• Title/Summary/Keyword: Chronic constipation

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Study of Radiological Approach to Treat a Chronic Constipation (만성변비환자의 방사선학적 접근방법에 관한 고찰)

  • Yoon, Seok-Hwan
    • Journal of radiological science and technology
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    • v.27 no.3
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    • pp.5-12
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    • 2004
  • I. Introduction : The constipation is one of the common gastrointestinal symptoms seen in the clinical practice. When people come to the clinic complaining of the constipation, it is generally one of the cases of infrequent, painful or difficult evacuation as well as the hardened feces and unsatisfactory evacuation sense. Since the constipation is heavily influenced by dietary habit as well as the social and medical environment, the diagnostic radiology is useful to establish the objective and standardized definition in consideration of those various factors before diagnosis and treatment of the constipation patient. This paper describes the study of such diagnosis. II. Main Subject : Testing of CTT (colon transit time) is key study of the colon performance. CTT is very helpful in classifying the pathologic physiological types and defining the treatment plan for the chronic constipation. The study methods include using the radipaque marker, multiple marker technique and scintigraphic measurement. The defecography is the functional radiologic examination a that provides not only the anatomical information of anorectal but also performance of the pelvic floor and rectal change during evacuation. Study of dynamic movement of the anorectal during evacuation is helpful for diagnosis and treatment planning as well as follow-up testing for the constipation patient. One of the issues essential for the case history is the thorough observation of whether the patient shows the psychic psychological symptoms such as the behavior disorder or emotional disturbance. In that case, the decision must be made whether or which type of medication is needed for such psychiatric problem. III. Conclusion : The main causes of the constipation are insufficient intake of fiber or liquid. The key objective of such tests is to check etiology of the constipation. In general, the radiological examination does not provde the colon or anorectal performance information. It is envisaged that this study will provide the information to decide the testing and treatment plans and predict the prognosis of the patient by classifying the pathologic physiological types.

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A Case Report of Chronic Insomnia Diagnosed Blood Stasis (어혈로 변증된 불면증 환자의 치험례)

  • Kim, Dong-Hee;Lee, Yu-Chan;Kim, Bo-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.28 no.2
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    • pp.137-143
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    • 2017
  • Objectives: Insomnia is a common disease in the general population. The purpose of this paper was to suggest that insomnia subtype of blood stasis can be effectively treated with Danggwisu-san and acupuncture. Methods: This is a clinical case report of a patient with chronic insomnia that was diagnosed with blood stasis subtype. I treated him with Danggwisu-san (Dangguixu-san) two to three times daily and with acupuncture and moxibustion two to three times weekly. Results: After short-term treatment, the patient was gradually recovering from deteriorating chronic insomnia and multiple accompanying symptoms such as severe constipation, spontaneous bleeding and edema, darkened face, depressive moods, etc. Conclusions: Results revealed a possibility that chronic insomnia subtype of blood stasis may be successfully treated with Danggwisu-san and acupuncture and moxibustion.

Korean Medicine Treatment for Dyspepsia and Constipation in a Patient with HIV: A Case Report

  • Ji-Su Ha;Han-Song Park;Hyun-Seo Park;Ka-Hyun Kim;Hae-Won Hong;In-Ae Youn
    • Journal of Acupuncture Research
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    • v.40 no.2
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    • pp.143-149
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    • 2023
  • Functional dyspepsia (FD) is a chronic and recurrent upper gastrointestinal symptom that has no organic cause. A 49-year-old male patient positive for human immunodeficiency virus (HIV) visited the clinic because of FD and constipation. He received complex Korean medicine treatment, including acupuncture and herbal medicines, from April 14 to July 18, 2022 (27 times) in the outpatient department. Gastrointestinal Symptom Rating Scale (GSRS), Nepean Dyspepsia Index (NDI), FD-related quality of life (FD-QoL), Euro QoL visual analog scale (EQ-VAS), and Numerical Rating Scale (NRS) were used as evaluation tools in this study. Symptoms were relieved after 3 months of treatment, and his QoL improved (GSRS, 15-3; NDI, 110-21; FD-QoL, 52-20 [eating status, 10-3; liveliness status, 12-8; psychological, 1-0; role-functioning status, 18-9]; EQ-VAS, 40-65; NRS, 8-4). The results revealed that complex Korean medicine treatment could alleviate FD and constipation in patients with HIV.

