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Veterinary Sciences Apr 2024The usefulness of antibiotics in dogs with acute diarrhea (AD) is controversial. It is also unclear what effect metronidazole has on potential enteropathogens such as...
The usefulness of antibiotics in dogs with acute diarrhea (AD) is controversial. It is also unclear what effect metronidazole has on potential enteropathogens such as and . Thus, the aim of this study was to evaluate the effect of metronidazole vs. a synbiotic on the clinical course and core intestinal bacteria of dogs with AD. Twenty-seven dogs with AD were enrolled in this prospective, randomized, blinded clinical trial and treated with either metronidazole (METg) or a synbiotic (SYNg; DSM 10663; NCIMB 10415/4b170). The Canine Acute Diarrhea Severity (CADS) index was recorded daily for eleven days. Bacteria were quantified using qPCR. Data were analyzed using mixed models with repeated measures. A higher concentration of was observed in the METg group vs. the SYNg group on Day 6 ( < 0.0001) and Day 30 ( = 0.01). Metronidazole had no effect on was significantly lower in the METg group than in the SYNg group on Days 6 and 30 ( < 0.0001; = 0.0015). No significant differences were observed in CADS index, fecal consistency, or defecation frequency between treatment groups (except for the CADS index on one single day). In conclusion, metronidazole negatively impacts the microbiome without affecting clinical outcomes. Thus, synbiotics might be a preferred treatment option for dogs with AD.
PubMed: 38787169
DOI: 10.3390/vetsci11050197 -
The Korean Journal of Gastroenterology... May 2024Functional constipation is a common clinical diagnosis that affects approximately 14% of the world's population. Non-pharmacological therapies often represent the... (Review)
Review
Functional constipation is a common clinical diagnosis that affects approximately 14% of the world's population. Non-pharmacological therapies often represent the initial steps in management and may include lifestyle adjustments or changes such as physical activity and diet. Pharmacological options have been used when the non-pharmacological approach has been ineffective. Biofeedback therapy, surgery, sacral nerve stimulation, botulinum toxin injection, and vibrating capsules can be considered in scenarios where the laxatives are ineffective. Biofeedback therapy is highly effective and safe in treating dyssynergic defecation, which affects more than half of patients with chronic constipation. This paper overviews non-pharmacological therapies for functional constipation.
Topics: Constipation; Humans; Chronic Disease; Biofeedback, Psychology; Electric Stimulation Therapy; Botulinum Toxins
PubMed: 38783620
DOI: 10.4166/kjg.2024.044 -
The Korean Journal of Gastroenterology... May 2024Chronic constipation is a common disease that can impair the quality of life, with a prevalence of 14% globally and 16.5% in South Korea. Straining, hard stools, the... (Review)
Review
Chronic constipation is a common disease that can impair the quality of life, with a prevalence of 14% globally and 16.5% in South Korea. Straining, hard stools, the sensation of incomplete evacuation, the sensation of anorectal blockage, and manual maneuvers to facilitate defecation are the related symptoms of chronic constipation. On the other hand, medications commonly referred to as laxatives are the essentials of treatment for constipation compared to non-pharmacological treatment, such as lifestyle modifications, biofeedback, or surgery. Unfortunately, there is still an unmet need to determine if pharmacological treatment for constipation is being administered appropriately. Therefore, there are many disadvantages as to whether the indications and side effects of laxatives are adequately considered and prescribed as the primary treatment modality for constipation in a real clinical situation in Korea. Laxatives are generally recommended as the next step for patients in whom organic causes have been excluded and have not responded to initial non-pharmacologic therapies such as dietary fiber intake and exercise. Laxatives can be classified as bulk-forming laxatives, osmotic laxatives, stimulant laxatives, and other novel laxatives. On the other hand, there are distinct mechanisms underlying constipation, and appropriate administration is the most decisive. Therefore, the present investigators prepared this review to discuss appropriate pharmacological strategies for chronic constipation in Korea. Moreover, this paper also includes suggestions for appropriate pharmacological treatment options for special patient populations.
