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Journal of Advanced Research Jan 2022Defecation is a complex process that is difficult to study and analyze directly. In anorectal disease conditions, the defecation process may be disturbed, resulting in...
INTRODUCTION
Defecation is a complex process that is difficult to study and analyze directly. In anorectal disease conditions, the defecation process may be disturbed, resulting in symptoms including fecal incontinence and constipation. Current state-of-the-art technology measures various aspects of anorectal function but detailed analysis is impossible because they are stand-alone tests rather than an integrated multi-dimensional test.
OBJECTIVES
The need for physiologically-relevant and easy-to-use diagnostic tests for identifying underlying mechanisms is substantial. We aimed to advance the field with integrated technology for anorectal function assessment.
METHODS
We developed a simulated stool named Fecobionics that integrates several tests to assess defecation pressures, dimensions, shape, orientation and bending during evacuation. A novelty is that pressures are measured in axial direction, i.e. in the direction of the trajectory. Using this novel tool, we present new analytical methods to calculate physiologically relevant parameters during expulsion in normal human subjects.
RESULTS
Data are reported from 28 human subjects with progressively more advanced versions of Fecobionics. A new concept utilizes the rear-front pressure (preload-afterload) diagram for computation of novel defecation indices. Fecobionics obtained physiological data that cannot be obtained with current state-of-the-art technologies.
CONCLUSION
Fecobionics measures well known parameters such as expulsion time and pressures as well as new metrics including defecation indices. The study suggests that Fecobionics is effective in evaluation of key defecatory parameters and well positioned as an integrated technology for assessment of anorectal function and dysfunction.
Topics: Anal Canal; Constipation; Defecation; Humans; Manometry; Rectum
PubMed: 35003792
DOI: 10.1016/j.jare.2021.05.005 -
Journal of Insect Physiology Jan 2019Feces provides information about the donor and potentially attracts both conspecifics and predators and also parasites. The excretory system must be coordinated with...
Feces provides information about the donor and potentially attracts both conspecifics and predators and also parasites. The excretory system must be coordinated with other behaviors in insects. We found that crickets started walking forward following defecation. Most intact crickets walked around the experimental arena, stopped at a particular site and raised their bodies up with a slight backward drift to defecate. After the feces dropped to the floor, a cricket started walking with a non-coordinated gait pattern away from the defecation site, and then changed to a tripod gait. To demonstrate that walking is a reflex response to defecation we analyzed the behavior of headless crickets and found that they also showed walking following defecation. In more than half of defecation events, headless crickets walked backwards before defecation. The posture adopted during defecation was similar to that of intact crickets, and forward walking after defecation was also observed. The frequency of forward walking after defecation in headless crickets was greater than in intact crickets. The gait pattern during forward walking was not coordinated and never transitioned to a tripod gait in headless crickets. In animals whose abdominal nerve cords were cut, in any position, pre- or post-defecation walking was not shown in either intact or headless crickets, although they defecated. These results indicated that the terminal abdominal ganglion receives information regarding hind gut condition. It also indicated that ascending signals from the terminal abdominal ganglion initiated leg movement through the neuronal circuits within the thoracic ganglia, and that descending signals from the brain must regulate the leg motor circuit to express the appropriate walking gait.
Topics: Animals; Defecation; Gryllidae; Walking
PubMed: 30468738
DOI: 10.1016/j.jinsphys.2018.11.004 -
Techniques in Coloproctology May 2021Defecation is a complex process and up to 25% of the population suffer from symptoms of defecatory dysfunction. For functional testing, diagnostics, and therapy of...
BACKGROUND
Defecation is a complex process and up to 25% of the population suffer from symptoms of defecatory dysfunction. For functional testing, diagnostics, and therapy of anorectal disorders, it is important to know the optimal defecation position. is The aim of this study was to evaluate defecation pressure patterns in side lying, seated and squatting defecation positions in normal subjects using a simulated stool device called Fecobionics.
