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Pediatric Surgery International Jun 2024The objective was to compare the immediate effects of pharmacological versus physiotherapy intervention versus a combination of physiotherapy and pharmacological... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
The objective was to compare the immediate effects of pharmacological versus physiotherapy intervention versus a combination of physiotherapy and pharmacological treatment, as well as the quality of life and the recurrence of symptoms in children with functional constipation after 3 months.
METHODS
A total of 69 children with functional constipation between the ages of 5 and 14 years of either gender were assessed and randomly assigned to one of three groups: Group A, B, and C. Visual Analogue Scale, Bristol Stool Form Scale, frequency of defecation, PedsQL GI symptom scale, and PedsQL Generic Core Scale were used as outcome measures. Pharmacology was used to treat Group A, physiotherapy was used to treat Group B, and a combination of both was used to treat Group C.
RESULTS
The study revealed statistically significant results on Visual Analogue Scale, Bristol Stool Form Scale, and frequency of defecation in all groups. However, no significant changes were observed on the PedsQL GI symptom scale and the Generic Core scale in Group A, whereas significant changes were observed in Groups B and C.
CONCLUSION
In this study, we found that there were significant differences in the short- and long-term effects across all groups. More changes occurred in Group C than in Groups A and B.
Topics: Humans; Constipation; Female; Male; Child; Child, Preschool; Adolescent; Quality of Life; Physical Therapy Modalities; Treatment Outcome; Defecation; Combined Modality Therapy
PubMed: 38824249
DOI: 10.1007/s00383-024-05733-w -
Clinica Chimica Acta; International... Jun 2024Irritable bowel syndrome (IBS) is a chronic gastrointestinal (GI) disorder characterized by altered bowel habits and abdominal discomfort during defecation. It... (Review)
Review
Irritable bowel syndrome (IBS) is a chronic gastrointestinal (GI) disorder characterized by altered bowel habits and abdominal discomfort during defecation. It significantly impacts life quality and work productivity for those affected. Global data suggests a slightly higher prevalence in females than in males. Today, unambiguous diagnosis of IBS remains challenging due to the absence of a specific biochemical, histopathological, or radiological test. Current diagnosis relies heavily on thorough symptom evaluation. Efforts by the Rome committees have established standardized diagnostic criteria (Rome I-IV), improving consistency and clinical applicability. Recent studies in this framework, seem to have successfully employed metabolomics techniques to identify distinct metabolite profiles in breath and stool samples of IBS patients, differentiating them from healthy controls and those with other functional GI disorders, such as inflammatory bowel disease (IBD). Building on this success, researchers are investigating the presence of similar metabolites in easily accessible biofluids such as urine, potentially offering a less invasive diagnostic approach. Accordingly, this review focuses on key metabolites specifically detected in IBS patients' biological specimens, with a focus on urinary metabolites, using various methods, particularly mass spectrometry (MS)-based techniques, including gas chromatography-MS (GC-MS), liquid chromatography-tandem MS (LC-MS/MS), and capillary electrophoresis-MS (CE-MS) metabolomics assays. These findings may make provision for a new set of non-invasive biomarkers for IBS diagnosis and management.
Topics: Irritable Bowel Syndrome; Humans; Biomarkers; Metabolomics
PubMed: 38821336
DOI: 10.1016/j.cca.2024.119753 -
Acta Tropica Aug 2024In Mexico, more than 30 species of triatomines, vectors of Trypanosoma cruzi, the etiological agent of Chagas disease, have been collected. Among them, Triatoma...
Behavioral and biological parameters of six populations of Triatoma pallidipennis (Heteroptera: Reduviidae) from areas with high and low prevalence rates of Trypanosoma cruzi human infection.
In Mexico, more than 30 species of triatomines, vectors of Trypanosoma cruzi, the etiological agent of Chagas disease, have been collected. Among them, Triatoma pallidipennis stands out for its wide geographical distribution, high infection rates and domiciliation. Local populations of triatomines have shown notable biological and behavioral differences, influencing their vectorial capacity. Six behaviors of epidemiological importance, namely, egg-to-adult development time, median number of blood meals to molt to the next instar, instar mortality rates, aggressiveness (delay in initiating a meal), feeding time and defecation delay, were evaluated in this study for six populations of T. pallidipennis. Those populations from central, western and southern Mexico were arranged by pairs with a combination of high (HP) and medium (MP) of Trypanosoma cruzi human infection and most (MFC) and low (CLF) collection frequencies: HP/MFC, HP/CLF, and MP/MFC. The development time was longer in HP/CLF populations (> 220 days). The median number of blood meals to molt was similar (7-9) among five of the six populations. Mortality rates were greater (> 40 %) in HP/CLF and one MP/MFC populations. All studied populations were aggressive but exhibited slight differences among them. The feeding times were similar (≥ 10 min) for all studied populations within instars, increasing as instars progressed. An irregular pattern was observed in defecation behaviors, with marked differences even between the two populations from the same pair. High percentages of young (57.3-87.9 %), and old (62.4-89.8 %) nymphs, of female (61.1-97.3 %) and male (65.7-93.1 %) of all the studied populations defecated quickly (while eating, immediately after finishing feeding or < 1 min postfeeding). Our results indicate that the HP/MFC populations are potentially highly effective vectors for transmitting T. cruzi infections, while HP/CLF populations are potentially less effective vectors T. cruzi infections.
