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PubMed2004

During toilet training, constipation occurs before stool toileting refusal.

BACKGROUND: Previous studies demonstrated that constipation and painful defecation are associated with stool toileting refusal (STR), but whether they are the result of STR or occur before this behavior is not known. OBJECTIVE: To determine whether constipation and painful defecation occur as a result of STR or occur before STR. METHODS: Three hundred eighty children between 17 and 19 months of age participated in a prospective longitudinal study of toilet training. Children were monitored with telephone interviews every 2 to 3 months until the completion of daytime toilet training. Information obtained in follow-up interviews included parents' reports on the presence and frequency of hard bowel movements, painful defecation, and child toilet training behaviors. Children were defined as completing daytime toilet training when they were experiencing <4 urine accidents per week and < or =2 episodes of fecal soiling per month. Children were defined as having frequent hard bowel movements if the parents reported a hard bowel movement approximately once per week in > or =2 follow-up telephone interviews or more than once per week in 1 follow-up telephone interview. RESULTS: The mean age at the completion of daytime toilet training was 36.8 +/- 6.1 months (range: 22-54 months). Ninety-three children (24.4%) developed STR. Parents of children who developed STR, in comparison with the rest of the sample, were more likely to report that the child had experienced hard bowel movements (67.7% vs 50.9%), frequent hard bowel movements (29.0% vs 14.3%), and painful defecation (41.9% vs 27.9%). Of the children who experienced both STR and hard bowel movements, 93.4% demonstrated constipation before the onset of STR. In that group, parents reported hard bowel movements at almost one-half of all follow-up telephone interviews before the onset of STR. Of the children who experienced both STR and painful defecation, 74.4% experienced the first episode of painful defecation before the onset of STR. Children with frequent hard bowel movements demonstrated a longer duration of STR (9.0 +/- 6.5 vs 4.8 +/- 3.0 months). CONCLUSIONS: When hard bowel movements or painful defecation is associated with STR, the first episode of constipation usually occurs before the STR. The fact that hard bowel movements frequently occur before the onset of STR suggests that for many of these children constipation is a chronic problem that is not being treated effectively. Therefore, hard bowel movements and painful defecation are factors that potentially contribute to the STR and for the majority of children are not caused solely by the STR behavior. Additional studies are needed to determine whether earlier and more effective treatment of constipation could decrease the incidence of STR.

Child Behavior↗

PubMed1994

Regulation of a periodic motor program in C. elegans.

A three-part motor program mediates a defecation every 45 sec in well-fed wild-type Caenorhabditis elegans. Individual worms maintain this 45 sec rhythm with an SD of about 3 sec. We present evidence that the defecation cycle is controlled by an endogenous clock, most likely a neuronal pattern generator. The phase of the behavioral rhythm can be reset like pattern generators in other animals. The rhythm was reset by stimulating a well-characterized neuronal circuit mediating response to light touch. Also, animals that spontaneously stopped feeding interrupted their defecation rhythms. When they resumed feeding these animals reactivated the motor program in phase with the previously established rhythm, indicating that an endogenous clock continues to run even when the behavior is not expressed. Control of the defecation rhythm is independent of expression of the motor program. Most previously isolated mutations that affect the motor program (Thomas, 1990) do not alter the rhythm of the behavior; the motor steps themselves are defective but not the timing of their activation. Laser kills of identified motor neurons that affect particular parts of the motor program also did not change the defecation rhythm. Another sensory stimulus, food, strongly modulates defecation behavior: animals away from food rarely activated the motor program, and food dilution resulted in a graded lengthening of the cycle period. To elucidate further the relationship between feeding and defecation rhythms we studied a mutation, dec-8(sa200), that caused worms to continue to activate the motor program in the absence of food. The mutant did not require the presence of food to activate the motor program, although food made the rhythm more precise. In the presence of food, dec-8(sa200) animals exhibited tandem activations of the defecation motor program; the principal activation was followed by a more variable second activation. Further experiments suggested that the tandem activations of the motor program are not due to the activity of multiple oscillators.

Activity Cycles↗

PubMed2005

Pelvic organ prolapse in defecatory disorders.

