treated with RE at two different doses determined by its content of rhein (supplementation of 12.5 mg and 25 mg per day) vs. placebo (maltodextrin) for 30 days. We demonstrated that daily oral supplementation of RE for 30 days was safe even at the higher dose. Stool frequency and consistency, and perceived change in transit problem, transit speed and difficulty in evacuating, investigated by validated questionnaires, were improved in both groups of RE-treated volunteers compared to placebo. Higher abundance of Lachnospiraceae (mainly Roseburia and Agathobacter) only occurred after RE treatment when present at low levels at baseline, whereas an opposite shift in short-chain fatty acid (SCFA) levels was observed in both RE-treated groups (increase) and placebo (decrease). Fecal Lachnospiraceae and SCFA were positively correlated with stool consistency. This study demonstrates that RE supplementation promotes butyrate-producing bacteria and SCFA, an effect that could contribute to relieving chronic constipation in middle-aged persons.
Collapse
Affiliation(s)
- Audrey M. Neyrinck
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Julie Rodriguez
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Bernard Taminiau
- Fundamental and Applied Research for Animal and Health (FARAH), Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium
| | | | - Patrice D. Cani
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium
- WELBIO-Walloon Excellence in Life Sciences and Biotechnology, WELBIO Department, WEL Research Institute, 1300 Wavre, Belgium
| | - Georges Daube
- Fundamental and Applied Research for Animal and Health (FARAH), Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium
| | - Laure B. Bindels
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Nathalie M. Delzenne
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium
- Correspondence:
| |
Collapse
|
15
|
Chen Y, Zhang R, Xu J, Ren Q. Alteration of intestinal microflora by the intake of millet porridge improves gastrointestinal motility. Front Nutr 2022; 9:965687. [PMID: 36071942 PMCID: PMC9442030 DOI: 10.3389/fnut.2022.965687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
Foxtail millet (Setaria italica) has a long history of treating gastrointestinal ailments in China; however, little is known about the functional mechanism driving its therapeutic effects. The primary edible form of millet is porridge. This study investigates the effects of millet porridge on diphenoxylate-induced constipation and intestinal microflora in mice. Fifty mice were randomly divided into five groups: normal control group, constipation model group, and low-dose, medium-dose, and high-dose millet porridge groups. After 14 days of millet porridge gavage, constipation was induced and measured. The results showed that millet porridge prevented constipation by increasing the water content of feces, shortened the time of the first melena defecation, promoted gastric emptying, and improved the rate of gastrointestinal propulsion. Millet porridge also dose-dependently increased levels of Bifidobacterium and Lactobacillus and decreased levels of Escherichia coli, Enterococcus, and Bacteroides in the intestine. These results show that millet porridge could accelerate intestinal motility and change the proportions of intestinal flora and that it has a potent prebiotic effect.
Collapse
Affiliation(s)
- Ying Chen
- School of Light Industry, Beijing Technology and Business University, Beijing, China
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Technology and Business University (BTBU), Beijing, China
| | - Rong Zhang
- Xinjiang Second Medical College, Karamay, China
| | - Jialiang Xu
- School of Light Industry, Beijing Technology and Business University, Beijing, China
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Technology and Business University (BTBU), Beijing, China
| | - Qing Ren
- School of Light Industry, Beijing Technology and Business University, Beijing, China
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Technology and Business University (BTBU), Beijing, China
- *Correspondence: Qing Ren,
| |
Collapse
|
16
|
Vollebregt PF, Wiklendt L, Burgell RE, Chaichanavichkij P, Dinning PG, Knowles CH, Scott SM. Abnormal Perception of Urge to Defecate: An Important Pathophysiological Mechanism in Women With Chronic Constipation. Am J Gastroenterol 2022; 117:1125-1136. [PMID: 35435855 DOI: 10.14309/ajg.0000000000001794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/13/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Although the association of absent or attenuated "call to stool" with constipation is well-recognized, no studies have systematically evaluated the perception of urge to defecate in a well-defined cohort of patients with chronic constipation (CC). METHODS A prospective study of 43 healthy adult women and 140 consecutive adult women attending a tertiary center for investigation of CC. All participants completed a 5-day viscerosensory questionnaire, and all women with CC also underwent anorectal physiologic investigations. Normal urge perception and abnormal urge perception were defined using a Naive Bayes model trained in healthy women (95% having normal urge). RESULTS In total, 181 toilet visits in healthy women and 595 in women with CC were analyzed. Abnormal urge perception occurred in 70 (50.0%) women with CC. In this group, the urge to defecate was more often experienced as abdominal sensation (69.3% vs 41.4%; P < 0.0001), and the viscerosensory referral area was 81% larger (median pixels anterior: 1,849 vs 1,022; P < 0.0001) compared to women with CC and normal urge perception. Abnormal (vs normal) urge in women with CC was associated with more severe constipation (Cleveland Clinic constipation score: 19 vs 15 P < 0.0001), irritable bowel syndrome (45.7% vs 22.9% P < 0.0001), and a functional evacuation disorder on defecography (31.3% vs 14.3% P = 0.023). A distinct pattern of abnormal urge was found in women with CC and rectal hyposensitivity. DISCUSSION Abnormal urge perception was observed in 50% of women with CC and was frequently described as abdominal sensation, supporting the concept that sensory dysfunction makes an important contribution to the pathophysiology of constipation.
