• 대한암한의학회지
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• 제25권2호
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• pp.37-49
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• 2020

Objective: Constipation is the most common adverse effect of opioid analgesic therapy in cancer patients. This can be associated with physical and emotional distress to cancer patients. The purpose of this study is to review the standard and alternative interventions of the management for opioid-induced constipation (OIC). Methods: The studies were searched from databases, including Pubmed, Google scholar, KISS, NDSL, and OASIS. The main search terms included such as constipation, opioid, opioid-induced constipation, cancer, management, herb, and acupuncture. Results: The prevention and usual care of constipation is a key tool for the management of OIC. Also, prophylactic laxatives starting concurrently with opiates helped to prevent developing constipation. Peripherally acting μ-opioid receptor antagonists (PAMORAs) significantly reduced OIC and well-tolerated. In addition, acupuncture, herb medicines, and interferential current or transcutaneous electrical nerve stimulation to acupoints had effectiveness in reducing constipation. Conclusion: Preliminary data indicate that PAMORAs and Traditional Korean Medicine may be considered as the management of unresolved OIC. However, due to the limited articles, more systematic and rigorous clinical trials are needed.

• International Journal of Internet, Broadcasting and Communication
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• 제13권2호
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• pp.145-155
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• 2021

With the recent rapid improvement in the standards of life and westernization of dietary lifestyles, the consumption of high-calorie diets such as high-fat and high-protein red meat and instant foods has increased, while less vegetables containing dietary fiber are consumed. In addition to that, stress, erroneous dietary behaviors, and contaminated environments are linked to the risk of developing ulcerative colitis, which is on the rise. Another cause of ulcerative colitis is that involve laxative abuse, including repeated, frequent use of laxatives, and include such conditions as deteriorated bowel function, irritable bowel syndrome, diarrhea, intestinal inflammation, etc. The present study aimed to investigate the comparative evaluation of pharmacological efficacy between sulfasalazine alone and combination with herbal medicine on dextran sodium sulfate (DSS)-induced UC in mice. Balb/c mice received 5% DSS in drinking water for 7 days to induce colitis. Animals were divided into five groups (n = 9): group I-normal group, group II-DSS control group, group III-DSS + sulfasalazine (30 mg/kg), group IV-DSS + sulfasalazine (60 mg/kg), group V-DSS + sulfasalazine (30 mg/kg) + Radish Extract mixture (30 mg /kg) (SRE). DSS-treated mice developed symptoms similar to those of human UC, such as severe bloody diarrhea and weight loss. SRE supplementation, as well as sulfasalazine, suppressed colonic length and mucosal inflammatory infiltration. In addition, SRE treatment significantly reduced the expression of pro-inflammatory signaling molecules through suppression both mitogen-activated protein kinases (MAPK) and nuclear factor-kappa B (NF-κB) signaling pathways, and prevented the apoptosis of colon. Moreover, SRE administration significantly led to the up-regulation of antioxidant enzyme including SOD and Catalase. This is the first report that Radish extract mixture combined with sulfasalazine protects against experimental UC via the inhibition of both inflammation and apoptosis, very similar to the standard-of-care sulfasalazine.

• Nutrition Research and Practice
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• 제16권4호
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• pp.435-449
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• 2022

