SEARCH · PubMed Health

Results for “DEFECATION”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources

PubMed1995

[Abdominal pain and defecation disorders without a known organic origin: importance of the psychodiagnosis].

The authors submitted some children examined in the Division of Pediatric Surgery of the Ospedali Galliera in Genoa to a psychodiagnostic evaluation. They presented abdominal pain and defecation disorders, whose organic etiology was not demonstrated. The psychodiagnostic evaluation, consisting in colloquia, tests, drawings and plays, was completed in 11 of the 28 patients referred. A profoundly disturbed and protagonist mother-child relationship and a frequent "border position" of the father was focused. The symptoms disappeared in 8 of the 11 patients during the diagnostic evaluation, that resulted, its own, therapeutic. 3 patients were treated with psychotherapy and a remarkable improvement at 6 months from the beginning of therapy was noticed. Seventeen patients were lost because they didn't come to the outpatient dates or because they were already followed by other specialists in their residential zones. The authors believe that a psychodiagnostic evaluation is important in children with abdominal pain and defecation disorders whose organic origin has not been demonstrated.

Abdominal Pain↗

PubMedDate not supplied

[Pelvic floor dyssynergia: videoproctographic analysis and pathologic associations in defecation obstruction syndrome].

INTRODUCTION: Pelvic floor dyssynergia is included pathophysiologically in the functional dyschezia group. It is characterized by the paradoxical contraction or lack of relaxation of the puborectal muscle and/or external sphincter during defecation, with consequent functional outlet obstruction. The diagnosis is not always easy because there is no really specific test, nor any diagnostic gold standard; also, many pathophysiologic and epidemiologic findings are still unknown. We tried to define the diagnostic criteria of this condition with the statistical analysis of the main defecographic parameters and to assess the radiologic correlation between functional forms and "mixed" forms, that is those associated with other anorectal disorders. MATERIAL AND METHODS: We reviewed 121 videoproctographic examinations performed January, 1995, to December, 1996, in patients with clinical and instrumental signs suggestive of pelvic floor dyssynergia and compared the findings with those of a control group of 20 patients with no defecation disorders. We also assessed the frequency of the major anorectal disorders associated with pelvic floor dyssynergia relative to the pure form. RESULTS: Initiation time (11 s versus 1 s; p < .05), evacuation time (47 s versus 10 s; p < .01) and the rate of residual contrast material (57 versus 7) were on average greater in dyssynergia patients. These parameters provide important information on the degree and rapidity of rectal voiding. 81% of our dyssynergia patients had rectal voiding time > 30 s, with final residual contrast material 1/3 to 2/3 of the initial volume. Posterior anorectal angle measurements showed significant differences on strain and evacuation and in anorectal angle excursion at rest/on evacuation (4 +/- 17 degrees; p < .01). Anorectal angle excursion < 15 degrees or its paradoxical reduction was associated with anal diameter < 12 mm during voiding in 85% of cases. We subdivided our population into 4 groups: group A (15 patients: median age: 38 +/- 14 years) with dyssynergia only: group B (22 patients; median age: 54 +/- 23 years) with dyssynergia associated with a functional megarectum); group C (66 patients; median age: 52 +/- 14 years) with mixed pathophysiological patterns such as megarectum, rectocele, intrarectal intussusception, mucosal prolapse and perineal descent; group D (18 patients; median age: 52 +/- 16 years) with the same characteristics as in group C but also with hemorrhoids and anal fissures. DISCUSSION AND CONCLUSIONS: At first (digital radiography) and second level (videoproctography), the diagnosis of pelvic floor dyssynergia is based manly on dynamic parameters (initiation and evacuation times) correlated with the residual contrast agent volume. At baseline, the diagnosis is based on the reduced/no excursion of the anorectal angle between rest and evacuation, together with a narrowed anal eanal. The rate of pure pelvic floor dyssynergia was lower (12.4%) than that of the pathophysiologically mixed patterns and the median age of this group of patients was 38 +/- 14 years, which is statistically lower than that of the other groups (52 +/- 14). Comparing the frequency of purely functional forms in the age range < 40 years, we observed a statistically significant difference (p < .001), which suggests that this disorder is always the first cause of the outlet obstruction syndrome.