The Effects of Acupuncture(ST25, TE6) Stimulation on Colonic Transit Time in Old Age Constipation Persons (천구 및 지구의 침 자극이 노인 변비의 대장 통과시간에 미치는 영향)

  • Hwang Sang Il;Rhim Eun Kyung;Lee Yun Jae;Jeong Hyun Ae;Moon Mi Hyun;Cho Young Kee;Lee Seong Kyun;Kim Dong Woung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.1
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    • pp.220-225
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    • 2004
  • We undertook this study to investigate the effects of acupuncture and electroacupuncture on colonic transit time in old age constipation persons. Twenty three volunteers were old age constipation persons(mean age 69.72±2.43 years, mean defecation rate 1.83±0.41/week). Before acupuncture was only to check the radio-opaque markers transit time all the way through gastrointestinal tract. Simple acupuncture was to apply acupuncture therapy for three days. The fourth acupoints(both ST.25, TE.6) were selected and the needle was kept for 15 minutes. Electroacupuncture was same as the simple acupuncture except for applying 2Hz electrical stimulation. After Then we compare with three method Each transit time in the whole colon, right colon, left colon and rectosigmoid colon were checked in the order of before acupuncture, simple acupuncture, and electroacupuncture stimulation. In the before acupuncture stimulation, the transit time in each part of colon was as follows 19.48±1.76 32.74±2.69 25.61±2.13 76.62±7.95 hours. Simple acupuncture stimulation, the transit time was 17.47±1.10 33.10±1.87 24.12±1.65 74.87±3.91 hours. Compared with before acupuncture stimulation, the transit time was significantly shortened(P<0.05), especially in right colon transit time of simple acupuncture stimulation was significantly shortened(P<0.05). Electroacupuncture stimulation, was 16.32±1.97 32.91±2.48 21.53±1.94 71.59±2.82. Compared with the previous two trial, transit time in right colon and rectosigmoid colon were significantly shortened(P<0.05). Acupuncture and electroacupuncture stimulation change on the right colonic transit time in old age constipation persons and rectosigmoid colonic transit time was changed as electroacupuncture stimulation. In other words, old age constipation persons who suffer chronic constipation, acupuncture and electroacupuncture stimulation reduces the total colonic transit time.

The rapid recovery of serum aminotransferase in a case of chronic active hepatitis type B treated with Sengangeonbi-tang (만성 활동성 B형 간염에서 생간건비탕(生肝健脾湯)으로 혈청 aminotransferase 수치가 저하된 1례)

  • Park, Jung-Mi;Jung, Woo-Sang
    • The Journal of Internal Korean Medicine
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    • v.21 no.2
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    • pp.337-339
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    • 2000
  • Indigestion is one of the most frequent symptom in chronic hepatitis. We treated a 20 year-old female patient of chronic active hepatitis type B with Sengangeonbi-tang. The patient complained indigestion and constipation. The serum aminotransferase were higher and viral marker showed hepatitis was in active phase. 1 week later, the symptom had been changed from severe to mild and aminotransferase decreased. We continued to prescribe the medicine 2 weeks more and could observe that the symptom disappeared and the aminotransferase fell down under normal value with no side effect. Sengangeonbi-tang showed desirable effect on indigestion and more rapid recovery of aminotransferase than previous reports about treating hepatitis.