OBJECTIVE: To compare the prevalence of pelvic organ prolapse in subjects with defecatory disorders with that in control subjects. METHODS: In 55 subjects with fecal incontinence, 42 subjects with obstructed defecation, and 45 healthy subjects without defecatory symptoms, a urogynecologist assessed pelvic organ prolapse by the pelvic organ prolapse quantification system, and a gastroenterologist evaluated perineal descent during simulated evacuation. A multiple logistic regression model evaluated whether obstetric-gynecological variables, including pelvic organ prolapse, could discriminate among controls, subjects with fecal incontinence, and subjects with obstructed defecation. RESULTS: Fifty-five percent of controls, 42% of those with obstructed defecation, and 29% of those with fecal incontinence had stage II or greater prolapse by clinical examination. Eleven percent of controls, 7% of those with obstructed defecation, and 47% of subjects with fecal incontinence had a forceps delivery. Eighteen percent of controls, 31% of those with obstructed defecation, and 64% of those with fecal incontinence had a hysterectomy. Even after controlling for a higher prevalence of obstetric risk factors and hysterectomy, fecal incontinence was associated with a lower risk of stage II or greater pelvic organ prolapse (odds ratio for fecal incontinence in > or = stage II pelvic organ prolapse relative to stage 0 pelvic organ prolapse = 0.1, 95% confidence interval 0.01-0.53). In contrast, pelvic organ prolapse severity was not associated with control versus obstructed defecation status. Seven percent of controls, 18% of subjects with obstructed defecation, and 7% of those with fecal incontinence had increased perineal descent during simulated evacuation. Excessive perineal descent was associated (P < .01) with pelvic organ prolapse. CONCLUSION: Despite a higher prevalence of risk factors for pelvic floor injury, pelvic organ prolapse severity was lower in those with fecal incontinence than in subjects without bowel symptoms. However, a subset of subjects with defecatory disorders, predominantly obstructed defecation, have excessive perineal descent, which is associated with pelvic organ prolapse.

Adult↗

PubMed2003

Colonic transit time and rectoanal videomanometry in Parkinson's disease.

BACKGROUND: Constipation is a prominent lower gastrointestinal tract dysfunction that occurs frequently in Parkinson's disease (PD). OBJECTIVE: To investigate colonic transport and dynamic rectoanal behaviour during filling and defecation in patients with PD. METHODS: Colonic transit time (CTT) and rectoanal videomanometry analyses were performed in 12 patients with PD (10 men and 2 women; mean age, 68 years, mean duration of disease, five years; mean Hoehn and Yahr grade, 3; decreased stool frequency (<3 times a week) in six, difficulty in stool expulsion in eight) and 10 age matched normal control subjects (7 men and 3 women; mean age, 62 years; decreased stool frequency in two, difficulty in stool expulsion in two). RESULTS: In the PD patients, CTT was significantly prolonged in the rectosigmoid segment (p<0.05) and total colon (p<0.01) compared with the control subjects. At the resting state, anal closure and squeeze pressures of PD patients were lower than those in control subjects, though not statistically significant. However, the PD patients showed a smaller increase in abdominal pressure on coughing (p<0.01) and straining (p<0.01). The sphincter motor unit potentials of the patients were normal. During filling, PD patients showed normal rectal volumes at first sensation and maximum desire to defecate, and normal rectal compliance. However, they showed smaller amplitude in phasic rectal contraction (p<0.05), which was accompanied by an increase in anal pressure that normally decreased, together with leaking in two patients. During defecation, most PD patients could not defecate completely with larger post-defecation residuals (p<0.01). PD patients had weak abdominal strain and smaller rectal contraction on defecation than those in control subjects, though these differences were not statistically significant. However, the PD patients had larger anal contraction on defecation (p<0.05), evidence of paradoxical sphincter contraction on defecation (PSD). CONCLUSIONS: Slow colonic transit, decreased phasic rectal contraction, weak abdominal strain, and PSD were all features in our PD patients with frequent constipation.

Adult↗

PubMed1997

Symptoms in chronic constipation.

