慢性便秘和慢病管理

Behavioral analysis of mental and psychological abnormalities and their significance in rats with functional constipation

AIM

To observe, compare, and analyze the behavior of rats with functional constipation and evaluate the psycho-logical basis for their behavior.

METHODS

Sixty SD rats with a male-female ratio of 1:1 were randomly and equally divided into three groups: a severe constipation group, a mild constipation group, and a control group. Constipation was induced in rats by intragastric administration of compound diphenoxylate. The difference between the severe constipation group and mild constipation group was the severity of constipate symptoms, which was caused by the difference in the dose of compound diphenoxylate used. The weight and defecation of each group were recorded after constipation was modeled successfully. Behaviors of all the groups were assessed by the empty bottle stress test (aggression, modification, and exploration), elevated plus-maze test (anxiety), and sucrose preference test (depression). The data obtained were then statistically analyzed.

RESULTS

In the empty bottle stress test, neither aggressive behavior nor modified behavior in both mild and severe constipation rats had a significant change compared with the control group; however, exploratory behavior showed a statistical change which seemed to be related with the severity of symptoms. No significant difference was observed among all groups in the elevated plus-maze test. As to the sucrose preference test, the sugar water consumption and preference degree of rats with severe constipation were significantly lower than those of the control group, while no difference was observed between the mild constipation group and control group.

CONCLUSION

The severity of constipate symptoms might be related to the dosage of modeling drugs. Also, the severity of symptoms is positively correlated with the behavioral abnormality. However, the behavioral performance of constipation rats is complicated, and the psychological state is generally inclined to depression.

Efficacy of chronic disease management in chronic constipation patients with different ages

AIM

To assess the efficacy of chronic disease management (CDM) in chronic constipation (CC) patients with different ages.

METHODS

Seven hundred and sixteen patients with CC treated at the First Hospital of Shanxi Medical University were divided into young, middle-aged and elderly groups according to age and asked to complete a questionnaire, based on which we designed a comprehensive management plan for patients with individual characteristics. A concept called "CDM" was used to give individualized interventions involving diet, exercise, and defection management. The patients were followed for a total of 6 mo (28 d per month), and during this period, a "defecation dairy" was performed to record the symptoms. Bowel symptoms, concomitant symptoms, laxative use and symptom improvement were compared and evaluated before and after the intervention.

RESULTS

After intervention, the defecation frequency, fecal character and the degree of difficulty in defecation were improved significantly (P < 0.01); concomitant symptoms in young and middle-aged patients were relieved (P < 0.05), but the elderly group had no significant changes (P > 0.05); laxative dependence was significantly lower (P < 0.01); and constipation was significantly improved (P < 0.05).

CONCLUSION

Individualized intervention based on CDM mode can effectively relieve bowel symptoms and concomitant symptoms, reduce laxative use, and improve constipation in patients with CC.