Topics: Animals; Triatoma; Chagas Disease; Mexico; Female; Trypanosoma cruzi; Insect Vectors; Humans; Male; Feeding Behavior; Prevalence; Defecation
PubMed: 38821148
DOI: 10.1016/j.actatropica.2024.107259 -
JMIR Research Protocols May 2024The population is constantly aging, and most older adults will experience many potential physiological changes as they age, leading to functional decline. Urinary and...
Finite Element Analysis of Pelvic Floor Biomechanical Models to Elucidate the Mechanism for Improving Urination and Defecation Dysfunction in Older Adults: Protocol for a Model Development and Validation Study.
BACKGROUND
The population is constantly aging, and most older adults will experience many potential physiological changes as they age, leading to functional decline. Urinary and bowel dysfunction is the most common obstacle in older people. At present, the analysis of pelvic floor histological changes related to aging has not been fully elucidated, and the mechanism of improving intestinal control ability in older people is still unclear.
OBJECTIVE
The purpose of this study is to describe how the finite element method will be used to understand the mechanical characteristics of and physiological changes in the pelvic cavity during the rehabilitation process, providing theoretical support for the mechanism for improving urination and defecation dysfunction in older individuals.
METHODS
We will collect magnetic resonance imaging (MRI) and computed tomography (CT) data of the pelvic cavity of one male and one female volunteer older than 60 years and use the finite element method to construct a 3D computer simulation model of the pelvic cavity. By simulating different physiological states, such as the Valsalva maneuver and bowel movement, we will verify the accuracy of the constructed model, investigate the effects of different neuromuscular functional changes, and quantify the impact proportions of the pelvic floor muscle group, core muscle group, and sacral nerve.
RESULTS
At present, we have registered the study in the Chinese Clinical Trial Registry and collected MRI and CT data for an older male and an older female patient. Next, the construction and analysis of the finite element model will be accomplished according to the study plan. We expect to complete the construction and analysis of the finite element model by July 2024 and publish the research results by October 2025.
CONCLUSIONS
Our study will build finite element models of the pelvic floor of older men and older women, and we shall elucidate the relationship between the muscles of the pelvic floor, back, abdomen, and hips and the ability of older adults to control bowel movements. The results of this study will provide theoretical support for elucidating the mechanism for improving urination and defecation dysfunction through rehabilitation.
TRIAL REGISTRATION
Chinese Clinical Trial Registry ChiCTR2400080749; https://www.chictr.org.cn/showproj.html?proj=193428.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
DERR1-10.2196/56333.
Topics: Humans; Male; Female; Finite Element Analysis; Pelvic Floor; Aged; Biomechanical Phenomena; Defecation; Middle Aged; Urination; Magnetic Resonance Imaging; Computer Simulation
PubMed: 38820582
DOI: 10.2196/56333 -
Journal of Wound, Ostomy, and...This purpose of this study was to evaluate the effect of pelvic floor muscle exercises (PFMEs) on bowel evacuation problems and health-related quality of life (HRQOL)... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
This purpose of this study was to evaluate the effect of pelvic floor muscle exercises (PFMEs) on bowel evacuation problems and health-related quality of life (HRQOL) following ostomy closure.
DESIGN
Randomized controlled trial.
SUBJECTS AND SETTING
Forty individuals following ostomy closure consented to participate in the study; 6 participants (15%) did not complete the trial (2 died and 2 required a second ostomy) yielding a study sample of 34. Participants were randomly allocated to an Exercise Group (EG, n = 17) and Control Group (CG, n = 17). The mean age of the EG was 55.7 (SD 12.6) years, whereas the mean age of the CG was 62.0 (SD 12.1) years. The study setting was the surgery clinic of 4 hospitals in Ankara, Turkey. Data were collected between December 2018 and May 2020.