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Long-term safety of PEG 4000 in children with chronic functional constipation: A biochemical perspective

  • Bae, Sun-Hwan
    • Clinical and Experimental Pediatrics
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    • v.53 no.7
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    • pp.741-744
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    • 2010
  • Purpose: To evaluate the long-term safety of polyethylene glycol (PEG) 4000 in children with constipation, particularly the biochemical aspects of safety. Methods: Medical records were evaluated, and 100 children, who had been taking PEG 4000 for more than 6 months, and who had been under clinical and biochemical monitoring, were enrolled. Ages; $6.11{\pm}3.12$ years, Duration of therapy; $16.93{\pm}7.02$ months, dose of PEG 4000; $0.72{\pm}0.21g/kg/d$. Results: None of the children complained of clinical adverse effect. The first biochemical test was performed at 8.05 months after beginning of PEG 4000. Serum phosphate (SP) value was high in 10 children, and leucopenia was noted in one child. The second test was performed in 44 children at 7.57 months after the first test. The SP value was high in four children, including the three children whose initial SP value was high and one new child. Six out of 10 children with high initial SP value became normal and one was lost. Hypernatremia was noted in one child. The third test was done in 15 children at 7.5 months after the second test. The SP value of the new child from the second test was high, but became normal after finishing treatment. Two out of 3 children with high SP value at the second test became normal and one was lost. The fourth test was done in 2 children few months after the third test. All of the results were normal. There were no relation between duration of therapy and hyperphosphatemia, or between dose of PEG 4000 and hyperphosphatemia. Conclusions: PEG 4000 is safe for long-term therapy in children with constipation with respect to biochemical parameters.

Maintenance dose of electrolyte free polyethylene glycol (PEG) 4000 in Korean children with chronic functional constipation (한국인 소아에서 만성 기능성 변비치료 시 전해질이 함유되지 않은 PEG 4000의 유지용량)

  • Lee, So Hee;Bae, Sun Hwan
    • Clinical and Experimental Pediatrics
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    • v.50 no.12
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    • pp.1212-1216
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    • 2007
  • Purpose : To determine optimal maintenance dose and to evaluation the efficacy and safety of polyethylene glycol 4000 (PEG4000) in children with chronic functional constipation. Methods : This study enrolled 41 children with chronic functional constipation at the Konkuk university hospital August 2005, then June, 2007. Effective maintenance dose was designed as initial amount of PEG4000 that improved frequency, bowel movement, stool consistency for 2 months. Clinical outcome was analysed on the basis of defecation diary. Adverse effect was monitored clinically and biochemically. Results : As a whole group effective maintenance dose of PEG4000 was $0.55{\pm}0.16g/kg/day$ (0.25-0.86). With respect to age, 3-5 years ($0.60{\pm}0.15$), 6-8 years ($0.57{\pm}0.16$), 9-13 years ($0.44{\pm}0.14$) (P=0.024). With respect to body weight, <30 kg ($0.62{\pm}0.14$), ${\geq}30kg$ ($0.41{\pm}0.10$) (P=0.001). One child comlained apigastric soreness on medication. Conclusion : PEG4000 is effective and safe in children with chronic constipation. Initial maintenance dose of PEG4000 was 0.55 g/kg/day.

Efficacy and safety of electrolytes-free polyethylene glycol (PEG) 4000 for disimpaction in children with chronic functional constipation (소아 만성 기능성변비 치료에서 전해질이 함유되지 않은 polyethylene glycol (PEG) 4000의 분변박힘 제거효과 및 안전성)

  • Lee, Jeong Hee;Lee, Ran;Bae, Sun Hwan
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.391-395
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    • 2008
  • Purpose : This study was performed evaluate optimal dose for disimpaction, efficacy and safety of PEG 4000 in children with chronic functional constipation. Methods : Eighty six children with chronic functional constipation were enrolled in this prospective study at Konkuk university hospital March, 2003 through August, 2006. Success in disimpaction with PEG 4000 was defined as meeting at least two out of three criteria; resolution of chief complaint, getting easiness of defecation with respect to frequency of bowel movement and hardness of stool based on defecation diary, and decrease in fecal impaction on simple abdominal X-ray test. Adverse effects of PEG 4000 were monitored clinically and biochemically. Results : Eighty three out of 86 children completed the study, and success rate of disimpaction was 99% (82/83). The mean dose of PEG 4000 for disimpaction was $0.93{\pm}0.28g/kg/day$ (0.4-2.0 g/kg/day, Max.: 30 g/day). Frequency of bowel movement increased ($5.02{\pm}2.71/wk$ vs. $11.25{\pm}5.43/wk$) in most children (79/83). Fecal impaction on simple abdominal X-ray test improved with statistical significance in 25 children (P=0.0007). Because of adverse effect of PEG 4000, 3 children did not complete the study; urticaria, severe diarrhea, diarrhea and abdominal pain. One 6-year-old girl who completed the study complained tingling sensation in the hand and foot without laboratory abnormality (4/86, 4.7%). Laboratory test revealed hyperosmolality without clinical symptom in 1 child, and eosinophilia in 6 children. Conclusion : The average safe and effective dose of PEG 4000 for disimpaction was $0.93{\pm}0.28g/kg/day$ (0.4-2.0 g/kg/day, Max : 30 g/day) in children with chronic functional constipation.

