• Title/Summary/Keyword: Bowel management

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Second Asian Consensus on Irritable Bowel Syndrome

  • Gwee, Kok Ann;Gonlachanvit, Sutep;Ghoshal, Uday C;Chua, Andrew SB;Miwa, Hiroto;Wu, Justin;Bak, Young-Tae;Lee, Oh Young;Lu, Ching-Liang;Park, Hyojin;Chen, Minhu;Syam, Ari F;Abraham, Philip;Sollano, Jose;Chang, Chi-Sen;Suzuki, Hidekazu;Fang, Xiucai;Fukudo, Shin;Choi, Myung-Gyu;Hou, Xiaohua;Hongo, Michio
    • Journal of Neurogastroenterology and Motility
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    • v.25 no.3
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    • pp.343-362
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    • 2019
  • Background/Aims There has been major progress in our understanding of the irritable bowel syndrome (IBS), and novel treatment classes have emerged. The Rome IV guidelines were published in 2016 and together with the growing body of Asian data on IBS, we felt it is timely to update the Asian IBS Consensus. Methods Key opinion leaders from Asian countries were organized into 4 teams to review 4 themes: symptoms and epidemiology, pathophysiology, diagnosis and investigations, and lifestyle modifications and treatments. The consensus development process was carried out by using a modified Delphi method. Results Thirty-seven statements were developed. Asian data substantiate the current global viewpoint that IBS is a disorder of gut-brain interaction. Socio-cultural and environmental factors in Asia appear to influence the greater overlap between IBS and upper gastrointestinal symptoms. New classes of treatments comprising low fermentable oligo-, di-, monosacharides, and polyols diet, probiotics, non-absorbable antibiotics, and secretagogues have good evidence base for their efficacy. Conclusions Our consensus is that all patients with functional gastrointestinal disorders should be evaluated comprehensively with a view to holistic management. Physicians should be encouraged to take a positive attitude to the treatment outcomes for IBS patients.

Comparison of the Effects of Abdominal Massage and Lower Extremity Exercise using Survival Analysis in Rehabilitation Patients of Brain Injury (생존분석을 이용한 복부마사지와 하지관절운동의 뇌병변 재활환자 배변완화시기 효과 비교)

  • Young-Ji, Kim;Dong-Soon, Shin;Sung-Lim, Kim;Kyu-Ock, Park;Na-Ryeong, Do
    • Journal of Industrial Convergence
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    • v.21 no.2
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    • pp.25-32
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    • 2023
  • Constipation is the most common digestive disorder, and it occurs frequently in the early stages and affects the prognosis on rehabilitation stage in the patients with brain injury. The purpose of this study is to evaluate the bowel habits of brain-injured patients undergoing enteral nutrition immediately after admission to rehabilitation and transmission, and to investigate the effects of abdominal massage and lower extremity exercise. The study design is a quasi-experimental study to investigate the effect of a bowel care intervention (abdominal massage and lower extremity exercise) applicable to patients with brain lesions. As a result of the study, the number of bowel movements was significantly higher in the intervention group (p=.030), and the use of suppositories in the control group was statistically significantly higher than that in the intervention group (p=.004). The time of constipation relief was 1.73 days for the experimental group and 4.61 days for the control group, indicating that there was a difference in the time of constipation relief between the two groups (p<.001). Abdominal massage and lower extremity exercise were effective as nursing interventions to relieve constipation and prevent constipation in patients with brain injury from the early stage of rehabilitation.

A Study on Irritable Bowel Syndrome and Sleep Quality of Dental Hygiene Students (일부 지역 치위생과 학생의 과민성 장 증후군과 수면의 질에 관한 연구)

  • Kim, Mi-Jeong
    • Journal of dental hygiene science
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    • v.14 no.1
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    • pp.22-28
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    • 2014
  • This research aimed to understand the relevance between irritable bowel syndrome (IBS) and sleep quality for dental hygiene students in certain areas. It was conducted on 344 students from four universities in Jeollabuk-do from May to September 2013 using a structured questionnaire. The following are the results. 57.6% of the IBS bowel movement conditions were mixed type, 10.5% constipation type, 7.6% uncategorized, and 6.1% diarrhea type. For sleep quality based on the subjects' general characteristics, third years were 11.45, second years 10.90, and first years 9.53 (p=0.034). The sleep quality was statistically significantly lower as the years increased, and even for IBS (p=0.026), it was low and showed a significant difference. For difference in sleep quality based on IBS presence, habitual sleep efficiency, sleeping pill dosage (p=0.043), and day time functional disorder (p=0.007) showed statistically significant differences and lower sleep quality than the control group. For difference in sleep quality based on IBS bowel movement condition, mixed type was the highest for sleep disturbance at 6.86, constipation type was 1.00 for habitual sleep efficiency, constipation type was 1.42 for subjective sleep quality, uncategorized type was 0.15 for sleeping pill dosage but not statistically significant. In day time functional disorder, constipation type was the highest at 2.61 and showed a significant difference (p=0.012). The correlation between the sub-factors of sleep quality was positive. Based on the above study results, we learned that for IBS, sleep quality becomes lower as the year increases, and functional disorder was observed during day time due to low sleep quality. Education on IBS symptoms is needed, adequate stress management method to alleviate symptoms and prevention programs for correct diet must be developed to enhance sleep quality.

