• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.1
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• pp.47-54
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• 2017

Purpose: Clinical symptoms associated with Clostridium difficile infection (CDI) can vary widely. Carrier state without apparent symptoms is relatively common during infancy. The objective of this study was to determine the association of C. difficile colonization with bowel habit change and the effect of C. difficile colonization treatment on restoration of normal bowel habit. Methods: Between 2006 and 2014, infants at 1 to 12 months of age with diarrhea for more than 2 weeks who did not improve with conservative care were recruited from Gachon University Gil Medical Center. Infants who were followed up for at least 7 days were included. The presence or absence of C. difficile colonization, effect of metronidazole, and other medical records were reviewed. To determine the association between CDI and bowel habit change, logistic regression analysis was used. Results: Of a total of 126 infants, 74 (58.7%) were male patients. Of the 126 patients, 27 (21.4%) had C. difficile colonization. Significant (p<0.05) risk factors for C. difficile colonization included artificial milk feeding (odds ratio [OR], 4.310; 95% confidence interval [CI], 1.564-11.878), prior rotavirus vaccination (OR, 4.322; 95% CI, 1.018-18.349), and antibiotic use (OR, 4.798; 95% CI, 1.430-16.101). There was improvement in bowel habit after metronidazole therapy (OR, 0.34; 95% CI, 0.15-0.79; p<0.05), regardless of the presence or absence of C. difficile colonization, Conclusion: There was no significant correlation between bowel habit change and C. difficile colonization during infancy. However, metronidazole can be used as an optional method to manage functional gastrointestinal disorders.

• The Korean Journal of Gastroenterology
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• v.72 no.5
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• pp.252-257
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• 2018

This guidance is an updated version of the irritable bowel syndrome (IBS) guidelines based on evidence-based medicine. IBS is a common chronic gastrointestinal syndrome that occurs in approximately 10% of the population and causes chronic abdominal pain as well as bowel habit changes, such as stool frequency or consistency. The final diagnosis of IBS is based on the exclusion of organic diseases that would explain the symptoms and the absence of endoscopic abnormalities. IBS can reduce the quality of life and cause a major disease burden, such as repeated examinations and continuous drug use, by mistaking organic diseases including malignancy. The major changes are as follows: 1) when to perform a colonoscopy under the impression of IBS; 2) effect of a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyol diet; 3) impact of probiotics in IBS; and 4) role of antibiotics in IBS. The Korean Society of Neurogastroenterology and Motility recently updated these guidelines to support physicians for qualified medical services and reduce the socioeconomic burden of IBS.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.33-39
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• 1986

A clinical and statistical study was done for 123 patients with histologically proven colorectal malignant tumor from 1983 to 1986 at the department of anatomical pathology. Yeung Nam University Hospital. The results were as follows: 1. Ratio between male and female was 1.6:1 and incidence was most prevalent in 7th decades comprising 29.3%. 2. Location of tumor was the most frequent in rectum(65%). 3. Frequent symptoms and signs in case of right colon were pain, abdominal mass and bowel habit change. In left colon, they were pain, bowel habit change and bloody stool or melena. In rectum, they were bloody stool or melena, bowel habit change and pain. 4. Duration of symptom was 1 to 3 months(33.3%). 5. The most frequent histological type was adenocarcinoma(82.9%). 6. According to Dukes's classification, 32.9% of the tumor were stage $C_2$. 7. Operative procedures were Mile's operation(47.0%), right hemicolectomy(19.8%) and lower anterior resection(11.7%). 8. Polyps were the most frequent associated disease. 9. The most common complication was wound infection(11.1%).

• The Korean Nurse
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• v.29 no.3
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• pp.25-35
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• 1990

