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American Family Physician Jun 2002Constipation is the reason for 2.5 million physician visits per year in the United States, with more than one half of these visits to primary care physicians. Patients... (Review)
Review
Constipation is the reason for 2.5 million physician visits per year in the United States, with more than one half of these visits to primary care physicians. Patients and physicians frequently define constipation differently. To determine the underlying cause of constipation, it is important to evaluate the patient's general health, psychosocial status, medical illnesses, dietary fiber intake, and use of constipating medications. The differential diagnosis of constipation and the approach to its evaluation differ in adults and children. Tests of physiologic function are usually reserved for constipation that does not respond to conventional therapy. Family physicians can effectively manage most patients who have constipation.
Topics: Adult; Child; Constipation; Defecation; Diagnosis, Differential; Humans; Physical Examination
PubMed: 12074527
DOI: No ID Found -
Sensors (Basel, Switzerland) Sep 2022(1) Background: Incontinence and its complications pose great difficulties in the care of the disabled. Currently, invasive incontinence monitoring methods are too...
(1) Background: Incontinence and its complications pose great difficulties in the care of the disabled. Currently, invasive incontinence monitoring methods are too invasive, expensive, and bulky to be widely used. Compared with previous methods, bowel sound monitoring is the most commonly used non-invasive monitoring method for intestinal diseases and may even provide clinical support for doctors. (2) Methods: This paper proposes a method based on the features of bowel sound signals, which uses a BP classification neural network to predict bowel defecation and realizes a non-invasive collection of physiological signals. Firstly, according to the physiological function of human defecation, bowel sound signals were selected for monitoring and analysis before defecation, and a portable non-invasive bowel sound collection system was built. Then, the detector algorithm based on iterative kurtosis and the signal processing method based on Kalman filter was used to process the signal to remove the aliasing noise in the bowel sound signal, and feature extraction was carried out in the time domain, frequency domain, and time-frequency domain. Finally, BP neural network was selected to build a classification training method for the features of bowel sound signals. (3) Results: Experimental results based on real data sets show that the proposed method can converge to a stable state and achieve a prediction accuracy of 88.71% in 232 records, which is better than other classification methods. (4) Conclusions: The result indicates that the proposed method could provide a high-precision defecation prediction result for patients with fecal incontinence, so as to prepare for defecation in advance.
Topics: Algorithms; Defecation; Humans; Neural Networks, Computer; Signal Processing, Computer-Assisted; Sound
PubMed: 36146430
DOI: 10.3390/s22187084 -
International Journal of Environmental... Jun 2019Water-, sanitation-, and hygiene-related diseases are killing many people each year in developing countries, including Rwanda, and children under the age of five are the...
Water-, sanitation-, and hygiene-related diseases are killing many people each year in developing countries, including Rwanda, and children under the age of five are the most vulnerable. This research assessed human waste disposal practices, knowledge on diseases caused by contact with human faeces, and knowledge on causes and prevention of selected WASH-related diseases. One thousand one hundred and seventy-three students were interviewed out of 2900 students. The results showed, regarding students' waste disposal practices, that 96.3% use latrines, 20.5% practice open defecation in bushes, and 3.2% defecate in water bodies. Regarding knowledge on diseases caused by contact with human faeces, 56.9% responded that they were aware of cholera, 26.5% of diarrhoea, 2.2% of dysentery, 0.3% of malaria, 0.1% of shigellosis, and 3.8% of typhoid. The majority of the respondents, between 50-99%, could not identify the main causes of the WASH-related diseases. This paper also showed that students lack health knowledge in regard to WASH-related diseases' causes and prevention. Therefore, the provision of water and sanitation infrastructures should go with the provision of health education on how to avoid these diseases and possible ways to improve the well-being of the students both at home and in their various schools.
Topics: Child; Defecation; Developing Countries; Diarrhea; Feces; Female; Health Education; Health Knowledge, Attitudes, Practice; Humans; Hygiene; Male; Refuse Disposal; Rwanda; Sanitation; Schools; Students; Toilet Facilities
PubMed: 31185642
DOI: 10.3390/ijerph16112052 -
Clinical and Translational... May 2021Defecatory disorders including obstructed defecation (OD) are currently diagnosed using specialized investigations including anorectal manometry and the balloon...
INTRODUCTION
Defecatory disorders including obstructed defecation (OD) are currently diagnosed using specialized investigations including anorectal manometry and the balloon expulsion test. Recently, we developed a simulated stool named Fecobionics that provides a novel type of pressure measurements and analysis. The aim was to study OD phenotypes compared with slow transit constipation (STC) patients and normal subjects (NS).