METHODS
The Fecobionics expulsion parameters were assessed in an interventional study design conducted from May 29 to December 9 2019. Subjects were invited to participate in the study through advertisement at The Chinese University of Hong Kong. The Fecobionics device consisted of a core containing pressure sensors at the front (caudal end) and rear (cranial end) and a polyester-urethane bag spanning most of the core length which also contained sensors. The Fecobionics bag was distended to 50 ml in the rectum of normal subjects (no present and past symptoms of defecatory disorders, no prior abdominal surgery, medication or chronic diseases). Studies were done in side lying (left lateral recumbent position), seated (hip flexed 90°) and squatting position (hip flexed 25°). Pressure endpoints including the rear-front pressure diagram and defecation indices were compared between positions.
RESULTS
Twelve subjects (6 females/6 males, mean age 26.3 ± 2.6 [19.0-48.0] years) were included and underwent the planned procedures. The resting anal pressure for side lying and seated positions were 33.1 ± 4.1 cmHO and 37.1 ± 4.0 cmHO (p > 0.3). The anal squeeze pressure for side lying and seated positions were 98.4 ± 6.9 cmHO and 142.3 ± 16.4 cmHO (p < 0.05). The expulsion duration for the side lying, seated and squatting positions were 108.9 ± 8.3 s, 15.0 ± 2.1 s and 16.1 ± 2.9 s, respectively (p < 0.01 between lying and the two other positions). The maximum evacuation pressure for seated and squatting were 130.1 ± 12.4 cmH2O and 134.0 ± 11.1 cmHO (p > 0.5). Rear-front pressure diagrams and distensibility indices demonstrated distinct differences in pressure patterns between the side lying position group and the other positions.
CONCLUSIONS
The delay in expelling the Fecobionics device in the lying position was associated with dyssynergic pressure patterns on the device. Quantitative differences were not found between the seated and squatting position. Trial Registration http://www.clinicaltrials.gov Identifier: NCT03317938.
Topics: Adult; Anal Canal; Constipation; Defecation; Female; Humans; Male; Manometry; Rectal Diseases; Rectum; Young Adult
PubMed: 33779850
DOI: 10.1007/s10151-021-02439-2 -
Canadian Journal of Gastroenterology &... 2018Functional dyspepsia (FD) is a common functional gastrointestinal disorder with pain or discomfort in the upper abdomen as the main characteristic. The prevalence of FD... (Review)
Review
Functional dyspepsia (FD) is a common functional gastrointestinal disorder with pain or discomfort in the upper abdomen as the main characteristic. The prevalence of FD worldwide varies between 5% and 11%. This condition adversely affects attendance and productivity in the workplace. Emerging evidence is beginning to unravel the pathophysiologies of FD, and new data on treatment are helping to guide evidence-based practice. In order to better understand the pathophysiologies of FD and explore better treatment options, various kinds of animal models of FD have been developed. However, it is unclear which of these models most closely mimic the human disease. This review provides a comprehensive overview of the currently available animal models of FD in relationship to the clinical features of the disease. The rationales, methods, merits, and disadvantages for modelling specific symptoms of FD are discussed in detail.
Topics: Animal Feed; Animals; Defecation; Disease Models, Animal; Dyspepsia; Gastric Emptying; Gastrointestinal Agents; Laparotomy; Stress, Psychological
PubMed: 29623262
DOI: 10.1155/2018/1531958 -
Pediatric Surgery International Dec 2023To investigate the correlation between postoperative feeding intolerance and defecation, with a view to carrying out prognostic assessment and timely intervention for...
PURPOSE
To investigate the correlation between postoperative feeding intolerance and defecation, with a view to carrying out prognostic assessment and timely intervention for the recovery of postoperative gastrointestinal function.
METHODS
The 114 neonates with congenital intestinal atresia who underwent primary anastomosis admitted to Shenzhen Children's Hospital from January 2014 to December 2022 were studied, and the patients' basic information, intraoperative conditions, postoperative feeding and defecation, and hospitalization time were retrospectively analyzed.