Technical and Clinical Considerations for Successful Management of Postoperative Bowel Perforation by Percutaneous Foley Catheter Placement (경피적 폴리 카테터 삽입을 이용하여 수술 후 장 누출을 성공적으로 관리하기 위한 기술적 및 임상적 요인들)

  • So young Cho;Jung Suk Oh;Hae Giu Lee;Byung Gil Choi
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1389-1396
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    • 2020
  • Purpose The aim of this study was to analyze several technical and clinical factors associated with the successful management of postoperative leakage by percutaneous Foley catheter placement. Materials and Methods Thirty-two patients were included in this retrospective study. Postoperative gastrointestinal leakage was diagnosed by computed tomography (CT) and the patients underwent percutaneous Foley catheter placement into the leakage site through Jackson-Pratt tubes or imaging-guided methods. Clinical success was defined as successful Foley catheter removal without symptom recurrence within 1 week and the risk factors for clinical failure were analyzed. Results In all patients, percutaneous Foley catheter placement was successfully achieved without complications. Foley catheter was placed at a median of 10 days (range, 1-68) after the confirmation of leakage on CT. Clinical success was achieved in 26 of the 32 patients (81%). Systemic comorbidity (p < 0.001) and failed oral intake (p = 0.015) were the statistically significant risk factors for clinical failure. Conclusion Percutaneous Foley catheter placement can be considered an effective approach for the management of postoperative bowel leakage. The presence of systemic comorbidity and successful oral diet after Foley catheter placement are significant factors for successful clinical recovery.

Diagnostic Value of Rectal Bleeding in Predicting Colorectal Cancer: a Systematic Review

  • Tong, Gui-Xian;Chai, Jing;Cheng, Jing;Xia, Yi;Feng, Rui;Zhang, Lu;Wang, De-Bin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.1015-1021
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    • 2014
  • This study aimed at summarizing published study findings on the diagnostic value of rectal bleeding (RB) and informing clinical practice, preventive interventions and future research areas. We searched Medline and Embase for studies published by September 13, 2013 examining the risk of colorectal cancer in patients with RB using highly inclusive algorithms. Data for sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and positive predictive value (PPV) of RB were extracted by two researchers and analyzed applying Meta-Disc (version 1.4) and Stata (version 11.0). Methodological quality of studies was assessed according to QUADAS. A total of 38 studies containing 5,626 colorectal cancer patients and 73,174 participants with RB were included. The pooled sensitivity and specificity were 0.47 (95% CI: 0.45-0.48) and 0.96 (95% CI: 0.96-0.96) respectively. The overall PPVs ranged from 0.01 to 0.21 with a pooled value of 0.06 (95% CI: 0.05-0.08). Being over the age of 60 years, change in bowel habit, weight loss, anaemia, colorectal cancer among first-degree relatives and feeling of incomplete evacuation of rectum appeared to increase the predictive value of RB. Although RB greatly increases the probability of diagnosing colorectal cancer, it alone may not be sufficient for proposing further sophisticated investigations. However, given the high specificity, subjects without RB may be ruled out of further investigations. Future studies should focus on strategies using RB as an "alarm" symptom and finding additional indications to justify whether there is a need for further investigations.

