• Title/Summary/Keyword: Chronic functional 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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Factors Contributing to Treatment Outcome of Functional Constipation in Children (소아 기능성 변비의 치료에 영향을 미치는 인자)

  • Kim, Hyung-Seok;Hong, You-Rha;We, Ju-Hee;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.36-43
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    • 2010
  • Purpose: The aim of this study was to evaluate the clinical features and factors contributing to treatment outcome for chronic functional constipation in children. Methods: We analyzed the medical records of patients with constipation, who visited the inpatient or outpatient clinic of the Department of Pediatrics of Pusan National University Hospital, between January 1998 and December 2007. The clinical features, outcomes, and factors affecting the treatment response according to the main drug (lactulose vs. PEG 4000) were analyzed retrospectively. Results: Two hundred forty children (142 males and 98 females) were enrolled in this study. The mean age was 51.2${\pm}$37.9 months. The duration of symptoms was 32.6${\pm}$33.7 months. The accompanying symptoms were as follows: encopresis, 91 (30.4%); abdominal pain, 76 (31.6%); and blood-tinged stool, 37 (15.4%). The treatment response was achieved earlier in females (p<0.001), patients with accompanying symptoms (p<0.05), and patients treated with PEG 4000 (p=0.001). The duration of symptoms (p<0.05) and stool frequency before treatment (p<0.05) were related to a delayed treatment response. Relapse occurred in 7 children, all of whom were treated successfully later. Conclusion: Factors contributing to treatment response are female gender, accompanying symptoms, duration of symptoms, and stool frequency before treatment. PEG 4000 is superior to lactulose in response time and taken into consideration as a primary drug for the treatment of functional constipation of children. Early treatment and sufficient treatment time may also be important factors to achieve an early response and prevent relapse.

The Latest Trend of Dynamic MR Defecography for the Chronic Constipation Patient (만성 기능성 변비 환자에서 동적 MR Defecography의 최신동향)

  • Yoon, Seok-Hwan
    • Journal of radiological science and technology
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    • v.27 no.4
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    • pp.17-21
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    • 2004
  • With advancement of the medical imaging technology, the dynamic pelvic MRI (magnetic resonance imaging) has been introduced and used for dynamic MR defecography to improved diagnosis of the patients. At the early stage of its use, it was mostly used to diagnose enterocele or cystocele, then its use was extended to diagnose the organ prolapse and other dysfunctional pelvis organs. There now have been many reports of other diseases such as the functional constipation and others. This paper introduces the pelvis MRI and the dynamic MR defecography and reports the future trend in their clinical applications. Until recently, the studies with pelvic MRI were mostly focused on observing the movement of the pelvis in the supine position. Yang and 26 others reported good result in observing the patients with the pelvic organ prolapse by using the pubococcygeal line as the anatomical index. Using the fast gradient recalled acquisition (fast GRASS), they compared cystocoele, genitourinary prolapse, enterocoele and rectocoele with the control group. Kruyt et al. observed the posterior compartment and reported that MRI was more helpful than the fluoroscopy. Healy et al. applied the dynamic MRI test on the patients with constipation or incontinence as well as the control group without those symptoms. Since then, MRI technology has further advance by Lienemann, who was able to attain the more detailed images using the fast T2 weighted turbo spin echo technology, and others. If its limitation in diagnosing intussusception and the like, since the observation can be made only from the supine position, can be overcome with open MR or others, it is envisages that the method can eventually replace the radiological defecography.

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Update on Irritable Bowel Syndrome Program of Research

  • Heitkemper, Margaret;Jarrett, Monica;Jun, Sang-Eun
    • Journal of Korean Academy of Nursing
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    • v.43 no.5
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    • pp.579-586
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    • 2013
  • Purpose: This article provides an update and overview of a nursing research program focused on understanding the pathophysiology and management of irritable bowel syndrome (IBS). Methods: This review includes English language papers from the United States, Europe, and Asia (e.g., South Korea) from 1999 to 2013. We addressed IBS as a health problem, emerging etiologies, diagnostic and treatment approaches and the importance of a biopsychosocial model. Results: IBS is a chronic, functional gastrointestinal disorder characterized by recurrent episodes of abdominal pain and alterations in bowel habit (diarrhea, constipation, mixed). It is a condition for which adults, particularly women ages 20-45, seek health care services in both the United States and South Korea. Clinically, nurses play key roles in symptom prevention and management including designing and implementing approaches to enhance the patients' self-management strategies. Multiple mechanisms are believed to participate in the development and maintenance of IBS symptoms including autonomic nervous system dysregulation, intestinal inflammation, intestinal dysbiosis, dietary intolerances, alterations in emotion regulation, heightened visceral pain sensitivity, hypothalamic-pituitary-adrenal dysregulation, and dysmotility. Because IBS tends to occur in families, genetic factors may also contribute to the pathophysiology. Patients with IBS often report a number of co-morbid disorders and/or symptoms including poor sleep. Conclusion: The key to planning effective management strategies is to understand the heterogeneity of this disorder. Interventions for IBS include non-pharmacological strategies such as cognitive behavior therapy, relaxation strategies, and exclusion diets.