Efficacy and Safety of Polyethylene Glycol(PEG) with Electrolytes for Disimpaction in Children with Chronic Functional Constipation (소아에서 만성 기능성 변비의 분변 박힘 제거에 대한 전해질이 함유된 Polyethylene Glycol(PEG)의 효과 및 안전성에 관한 연구)

  • So, Hong Seop;Bae, Sun Hwan;Yoon, Hei Sun;Hwang, Jin Soon
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1089-1094
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    • 2003
  • Purpose : Polyethylene glycol(PEG) with electrolytes has been used for intestinal clearance for colonoscopy and operations in children. But its efficacy and safety for disimpaction in children with chronic functional constipation has been studied little. Methods : This study enrolled 26 patients with chronic functional constipation(11 children had failed to disimpaction by conventional management at OPD) who were admitted to the Eul-Ji Hospital between May 2000 and July 2003. PEG with electrolytes was administered per oral and/or rectal enema. We observed the effects for disimpaction by measuring the frequency and consistency of stools, and by simple abdominal X-ray. We evaluated the safety by measuring serum electrolytes and osmolarity in three hours after PEG with electrolytes administration, and by observation of the clinical status of the patients. The protocol of PEG with electrolytes was a dose of 60-80 mL/kg within three hours per oral and/or of 15-25 mL/kg by rectal enema. Results : In all patients, simple abdominal X-ray films showed improvements of fecal impaction. Consistency and frequency of stool were improved in all patients except one. As for side effects, diarrhea developed in three patients(11.5% of all patients). Headaches developed in one patient(3.8% of all patients) but it improved without treatment. Serum electrolytes was checked in 16 patients after PEG with electrolytes management and mild hypernatremia(146 mmol/L) was checked in one patient. Serum osmolarity was checked in 11 patients after PEG with electrolytes management and was normal in all patients. Conclusion : PEG with electrolytes was effective and safe for disimpaction in children with chronic functional constipation, including patients who had failed in disimpaction by conventional management.

A Case of Hinman Syndrome Complicated by Chronic Renal Failure (만성 신부전을 초래한 Hinman 증후군 1례)

  • Lee Gyeong-Hoon;Lee Eun-Sil;Park Yong-Hoon
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.90-94
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    • 1998
  • Hinman syndrome is a condition representing urinary voiding dysfunction in the neurologically intact child. The syndrome is probably caused by acquired behavioral and psychosocial disorders manifested by bladder and/or bowel dysfunction mimicking neurologic disease. Clinically, the symptom complex may include day and night time enuresis, encopresis, constipation, and recurrent urinary tract infections. Cystoscopy frequently demonstrates normal vesicourethral anatomy. Voiding films usually demonstarate a carrot-shaped proximal urethra with a persistent narrowing at the external sphincter. The bladder is large and often appears trabeculated with a thickened wall and significant postvoid residual. A 13-year-old male child was admitted due to fever, urinary tract infection, enuresis and flank pain. His neurologic examination was normal. Renal sonograms showed moderate hydronephrosis. Voiding cystourethrograms showed a huge, trabeculated bladder without vesicourethral reflux and urethral valves. No abnormal findings was found in spinal MRI.

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