METHODS
Fecobionics expulsion parameters were assessed in an interventional study design. The Fecobionics device contained pressure sensors at the front, rear, and inside a bag. All constipation patients had colon transit study, defecography, anorectal manometry, and balloon expulsion test performed. The Fecobionics bag was distended in the rectum until desire-to-defecate in 26 OD compared with 8 STC patients and 10 NS. Rear-front pressures (preload-afterload parameters) and defecation indices (DIs) were compared between groups.
RESULTS
The Wexner constipation scoring system score was 13.8 ± 0.9 and 14.6 ± 1.5 in the OD and STC patients (P > 0.5). The median desire-to-defecate volume was 80 (quartiles 56-80), 60 (54-80), and 45 (23-60) mL in OD, STC, and NS, respectively (P < 0.01). The median expulsion duration was 37 (quartiles 15-120), 6 (3-11), and 11 (8-11) seconds for the 3 groups (P < 0.03). Fecobionics rear-front pressure diagrams demonstrated clockwise loops with distinct phenotype differences between OD and the other groups. Most DIs differed between OD and the other groups, especially those based on the anal afterload reflecting the nature of OD constipation. Several OD subtypes were identified.
DISCUSSION
Fecobionics obtained novel pressure phenotypes in OD patients. DIs showed pronounced differences between groups. Larger studies are needed on OD subtyping.
Topics: Anal Canal; Bionics; Constipation; Defecation; Feces; Female; Gastrointestinal Transit; Humans; Male; Manometry; Middle Aged; Pressure; Rectum
PubMed: 33949343
DOI: 10.14309/ctg.0000000000000354 -
World Journal of Gastroenterology Sep 2016Obstructed defecation syndrome (ODS) is a functional disorder commonly encountered by colorectal surgeons and gastroenterologists, and greatly affects the quality of... (Review)
Review
Obstructed defecation syndrome (ODS) is a functional disorder commonly encountered by colorectal surgeons and gastroenterologists, and greatly affects the quality of life of patients from both societal and psychological aspects. The underlying anatomical and pathophysiological changes of ODS are complex. However, intra-rectal intussusception and rectocele are frequently found in patients with ODS and both are thought to play an important role in the pathogenesis of ODS. With the development of evaluation methods in anorectal physiology laboratories and radiology studies, a great variety of new operative procedures, especially transanal procedures, have been invented to treat ODS. However, no procedure has been proved to be superior to others at present. Each operation has its own merits and defects. Thus, choosing appropriate transanal surgical procedures for the treatment of ODS remains a challenge for all surgeons. This review provides an introduction of the current problems and options for treatment of ODS and a detailed summary of the essential assessments needed for patient evaluation before carrying out transanal surgery. Besides, an overview of the benefits and problems of current transanal surgical procedures for treatment of ODS is summarized in this review. A report of clinical experience of some transanal surgical techniques used in the authors' center is also presented.
Topics: Anal Canal; Constipation; Defecation; Defecography; Digestive System Surgical Procedures; Female; Humans; Male; Postoperative Complications; Quality of Life; Rectal Diseases; Rectocele; Rectum; Surgical Stapling; Surveys and Questionnaires; Treatment Outcome
PubMed: 27672293
DOI: 10.3748/wjg.v22.i35.7983 -
Medical Humanities Mar 2021This essay focuses on sensory aspects of care in situations surrounding defecation in hospitals and other care institutions. Sensory activity does not merely encompass...
This essay focuses on sensory aspects of care in situations surrounding defecation in hospitals and other care institutions. Sensory activity does not merely encompass pleasant experiences that enhance healing and well-being. Anthropologists-and other disciplines as well-have paid little attention to unpleasant and disgusting experiences that our senses meet and that may rather increase pain and suffering in the context of care. Our essay therefore reflects on a common but highly uncomfortable aspect of being a-sometimes bedridden-patient: defecation. The sensory effects of human defecation are well known. They affect at least four of the five traditional senses. But equally repulsive are the social and emotional effects that defecation in a hospital context has on both patients and professional and other care providers. The essay is based on anthropological observations and the authors' personal experiences in Bangladesh, Ghana and the Netherlands and covers a wide variety of cultural and politicoeconomic conditions. It further draws on (scarce) scientific publications as well as on fictional sources. Extensive quotations from these various sources are presented to convey the lived sensorial experience of disgust and overcoming disgust more directly to the reader.
Topics: Defecation; Emotions; Hospitals; Humans; Netherlands; Sensation
PubMed: 32606069
DOI: 10.1136/medhum-2019-011766 -
Clinical and Translational... May 2022Biofeedback therapy (BFT) is a well-known treatment for functional anorectal disorders. The effect of BFT was monitored in fecal incontinence (FI) patients with the...