OBJECTIVES: This study was designed to evaluate whether detailed symptom analysis would help to identify pathophysiologic subgroups in chronic constipation. METHODS: In 190 patients with chronic constipation (age, 53 (range, 18-88) years; 85 percent of whom were women), symptom evaluation, transit time measurement (radiopaque markers), and functional rectoanal evaluation (proctoscopy, anorectal manometry, defecography) were performed. Patients were classified on the basis of objective data from all tests in four different groups ("disordered defecation," "slow gastrointestinal transit," "disordered defecation combined with slow-transit stool," and "no pathologic finding"). RESULTS: In 59 percent of patients, disordered defecation was found, and 27 percent had slow-transit stool. In 6 percent of patients, a combination of both was found; in only 8 percent of patients, there were no pathologic findings. Straining was reported by the vast majority in all groups (82-94 percent). Infrequent bowel movements and abdominal bloating were more common in slow-transit stool (87 and 82 percent vs. 69 and 55 percent, respectively; both P < 0.01). Feeling of incomplete evacuation was more common in disordered defecation (84 vs. 46 percent; P < 0.0001). However, specificity of these symptoms was discouraging (for slow-transit stool: infrequent bowel movements had a sensitivity of 87 percent and a specificity of 32 percent and abdominal bloating had a sensitivity of 82 percent and specificity of 45 percent; for disordered defecation: feeling of incomplete evacuation had a sensitivity of 84 percent and a specificity of 54 percent). Only the sense of obstruction and digital maneuvers were acceptably specific (79 and 85 percent, respectively) for disordered defecation, but sensitivity was low. CONCLUSIONS: Definition of chronic constipation by infrequent bowel movements alone is of little value; the symptom "necessity to strain" is much better suited (94 percent sensitivity). Specificity of infrequent bowel movements for slow-transit stool was discouraging. Sense of obstruction and digital manipulation for evacuation are relatively specific for disordered defecation but insensitive. Therefore, symptoms of chronically constipated patients are not well suited to differentiate between the pathophysiologic subgroups suffering chronic constipation.

Adolescent↗

PubMedDate not supplied

Fecoflowmetry: a new parameter assessing rectal function.

Fecoflowmetry is a new technique by which the fecal flow rate is studied through recorded curves representing the changes which occur in the rate against time. Fecal flow rate is the product of rectal detrusor action against outlet resistance. The technique was performed on 36 normal volunteers and 8 chronically constipated patients. A one liter water enema was given to the individual. On feeling the desire to defecate, he or she was placed on the commode of a fecoflowmeter and was asked to defecate. Defecation flow curves were obtained. Evaluation of the curve comprises reporting on the defecated volume, flow time, maximum and mean flow rates and the shape of the curve. The technique was developed to stimulate natural defecation. It provides quantitative and qualitative data concerning the act of defecation. It assesses all objective parameters in one test. The procedure is simple, non-invasive and constitutes a useful screening tool in defecation and rectal disorders.

Adolescent↗

PubMed1995

Biofeedback treatment for chronic constipation and encopresis in childhood: long-term outcome.

OBJECTIVE: Abnormal defecation dynamics often are present in children with chronic constipation and encopresis. Patients who learned normal defecation dynamics with biofeedback treatment had improved short-term outcome. The aim of our research was to evaluate if biofeedback treatment improved long-term outcome. DESIGN: One hundred twenty-nine children with constipation, encopresis, and abnormal defecation dynamics were treated conventionally; 63 of them received additional biofeedback training directed towards teaching normal defecation dynamics. RESULTS: At follow-up (4.1 +/- 1.5 years), 86% of conventionally treated patients and 87% of biofeedback-treated patients had improvement in encopresis; 62% of conventionally treated patients, 50% of successful biofeedback-treated patients, and 23% of unsuccessful biofeedback-treated patients had recovered from chronic constipation and encopresis. Recovery rates were similar for conventionally treated patients and biofeedback-treated patients who learned normal defecation dynamics (P > .2) but significantly lower for unsuccessful biofeedback-treated patients (P < .02). Length of follow-up was significantly related to recovery (P < .01). CONCLUSION: Learning normal defecation dynamics with biofeedback training did not increase long-term recovery rates in children with chronic constipation, encopresis, and abnormal defecation dynamics above those achieved with conventional treatment alone.