Adolescent↗

PubMed2001

Prevention of irinotecan (CPT-11)-induced diarrhea by oral alkalization combined with control of defecation in cancer patients.

It has been reported that 7-ethyl-10-[4-(1-piperidino)-1-piperidino]carbonyloxy-camptothecin (CPT-11) and its active metabolite, 7-ethyl-10-hydroxy-camptothecin (SN-38), have absorption characteristics of weakly basic drugs, suggesting that alkalization of the intestinal lumen might reduce reabsorption and its attendant side effects. Furthermore, stasis of stools containing these compounds is thought to induce damage to the intestinal mucosa. The prevention of CPT-11-induced side effects by oral alkalization (OA) combined with control of defecation (CD) was estimated in a case-control study of lung cancer patients. Coinciding with day 1 of CPT-11 infusion and for 4 days thereafter, OA and CD were practiced utilizing orally administered sodium bicarbonate, magnesium oxide, basic water and ursodeoxycholic acid. OA involved the daily use of all four therapeutics, and CD required doses of up to 4.0 g/day of magnesium oxide and 2 L/day of excess basic water. From three ongoing prospective phase I/II studies, we selected 37 consecutive patients who were treated with CPT-11 in combination with cisplatin in the presence of OA and CD (group B). Thirty-two control subjects who were matched to the background characteristics of the case patients were treated with the same regimen in the absence of OA and CD (group A). Toxicities induced by the CPT-11/cisplatin combination were evaluated and analyzed in group A and group B in a case-control format. The use of OA and CD resulted in significantly higher stool pH (p < 0.0001), while reducing the incidence of delayed diarrhea (> or = grade 2: group A 32.3% versus group B 9.4%; p = 0.005), nausea (p = 0.0001), vomiting (p = 0.001) and myelotoxicity, especially granulocytopenia (p = 0.03) and lymphocytopenia (p = 0.034). In addition, dose intensification was well tolerated in patients receiving OA and CD, allowing dose escalation from 35.6 +/- 6.0 to 39.9 +/- 5.6 mg/m(2)/week (p < 0.001). Tumor response rates for non-small cell lung cancer were 59.3% (16/27 patients) in group B compared with 38.5% (10/26 patients) in group A. Multivariate analysis revealed that the risk of CPT-11-induced delayed diarrhea greater than grade 2 was associated with OA and CD (odds ratio for delayed diarrhea, 0.14 with use of OA and CD; 95% confidence interval, 0.05 to 0.4; p = 0.0002) and age (odds ratio, 1.08 per increase in age; 95% confidence interval, 1.02 to 1.15; p = 0.009). OA and CD appear to be useful in preventing the dose-limiting side effects of CPT-11 noted in clinical practice, mainly nausea, vomiting, granulocytopenia and especially delayed diarrhea. Risk factors statistically associated with delayed diarrhea include advanced age and the use of CPT-11 without OA and CD.

Adult↗

PubMed1992

[Electromyography and functional analytic findings in obstructive disorders of defecation. A contribution to the differentiation of neurogenic and myogenic sphincter damage].

The aim of this study was to get further information about functional results in patients with outlet obstruction. We investigated 27 patients (age between 42 and 74 years) by electromyography (EMG), manometry and radiology with contrast-solution. The electromyography, a dynamic investigation method, allows the differentiation between neuronal and muscular malfunctions of the voluntary controlled pelvis muscles. Patients with outlet obstruction should be divided into three groups by EMG diagnosis: One group with neuronal alterations, another group with muscular alterations and one group with neuro-muscular alterations. We obtained marked statistical differences between patients with neuronal or muscular malfunctions in the mean amplitude, the turns per second and the integration of the mean amplitude compared to the control group (14 patients). Patients with only neuronal alterations showed furthermore statistically significant distinctions of the action potential duration from control, whereas the data of patients with muscular malfunctions were significantly different from control in the peak amplitude of the action potentials. 77% of all investigated patients were not able to relax the pelvis muscles during defecation.