INTRODUCTION
Biofeedback therapy (BFT) is a well-known treatment for functional anorectal disorders. The effect of BFT was monitored in fecal incontinence (FI) patients with the Fecobionics test and with the conventional technologies, anorectal manometry (ARM) and balloon expulsion test (BET).
METHODS
Studies were performed in 12 patients before and after 8 weeks of biofeedback training. The Fecal Incontinence Severity Index (FISI) score was obtained. Anal resting and squeeze pressures were measured before the bag was distended in the rectum until urge to defecate. Pressure recordings were made during Fecobionics evacuation.
RESULTS
BFT resulted in 24% reduction in FISI scores (P < 0.01). Seven patients were characterized as responders. Anal pressures, the urge-to-defecate volume, and defecatory parameters did not change significantly during BFT. For ARM-BET, the maximum anal squeeze pressure, the urge-to-defecate volume, and the expulsion time were lower after BFT compared with those before BFT (P < 0.05). For Fecobionics, the change in urge volume (r = 0.74, P < 0.05) and the change in defecation index (r = 0.79, P < 0.01) were associated with the change in FISI score. None of the ARM-BET parameters were associated with the change in FISI score. It was studied whether any pre-BFT data could predict treatment success. The Fecobionics expulsion duration and the defecation index predicted the outcome (P < 0.05). The defecation index had a sensitivity of 100% and a specificity of 72%. None of the ARM-BET parameters predicted the outcome (all P > 0.2).
DISCUSSION
Fecobionics was used as a tool to monitor the effect of BFT and proved better than conventional technologies for monitoring and predicting the outcome in the FISI score.
Topics: Biofeedback, Psychology; Defecation; Fecal Incontinence; Humans; Manometry; Severity of Illness Index
PubMed: 35363631
DOI: 10.14309/ctg.0000000000000491 -
Journal of Dairy Science Jul 2014A better understanding of when and where group-housed calves are most likely to defecate or urinate might permit improved housing design or more efficient use of...
A better understanding of when and where group-housed calves are most likely to defecate or urinate might permit improved housing design or more efficient use of cleaning routines. However, this is the first study to address the urination and defecation habits of calves. The primary aims of this study were to report the daily frequency of calves' urination and defecation and determine when and where group-housed dairy calves defecate and urinate most frequently. We were also interested to see if incidence of urination and defecation changed with increasing age and the change in diet at weaning. We observed 36 female Holstein calves, housed in groups of 9, and fed milk, grain, and hay from automated feeders. For the purposes of another experiment, these calves were assigned to 1 of 3 experimental treatments relating to age at start of weaning and milk allowance: low milk allowance and early weaning (6 L/d, 42 d), high milk allowance and early weaning (12 L/d, 42 d), and high milk allowance and late weaning (12 L/d, 84 d) The occurrence of defecations and urinations was determined by continuous observation of video recordings taken over 72 h at 2 age periods (age, mean ± SD; period 1=32.0 ± 11.13 d and period 2=61 ± 11.29 d). Due to the treatments, weaned and unweaned calves were observed in each period (period 1: 34 unweaned and 2 weaned calves; period 2: 16 unweaned and 20 weaned calves). Large differences were found between calves in mean daily frequency of total urinations and defecations across a 3-d period (mean=17.56 ± 5.07/d, range=4.33 to 28.67). Differences between individual calves did not change significantly over time, provided calves remained unweaned. Two days of observation was sufficient to give a reliable estimate of daily urination and defecation frequency. Frequency of urination and defecations was higher in calves postweaning. Higher age and visits to the milk feeder were associated with a higher frequency of urinations and defecations preweaning. After weaning, frequency of eliminations increased with increasing visits to the water feeder. An effect of time of day was observed, with significantly more events during daylight hours (0600-1800 h) in comparison to night (1800-0600 h). Before weaning, calves urinated and defecated significantly more on slatted flooring and sawdust-bedded areas than within the feeder (daily mean ± SD=6.96 ± 3.15, 6.49 ± 3.90, and 4.10 ± 2.67 for slatted floor, bedded floor, and feeder areas, respectively). Frequency of eliminations in feeders and slatted, but not sawdust-bedded, areas was higher in calves postweaning. Calves urinate and defecate more frequently during daylight hours when they are more active. Slatted flooring around feeders is useful to reduce soiling of bedded areas, particularly as calves increase in age.
Topics: Animals; Behavior, Animal; Cattle; Defecation; Female; Housing, Animal; Milk; Urination; Weaning
PubMed: 24819136
DOI: 10.3168/jds.2013-7558 -
Environmental Science and Pollution... Jun 2022The Swachh Bharat Mission undertaken by the Government of India (GoI) has been successful in accomplishing this objective within a short period thereby catalyzing...