Quality of Life Findings of Adjuvant FOLFOX4 vs. XELOX in Stage III Colon Cancer Patients

  • Youn Jung Choi;Seun Ja Park;Moo In Park;Won Moon;Sung Eun Kim;Jae Hyun Kim;Byung Kwon Ahn;Sung Uhn Baek;Seung Hyun Lee;Seung Hun Lee
    • Journal of Digestive Cancer Research
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    • v.5 no.2
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    • pp.73-85
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    • 2017
  • Background: To compare the quality of life (QoL), the convenience of chemotherapy and satisfaction between colon cancer patients treated with FOLFOX4 and XELOX. Methods: The study was conducted in 26 patients with stage III colon cancer. Patients were received FOLFOX4 (n=17) or XELOX (n=9). QoL, convenience, and satisfaction were assessed using the Quality of Life Questionnaire-C30 (QLQ-C30), Quality of Life Questionnaire-Chemotherapy Induced Peripheral neuropathy (QLQ-CIPN) and Functional Assessment of Chronic Illness Therapy Chemotherapy Convenience and Satisfaction Questionnaire (FACIT-CCSQ), respectively. Patients completed questionnaires at baseline, at cycle 4 (C4) and cycle 8 (C8) (FOLFOX4) or at cycle 3 (C3) and cycle 6 (C6) visits (XELOX) and at their final visit. Results: In the QLQ-C30, at the final visit, XELOX patients had better functional scores than FOLFOX4 patients (physical: 85.7 vs.60.4, p=0.03; role: 83.3 vs. 57.5, p=0.04) as well as better symptom scores (constipation: 9.5 vs. 40.4, p=0.01). In CIPN, at the C6/C8 visit, XELOX patients had lower motor scale scores than FOLFOX4 patients (3.8 vs. 21.6, p=0.02). Moreover, at the C6/C8 visit, XELOX was more convenient than FOLFOX4 in FACIT-CCSQ (79.7 vs. 55.5, p=0.04). Male patients were especially likely to consider XELOX to be more convenient (90.0 vs. 55.0, p=0.01) and satisfactory (55.4 vs. 26.2, p=0.03) and fewer concern (91.0 vs. 65.0, p=0.03) than FOLFOX4. XELOX patients spent fewer days on hospital visits at C3/C4, C6/C8 and final visit (2.8 vs. 4.2, p=0.01; 2.7 vs. 4.1, p=0.01; 3.0 vs. 4.5, p=0.01). Conclusion: XELOX may be a better adjuvant chemotherapy choice for patients with colon cancer than FOLFOX4 in terms of QoL, convenience, and satisfaction.

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Antioxidant and Anti-inflammatory Effects of Plantago asiatica L. Extract (질경이 추출물의 항산화 및 항염증 활성)

  • Choi, Yukyung;Choo, Byung-Kil
    • Korean Journal of Organic Agriculture
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    • v.32 no.1
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    • pp.91-105
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    • 2024
  • Plantago asiatica L. (P. asiatica) is a perennial plant belonging to the plantaginaceae and is useful in treating a various diseases such as wounds, bronchitis, and chronic constipation. The bioactive effects of P. asiatica extract was evaluated to determine its potential for use as a variety materials in the food, pharmaceutical, and agricultural industries. Polyphenol and flavonoid contents, free radical scavenging, reducing power activity, and reactive oxygen species (ROS) expression were measured to identify the antioxidative activity. Anti-inflammatory effects were evaluated via analysis of nitric oxide (NO) and pro-inflammatory protein expression in LPS-induced RAW 264.7 cell. As a result of measuring the antioxidant activities of the P. asiatica extract, the total polyphenol content was 50.91±0.78 mg gallic acid equivalents/g and the flavonoid content was 100.99±0.44 mg rutin equivalents/g, and both DPPH and ABTS radical scavenging activities and reducing power increased depending on the concentration. Also, intracellular ROS production was inhibited by the P. asiatica extract. No cytotoxicity was observed when P. asiatica extract was treated, and NO and inflammatory protein expression were inhibited, and nuclear factor kappa B (NF-κB) phosphorylation was also inhibited in a concentration-dependent manner. In conclusion, P. asiatica is a functional natural resources of antioxidant and anti-inflammatory agents that can be used in various industries, including food and agriculture.

Production of Lactulose by Biological Methods and Its Application (생물학적 방법을 통한 기능성 이당 lactulose의 생산과 응용 연구)

  • Kim, Yeong-Su;Kim, Do-Yeon;Park, Chang-Su
    • Journal of Life Science
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    • v.26 no.12
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    • pp.1477-1486
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    • 2016
  • Lactulose (4-O-${\beta}$-D-galactopyranosyl-D-fructose) is a non-digestible synthetic ketose disaccharide which can used in food and pharmaceutical fields due to its useful functions for encephalopathy, chronic constipation, hyperammonemia, etc. Therefore, the lactulose is regarded as one of the most important disaccharides and have been concentrated much interesting as an attractive functional material in the current industry. From this reason, the research related on the production of lactulose has been carried out various academic and industrial research groups. To produce lactulose, two main methods, chemical production and enzymatic production have been used. Commercially lactulose produced by alkaline isomerization of lactose as chemical production method but it has many disadvantages such as rapid lactulose degradation, purification, and waste management. From these reasons, lactulose produced by enzymatic method which solves these problems has been suggested as a proper method for lactulose production. Two different enzymatic methods have been reported as methods for lactulose production. Lactulose can be obtained through hydrolysis and transfer reaction catalyzed by a ${\beta}$-galactosidase which requires fructose as co-substrate and exhibits a low conversion. Alternatively, lactulose can be produced by direct isomerization of lactose to lactulose catalyzed by cellobiose 2-epimerase which requires lactose as a single substrate and achieves a high lactulose yield. This review summarizes the current state of lactulose production by chemical and biological methods.