METHODS
The study intervention, PFME training by a clinician, was administered to participants in the EG; CG participants received no information regarding PFME. Data were collected during face-to-face interviews on the day before discharge and by phone at the first, second, third, and sixth months after surgery. A questionnaire was used for data collection that queried a demographic and pertinent clinical questions, along with the Assessment Form for Bowel Evacuation Habits and Psychosocial Problems, Wexner Scale, and the Short Form (SF-36) Health-related Quality of Life Scale. Descriptive statistics and Mann-Whitney U test, t-test, Pearson-χ2 test, Fisher's Exact test, Friedman test, and Cochran-Q test statistical analysis according to normal distribution were used in data evaluation.
RESULTS
The number of defecations in the EG was statistically significantly lower than the CG at the second, third, and sixth months (P = .002, P = .002, P = .001, respectively). In addition, the number of individuals experiencing night defecation was statistically significantly less in the EG compared to the CG at the second-, third-, and sixth-month follow-ups (P = .001, P = .001, P = .028, respectively). HRQOL scores were also significantly higher in the EG.
CONCLUSION
Pelvic floor exercises applied after ostomy closure are effective in reducing bowel evacuation and increasing quality of life. Given these findings, PFMEs are recommended for patients after ostomy closure.
Topics: Humans; Quality of Life; Female; Middle Aged; Male; Pelvic Floor; Turkey; Aged; Exercise Therapy; Ostomy; Adult; Defecation; Surveys and Questionnaires
PubMed: 38820220
DOI: 10.1097/WON.0000000000001084 -
European Journal of Pediatrics May 2024The purpose of this study is to describe the defecation pattern of healthy infants up to 17 weeks of age. We included 1052 healthy term infants from the prospective...
The purpose of this study is to describe the defecation pattern of healthy infants up to 17 weeks of age. We included 1052 healthy term infants from the prospective HELMi cohort (NCT03996304). Parents filled in recurring online questionnaires on feeding, gastrointestinal function, and crying weekly for the first 17 weeks of life. Defecation frequency was highest at the age of 3 weeks (a median of 4 times/day, interquartile range (IQR) 2.9-5). At each time point, the median defecation frequency of breastfed infants was higher than that of infants receiving formula (e.g., at week 17 a median of 2 times/day, IQR 0.9-3.6, and a median of 1.1, IQR 0.6-1.4, respectively). The dominant color of the stool was most often yellow or light brown. Nearly black stools were reported in the first week of life in 3.4%. Nearly half (47.4%) of the infants had green stool color dominating for at least 1 week, with comparable frequency among breastfed (47.7%) and formula-fed (45.2%) infants. Green stools were associated with a higher defecation frequency (linear mixed-effect model p < 0.0001). Occasional blood in stool was reported in 9.3% and recurrent blood in 5.2% of the infants with no difference in stool consistency. Hard stools were rare (≤ 1%). Conclusion: This study enlightens the spectrum of defecation patterns in healthy term infants during the first 17 weeks of life. A better understanding of bowel function helps healthcare professionals distinguish normal from abnormal when addressing defecation, the color of stools, and the type of feeding. What is Known: • Breastfed infants have more frequent and more yellow-colored stools than formula-fed infants. • Stools with green color are often suggested by the parents or even by medical professionals to indicate disease or discomfort in early life. What is New: • Nearly half of the healthy term infants had green stool dominating for at least one week during the first 17 weeks and occasional blood was reported in almost 10% of the infants during this period. • Data on normal variation in bowel function and stool may serve primary health care professionals when educating the families and caretakers of infants.
PubMed: 38819500
DOI: 10.1007/s00431-024-05625-0 -
Advances in Neonatal Care : Official... Jun 2024The incidence of neonatal hyperbilirubinemia in Europe and the United States is estimated to be 3.2 and 4.4 per 10,000 live births, respectively. Abdominal massage for... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The incidence of neonatal hyperbilirubinemia in Europe and the United States is estimated to be 3.2 and 4.4 per 10,000 live births, respectively. Abdominal massage for hyperbilirubinemia is considered a safe complementary treatment for infants that may increase number of defecations and decrease bilirubin levels.
PURPOSE
This study was designed as a randomized controlled trial to determine the effect of abdominal massage on bilirubin levels in term infants receiving phototherapy.
METHODS
The sample consisted of 43 term newborns (intervention group: 23; control group: 20) who received phototherapy in a university hospital between June 2019 and February 2021. Information and observation forms were used for data collection. The intervention group received 6 abdominal massages over 2 days, performed 3 times a day, 6 hours apart, and lasting 5 minutes each.