Topics: Constipation; Humans; Laxatives; Chronic Disease; Dietary Fiber
PubMed: 38783619
DOI: 10.4166/kjg.2024.045 -
The Korean Journal of Gastroenterology... May 2024Patients with chronic constipation (CC) usually complain of mild to severe symptoms, including hard or lumpy stools, straining, a sense of incomplete evacuation after a... (Review)
Review
Patients with chronic constipation (CC) usually complain of mild to severe symptoms, including hard or lumpy stools, straining, a sense of incomplete evacuation after a bowel movement, a feeling of anorectal blockage, the need for digital maneuver to assist defecation, or reduced stool frequency. In clinical practice, healthcare providers need to check for 'alarm features' indicative of a colonic malignancy, such as bloody stools, anemia, unexplained weight loss, or new-onset symptoms after 50 years of age. In the Seoul Consensus on the diagnosis and treatment of chronic constipation, the Bristol stool form scale, colonoscopy, and digital rectal examination are useful for objectively evaluating the symptoms and making a differential diagnosis of the secondary cause of constipation. If patients with CC improve to lifestyle modification or first-line therapies, the effort to determine the subtypes of CC is usually not considered. On the other hand, if conventional therapeutic strategies fail, diagnostic testing needs to be considered to distinguish between the different subtypes of functional constipation (normal-transit constipation, slow transit constipation, or defecatory disorder) because these subtypes of constipation have different therapeutic implications and a correct diagnosis is critical. In the Seoul consensus, physiological testing is recommended for patients with functional constipation who have failed to respond to treatment with available laxatives (for a minimum of 12 weeks and recommended a therapeutic regimen) or who are strongly suspected of having a defecatory disorder. The Seoul consensus contains statements of physiological testing, including balloon expulsion test, anorectal manometry, defecography, and colon transit time.
Topics: Constipation; Humans; Chronic Disease; Manometry; Colonoscopy; Digital Rectal Examination; Defecography; Gastrointestinal Transit
PubMed: 38783618
DOI: 10.4166/kjg.2024.039 -
BMC Pediatrics May 2024Limited data are available regarding the risk factors for fistula-in-ano (FIA) in infants and toddlers, potentially affecting their daily lives.
BACKGROUND
Limited data are available regarding the risk factors for fistula-in-ano (FIA) in infants and toddlers, potentially affecting their daily lives.
OBJECTIVES
The purpose of this study was to identify potential risk factors for FIA in infants and toddlers, in order to implement early preventive interventions, avoid disease progression, and develop therapeutic strategies.
DESIGN AND SETTINGS
A retrospective case-control study was conducted, comparing 41 infants and toddlers diagnosed with FIA with 41 healthy controls, between August 2020 and December 2021.
INDEPENDENT VARIABLES
(a) maternal characteristics during pregnancy and delivery, (b) perinatal characteristics, dietary behaviors, and defecation-related behaviors in infants and toddlers, (c) family dietary behaviors.
RESULTS
Mothers of infants and toddlers with FIA had given birth more times in the past, while the infants and toddlers themselves had less mealtime, a higher rate of exclusive breastfeeding, frequent loose stools, and a larger proportion of used wipes, experiencing perianal skin anomalies. The logistic regression analysis revealed that there are four significant risk factors associated with the development of FIA in infants and toddlers, including the number of previous deliveries by the mother (OR 6.327), defecation frequency score (OR 5.351), stool consistency score (OR 5.017), and cleaning with wipes after defecation (OR 8.089).
CONCLUSION
Based on our data, it appeared that FIA in infants and toddlers could be attributed to several factors. These included an increased number of previous deliveries by mothers, frequent loose stools, and repeated wipe use. To prevent the occurrence and worsening of the disease, it is important to improve the frequency and consistency of stooling and provide proper care. Further research is required to verify these findings in other clinical settings.
Topics: Humans; Infant; Risk Factors; Case-Control Studies; Female; Retrospective Studies; Male; Child, Preschool; Rectal Fistula; Defecation; Breast Feeding; Pregnancy; Infant, Newborn
PubMed: 38783262
DOI: 10.1186/s12887-024-04826-8 -
ENeurologicalSci Jun 2024Constipation is one of the most common non-motor symptoms of Parkinson's disease (PD) and is associated with reduced quality of life in patients with PD. The aim of this...
INTRODUCTION
Constipation is one of the most common non-motor symptoms of Parkinson's disease (PD) and is associated with reduced quality of life in patients with PD. The aim of this study was to evaluate the effect of lactulose on defecation status in patients with PD.
METHODS
In this open-label, single-center, exploratory pilot study, twenty-nine patients with PD received lactulose for three weeks for the treatment of constipation. The primary endpoint was the number of spontaneous bowel movements (SBMs). The secondary endpoints were stool consistency (Bristol Stool Form Scale [BSFS]) and the number of rescue laxatives used.