Gastrointestinal hemangioma in childhood: a rare cause of gastrointestinal bleeding

  • Han, Eon Chul;Kim, Soo-Hong;Kim, Hyun-Young;Jung, Sung-Eun;Park, Kwi-Won
    • Clinical and Experimental Pediatrics
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    • v.57 no.5
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    • pp.245-249
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    • 2014
  • Gastrointestinal (GI) hemangiomas are relatively rare benign vascular tumors. The choice of an appropriate diagnostic method depends on patient age, anatomic location, and presenting symptoms. However, GI hemangiomas are not a common suspected cause of GI bleeding in children because of their rarity. Based on medical history, laboratory results, and imaging study findings, the patient could be treated with either medication or surgery. Herein, we report 3 cases of GI hemangioma found in the small bowel, rectum, and GI tract (multiple hemangiomas). Better knowledge and understanding of GI hemangioma could help reduce the delayed diagnosis rate and prevent inappropriate management. Although rare, GI hemangiomas should be considered in the differential diagnosis of GI bleeding.

Irritable Bowel Syndrome and Sleep: Is there a Relationship?

  • Heitkemper, Margaret;Jarrett, Monica;Park, Hyo-Jung
    • Perspectives in Nursing Science
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    • v.2 no.1
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    • pp.1-18
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    • 2005
  • Health care providers working with IBS patients are challenged in that the underlying pathophysiology remains poorly defined and treatments are not universally effective (American College of Gastroenterology Functional Gastrointestinal Disorders Task Force, 2002). Nurses often work with patients to identify factors provoking or alleviating symptoms and based on these observations hone strategies to manage symptoms. Understanding stress induced alterations in sleep and ANS function may provide important clues as to additional self-management strategies to test.

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Disseminated Cytomegalovirus Infection and Protein Losing Enteropathy as Presenting Feature of Pediatric Patient with Crohn's Disease

  • Cakir, Murat;Ersoz, Safak;Akbulut, Ulas Emre
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.1
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    • pp.60-65
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    • 2015
  • We report a pediatric patient admitted with abdominal pain, diffuse lower extremity edema and watery diarrhea for two months. Laboratory findings including complete blood count, serum albumin, lipid and immunoglobulin levels were compatible with protein losing enteropathy. Colonoscopic examination revealed diffuse ulcers with smooth raised edge (like "punched out holes") in the colon and terminal ileum. Histopathological examination showed active colitis, ulcerations and inclusion bodies. Immunostaining for cytomegalovirus was positive. Despite supportive management, antiviral therapy, the clinical condition of the patient worsened and developed disseminated cytomegalovirus infection and the patient died. Protein losing enteropathy and disseminated cytomegalovirus infection a presenting of feature in steroid-naive patient with inflammatory bowel disease is very rare. Hypogammaglobulinemia associated with protein losing enteropathy in Crohn's disease may predispose the cytomegalovirus infection in previously healthy children.

Anti-Tumor Necrosis Factor Therapy in Intestinal Behçet's Disease

  • Park, Jihye;Cheon, Jae Hee
    • Gut and Liver
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    • v.12 no.6
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    • pp.623-632
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    • 2018
  • Intestinal Behçet's disease is a rare, immune-mediated chronic intestinal inflammatory disease; therefore, clinical trials to optimize the management and treatment of patients are scarce. Moreover, intestinal Behçet's disease is difficult to treat and often requires surgery because of the failure of conventional medical treatment. Administration of anti-tumor necrosis factor-${\alpha}$, a potential therapeutic strategy, is currently under active clinical investigation, and evidence of its effectiveness for both intestinal Behçet's disease and inflammatory bowel diseases has been accumulating. Here, we review updated data on current experiences and outcomes after the administration of anti-tumor necrosis factor-${\alpha}$ for the treatment of intestinal Behçet's disease. In addition to infliximab and adalimumab, which are the most commonly used agents, we describe agents such as golimumab, etanercept, and certolizumab pegol, which have recently been shown to be effective in refractory intestinal Behçet's disease. This review also discusses safety issues associated with anti-tumor necrosis factor-${\alpha}$, including vulnerability to infections and malignancy.

Various Approaches and Treatments for Pelvic Organ Prolapse in Women

  • Chung, Soo-Ho;Kim, Woong Bin
    • Journal of Menopausal Medicine
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    • v.24 no.3
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    • pp.155-162
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    • 2018
  • Pelvic organ prolapse (POP) is bulging of one or more of the pelvic organs into the vagina and triggered by multiple causes. It is a very common disorder, especially among older women. POP is characterized by protrusion of the presentation part visible by the naked eye, and problems with urination or bowel movements. POP can be diagnosed based on the onset of symptoms and a pelvic exam, and management options include medical and surgical treatment. Although medical treatment cannot correct the abnormal herniation of the pelvic structures, this can help alleviate symptoms. One of the disadvantages of surgical interventions is recurrence, and advances in surgical techniques have decreased recurrence rates of POP. Therefore, author will explain the gynecology and urology approach and treatment.