RESULTS
Transcutaneous bilirubin levels and heart rate were significantly lower in the intervention group than in the control group at 48 hours (P = .015 and P = .033, respectively). Number of defecations was higher in the intervention group at 24 hours (P = .007) but there was no significant difference at 48 hours. The decrease in serum bilirubin between 24 and 48 hours was significantly greater in the intervention group (P = .005).
IMPLICATION FOR PRACTICE AND RESEARCH
Abdominal massage was effective in reducing bilirubin levels and may increase the number of defecations. Providing massage training to the parents of infants who are discharged early could be a protective approach to prevent the rise in bilirubin levels.
Topics: Humans; Massage; Infant, Newborn; Bilirubin; Phototherapy; Female; Male; Hyperbilirubinemia, Neonatal; Abdomen
PubMed: 38815281
DOI: 10.1097/ANC.0000000000001149 -
Inflammatory Bowel Diseases May 2024
PubMed: 38811018
DOI: 10.1093/ibd/izae118 -
Caspian Journal of Internal Medicine 2024Flaxseed powder seems to improve bowel movements in these patients. Therefore, this study compares the effects of flaxseed powder and magnesium hydroxide on bowel...
BACKGROUND
Flaxseed powder seems to improve bowel movements in these patients. Therefore, this study compares the effects of flaxseed powder and magnesium hydroxide on bowel movements of acute myocardial infarction patients hospitalized in ICU.
METHODS
The population of the present parallel randomized controlled clinical trial included 70 acute myocardial infarction patients hospitalized in ICU who had no history of chronic constipation. The patients in the intervention group were given three sachets of flaxseed powder (each sachet was 3 g) twice a day for four days. The patients in the control group were given 20 cc of magnesium hydroxide syrup each morning. The Bristol scale was used to describe stool consistency.
RESULTS
The mean and standard deviation of the number of bowel movements within five days after intervention are 1.86 ± 1.08 and 1.6 ± 0.65 in the intervention and the control groups, respectively. The frequency of normal stool consistency of the first bowel movement is 94.3% for the intervention group and 85.7% for the control group, which shows no significant differences between the two groups in terms of stool consistency and bowel movement frequency (P=0.510). The bowel movements started on average after 35.2±97.97 hours in the flaxseed group and 24.771±2.677 hours in the magnesium hydroxide group (P=0.023).
CONCLUSION
The results showed that flaxseed powder increases bowel movement frequency and improves the patients' stool consistency, but the differences between the two groups are insignificant. Finally, the time to the first defecation was shorter in the magnesium hydroxide group.
PubMed: 38807721
DOI: 10.22088/cjim.15.2.234 -
Journal of Tropical Medicine 2024Diarrhea continues to be one of the top causes of death in children under the age of five, particularly in developing nations. In Ethiopian traditional medicine, a...
Diarrhea continues to be one of the top causes of death in children under the age of five, particularly in developing nations. In Ethiopian traditional medicine, a variety of medicinal plants are used to treat diarrhea. One of these plants is (Loes.) Sebsebe (fam. Celastraceae), which is endemic to the Afromontane forests, especially along forest margins, of Ethiopia. The air-dried powdered leaves of were macerated with 80% methanol to yield a crude extract. Additionally, the powdered plant material underwent sequential solvent extraction using chloroform, methanol, and water to obtain solvent fractions. The 80% methanol leaf extract, solvent fractions, and an isolated compound from were evaluated for their antidiarrheal activity using castor oil-induced diarrheal model, anti-enteropooling test, and charcoal meal test in mice. The results showed that the 80% methanolic leaf extract significantly reduced the onset of diarrhea, the weight of feces, and the frequency of defecation in all the tested doses. The methanol and water fractions of the hydroalcoholic extract also exhibited dose-dependent antidiarrheal activity, with the methanol fraction showing the highest activity at 400 mg/kg dose. Subsequently, the most active methanol fraction was subjected to C-18 solid phase extraction, resulting in the isolation of a 3-hydroxyflavone, identified as quercetin by ESI-qToF-MS, H, and C-NMR spectroscopic techniques. Quercetin demonstrated a strong antidiarrheal activity in a dose-dependent manner. Thus, the present study provided evidence that the leaves of possess genuine antidiarrheal activity upholding the traditional medicinal use of the plant for the treatment of diarrhea. The findings also suggest that quercetin is responsible, in full or in part, for the activity of the plant.
PubMed: 38803577
DOI: 10.1155/2024/5922487