Adult↗

PubMed1991

Midbrain stimulation inhibits the micturition, defecation and rhythmic straining reflexes elicited by activation of sacral vesical and rectal afferents in the dog.

Inhibition of the micturition, defecation and rhythmic straining reflexes by midbrain stimulation was compared with the inhibition of the jaw-opening reflex caused by tooth pulp stimulation in decerebrate dogs. All of the reflexes were inhibited by stimulation of the dorsal and ventral periaqueductal gray, dorsal raphe nucleus and central tegmental field with similar threshold intensities. After a hemisection of the spinal cord at the C2 segment, the midbrain stimulation still suppressed the micturition reflex as well as field potential changes which were evoked by stimulation of the pelvic nerve and recorded from the lateral funiculus just caudal to the hemisection, but did not influence the discharges of the vesical branch of the pelvic nerve which were elicited by stimulation of the lateral funiculus just rostral to the hemisection. The results suggest that stimulation of the neural elements in the 4 midbrain areas depresses the ascending activities from vesical and colorectal afferents of the pelvic nerve at the spinal level, and consequently inhibits the pelvic nerve reflexes. Systemic methysergide suppressed midbrain inhibition of the jaw-opening reflex, but did not affect the midbrain inhibition of the pelvic nerve reflexes. Systemic naloxone did not influence midbrain inhibition of the pelvic nerve reflexes or the jaw-opening reflex, but enhanced the micturition and rhythmic straining reflexes. Possible roles of the midbrain inhibition of the pelvic nerve reflexes are discussed.

Analgesia↗

PubMed1984

Defecography: II. Contribution to the diagnosis of defecation disorders.

Our simple method of defecography has proved to be more sensitive than clinical evaluation in the detection and description of defecation disorders. Among the different types of disorders, described on the basis of 144 abnormal defecograms, the most common are rectal intussusception (RI), intraanal rectal intussusception (IRI), external manually (EMRP) or spontaneously (ESRP) reducible prolapses, rectocele, and accentuation of the impression of the puborectalis sling (AIPR). Study of the mean values of the anorectal angle (ARA) (normal mean value = 92 degrees at rest) reveals an increase (p less than 0.05) in the ARA in IRI and ESRP and a decrease (p less than 0.05 at rest, p less than 0.001 at strain) in AIPR. The most striking observation is a highly significant increase (p less than 0.001) in the ARA associated with incontinence.

Adolescent↗

PubMed1993

Defecation syncope secondary to functional inferior vena caval obstruction during a Valsalva maneuver.

This report describes a case of defecation syncope secondary to functional inferior vena cava (IVC) obstruction. Preoperative hemodynamic assessment revealed a marked decrease in blood pressure and IVC obstruction when the patient performed a Valsalva maneuver. The intraoperative approach included continuous hemodynamic monitoring as well as transesophageal ultrasonography to assess IVC patency during surgical mobilization of the IVC. Functional obstruction of the IVC at the diaphragmatic hiatus was identified, and this obstruction was relieved with extensive mobilization of the IVC and right crural myotomy. This report describes an effective surgical approach to a rare functional disorder involving the IVC.

Adult↗

PubMed1985

Disturbances in the defecation mechanism with special reference to intussusception of the rectum (internal procidentia).

Anorectal disorders that disturb normal defecation are described, especially intussusception of the rectum (internal procidentia). A review of 190 patients, half of whom were treated operatively and the other half conservatively, is presented. Diagnostic procedures, symptoms, and indications for operations are evaluated. We believe that intussusception of the rectum is a relatively common cause of difficult emptying of the rectum and, when the correct diagnosis is established, operation presents a fair chance for improvement.

Adult↗

PubMedDate not supplied

A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. IX. Single loop continence: a new theory of the mechanism of anal continence.