RESULTS
The risk factors for feeding intolerance after primary anastomosis for intestinal atresia are the gestational days, the time of the first postoperative defecations, the number of defecations on the previous day and the average number of defecations before feeding.
CONCLUSION
The incidence of postoperative feeding intolerance is higher in preterm infants, and pediatricians can decide the timing of breastfeeding on the basis of the patients' defecation. The focus on accurate defecation may be more meaningful in determining and predicting postoperative feeding intolerance in the infants.
Topics: Infant; Child; Female; Infant, Newborn; Humans; Infant, Premature; Defecation; Intestinal Atresia; Retrospective Studies; Infant, Newborn, Diseases; Anastomosis, Surgical
PubMed: 38133659
DOI: 10.1007/s00383-023-05603-x -
Scientific Reports Jun 2022Defecatory disorders including fecal incontinence (FI) are diagnosed on the symptom pattern supplemented by anorectal manometry (ARM), the balloon expulsion test (BET),...
Defecatory disorders including fecal incontinence (FI) are diagnosed on the symptom pattern supplemented by anorectal manometry (ARM), the balloon expulsion test (BET), and endo-anal ultrasonography. In this study, we used a simulated stool named Fecobionics to study distinct defecation patterns in FI patients using preload-afterload diagrams and to provide comparative data on defecation indices (DIs) between passive and urge incontinent patients. All subjects had Fecobionics, endo-anal ultrasonography and ARM-BET done. The Fecobionics bag was distended in rectum until urge in 37 female patients (64.1 ± 1.5 yrs) and a group of normal subjects (NS, 12F, age 64.8 ± 2.8 yrs). Rear-front pressure (preload-afterload) diagrams and DIs were compared between groups. The FISI score in the patients was 8.6 ± 0.6. The NS did not report FI-related symptoms. All patients and NS defecated Fecobionics and ARM-BET within 2 min. The urge volume was 46.1 ± 3.6 and 35.3 ± 5.9 mL in the FI and normal groups (P > 0.1). The expulsion duration was 14.8 ± 2.4 and 19.8 ± 5.1 s for the two groups (P > 0.1). The preload-afterload diagrams demonstrated clockwise loops that clearly differed between the FI subtypes and NS. The DIs showed profound difference between patients and NS. Fecobionics data showed higher correlation with symptoms in FI patients than ARM-BET. Fecobionics obtained novel pressure signatures in subtypes of FI patients and NS. Fecobionics provides DI data that cannot be obtained with ARM-BET.
Topics: Aged; Anal Canal; Defecation; Fecal Incontinence; Female; Humans; Manometry; Middle Aged; Rectum
PubMed: 35732729
DOI: 10.1038/s41598-022-14919-y -
Neurogastroenterology and Motility Oct 2020Symptoms such as a feeling of incomplete evacuation, straining, absence of the call to stool, anal blockage, or digitation suggest the presence a functional defecation... (Review)
Review
Symptoms such as a feeling of incomplete evacuation, straining, absence of the call to stool, anal blockage, or digitation suggest the presence a functional defecation disorder. As symptoms do not distinguish between patients with and without functional defecation disorder, Rome IV criteria recommend that this disorder is diagnosed when two of three tests are positive: balloon expulsion test (BET), anorectal manometry (ARM), and defecography. However, previous studies have demonstrated that the agreement among these tests is limited. In this issue of Neurogastroenterology and Motility, Sharma et al tested the hypothesis that conducting the ARM in a seated position would increase the diagnostic accuracy of the test in discriminating between patients with normal and prolonged BET. This minireview discusses the current knowledge on the role of the techniques to diagnose defecation disorder and the potential role of the ARM in a seated position.
Topics: Anal Canal; Constipation; Defecation; Defecography; Diagnostic Tests, Routine; Humans; Manometry; Rectum; Sitting Position
PubMed: 32990409
DOI: 10.1111/nmo.14001 -
Digestive Diseases and Sciences Mar 2022
Topics: Constipation; Defecation; Fecal Incontinence; Humans
PubMed: 34008113
DOI: 10.1007/s10620-021-07019-w -
American Journal of Primatology Feb 2022To define the chances of a dispersed seed to produce a new recruit, it is essential to consider all stages of the dispersal process. Howler monkeys are recognized to...
