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Bowel disorders
Published in Henry J. Woodford, Essential Geriatrics, 2022
A number of factors are necessary to maintain bowel motions (seeFigure 12.1). These include adequate hydration, dietary fibre and mobility. The colon usually removes 90% of the water from its contents. Despite this, the normal composition of faeces is approximately three-quarters water with the rest being mainly fibre, bacteria and inorganic matter (e.g. calcium and phosphate). The proportion of water absorbed is increased in the presence of dehydration or a prolonged bowel transit time. Dietary fibre helps retain stool water by assisting peristalsis due to its bulk and by an osmotic effect. Moving around aids bowel peristalsis to reduce transit time. The gastrocolic reflex is a normal hormonally-mediated physiological occurrence whereby colonic contraction is stimulated 20–30 minutes after gastric distension. Hence, bowel evacuation is more likely after eating. Defaecation is also more likely to occur in the morning.5
Rational Medical Therapy of Functional GI Disorders
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Richard M. Sperling, Kenneth R. McQuaid
The effects of various calcium channel blockers on the GI tract have been assessed, including those of pinaverium, nicardipine, and nifedipine. These agents have been shown to inhibit postprandial spike potentials in the colon and to abolish the postprandial gastrocolic reflex (164-167). They have also been shown to inhibit the number and amplitude of rectosigmoid contractions and distension-induced rectosigmoid contractions (165,166). Pinaverium has poor GI absorption and marked hepatobiliary excretion; hence, it appears to have limited cardiovascular side effects at doses that effectively relieve GI spasm.
Fluid balance and continence care
Published in Barbara Smith, Linda Field, Nursing Care, 2019
Once the cause of the constipation has been identified, advice and treatment should be given in order to promote regular opening of the bowels without strain or discomfort. Patients should be advised not to ignore urges to open their bowels and to adopt the correct toilet position with the knees slightly higher than the hips and the feet supported on a step if necessary (Sikirov, 2003, cited in Rogers, 2012). Using the gastrocolic reflex, particularly in the morning or after meals should be encouraged (Rogers, 2012). Medication may be prescribed initially, but for the long-term treatment of simple constipation, a change in dietary habits, increased fluid intake and improvements in mobility may be all that are needed.
Evaluation of myoelectrical activities of descending colon by electrointestinogram in patients with ATTRm amyloidosis
Published in Amyloid, 2019
Konen Obayashi, Teruaki Masuda, Masayoshi Tasaki, Yukio Ando, Mitsuharu Ueda
Our cutaneous EIG recording method could assess the gastrointestinal function in ATTRm amyloidosis patients. Not only the mean dominant peak frequency of descending colon in diarrhea case but also the peak delay of gastrocolic reflex after meal start in constipation case may have a potential as an evaluating marker for the early detection of gastrointestinal dysfunction in these patients.