The role of the external and internal anal sphincters in the mechanism of anal continence is presented. The external sphincter induces continence by 1) preventing internal sphincter relaxation, what I have called the "voluntary inhibition action," and 2) mechanical compression of the rectal neck and anal canal proper. The mechanism of both actions is described. The internal sphincter plays a significant role not only in involuntary, but also in voluntary, continence. The importance of this role in the correction of anal incontinence is clarified. "Stress defecation," a condition which follows internal sphincter damage, is discussed. A "single loop continence" theory is presented, based on the fact that each of the three loops of the external sphincter has its own innervation, attachment, and direction of muscle bundles; each loop thus acts as a separate sphincter. The clinical application of this theory is presented.

Anal Canal↗

PubMed2006

Defecation disorders: neuromuscular aspects and treatment.

Chronic constipation and fecal incontinence affect 20% of the population and are more prevalent in women, the elderly, those of lower socioeconomic status, and nursing home residents. These disorders pose a significant economic burden and affect quality of life. During the past decade, significant strides have been made in the understanding and treatment of defecation disorders, which have led to real advances in the management of these disorders. These treatments include biofeedback therapy, tegaserod, and lubiprostone for chronic constipation.

Biofeedback, Psychology↗

PubMed1984

A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. Treatment of hemorrhoids: report of a technique.

A technique for the treatment of hemorrhoids has been presented. It is based on a recent study in which the persistence of the anorectal band, a remnant of the anorectal sinus, and failure of rectal neck remodeling are considered responsible for the initiation of the hemorrhoid disease. The constricting effect of the anorectal band on the rectal neck results in elevation of its pressure, straining at defecation, and prolapse of the rectal mucosa. There were 502 patients with third and fourth degree hemorrhoids. The preoperative rectal neck pressure was high in all of them. The technique comprises division of the anorectal band and hemorrhoid ligation. The results were satisfactory, and the complications were negligible. The rectal neck pressure was normalized and straining disappeared. The procedure is simple and easy. Compared with the other techniques for hemorrhoid treatment, it offers the advantage of dealing with the primary etiologic factor.

Adult↗

PubMed1993

Comparison of the effects of trimebutine and YM114 (KAE-393), a novel 5-HT3 receptor antagonist, on stress-induced defecation.

YM114 (KAE-393), (R)-5-[(2,3-dihydro-1-indolyl)carbonyl]-4,5,6,7- tetrahydro-1H-benzimidazole hydrochloride, is a derivative of YM060, a potent 5-HT3 receptor antagonist. We investigated the effects of YM114 on 5-HT3 receptors, both in vitro and in vivo, and on bowel dysfunction induced by restraint stress, 5-HT and thyrotropin-releasing hormone (TRH), and compared them with the effect of trimebutine. YM114 dose dependently inhibited the reduction in heart rate induced by 5-HT (30 micrograms/kg i.v.) in rats (ED50 = 0.31 micrograms/kg i.v.), and the potency of YM114 was almost the same as that of the racemate. The S-form of YM114 also inhibited 5-HT-induced bradycardia, but 1350 times less potent than the R-form. YM114 and its S-form inhibited [3H]GR65630 binding to N1E-115 cell membranes in a concentration-dependent manner with Ki values of 0.341 and 616 nM, respectively, showing the isomeric activity ratio (R-/S-form) of YM114 to be much greater (1800). YM114 antagonized 5-HT-induced depolarization of the nodose ganglion (EC50 = 1.39 nM). Trimebutine (1 mg/kg i.v.) failed to inhibit 5-HT-induced bradycardia, implying that it does not possess 5-HT3 receptor antagonistic activity. YM114 significantly and dose dependently prevented restraint stress-, 5-HT- and TRH-induced increases in fecal pellet output, and restraint stress- and 5-HT-induced diarrhea in rats and mice (ED50 = 6.9, 72.5, 154.6, 9.7 and 52.4 micrograms/kg p.o., respectively). Trimebutine significantly prevented stress- and 5-HT-induced diarrhea (ED50 = 29.4 and 87.3 mg/kg p.o., respectively), but only partially affected stress-, 5-HT- and TRH-induced increases in fecal pellet output. Thus, YM114 is a potent and stereoselective 5-HT3 receptor antagonist with much greater protective effects against stress-induced defecation than trimebutine.