Adolescent↗

PubMed1989

Defecometry. A new method for determining the parameters of rectal evacuation.

The parameters of defecation, i.e., maximum rectal pressure increase during straining, duration of effective evacuation, and the work performed to evacuate a simulated stool, can be quantified by defecometry, a new method to evaluate the defecation act. Simultaneous anal pressure records demonstrate the nature of the sphincter activity during simulated defecation. The test was performed on 19 patients with constipation and on 14 controls. Five patients could not evacuate the simulated stool, while five others could, but more laboriously than the remaining nine patients whose defecation was comparable with the controls. Laborious defecation is characterized by longer duration and more performed work during evacuation. Every patient with difficult or ineffective evacuation had sphincter contraction during defecation, whereas this phenomenon was not observed in patients with normal defecation. Defecometry permits more adequate identification and characterization of the outlet-obstruction-type constipated patients than the simple balloon expulsion test and the analysis of sphincter activity during straining with empty rectum in lateral decubitus. Early diagnosis and treatment of patients with outlet obstruction is important to avoid late neuromuscular damage to the pelvic floor.

Adult↗

PubMed1989

A longitudinal survey of self-reported bowel habits in the United States.

Information concerning bowel habits was gathered from a representative sample of 14,407 United States adults in the first National Health and Nutrition Examination Survey in 1971-1975 and approximately 10 years later among the same individuals. The prevalence of self-reported constipation, diarrhea, infrequent defecation (three or fewer bowel movements per week), and frequent defecation (two or more bowel movements per day) increased with aging. Women were more likely than men (P less than 0.05) to report constipation (20.8% compared to 8.0%) and infrequent defecation (9.1% compared to 3.2%). Blacks were more likely than whites to report infrequent defecation (P less than 0.05). Older respondents reporting constipation were more likely to use laxatives or stool softeners than younger respondents reporting constipation, but they were also less likely to have infrequent defecation. To evaluate factors predictive of impaired bowel function, case definitions were created using information concerning complaint of constipation, laxative use, frequency of defecation, and stool consistency. Female gender, black race, fewer years of education, low physical activity, and symptoms of depression were independent risk factors for impaired bowel function. This study provides national estimates of bowel complaints and their natural history and examines possible risk factors for constipation.

Adult↗

PubMed2003

Colorectal motility induction by sacral nerve electrostimulation in a canine model: implications for colonic pacing.

PURPOSE: This study investigated the role of the sacral nerves in the mechanism of defecation using adult mongrel dogs. The possibility of designing a colonic pacemaker as a new therapeutic device to treat defecation disturbances, such as fecal incontinence and severe constipation, is also discussed. METHODS: Colorectal motility during spontaneous defecation was monitored with force strain-gauge transducers implanted in the proximal, distal, and sigmoid colon, rectum, and internal anal sphincter. Under general anesthesia, the sacral nerve was stimulated electrically, and the colorectal motility response was examined. RESULTS: During spontaneous defecation, three characteristic motility patterns were observed: 1) giant migrating contractions of the colon were propagated to the rectum or anus; 2) the rectum relaxed before the giant migrating contractions were propagated; and 3) the internal anal sphincter was relaxed during the propagation of the giant migrating contraction. Sacral nerve stimulation elicited the following three unique responses: 1) contractile movements were propagated from the distal colon to the rectum; 2) a relaxation response was noted in the rectum; and 3) the internal anal sphincter exhibited a relaxation response. The duration and propagation velocity of the contractile responses and the duration of relaxation responses elicited by electrical stimulation of the sacral nerve were similar to those that occurred during spontaneous defecation, but their amplitudes were smaller. CONCLUSION: The coordinated processes of the colon and anorectum during defecation were affected by the sacral nerves. This suggests that it is possible to design a colonic pacemaker to control lower colonic and rectal movements.

Animals↗

PubMed1981

Quantitative measures of aging in the nematode Caenorhabditis elegans. I. Population and longitudinal studies of two behavioral parameters.