The Swachh Bharat Mission undertaken by the Government of India (GoI) has been successful in accomplishing this objective within a short period thereby catalyzing governance following Sustainable Development Goals (SDGs). It is the responsibility of any democratic nation to ensure that its citizens have universal access to adequate and equitable sanitation. The key approach adapted to igniting a change in sanitation behavior rather than constructing toilets. An effort has been made in the study to affirm that even the marginalized sections of the society residing in tribal communities of West Bengal and Chhattisgarh have benefitted from this Government of India Mission and derived the required benefits. There is enough literature available to support the justification that civil participation holds the key for successful implementation of CLTS thereby making the communities open defecation free (ODF). It is therefore imperative to understand the behavioral transformation that takes place during the CLTS implementation. A hybrid model has been proposed in the study making use of the theory of reasoned action (TRA) and theory of planned behavior (TPB) to understand the pre-adoption and post-adoption behavior of residents. In present study, used model was empirically tested for several hypotheses. The finding reflects towards subjective norms and facilitating conditions as major determinants that ensure the continuation of intention for CLTS. They play a pivotal role in improving the health and hygiene conditions in the region and thus decrease the risk of spread of epidemic diseases.
Topics: Defecation; Humans; Hygiene; Rural Population; Sanitation; Toilet Facilities
PubMed: 35147880
DOI: 10.1007/s11356-022-18854-3 -
The Journal of Physiology Dec 2023Agonists of dopamine D2 receptors (D2R), 5-hydroxytryptamine (5-HT, serotonin) receptors (5-HTR) and ghrelin receptors (GHSR) activate neurons in the lumbosacral...
Agonists of dopamine D2 receptors (D2R), 5-hydroxytryptamine (5-HT, serotonin) receptors (5-HTR) and ghrelin receptors (GHSR) activate neurons in the lumbosacral defecation centre, and act as 'colokinetics', leading to increased propulsive colonic motility, in vivo. In the present study, we investigated which neurons in the lumbosacral defecation centre express the receptors and whether dopamine, serotonin and ghrelin receptor agonists act on the same lumbosacral preganglionic neurons (PGNs). We used whole cell electrophysiology to record responses from neurons in the lumbosacral defecation centre, following colokinetic application, and investigated their expression profiles and the chemistries of their neural inputs. Fluorescence in situ hybridisation revealed Drd2, Ghsr and Htr2C transcripts were colocalised in lumbosacral PGNs of mice, and immunohistochemistry showed that these neurons have closely associated tyrosine hydroxylase and 5-HT boutons. Previous studies showed that they do not receive ghrelin inputs. Whole cell electrophysiology in adult mice spinal cord revealed that dopamine, serotonin, α-methylserotonin and capromorelin each caused inward, excitatory currents in overlapping populations of lumbosacral PGNs. Furthermore, dopamine caused increased frequency of both IPSCs and EPSCs in a cohort of D2R neurons. Tetrodotoxin blocked the IPSCs and EPSCs, revealing a post-synaptic excitatory action of dopamine. In lumbosacral PGNs of postnatal day 7-14 rats, only dopamine's postsynaptic effects were observed. Furthermore, inward, excitatory currents evoked by dopamine were reduced by the GHSR antagonist, YIL781. We conclude that lumbosacral PGNs are the site where the action of endogenous ligands of D2R and 5-HT2R converge, and that GHSR act as a cis-modulator of D2R expressed by the same neurons. KEY POINTS: Dopamine, 5-hydroxytryptamine (5-HT, serotonin) and ghrelin (GHSR) receptor agonists increase colorectal motility and have been postulated to act at receptors on parasympathetic preganglionic neurons (PGNs) in the lumbosacral spinal cord. We aimed to determine which neurons in the lumbosacral spinal cord express dopamine, serotonin and GHSR receptors, their neural inputs, and whether agonists at these receptors excite them. We show that dopamine, serotonin and ghrelin receptor transcripts are contained in the same PGNs and that these neurons have closely associated tyrosine hydroxylase and serotonin boutons. Whole cell electrophysiology revealed that dopamine, serotonin and GHSR receptor agonists induce an inward excitatory current in overlapping populations of lumbosacral PGNs. Dopamine-induced excitation was reversed by GHSR antagonism. The present study demonstrates that lumbosacral PGNs are the site at which actions of endogenous ligands of dopamine D2 receptors and 5-HT type 2 receptors converge. Ghrelin receptors are functional, but their role appears to be as modulators of dopamine effects at D2 receptors.
Topics: Humans; Rats; Animals; Mice; Dopamine; Serotonin; Receptors, Ghrelin; Rats, Sprague-Dawley; Rodentia; Defecation; Ghrelin; Tyrosine 3-Monooxygenase; Receptors, Serotonin; Receptors, Dopamine D2
PubMed: 37772438
DOI: 10.1113/JP285217