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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 the Experimental Analysis of... Jul 1982Excessive defecation, typically considered to be a concomitant of stress, was experimentally induced or eliminated under specific schedules of positive reinforcement of...
Excessive defecation, typically considered to be a concomitant of stress, was experimentally induced or eliminated under specific schedules of positive reinforcement of lever pressing by rats. The schedules were, by and large, those under which polydipsia is typically induced. In the first of three experiments, rats under fixed-interval 32-second schedules and variable interval 32-second schedules for food and water reinforcers defecated profusely, but not under fixed-interval one-second schedules or other small interval schedules. Somewhat higher rates of defecation were observed on variable interval 32-second schedules than on fixed-interval 32-second schedules. In a second experiment, fixed-ratio schedules were used, some of which resulted in responding such that reinforcement densities were similar to those on the interval schedules that induced defecation. Defecation was not systematically induced by these ratio schedules. In a third experiment, fixed-time schedules of food presentations were utilized. High rates of defecation were induced comparable to those induced by interval schedules of the same time parameter. No other behavior commonly termed "emotional" was observed in any of these experiments.
Topics: Animals; Conditioning, Operant; Defecation; Drinking Behavior; Feeding Behavior; Female; Humans; Male; Rats; Reinforcement Schedule; Reinforcement, Psychology; Stress, Psychological
PubMed: 7202038
DOI: 10.1901/jeab.1982.38-19 -
Tidsskrift For Den Norske Laegeforening... Jun 2010Restorative proctocolectomy and pelvic pouch surgery (construction of a pelvic pouch from intestine) is standard surgical treatment of patients with ulcerative colitis....
BACKGROUND
Restorative proctocolectomy and pelvic pouch surgery (construction of a pelvic pouch from intestine) is standard surgical treatment of patients with ulcerative colitis. It is a surgical approach that has been used for more than 30 years. The goal with this study was to report complications and functional results of restorative proctocolectomy performed by gastric surgeons in a local hospital.
MATERIAL AND METHOD
All patients who had undergone pelvic pouch surgery at Levanger hospital in the period 1989 - 2006 were evaluated. Data were collected through retrospective assessment of journals, and through questionnaires (that the patients were requested to complete) on functioning of the pelvic pouch.
RESULTS
The material consisted of 43 patients with a median follow-up time of 109 months (range 14 - 216). Four (9 %) patients with a non-functioning pelvic pouch were excluded from the analysis of self-defined function. 31 of 39 patients completed the questionnaire. Pouch-related complications were identified in 21(49 %) patients, and 9 (21 %) developed other complications. The mean number of daily defecation was 6 (range 3 - 11) and the mean number of nightly defection was 1 (range 0 - 4). Six (19 %) patients had some type of incontinence problem related to defecation. 29 (94 %) of the 31 patients who completed the questionnaire were content with functioning of their pouch.
INTERPRETATION
Despite the high frequency of both pouch-related and other complications, most patients were content with having a pelvic pouch.
Topics: Adult; Colonic Pouches; Defecation; Fecal Incontinence; Female; Follow-Up Studies; Humans; Male; Middle Aged; Patient Satisfaction; Proctocolectomy, Restorative; Retrospective Studies; Surveys and Questionnaires; Treatment Outcome
PubMed: 20531502
DOI: 10.4045/tidsskr.09.0808 -
Journal of Dairy Science Oct 2011The accumulation of urine and feces can be responsible for many cow and environmental problems. Despite this, little is known about the factors affecting defecation and...
The accumulation of urine and feces can be responsible for many cow and environmental problems. Despite this, little is known about the factors affecting defecation and urination. In the first experiment, the occurrence of defecation and urination behaviors of 48 lactating Holstein cows was observed [days in milk (DIM) = 144.7 ± 38.0 d, body weight (BW) = 667.1 ± 72.0 kg, parity = 2.8 ± 2.3] in freestalls over 48 h. In the second experiment, defecation and urination by 29 lactating Holstein dairy cows were observed (DIM = 62 ± 22.1 d, BW = 590 ± 70.0 kg, parity = 2 ± 1.3) in another freestall barn over a period of 5 d and related to cow activity and feeding behavior. In both experiments, based on total occurrence of eliminative behaviors, cows mainly defecated (experiment 1: 33.4 ± 2.0%; experiment 2: 42.3 ± 3.1%) and urinated (experiment 1: 28.2 ± 2.5%; experiment 2: 42.7 ± 4.0%) in the feed alley and while occupying a stall (defecation: experiment 1: 28.5 ± 1.0%; experiment 2: 26.2 ± 3.0%; urination: experiment 1: 42.2 ± 1.5%; experiment 2: 39.9 ± 3.8%). Occupying a stall included lying, standing in the stall, or standing with 2 feet in the stall and 2 feet in the alley. In both experiments, differences were found between cows in frequency of defecation (experiment 1: 9.8 ± 4.2/d, range = 3 to 20; experiment 2: 15.4 ± 4.3/d, range = 6 to 36) and in frequency of urination (experiment 1: 7.0 ± 3.1/d, range = 2 to 18; experiment 2: 9.3 ± 2.8/d, range = 3 to 19). Large differences between cows were observed in the frequency of defecation and urination, but these were not correlated with parity, milk production, BW, DIM, or dry matter intake.