As a first step in the quantitative characterization of senescence in the nematode Caenorhabditis elegans, we have studied movement wave frequency, defecation frequency, and whole-body water efflux as a function of age. Populations of C. elegans, strain N2, were cultured monoxenically on E. coli lawns at 20 degrees C. The median lifespan in such populations was approximately 12 days. Population mean movement wave frequency declined linearly with age (slope = -4.66 waves/minute per day). The decline in population mean defecation frequency (defecations per minute) was multiphasic, consisting of (1) a rapid decline (slope = -0.233 defecations/minute per day) from day 3 to day 6, (2) no apparent trend from day 6 to day 9, and (3) a gradual decline (slope = -0.089 defecations/minute per day) from 9 to day 14. Animals alive on or after day 15 were not observed to defecate. In longitudinal studies, individual animals exhibited linear declines in movement wave frequency and multiphasic declines in defecation frequency. For future population studies, the age-dependent declines in movement and defecation frequency appear sufficiently large and reproducible to a multiparametric description of senescence in C. elegans. One physiological parameter, 3H2O efflux, was found to be age-independent and to consist of two first-order rates. The half-times of the slow and fast efflux rates were approximately 15 and approximately 2.1 minutes, respectively. The two half-times and the fractions of 3H2O exhibiting the two half-times were invariant with age.

Aging↗

PubMed1976

A reevaluation of the relation between estrogen and emotionality in female rats.

It has been hypothesized that the emotionality of the female rat is reduced at estrus. In confirmation of previous research, it was found that administration of estradiol benzoate (EB;20 mug/kg) to female rats of the Maudsley Reactive (MR) strain increased open-field activity and decreased open-field defecation. In addition, ovariectomy increased open-field defecation in MR females. Supporting the generality of these findings, hormone administration reduced open-field defecation and increased open-field activity in intact females of a genetically heterogeneous background. Additional studies suggested that the decrease in open-field defecation at estrus is dependent on estrogenic suppression of food intake. Hormone replacement decreased food intake in the period preceding the open-field test, and colonic contents were also lower in rats treated with EB+P (progesterone) immediately after the completion of the open-field test. These changes were seen in both MR and genetically heterogeneous females. It was concluded that the decrease in open-field defecation at estrus may be mediated by a reduction in food intake and a consequent decrease in colonic contents and that the validity of the defecation response as a measure of emotionality may be seriously questioned under these circumstances.

Animals↗

PubMedDate not supplied

Factors responsible for persistence of childhood constipation.

In this study 56% of children with chronic constipation and encopresis were unable to defecate rectal balloons. Most of them had an abnormal contraction of the external and sphincter during defecation trials. Eighty-six percent were still unable to defecate balloons 1 year later after having complied with a conventional treatment program. Only 14% of patients unable to defecate balloons had recovered by 1 year, whereas 64% of patients able to had recovered (p less than 0.02). Only 13% of patients unable to relax the external sphincter had recovered by 1 year, whereas 70% of those able to do so had recovered (p less than 0.01). In addition, none of the patients with an abdominal fecal mass present during the initial examination independent of ability or inability to defecate balloons had recovered (p less than 0.001). This study shows that abnormal defecation dynamics and the severity of constipation are predictors for persistence of chronic constipation and encopresis.

Adolescent↗

PubMed1989

Factors determining outcome in children with chronic constipation and faecal soiling.

To evaluate factors which might contribute to treatment failure in children with chronic constipation and soiling, we evaluated the history, physical findings, defecation dynamics, and anorectal function in 97 patients. We treated them with milk of magnesia, high fibre diet, and bowel training techniques and evaluated outcome at one year when 43% had recovered. Recovery rates were similar for boys and girls. Fifty seven per cent of the patients had not recovered. This group at the outset had more frequent soiling episodes, more severe constipation, were less likely to defecate water filled rectal balloons and to relax the external sphincter during defecation. In general girls had more severe constipation, abdominal pain, and a previous urinary tract infection than boys. Girls were more compliant during treatment and had less frequent soiling episodes at one year. Stepwise logistic regression showed that severe constipation, abnormal contraction of the external sphincter and pelvic floor during attempted defecation, and inability to defecate the 100 ml balloon in less than or equal to 1 min was significantly related to treatment failure. Defecation of smaller balloons, volumes for threshold of rectal sensation, critical volume and rectal contraction, and compliance with treatment could not predict treatment failure.