Animals↗

PubMed1994

In utero defecation of the nondistressed fetus: a roentgen study in the goat.

An experimental study was performed to investigate gastrointestinal motility and meconium passage, with simultaneous blood gas measurements, in the fetuses of eight pregnant goats at 110 to 114 days' gestation (full term, 147 to 155 days). With the goats under halothane anesthesia, a nasogastric tube and a heparinized central venous catheter were inserted into the fetuses. 24 hours after surgery, 10 mL of gastric juice from the fetus was replaced with a nonhydrosoluble contrast medium, and serial roentgenograms and blood samples (for pH, PO2, and PCO2 measurement) were taken every 4 hours. All fetuses began to pass the contrast medium into the amniotic cavity within 16 to 22 hours, and central venous blood gas values were normal. The results of this study suggest that the fetus, which urinates routinely, also defecates routinely into the amniotic cavity, even in the absence of distress. The increased incidence of meconium staining in fetal distress conditions may be indicative of impaired clearance of amniotic fluid.

Animals↗

PubMed1995

Behavior of the Roman/Verh high- and low-avoidance rat lines in anxiety tests: relationship with defecation and self-grooming.

The Swiss sublines of Roman high- and low-avoidance (RHA/Verh and RLA/Verh) rats have been selected and bred for rapid (RHA/Verh) vs. extremely poor (RLA/Verh) acquisition of two-way active avoidance. Behavioral and physiological measures of emotionality, or reactivity to stress, appear to be among the most prominent characteristics differentiating both rat lines. The present study shows that RLA/Verh rats are more sensitive, as compared to their RHA/Verh counterparts, to the conflict involved in the shock-induced suppression of drinking paradigm, as well as in a hyponeophagia test. RLA/Verh rats also showed higher defecation values which were significantly correlated with the main hyponeophagia test variables. Likewise, self-grooming was more frequent in RLA/Verh rats than in their RHA/Verh counterparts and showed significant correlations with conflict-related behaviors (i.e., latency to start eating and time spent eating) from the hyponeophagia test. These results give additional support to the contention that RLA/Verh rats present higher anxiety (emotionality) than their RHA/Verh counterparts.

Animals↗

PubMed2004

Use of Rome II criteria in childhood defecation disorders: applicability in clinical and research practice.

OBJECTIVES: To evaluate the prevalence of pediatric functional gastrointestinal disorders with the use of the Rome II criteria and to compare these data with the classic Iowa criteria. STUDY DESIGN: Patients recorded defecation and encopresis frequency. A standard history was taken and a physical examination including a rectal examination was done. The prevalence of both criteria was assessed and compared. RESULTS: One hundred ninety-eight consecutive patients (age, 0.66 to 15.76 years; 131 male subjects) were included. According to the Rome II criteria, 64%, 18%, and 21% of patients fulfilled the criteria for functional constipation, functional fecal retention, and functional nonretentive fecal soiling, respectively. Using the classic criteria, 74% and 18% of patients fulfilled the criteria for pediatric constipation and solitary encopresis, respectively; 16% of the patients fulfilling the pediatric constipation criteria were not recognized by the Rome II constipation criteria. Fair agreement was found between functional nonretentive fecal soiling and solitary encopresis. Encopresis was present in 79% of constipated children. CONCLUSIONS: The Rome criteria are restrictive and exclude several children with constipation. We recommend including encopresis and rectal digital examination and excluding arbitrary age limits and retentive behavior in the revision of the Rome criteria.

Adolescent↗

PubMed1997

Pharmacologically initiated defecation for persons with spinal cord injury: effectiveness of three agents.