BACKGROUND/OBJECTIVES: Cheonggukjang is a traditional fermented soybean paste with significant health-promoting effects. On the other hand, there have been insufficient studies on the safety and efficacy of Cheonggukjang, which is produced using traditional methods containing toxins and biogenic amines (BAs). This study compared the laxative effect of Cheonggukjang, containing high or low levels of toxins and BAs (HTBC or LTBC) in a loperamide (Lop)-induced constipation mouse model. MATERIALS/METHODS: To induce constipation, Lop (5 mg/kg) was administered orally to ICR mice twice a day for 4 days, and the dose was increased to 8 mg/kg after a 3-day rest period. Cheonggukjang (500 mg/kg, HTBC, or LTBC respectively) was administered for four weeks before the Lop treatment. RESULTS: The number of stools, fecal weight, water contents, gastrointestinal transit, and histological alterations were recovered significantly in the HTBC or LTBC groups. HTBC and LTBC administration did not induce significant changes in body weight, dietary intake, and behavior. The opioid-receptor downstream signaling pathway in colon tissues was also evaluated. The c-Kit, stem cell kinase, and mitogen-activated protein kinases subfamilies, including extracellular signal-regulated kinase 1/2, c-Jun N-terminal kinases, and p38, were all downregulated in the HTBC or LTBC-administered mice colon compared to the Lop group. CONCLUSION: These results show that Cheonggukjang, containing high levels of toxins and BAs, have a similar laxative effect in a mouse model of Lop-induced constipation.

• 근관절건강학회지
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• 제29권2호
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• pp.81-90
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• 2022

Purpose: The purpose of this study was to evaluate the efficacy of applying a defecation encouragement program for patients undergoing total knee replacement arthroplasty (TKRA). Methods: This program was based on the nursing best practice guideline: prevention of constipation in the older adult population by the National Guideline Clearing House (NGC) in 2011, which included fluid intake, bowel training, and abdominal and pelvic floor exercises. A team of one orthopaedic clinical nurse specialist and six orthopaedic nurses with a 10 years of clinical experience applied and assisted patients with the program. Formal counsel was provided by one orthopaedic doctor, one gastroenterologist, and one exercise therapist. Patients who defecated one day prior to or on the day of TKRA surgery were included. Data collected from 72 subjects were analyzed using SPSS/WIN 21.0. Results: Time until first defecation after surgery was 2.4±1.1 days in experimental group, which was significantly shorter than the 3.5±0.9 days in control group (t=4.28, p<.001). Constipation assessment scale showed significantly lower points (t=2.55, p=.013) in experimental group (1.3±1.2) compared to control group (2.6±2.6). The experimental group and control group were 17.3±7.67 and 23.7±14.43, respectively, and the experimental group used less laxatives (t=2.83, p=.021). Conclusion: A defecation encouragement program was proved to be an appropriate nursing intervention for patients undergoing TKRA. This study confirmed that constipation is a nursing problem that can be sufficiently prevented if nurses are interested and encourage defecation.

• 대한한의학회지
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• 제43권4호
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• pp.8-19
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• 2022

Objectives: Parkinson's disease (PD) patients experience various non-motor symptoms, among which constipation is the second most common after anosmia. However, there are no clear guidelines or effective treatment for constipation in PD. Methods: To investigate the efficacy of Majainhwan (MH) on constipation in patients with PD, we conducted a retrospective chart review study of PD or Parkinsonism patients with constipation who received outpatient or inpatient treatment and whose previous laxatives were replaced by MH from August 2016 to July 2019. Results: In this study, a total of 68 patients' medical records were reviewed. Among the 44 outpatients with MH treatment, "effective" results were observed in 86.4% patients. Similarly, among the 24 inpatients, "effective" results were noted in 95.8% patients. The adverse effect was "diarrhea" reported in five cases. Conclusion: Based on these findings, we could suggest that MH is relatively safe and may be effective in the treatment of constipation in patients with PD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제27권2호
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• pp.125-135
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• 2024