It is a fact that there are recent increasing trends or incidence of the colorectal carcinoma among other colorectal diseases. In such trend, the early detection remain to be most important by the air contrast barium enema and total colonofiberscopy. There are several ways to prepare the colon for barium enema and colonofiberscopy which include several agents. The mechanical cleansing have been used most frequently since Brown's method was adapted to be most perfect for colon deansing. The ideal laxatives and enema solutions were limited to adequate dose, it's effectiveness, patient's diet and bowel habit, minimal side effect, low cost and simple to perform. In order to compare the effectiveness of various cleansing solutions, six experimental methods were formed as shown; 1. normal saline enema, 2. castor oil with normal saline enema, 3. castor oil with soap suds enema, 4. magnesium citrate with normal saline, 5. magnesium citrate with soap suds enema and 6. ingestion of Golyetly solution. The authors have compared and determined the degree of cleanness by an experienced endoscopist. The total number of patients was 247, age distribution was $43{\pm}15$ years old, and sex distribution was 133 males and 114 females. The grade I and II represented no difficulties at performing the colonofiberscopy, but grade ill and N had some difficulties, even unable to perform the colonofiberscopy. The effectiveness the cleansing agents, represented with grade I and II was 95.9% (47/49) in method 6, 93.2%(54/58) in method 2, 83.3%(30/33) in method 3, 70.0%(28/10) in method 5, 66.7%(16/24) in method i, and 45.7%(18/40) in method 4. Method 2 and 6 were the most effective in normal bowel habit patients. In constipated patients, method 6 was the most effective and all method except method 11 were effective in diarrhea patients. The degrees of less mucosal irritation by various bowel cleansing method were in the order of method 6(100%), 1(100%), 5(74%), 2(69%). In subjective symptoms and cleansing groups, abdominal distension, pain, nausea and vomiting were complained, and that's subject symptoms were in the order of method 3(88.9%), 6 (79.6%), 1(75%), 5(72.5%), 2(72.4%), 4(67.5%). In conclusion, we believe that the Golytely of the mechanical cleansing solution for colonofiberscopy was the most effective, but others depended on the patient's condition und bowel habit.

• 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.

• Journal of Korean Academy of Nursing Administration
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• v.10 no.4
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• pp.449-457
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• 2004

Purpose: This study seeks to identify situations where nurses are required to consider alternatives, for the delivery of nursing care, appropriate to the needs of a medical care unit, surgical care unit, and intensive care unit in a university hospital. Method: Data was collected from 100 nurses using an open questionnaire, during a one week period in May, 2003. These nurses all had at least two years of experience within a medical care unit, surgical care unit, or intensive care unit at a university hospital. Results: The situations that nurses typically faced were categorized into 21 problems for nurses including : respiratory problems(26.8%), pain(23.6%), problems in relation to bowel habit(23.2%). In cases where nurses were faced with making decisions in relation to solving respiratory problems, the alternatives included ; applying oxygen(29.3%), physical assessment and monitoring(14.7%), refining and modifying order and suggestion order(9.3%). Ventilator care(9.3%), was chosen to solve pain problems ; doing pm orders(30.3%), placebo medication(27.3%), and to refine and modify orders and suggestions(18.2%). To solve problems in relation to bowel habits ; enemas accounted for 32.3%, and laxative medication 30.8%. Conclusion: To improve the quality of nursing, the outcome of nursing care associated with 21 problems for nurses including : respiratory problems, pain, and problems in relation to bowel habit, should be identified and the best alternative nursing care should be developed.

• Korean Journal of Community Nutrition
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• v.10 no.1
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• pp.36-45
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• 2005

The aim of this study was to investigate the dietary and lifestyle factors related to bowel pattern of female high school and college students in Gyeonggi Province. The total of 202 self-administered questionnaires (high school students 77 ; college students 125) were analyzed. All respondents were devided into four groups based on their self-reported pattern of defecation: 18 subjects ($9.0\%$) comprised the normal group, 73 ($36.1\%$) the constipation group, 73 ($36.1\%$) the constipation/diarrhea group, and 38 ($18.8\%$) the diarrhea group. Regularity of exercise was significantly higher in the college students than high school students, and times spending on a chair were longer in the high school students than college students. Most students ($72.7\%$) reported that they had stress. Fourty point six percent of the subjects reported that they had 3 meals per day, which tended to be higher in the normal and diarrhea group than constipation and constipation/ diarrhea group. Most students (69.7) skipped breakfast which was lower in the normal group than the other groups. The most preferred dietary fiber food was korean cabbage kimchi. Fifty-eight point four percent of the subjects reported that they had irregular bowel movement. Bowel movement was more irregular in the high school students than college students, and in the constipation group than the other groups. Of the subjects, $77.7\%$ had defecation frequency between three per week and three per day. Those who spent within 10 minutes for defecation were $79.6\%$, and those had difficulty in evacuating were $76.0\%$. High school students and those with constipation and constipation/diarrhea had a significantly lower defecation frequency, longer time spent at the toilet, and greater difficulty in evacuating than college students and normal and diarrhea group. The percentage of those who had feelings of residue in the intestine after defecation was $92.5\%$, and it was greater in the constipation or diarrhea group than in the normal group. Most students ($93.5\%$) reported that they had abdominal pain or discomfort. These results suggest that decreasing times spending on a chair, decreasing stress, keeping 3 meal per day at regular hours, and increasing dietary fiber intake are associated with desirable bowel pattern.