Adolescent↗

PubMed1977

[Effects of minor tranquilizers and neuroleptics on open-field behavior in rats (author's transl)].

Minor tranquilizers (diazepam, nitrazepam, oxazepam, bromazepam, medazepam, fludiazepam, meprobamate) at low doses increased ambulation score to 145 approximately 288% of control rats. Nitrazepam, diazepam and bromazepam which are potent, clinically prescribed minor tranquilizers increased the ambulation at lower doses than was seen with the other drugs. Fludiazepam and nitrazepam showed a maximum increase in ambulation at the same dose. Fludiazepam, nitrazepam and diazepam proved to have potent inhibitory effects on defecation. Trifluperidol, haloperidol and ID-4708 (a new butyrophenone derivative) and chlorpromazine when given at low doses reduced ambulation, while at higher doses defecation was inhibited. These four drugs reduced ambulation and elicited a recover in rates of defecation in methamphetamine treated rats. Clozapine, thioridazine and floropipamide inhibited defecation at nearly the same doses which reduced ambulation in rats not given the methamphetamine tratment. These three durugs reduced ambulation, but did not produce a recovery in the defecation rates in methamphetamine-treated rats. These results indicate that neuroleptics such as clozapine which rarely induce extrapyramidal side-effects when clinically prescribed, inhibit defecation at nearly the same doses which reduce ambulation. In methamphetamine-treated rats, haloperidol was 31 times more potent than chlorpromazine in inhibiting activity noted with ambulation. This ratio in open-field test was close to the ratio of potency of these drugs as antipsychotic clinically prescribed agents.

Animals↗

PubMed2001

The effect of anorectal manometry on the outcome of treatment in severe childhood constipation: a randomized, controlled trial.

OBJECTIVE: Approximately 50% of constipated children contract rather than relax the external sphincter complex during a defecation attempt. Although biofeedback training (BF) is able to change this defecation behavior, there is no additional effect of BF to conventional treatment (CT) on clinical outcome compared with CT alone. It has been postulated that the absence of a significant difference between these 2 treatment options might be because of a therapeutic, "demystifying" effect of performing anorectal manometry in conventionally treated children, necessary to obtain basal manometric data. The objective of this prospective, controlled, randomized study was to evaluate the effect of CT with 2 anorectal manometry sessions compared with CT alone (dietary advice, diary, toilet training, oral laxatives, and enemas) on clinical outcome. METHODS: A total of 212 constipated children (143 boys) who were visiting a referral pediatric gastroenterologic practice were randomized prospectively to CT alone (115 patients) or to CT combined with 2 manometry sessions (CTM; 97 patients). Patients were included in the study when they fulfilled at least 2 of the 4 following criteria: stool frequency fewer than 3 per week, 2 or more soiling and/or encopresis episodes per week, periodic passage of very large amounts of stool every 7 to 30 days, or a palpable rectal or abdominal fecal mass. CT comprises dietary advice, a daily diary, toilet training, and oral laxative treatment preceded by rectal disimpaction with enemas on 3 consecutive days. During both manometries, the child and the parent could watch the tracing on the computer screen. No explanation was given to either the child or the parents during the procedure. When the procedure was finished, the tracings were clarified. Successful treatment was defined as a defecation frequency of 3 or more per week and fewer than 1 soiling/encopresis episode per 2 weeks and no use of laxatives. RESULTS: Only 4 and 2 children from the CT and CTM groups showed no soiling and/or encopresis, whereas 76% and 65%, respectively, reported the periodic passage of large stools. In 26% and 30% of the patients, a rectal scybalum was found on physical examination. The success rates at 6, 26, 52, and 104 weeks' follow-up were 4%, 24%, 32%, and 43% and 7%, 22%, 30%, and 35% in the CT and CTM group, respectively. No significant difference in success percentage was observed between the 2 groups at any time of follow-up with relative risks (CT/CTM) and 95% confidence intervals, respectively, of 0.55 (0.16-1.89), 1.13 (0.67-1.89), 1.07 (0.69-1.65), and 1.23 (0.81-1.85). A significant increase in defecation frequency was observed between the first (intake) and second visits, which was sustained at all subsequent visits and stages of follow-up in both groups (not significant). Also in relation to the first visit, a significant decrease in encopresis episodes was shown and a further slow but significant decrease at 52 weeks of follow-up in both groups. The manometric data obtained from the CTM group showed a low percentage of children with normal defecation dynamics, namely 28%, which (significantly) increased to 38% at the last manometry. CONCLUSIONS: Anorectal manometry combined with CT compared with CT alone did not result in higher success rates in chronically constipated children. Therefore, anorectal manometry has no additional demystifying or educational effect on clinical outcome in chronically constipated children. This observation together with the observation in the current and previous studies that no correlation was found between (achievement of) normal defecation dynamics and success and that no relation was observed between volume of urge or critical volume and success leaves no diagnostic or therapeutic role for anorectal manometry in chronic constipated children, except its use as a diagnostic test to exclude Hirschsprung's disease. A simple CT is successful in 30% of severely constipated children who are referred to a tertiary hospital, underscoring the importance of long-lasting and adequate laxative treatment.