Topics: Animals; Behavior, Animal; Cattle; Dairying; Defecation; Feeding Behavior; Female; Housing, Animal; Urination
PubMed: 21943740
DOI: 10.3168/jds.2010-4028 -
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 -
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 -
The Western Journal of Medicine Aug 1997Normal pelvic floor function involves a set of learned and reflex responses that are essential for the normal control and evacuation of stool. A variety of functional... (Review)
Review
Normal pelvic floor function involves a set of learned and reflex responses that are essential for the normal control and evacuation of stool. A variety of functional disturbances of the pelvic floor, including incontinence and constipation, are not life threatening, but can cause significant distress to affected patients. Understanding the normal anatomy and physiology of the pelvic floor is essential to understanding and treating these disorders of defecation. This article describes the normal function of the pelvic floor, the diagnostic tools available to investigate pelvic floor dysfunction, and the etiology, diagnosis, and management of the functional pelvic floor disorders that lead to incontinence and constipation.
Topics: Constipation; Defecation; Fecal Incontinence; Feedback; Female; Humans; Male; Pelvic Floor; Prognosis; Reference Values
PubMed: 9291746
DOI: No ID Found -
Ultrasound in Obstetrics & Gynecology :... May 2002
Topics: Adult; Amniotic Fluid; Defecation; Female; Fetus; Humans; Pregnancy; Pregnancy Outcome; Pregnancy Trimester, Third; Ultrasonography, Doppler, Color; Ultrasonography, Prenatal
PubMed: 11982996
DOI: 10.1046/j.1469-0705.2002.00699.x -
International Urogynecology Journal Nov 2022Obstructive defecation syndrome (ODS) is a common urogynaecology presentation. This study compares two questionnaires, the electronic Personal Assessment Questionnaire...
INTRODUCTION AND HYPOTHESIS
Obstructive defecation syndrome (ODS) is a common urogynaecology presentation. This study compares two questionnaires, the electronic Personal Assessment Questionnaire (e-PAQ), used in urogynaecology clinics, with the ODS-Score (ODS-S), a simple validated scoring system used in colorectal clinics for diagnosing ODS, to identify patients with an ODS-S cut-off ≥9.
METHODS
A total of 221 paired ODS-S and e-PAQ questionnaires were completed; 80 during the second trimester of pregnancy, 73 during the third and 68 post-natally, including women sustaining obstetric anal sphincter injury (OASI). e-PAQ score and ODS-S were compared and Pearson's correlation coefficient calculated. Areas under the curve assessed the diagnostic ability of e-PAQ scores to identify patients with ODS-S of ≥9.
RESULTS
The e-PAQ and ODS-S scores showed a positive correlation in the second and third trimesters of pregnancy, post-natally and following OASI. Pearson's correlation coefficient was calculated (0.77; p < 0.001, 0.79; p < 0.001, 0.66; p = 0.001 and 0.79; p < 0.001 respectively). An e-PAQ evacuatory domain score of ≥33 identified women with an ODS score of ≥9 with a sensitivity and specificity of 71% and 94% in the second trimester, 86% and 95% third trimester and 78% and 97% in the OASI group respectively. Area under the curve was >0.90 for all groups.
CONCLUSIONS
Comparison of e-PAQ evacuatory domain scores and ODS-S show a strong correlation, with an e-PAQ score of ≥33 promising for identifying women with an ODS score of ≥9, indicating ODS. This study will enable us to identify women during pregnancy and post-natally with ODS for whom early recognition and intervention may be beneficial.
Topics: Anal Canal; Defecation; Female; Humans; Pregnancy; Sensitivity and Specificity; Surveys and Questionnaires
PubMed: 35267060
DOI: 10.1007/s00192-022-05114-8 -
Neurogastroenterology and Motility Aug 2011Although constipation can be a chronic and severe problem, it is largely treated empirically. Evidence for the efficacy of some of the older laxatives from well-designed... (Review)
Review
BACKGROUND
Although constipation can be a chronic and severe problem, it is largely treated empirically. Evidence for the efficacy of some of the older laxatives from well-designed trials is limited. Patients often report high levels of dissatisfaction with their treatment, which is attributed to a lack of efficacy or unpleasant side-effects. Management guidelines and recommendations are limited and are not sufficiently current to include treatments that became available more recently, such as prokinetic agents in Europe.
PURPOSE
We present an overview of the pathophysiology, diagnosis, current management and available guidelines for the treatment of chronic constipation, and include recent data on the efficacy and potential clinical use of the more newly available therapeutic agents. Based on published algorithms and guidelines on the management of chronic constipation, secondary pathologies and causes are first excluded and then diet, lifestyle, and, if available, behavioral measures adopted. If these fail, bulk-forming, osmotic, and stimulant laxatives can be used. If symptoms are not satisfactorily resolved, a prokinetic agent such as prucalopride can be prescribed. Biofeedback is recommended as a treatment for chronic constipation in patients with disordered defecation. Surgery should only be considered once all other treatment options have been exhausted.
Topics: Chronic Disease; Clinical Trials as Topic; Constipation; Defecation; Europe; Gastrointestinal Agents; Gastrointestinal Transit; Guidelines as Topic; Humans; Laxatives; Patient Satisfaction
PubMed: 21605282
DOI: 10.1111/j.1365-2982.2011.01709.x