OBJECTIVE: To compare the effectiveness of hydrogenated vegetable oil-based bisacodyl (HVB) suppositories, polyethylene glycol-based bisacodyl (PGB) suppositories, and polyethylene glycol-based, glycerine, docusate sodium mini-enemas (TVC) in subjects with upper motor neuron spinal cord lesions. STUDY DESIGN: Prospective randomized double blind. Fifteen subjects received one of 3 HVB and 3 PGB suppositories in randomized sequence for each of six scheduled bowel care sessions. Additionally, 10 subjects received 3 TVC. The analysis used timed events that divided the bowel care sessions into discrete intervals. The analysis also compared digital simulations, incontinence, and quantity of stool. Wilcoxon rank sum tests and paired t tests were used to compare the means of intervals during bowel care initiated by HVB, PGB, and TVC. RESULTS: (means in minutes and p values): Time to Flatus-HVB, 32; PGB, 15; TVC, 15; p < .026, HVB-PGB; p < .983, PGB-TVC; Flatus to Stool Flow-HVB, 6.7; PGB, 5.5; TVC, 3.9; p < .672, HVB-PGB; p < .068, PGB-TVC; Defecation Period-HVB, 36; PGB, 20; TVC, 17; p < .037, HVB-PGB; p < .479, PGB-TVC; Wait Until Transfer-HVB, 10.9; PGB, 10.7; TVC, 7.4; p < .932, HVB-PGB; p < .043, PGB-TVC; Total Time for the bowel program-HVB, 74.5; PGB, 43; TVC, 37; p < .010, HVB-PGB; p < .458, PGB-TVC; percent incidence of incontinence between bowel care sessions-HVB, .067; PGB, .067; TVC, .033; p < 1.0, HVB-PGB; p < .678, PGB-TVC; amount of stool produced-HVB, 3.30; PGB, 3.49; TVC, 3.38; p < .276, HVB-PGB; p < .630, PGB-TVC; average number of digital stimulations per bowel care procedure-HVB, 4.4; PGB, 4.1; TVC, 3.8; p < .411, HVB-PGB; p < .293, PGB-TVC; time per digital stimulation in seconds-HVB, 107; PGB, 40; TVC, 83; p < .149, HVB-PGB; p < .352, PGB-TVC; and the total time, in minutes, spent performing digital stimulations during bowel care-HVB, 10.0; PGB, 2.7; TVC, 5.9; p < .151, HVB-PGB; p < .325, PGB-TVC. CONCLUSION: Bowel care took less time when initiated with the PGB bisacodyl suppository or TVC mini-enema as compared with the HVB bisacodyl suppository (p < .01).

Adult↗

PubMed2005

[Anatomy and physiology of continence and defecation].

Continence and defecation are two essential functions in humans. Any alteration resulting in anal incontinence and/or constipation can severely impair the patient's quality of life. This study analyzes the anatomical structures and physiologic mechanisms accepted as factors involved in the correct development of both functions, while recognizing that there are still many unclear issues within this complex and sometimes paradoxical structure/function of the human body.

Anal Canal↗

PubMed2004

SHN-1, a Shank homologue in C. elegans, affects defecation rhythm via the inositol-1,4,5-trisphosphate receptor.

Protein localization in the postsynaptic density (PSD) of neurons is mediated by scaffolding proteins such as PSD-95 and Shank, which ensure proper function of receptors at the membrane. The Shank family of scaffolding proteins contain PDZ (PSD-95, Dlg, and ZO-1) domains and have been implicated in the localizations of many receptor proteins including glutamate receptors in mammals. We have identified and characterized shn-1, the only homologue of Shank in Caenorhabditis elegans. The shn-1 gene shows approximately 40% identity over 1000 amino acids to rat Shanks. SHN-1 protein is localized in various tissues including neurons, pharynx and intestine. RNAi suppression of SHN-1 did not cause lethality or developmental abnormality. However, suppression of SHN-1 in the itr-1 (sa73) mutant, which has a defective inositol-1,4,5-trisphosphate (IP(3)) receptor, resulted in animals with altered defecation rhythm. Our data suggest a possible role of SHN-1 in affecting function of IP(3) receptors in C. elegans.

Adaptor Proteins, Signal Transducing↗