Collapse
Affiliation(s)
- Paul F Vollebregt
- National Bowel Research Centre and GI Physiology Unit, Blizard Institute, Centre for Neuroscience, Surgery, and Trauma, Queen Mary University of London, London, UK
| | - Lukasz Wiklendt
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Rebecca E Burgell
- National Bowel Research Centre and GI Physiology Unit, Blizard Institute, Centre for Neuroscience, Surgery, and Trauma, Queen Mary University of London, London, UK
- Department of Gastroenterology, Alfred Health and Monash University, Melbourne, Victoria, Australia
| | - Pam Chaichanavichkij
- National Bowel Research Centre and GI Physiology Unit, Blizard Institute, Centre for Neuroscience, Surgery, and Trauma, Queen Mary University of London, London, UK
| | - Phil G Dinning
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Department of Gastroenterology, Flinders Medical Centre, Adelaide, Australia
| | - Charles H Knowles
- National Bowel Research Centre and GI Physiology Unit, Blizard Institute, Centre for Neuroscience, Surgery, and Trauma, Queen Mary University of London, London, UK
| | - S Mark Scott
- National Bowel Research Centre and GI Physiology Unit, Blizard Institute, Centre for Neuroscience, Surgery, and Trauma, Queen Mary University of London, London, UK
| |
Collapse
|
17
|
Inczefi O, Bacsur P, Resál T, Keresztes C, Molnár T. The Influence of Nutrition on Intestinal Permeability and the Microbiome in Health and Disease. Front Nutr 2022; 9:718710. [PMID: 35548572 PMCID: PMC9082752 DOI: 10.3389/fnut.2022.718710] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 02/22/2022] [Indexed: 01/09/2023] Open
Abstract
The leakage of the intestinal barrier and the disruption of the gut microbiome are increasingly recognized as key factors in different pathophysiological conditions, such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), chronic liver diseases, obesity, diabetes mellitus, types of cancer, and neuropsychiatric disorders. In this study, the mechanisms leading to dysbiosis and "leaky gut" are reviewed, and a short summary of the current knowledge regarding different diseases is provided. The simplest way to restore intestinal permeability and the microbiota could be ideal nutrition. Further therapeutic options are also available, such as the administration of probiotics or postbiotics or fecal microbiota transplantation.
Collapse
Affiliation(s)
- Orsolya Inczefi
- Department of Gastroenterology, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Péter Bacsur
- Department of Gastroenterology, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Tamás Resál
- Department of Gastroenterology, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Csilla Keresztes
- Department for Medical Communication and Translation Studies, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Tamás Molnár
- Department of Gastroenterology, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary,*Correspondence: Tamás Molnár,
| |
Collapse
|
18
|
CHINZON D, CHINZON M. CONSTIPATION. AN OLD NEW PROBLEM. ARQUIVOS DE GASTROENTEROLOGIA 2022; 59:1-2. [DOI: 10.1590/s0004-2803.202200001-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
19
|
Scarpellini E, Ianiro G, Tack J. Editorial: Pharmacological Treatments Affecting Gastro-Intestinal Motility in Man. Front Pharmacol 2022; 12:801136. [PMID: 35126136 PMCID: PMC8807642 DOI: 10.3389/fphar.2021.801136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- E. Scarpellini
- Translational Research Center for Gastrointestinal Diseases (TARGID), University of Leuven, Leuven, Belgium
| | - G. Ianiro
- Internal Medicine and Gastroenterology Unit, Gemelli University Hospital, Rome, Italy
| | - J. Tack
- Translational Research Center for Gastrointestinal Diseases (TARGID), University of Leuven, Leuven, Belgium
- *Correspondence: J. Tack,
| |
Collapse
|
20
|
Hu W, Ying X, Sun J, Fan B, Guo R. Self-administered acupressure for chronic severe functional constipation: A study protocol for a randomized controlled trial. Medicine (Baltimore) 2021; 100:e26349. [PMID: 34160401 PMCID: PMC8238285 DOI: 10.1097/md.0000000000026349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 06/01/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Functional constipation is a disease with a high incidence, which has a bad effect on general health, mental health, and social functioning. However, current treatment is sometimes unsatisfactory. Acupuncture has been proven effective in some randomized controlled trials. Acupressure is a subtype of acupuncture and can be manipulated by the patients at home. But the evidence is limited now. This study aims to provide some strict evidence for the use of self-administered acupressure in the treatment of functional constipation. METHODS This 2-armed, parallel, nonspecific controlled, randomized trial will be conducted at The Third Affiliated Hospital of Zhejiang Chinese Medical University in Hangzhou. A total of 154 FC patients will be enrolled into the acupoint group and the sham acupoint group with a ratio of 1:1 into this trial and it will consist of a 2-week run-in period, an 8-week intervention period, and an 8-week follow-up period. The treatment will be done by the patients themselves at home twice a day and they should sign in on the WeChat APP every day to make sure they have done the acupressure. The outcome will also be collected in WeChat APP through the diary and questionnaires. For the one who is unable to use the WeChat, the print edition of the diary and questionnaires are provided and the supervision will be done by the short message. The primary outcome will be the proportion of participants whose CSBM≥3 during week 3 to 10. The secondary outcome will be the proportion of participants whose CSBM ≥3 between 2 groups in week 11 to 18, Spontaneous bowel movements, Bristol Stool Form Scale, Straining severity scores, Patient assessment of constipation quality of life, and Medicine use. DISCUSSION Acupressure is not an invasive method and can be done by the patient itself at home. We hope this trial will provide credible evidence to the application of self-acupressure for the management of severe chronic functional constipation. TRIAL REGISTRATION This trial has been registered at the Chinese Clinical Trial Registry (ChiCTR2000038594).
Collapse
Affiliation(s)
- Weifeng Hu
- The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University
| | | | | | - Binghua Fan
- The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University
| | - Rubao Guo
- Department of Intervertebral Discs, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China
| |
Collapse
|