Purpose: The updated ROME IV criteria for functional constipation (FC) in children were published in 2016. However, information on the use of these criteria is scarce. This study aimed to report the frequency of the use of the ROME IV criteria by Indonesian pediatricians and general practitioners (GPs) in FC management in infants and toddlers. Methods: An anonymous cross-sectional online survey was conducted between November 2021 and March 2022. Results: A total of 248 respondents (183 pediatricians and 65 GPs) from 24 Indonesian provinces completed the survey. Most respondents reported an estimated prevalence of FC to be less than 5% both in infants and toddlers. On average, only 64.6% of respondents frequently used the ROME IV criteria. Pediatricians used the ROME IV criteria more often than GPs did (p<0.001). The most frequently used criteria were painful or hard bowel movements (75.0%) and ≤2 defecations/week (71.4%). Lactulose as a laxative was the preferred treatment choice, followed by changing the standard formula to a specific nutritional formula. Most of the respondents carried out parenteral reassurance and education. Normal growth, as a marker of good digestion and absorption function, and normal stool consistency and frequency were the most reported indicators of gut health. Conclusion: The ROME IV criteria for functional constipation are not extensively used by pediatricians and GPs in Indonesia. Laxatives and specific nutritional formulas were the most used management approaches in infants and toddlers. Medical education, especially for general practitioners, should be updated.

• 동의신경정신과학회지
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• 제12권2호
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• pp.17-25
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• 2001

Objectives: Obesity is related to psychological problems as well as physical problems. This study was designed to investigate the eating attitude and depression of females who participated in a fasting therapy. They were considered to have many eating attitude and psychological problems. Methods: 59 females were selected, they were admitted in Woosuk university hospital of oriental medicine(from August 1st, 2000 to July 31th, 2001) and 42 females were selected, they were college students of Woosuk university, Jeonju, Korea. We checked height, weight and administerd the Korean Eating Attitudes Test-26(KEAT-26), Beck Depression Inventory(BDI) and questions about binge-eating, smoking, drinking, exercise and body weight-wanted to females in two groups. Results: In fasting women group, 2(3.39%) were underweight, 24(40.68%) were average. The average of KEAT-26 in fasting women group$(13.33{\pm}7.65)$ was higher than that in college women group$(4.76{\pm}5.54)$(p<0.001). In fasting women group, 5(8.47%) had mild eating problem, 4(6.78%) had moderate eating problem, and 5(8.47%) had severe eating problem. In fasting women group, 47(79.66%) said 'yes' at the question(A-1, DSM-IV bulimia nervosa diagnosis), 33(55.93%) said 'yes' at the question(A-2, DSM-IV bulimia nervosa diagnosis) about binge eating. In fasting women group, 14(23.73%) had used vomiting, 13(22.03%) enemas, 27(45.76%) laxatives, 7(11.86%) diuretics, 6(10.17%) other drugs, 38(64.41%) fasting, 15(25.42%) severe exercise, and others 2(3.39%) to reduce their weight. The average of BDI in fasting women group$(12.44{\pm}6.70)$ was higher than that in college women group$(7.47{\pm}5.48)$(p<0.001). In fasting women group, 10(16.95%) had mild depression problem, 4(6.78%) had moderate depression problem, and 3(5.08%) had severe depression problem. In fasting women group, 41(64.49%) had under 5Kg-gap, and 18(30.51%) has over 5Kg-gap between weight-reasonable and weight-wanted. In 26 fasting women who were underweight or average-weight, 14 had over 5Kg-gap. Conclusions: These results suggest that the females who participated in a fasting therapy had many depression and eating problems, and we should pay attention to the eating disorders and psychological problems including depression as well as the physical problems when we treat obesity.

• 대한간호
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• 제29권3호
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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.

• 한국보건간호학회지
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• 제14권2호
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• pp.431-445
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• 2000