Adolescent↗

PubMed2000

[Weight of feces and its daily fluctuation in young women. Part 1. A survey of the relation fecal weight and dietary habits and life-styles].

This study investigates the relation of fecal production and dietary habits and life-styles in four 21 to 22 year-old healthy female students. The survey was conducted over 30 days and was repeated twice. All feces that were discharged were collected and weighed. The subjects performed very little physical exercise. The fecal weight, the number of defecations per day, gastrointestinal symptoms, feeling of incomplete defecation and of abdominal distention were recorded. The fecal weight was converted to autocorrelation, and the day-by-day variation was examined by a time series analysis (correlogram). Free access to foods was allowed. The weight of each food item was weighed for nutritional evaluation. The daily number of steps walked and sleeping hours were taken as indicators of life-style. The average fecal weight ranged from 96.8 g/day to 127.8 g/day, with a grand mean for the four subjects of 94.1 g/day. The average number of times of defecation during the 60 days period was 53 to 72, or 0-3 a day. The subjects tended to have feeling of incomplete defecation when the stool was hard and fecal weight was less than 100 g per day, whereas the subjects felt incomplete defecation less frequently when the stool was well-formed or pasty. The time series analysis by correlogram indicates that the variation in fecal weight formed a 3-4 day cycle and that the cycle was irrelevant to fecal weight. This survey shows that there was no apparent correlation among the fecal weight and nutrient intake, the number of meals per day, the number of steps walked or sleeping hours per day. It also indicates that defecation factors differ from individual to individual.

Adult↗

PubMed1979

Induction of intestinal evacuation or vomition (or both) in the dog by prostaglandin F2alpha injection: clinical potential.

Different groups of dogs were given prostaglandin F2alpha IM. The dosage range was between 0.022 and 0.555 mg/kg of body weight. Defecation, including contents from the cranial portion of the large intestine, occurred in 40% to 100% of the dogs within 3.16 to 12.5 minutes after injection depending on dosage administered. Defecation (83.3% of dogs), without vomition, occurred in dogs given a dosage of 0.111 mg/kg. Emesis (87.5% of dogs) and defecation (75.0% of dogs) were observed in dogs given a dosage of greater than or equal to 0.444 mg/kg. Emesis occurred in 1.6 to 2.6 minutes after defecation in dogs given more than 0.444 mg/kg. Latency for emesis response varied between 3.2 and 11.5 minutes. The effect of the drug lasted approximately 15 minutes, with most dogs showing a single episode of defecation or vomition (or both). Besides a marked increase in respiratory rate, side effects were minor. Seemingly, prostaglandin-F2alpha may become the preferred drug for the clinical inducement of vomition and defecation in dogs.

Animals↗