RESULTS
Twenty-five patients with PD completed the study. The number of SBMs recorded during the lactulose intervention period was significantly increased compared with that recorded during the pre-intervention period. During the intervention period, the BSFS scores of the patients increased significantly, whereas the number of rescue laxatives they used decreased significantly. No serious adverse events were observed during the study period. Lactulose was well-tolerated.
CONCLUSIONS
The results of this study suggest that lactulose may be effective in improving defecation status in patients with PD. Further randomized controlled trials are needed to confirm the effects of lactulose on constipation in patients with PD.
PubMed: 38779414
DOI: 10.1016/j.ensci.2024.100503 -
Journal of Smooth Muscle Research =... 2024Functional bowel disorders (FBD) have a major potential to degrade the standards of public life. Juniperus oxycedrus L. (J. oxycedrus) (Cupressaceae) has been described...
Functional bowel disorders (FBD) have a major potential to degrade the standards of public life. Juniperus oxycedrus L. (J. oxycedrus) (Cupressaceae) has been described as a plant used in traditional medicine as an antidiarrheal medication. The present study is the first to obtain information on the antispasmodic and antidiarrheic effects of J. oxycedrus aqueous extract through in vitro and in vivo studies. An aqueous extract of J. oxycedrus (AEJO) was extracted by decoctioning air-dried aerial sections of the plant. Antispasmodic activity was tested in an isolated jejunum segment of rats exposed to cumulative doses of drogue extract. The antidiarrheic activity was tested using diarrhea caused by castor oil, a transit study of the small intestine, and castor oil-induced enteropooling assays in mice. In the jejunum of rats, the AEJO (0.1, 0.3 and 1 mg/ml) diminished the maximum tone induced by low K (25 mM), while it exhibited a weak inhibitory effect on high K (75 mM) with an IC=0.49 ± 0.01 mg/ml and IC=2.65 ± 0.16 mg/ml, respectively. In the contractions induced by CCh (10 M), AEJO diminished the maximum tone, similar to that induced by low K (25 mM). with an IC=0.45 ± 0.02 mg/ml. The inhibitory effect of AEJO on low K induced contractions was significantly diminished in the presence of glibenclamide (GB) (0.3 µM) and 4-aminopyrimidine (4-AP) (100 µM), with IC values of 1.84 ± 0.09 mg/ml. and 1.63 ± 0.16 mg/ml, respectively). The demonstrated inhibitory effect was similar to that produced by a non-competitive antagonist acting on cholinergic receptors and calcium channels. In castor oil-induced diarrhea in mice, AEJO (100, 200, and 400 mg/kg) caused an extension of the latency time, a reduced defecation frequency, and a decrease in the amount of wet feces compared to the untreated group (distilled water). Moreover, it showed a significant anti-motility effect and reduced the amount of fluid accumulated in the intestinal lumen at all tested doses. These findings support the conventional use of Juniperus oxycedrus L. as a remedy for gastrointestinal diseases.
Topics: Animals; Jejunum; Antidiarrheals; Parasympatholytics; Plant Extracts; Juniperus; Mice; Rats; Diarrhea; Male; Castor Oil; Gastrointestinal Transit; Rats, Wistar; Gastrointestinal Motility; Muscle, Smooth; Muscle Contraction
PubMed: 38777767
DOI: 10.1540/jsmr.60.10 -
PloS One 2024Shorter and longer sleep durations are associated with adverse health consequences. However, available evidence on the association of sleep duration with constipation is...
AIMS
Shorter and longer sleep durations are associated with adverse health consequences. However, available evidence on the association of sleep duration with constipation is limited, especially in patients with diabetes, who are at a high risk of both conditions. This study aimed to examine the association between sleep duration and constipation in patients with type 2 diabetes.
METHODS
A total of 4,826 patients with type 2 diabetes were classified into six groups according to sleep duration: <4.5, 4.5-5.4, 5.5-6.4, 6.5-7.4, 7.5-8.4, and ≥8.5 hours/day. The odds ratios for the presence of constipation, defined as a defecation frequency <3 times/week and/or laxative use, were calculated using a logistic regression model.
RESULTS
Shorter and longer sleep durations were associated with a higher likelihood of constipation than an intermediate duration (6.5-7.4 hours/day). This U-shaped association persisted after adjusting for confounding factors, including lifestyle behavior, measures of obesity and glycemic control, and comorbidities. Broadly identical findings were observed when decreased defecation frequency and laxative use were individually assessed.