• The Korean Journal of Food And Nutrition
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• v.27 no.4
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• pp.581-587
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• 2014

In this study we included 298 working women in Kangwon province to investigate the life style and eating habits related to constipation. The subjects were divided into 3 groups according to Roman II criteria as follows : normal, mild constipation and constipation groups. For the result, 48.4%, 42.7%, 27.2% and 28.6% of the subjects had constipation in the order of 20's, 30's, 40's, and 50's, respectively. Constipation group had low frequency of bowel movement per week and irregular visit to toilet compared to normal and mild constipation groups. There were higher percentage of people with reading habit while sitting on a toilet, in the constipation group compare to other groups. Constipation groups had difficulty having bowel movement when sleeping outside of their home. There was a significant difference in water consumption per day among the 3 groups. But there was no significant difference in the amount of meals consumed and the number of meals with snacks per day. For the food frequency, there was lower frequency of yogurt and vegetables consumption in the constipation group. But there was no difference in how to eat fruits. From these results, we concluded that in order to treat the constipation, it is recommended to take enough water and dietary fiber, and to have physical activities for the working women.

• Korean Journal of Community Nutrition
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• v.16 no.1
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• pp.23-36
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• 2011

The purpose of this study was to obtain baseline data on dietary management of women's constipation. We estimated the prevalence of self reported constipation, bowel habits and foods & nutrients intake. The subjects were 169 female college students (normal = 92, constipation group = 77) aged 19 to 23 years. We conducted anthropometric measurements, an evacuation habits survey, and a dietary intake assessment for three days by a 24 hour recall method. The prevalence of self reported constipation was 46% (n = 77). Results showed that bowel habits (the difficulty of evacuation, the duration of evacuation and the feeling after evacuation) were significantly different between the two groups. Over 65% of constipation group used laxatives for constipation relief. Frequency of stress and deep sleeping were related with constipation. In daily food consumption and nutrients intake, there was not a significant difference between the groups. However in relation to bowel habits which factors influence constipation, the study showed that the intake of water, potatoes, kimchi, and fruits correlated with evacuation facility. Further, there were no findings in the difference of foods consumption and nutrients intake between the two groups. But some life style changes and food intakes (potato and kimchi) may be useful to improve constipation symptoms in young women.

• The Journal of Pediatrics of Korean Medicine
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• v.31 no.3
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• pp.1-13
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• 2017

Objectives The purpose of this study is to investigate how irritable bowel syndrome (IBS) affects fatigue scales and eating habits in children and adolescents using Rome IV criteria. Methods Questionnaires and The $PedsQL^{TM}$ Multidimensional Fatigue Scale (MFS) have been given to 211 children and adolescents aged 8 to 18 years old who were admitted to ${\bigcirc}{\bigcirc}$ university Korean medicine hospital pediatric departments, from 29th, July, 2016 to 12th, August, 2016 to evaluate their eating habits and fatigue. Additionally, PASW statistics 18.0 were used to analyze influence of irritable bowel syndrome on eating habits and fatigue in children and adolescents by using chi-square test, independent t-test and linear regression. Results In total of 211 subjects, 29 (13.7%) were diagnosed with IBS according to the Rome IV criteria. 1. There was a statistically significant difference (p<0.05) between IBS group and non-IBS group on a specific question in the eating habit questionnaire: the amount of sugar intake and the prevalence of IBS. 2. There was a statistically significant difference in general fatigue and cognitive fatigue categories when comparing the MFS subscores according to the prevalence of IBS. Conclusions Considering patients eating habits and fatigue is a necessary process for the successful treatment of irritable bowel syndrome. Korean medicine that maximizes quality of life while minimizing the potential risks to the patients of gastrointestinal disease should also include administrative interventions that may be helpful in the daily life of IBS patients.