To define the chances of a dispersed seed to produce a new recruit, it is essential to consider all stages of the dispersal process. Howler monkeys are recognized to have positive impacts on forest regeneration, acting as primary dispersers. Furthermore, dung beetles attracted to their feces protect the seeds against predators, and provide a better microenvironment for germination due to the removal of fecal matter, to seed burial, and/or by reducing the spatial aggregation of seeds in fecal clumps. Despite the recognized positive effects of primary seed dispersal through defecation by howler monkeys for plant recruitment, there are some important aspects of their behavior, such as the habit of defecating in latrines, that remain to be explored. Here, we investigated the fate of Campomanesia xanthocarpa seeds defecated by brown howlers, Alouatta guariba clamitans, and the secondary seed dispersal by dung beetles, considering how this process is affected by the monkey's defecation patterns. We found that brown howler monkeys dispersed seeds from several species away from fruit-feeding trees, partly because defecation under the canopy of such trees was not very frequent. Instead, most defecations were associated with latrines under overnight sleeping trees. Despite a very similar dung beetle community attracted to howler feces in latrines and fruit-feeding sites, seeds were more likely to be buried when deposited in latrines. In addition, C. xanthocarpa seeds showed higher germination and establishment success in latrines, but this positive effect was not due to the presence of fecal matter surrounding seeds. Our results highlight that A. guariba clamitans acts as a legitimate seed disperser of C. xanthocarpa seeds in a preserved context of the Brazilian Atlantic Forest and that defecations in latrines increase the dispersal effectiveness.
Topics: Alouatta; Animals; Defecation; Feeding Behavior; Seed Dispersal; Seeds; Trees
PubMed: 34878682
DOI: 10.1002/ajp.23354 -
Journal of Feline Medicine and Surgery Feb 2022Changes in bowel movements (BMs) are an important clinical sign in many diseases, including chronic kidney disease (CKD), and the purpose of this study was to collect...
OBJECTIVES
Changes in bowel movements (BMs) are an important clinical sign in many diseases, including chronic kidney disease (CKD), and the purpose of this study was to collect information on BMs and fecal scores in both apparently healthy and CKD cats. A secondary aim was to assess owner awareness of BM frequency.
METHODS
Owners were asked to complete an initial online questionnaire about their cat's health and litter box habits (including predicted BM frequency and fecal scores) and were then asked to clean the box daily for 7 days and report results (observed frequency of BMs and fecal scores) daily. Differences in BM frequency and fecal scores between apparently normal and CKD cats were compared using the Mann-Whitney test, and predicted vs observed data were compared using the Wilcoxon signed rank test. Difference in percentage of cats defecating more or less than once daily were assessed with Fisher's exact test.
RESULTS
Survey data from 124 owners of apparently healthy cats and 43 owners of CKD cats who submitted two or more days of daily observations (in addition to the initial questionnaire) were analyzed. Eighty-five percent of apparently healthy cats were observed to defecate one or more times per day and 15% defecated less than once per day. Fifty-eight percent of CKD cats defecated one or more times per day and 42% defecated less than once per day. A significantly higher percentage of CKD cats defecated less than once per day in comparison with apparently healthy cats ( <0.0001). Observed BM frequency was significantly less in CKD cats compared with healthy cats ( = 0.02). Observed fecal scores were not significantly different between healthy and CKD cats.
CONCLUSIONS AND RELEVANCE
The observed BM frequency of cats with CKD was less than apparently healthy cats and represents a clinically important variation from normal.
Topics: Animals; Behavior, Animal; Cat Diseases; Cats; Defecation; Feces; Renal Insufficiency, Chronic; Surveys and Questionnaires
PubMed: 34013812
DOI: 10.1177/1098612X211012684