CONCLUSIONS
This study shows a U-shaped association between sleep duration and constipation in patients with type 2 diabetes, and highlights the importance of assessing sleep duration in daily clinical practice.
Topics: Humans; Constipation; Diabetes Mellitus, Type 2; Male; Female; Middle Aged; Aged; Sleep; Registries; Japan; Time Factors; Risk Factors; Sleep Duration
PubMed: 38776319
DOI: 10.1371/journal.pone.0302430 -
BMC Public Health May 2024Oxidative stress is closely related to gut health. Exposures to oxidative stress in one's diet and lifestyle can be evaluated by the oxidative balance score (OBS)....
BACKGROUND
Oxidative stress is closely related to gut health. Exposures to oxidative stress in one's diet and lifestyle can be evaluated by the oxidative balance score (OBS). However, the relationship between OBS and intestinal habits is unknown. This study aimed to investigate the relationships between OBS and intestinal habits (chronic diarrhea and chronic constipation) and the underlying mechanisms involved.
METHODS
Using data from the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2010, we included a total of 8065 participants. Twenty dietary and lifestyle factors were selected for the OBS calculates. Chronic constipation and chronic diarrhea were defined using the Bristol stool form scale (BSFS) types 1 and 2 and the BSFS 6 and 7, respectively. Multivariate logistic regression, subgroup analysis, and restricted cubic splines (RCS) analysis were used to evaluate the relationship between OBS and defecation habits. Finally, we used mediation analysis to explore the indirect effects of oxidative stress and inflammatory markers on these associations.
RESULTS
After adjusting for all the covariates, multivariate logistic regression analysis revealed that OBS was negatively correlated with diarrhea (OR = 0.57; 95%CI = 0.39-0.83; P = 0.008)and positively correlated with constipation (OR = 1.75; 95%CI = 1.19-2.25; P = 0.008). The RCS showed a nonlinear relationship between OBS and diarrhea (P for nonlinearity = 0.02) and a linear relationship between OBS and constipation (P for nonlinearity = 0.19). Mediation analysis showed that the C-reactive protein (CRP) concentration and white blood cell (WBC) count mediated the correlation between OBS and diarrhea by 6.28% and 6.53%, respectively (P < 0.05).
CONCLUSIONS
OBS is closely related to changes in patients' defecation habits. Oxidative stress and inflammation may play a role in the relationship between the two. This result emphasizes the importance of the public adjusting their lifestyle and dietary habits according to their own situation. However, further prospective studies are needed to analyze the relationship between oxidative stress and changes in defecation habits.
Topics: Humans; Constipation; Oxidative Stress; Female; Diarrhea; Male; Middle Aged; Adult; Chronic Disease; Nutrition Surveys; Life Style; Aged; Cross-Sectional Studies
PubMed: 38773415
DOI: 10.1186/s12889-024-18683-8 -
International Journal of Surgery Case... Jun 2024Bone hydatidosis is a rare parasitic infection caused by Echinococcus granulosus, with a frequency of 1-2 %, it has a high morbidity and mortality rate due to its long...
INTRODUCTION AND IMPORTANCE
Bone hydatidosis is a rare parasitic infection caused by Echinococcus granulosus, with a frequency of 1-2 %, it has a high morbidity and mortality rate due to its long clinical latency and lack of symptomatic specificity. This often leads to delayed diagnosis and discovery, usually at the stage of complications.
CASE PRESENTATION
We present a case of sacral hydatidosis in a 71-year-old patient with no prior medical history. The symptomatology was a pelvic pain that had been ongoing for 5 months with constipation and difficulty with defecation. The clinical and radiological findings initially suggested a primary or metastatic malignant tumour. The biopsy revealed a multivesicular cystic lesion, indicating a hydatid cyst of the sacrum, confirmed later by anatomopathological examination. The lesion was almost completely removed, drainage was performed and the patient was put on anti-parasitic treatment.
CLINICAL DISCUSSION
The clinical presentation of bone hydatidosis is poor and its course is insidious, which often leads to a delay in diagnosis. Medical imaging can provide a precise assessment of the lesion, allowing for extensive surgical resection to be planned. However, therapeutic methods and health education in endemic countries are still the best measures for limiting the considerable damage caused by this parasite.
CONCLUSION
Hydatid osteopathy is a slow and progressive disease that can be difficult to diagnose early, which can compromise the quality of treatment. Therefore, it is important to focus on preventive measures to eradicate this parasitic infection.
PubMed: 38772245
DOI: 10.1016/j.ijscr.2024.109772