In general the prevalence of old people is high and frequently have multiple diseases and symtoms requiring treatment. The nature of illness in the elderly has to be faced, and drugs do have an important part in the treatment of that illness. The purpose of this study were to describe health status and medication, and to provide some basic data for elderly's health education, especially for the right medication. Body mass index, self perceived health status, activities of daily living, disease and experience of past operation were surveyed to recognize the 249 elderly's actual health status. The degree of the elderly's understanding the way of medication, experience of side effects, experience of drug combination and incidence of drug adverse reaction along with drug combination were examined for medication. The aged $women(BMI; 10.7\pm13.3\%)$ overweighed the aged $men(BMI; 4.0\pm10.4\%)$. $69.0\%$ of them recognized their health good. Their activities of daily living were diminished following by the age group(p=0.0068) and relationship with self perceived health status were very significant(p=0.0005). They(192 elderly) suffered from multiple disease such as $osteoarthritis(49.5\%)$, $hypertension(32.0\%)$, gastric $disorder(16.1%)$, $diabetes(14.6\%)$, $osteomalacia(10.9\%)$, cardiovascular $disease(9.9\%)$, senile $cataract(5.7\%)$, skin $rash(5.2\%)$, liver $disease(4.2\%)$, kidney $disease(3.6\%)$, spinal cord $problem(3.6\%)$, respiratory $disease(2.1\%)$ $tuberculosis(1.0\%)\;etc(1.0\%).$ $28.3\%$ of them replied that they had an operation for appendictis senile cataract, peptic ulcer, spinal cord problem, pleurisy, hemorrhoid and the rest. Most of $them(87.4\%)$ knew the way very well how to use drugs, and $21.6\%$ of the replied 171 elderly experienced adverse drug reaction. Drug compliance rate were $high(83.6\%)$. In our study 56.9% of the 167 elderly took several medicine together. And $18.9\%$ of the 95 elderly who did drug combination had an experience of drug interaction. One person kept average 5.5 kinds of drugs at home among 243 elderly. They kept $digestives(79.4\%)$, $ointments(68.7\%)$, $vitamins(59.7\%)$, $analgesics(59.7\%)$, cold $medicines(45.3\%)$ antiarthritic $drugs(33.3\%)$, health $foods(27.7\%)$, antihypertensive $drugs(25.1\%)$, anti peptic ulcer $drugs(24.7\%)$, $laxatives(19.8\%)$, $antacids(16.5\%),\;antibiotics(l6.5\%)$, hypoglycemic $agents(10.3\%)$, cardiac $stimulants(7.0\%)$, $diuretics(4.5\%)$, antiarrhythmic $drugs(4.9\%)$, anti anginal $drugs(4.1\%)$, $hypnotics(3.3\%)$, $etc(38.3\%)$. With this result, we ascertain that polypharmacy in the elderly caused by multiple disease is common, which lead to drug interaction. So our task is to educate elderly how to use drugs in order to maximize their efficiency and to minimize their adverse effects.

• 한국임상약학회지
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• 제23권1호
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• pp.42-48
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• 2013

Background: Patients diagnosed with cancer tend to have multiple risk factors for drug related problems such as old age, comorbid conditions, self-medication, additional medications for supportive therapy, and the cancer treatment itself. Objective: The aim of this study was to investigate notable polypharmacy and related problems in oncology patients during hospitalization or following clinic visit. Method: The electronic medical records of patients who were discharged from oncology division at Seoul National University Hospital (SNUH) from June $1^{st}$ to June $30^{th}$, 2011 were retrospectively reviewed. Results: A total of 334 discharged patients were included in this study. Among them, 221 patients had pre-admission medications. Forty percent of the patients, including 60.3% of elderly patients (over 65 years of age) were prescribed more than 5 kinds of medications. Twenty percent of the patients were prescribed to take medications more than 7 times a day. Medication duplications were observed in 2.4% of patients. In 10.5% of the reviewed patients, 47 cases of potential drug-drug interaction including 3 cases of contraindication and 17 cases of major clinical implication according to Micromedex were detected. Medication changes were made in 88% of patients during hospitalization and in 94.7% of patients at their first visit after discharge. Antidiarrheal agent (loperamide) was prescribed along with laxatives in 18.5% of the prescriptions and inadequate instructions on how to take it were observed in 63% of the prescriptions. Conclusion: This study identified the prevalence of polypharmacy and related problems in cancer patients, which presents the need for an active role of pharmacists in pharmaceutical care in oncology wards.