Chronic constipation
Samar Razaq in Difficult Cases in Primary Care, 2021
Which of the following statements is/are true? Mark’s symptoms are typical of chronic non-specific diarrhoea, otherwise known as toddler diarrhoea.Hirschsprung’s disease is a common diagnosis in this age group.Encopresis (chronic faecal soiling at the age of 4 years and older) and constipation are closely linked with bladder dysfunction.Abdominal radiographs should be routinely performed in the evaluation of a child with constipation.Macrogol (polyethylene glycol) laxatives may be used if faecal impaction is suspected in the child.Answer: c and e
In-vivo Colonic Motility and Transit in Ulcerative Colitis
William J. Snape, Stephen M. Collins in Effects of Immune Cells and Inflammation on Smooth Muscle and Enteric Nerves, 2020
All patients consumed a clear liquid diet the day before and fasted 12 hrs before the study. The colon was prepared by having the subjects drink one gallon (3.785L) of Colyte, a balanced electrolyte solution the day before. A polyvinyl open-tipped catheter (ID = 0.8 mm and OD = 1 mm) was used to record intraluminal pressure and to instill the radionuclide marker, 99m technetium. The procedure was previously described [11,12]. The subjects were placed supine under a gamma camera (Pho/Gamma HP, Nuclear Chicago) and 99mTc DTPA (1 mCi) was injected into the splenic flexure. The movement of the tracer was measured by scintigraphic images acquired every one minute on a dedicated computer (Sopha Medical Computer, Baltimore, MD). The pressure was recorded on a Beckman dynograph.
Flexible endoscopy
P Ronan O’Connell, Robert D Madoff, Stanley M Goldberg, Michael J Solomon, Norman S Williams in Operative Surgery of the Colon, Rectum and Anus Operative Surgery of the Colon, Rectum and Anus, 2015
Generally, oral bowel preparations can be divided into three types. Isosmotic preparations (Golytely®, Glycoprep®, Colyte®, and Nulytely®) usually contain polyethylene glycol (PEG) and are osmotically balanced, high volume, nonabsorbable, and non-fermentable electrolyte solutions. They cleanse the colon by the mechanical effect of large volume lavage. The conventional dose is 3–4 L given as divided doses over a period of some hours. They may also be administered via a nasogastric tube at a rate of 20–30 mL/min. In the case of afternoon lists, it may be preferable to institute a split-dose regimen the afternoon before and early on the morning of the procedure. Low volume PEG solutions are available, combined with stimulant laxatives or ascorbic acid (Halflytely®, Moviprep®).Hyperosmotic preparations draw water into the bowel lumen which stimulates peristalsis and evacuation. Although small volume, these preparations can cause significant fluid and electrolyte shifts. Sodium phosphate (Fleet Phospho-Soda®, Osmoprep®, Fleet®) and sodium sulfate (Picoprep®) preparations are available.Stimulant laxatives include senna, an anthracene derivative, which stimulates colonic peristalsis. Bisacodyl is a diphenylmethane derivative which is poorly absorbed in the small intestine, but following hydrolysis by endogenous estersases its metabolites stimulate colonic motility.
Effect of prophylactic endoscopic closure for an artificial ulceration after colorectal endoscopic submucosal dissection: a randomized controlled trial
Published in Scandinavian Journal of Gastroenterology, 2019
Sang Pyo Lee, In-Kyung Sung, Jeong Hwan Kim, Sun-Young Lee, Hyung Seok Park
Informed consent of the procedure was obtained from the patients before their examination, and all patients were informed of the risks and benefits of prophylactic endoscopic closure. Anti-platelet or anti-coagulation drugs were stopped before the procedure, if possible. The duration of stopping medication was determined according to the cardiologist's recommendations [21]. The colon was cleansed with polyethylene glycol-based solution (Colyte® or Coolprep®, Taejun Co., Seoul, Korea). Subsequently, ESD was performed using standard colonoscope (CF-H260 or CF-H290; Olympus, Tokyo, Japan) by highly experienced endoscopists. Conscious sedation was performed using midazolam (Dormicum®, Bukwang Pharma, Seoul, Korea) or dexmedetomidine (Precedex®; Hospira Korea Co., Seoul, Korea) and pethidine (Pethidine HCl Injection®, Myungmoon Pharma, Seoul, Korea) were administered to all subjects for pain control.
Plecanatide for the treatment of chronic idiopathic constipation in adult patients
Published in Expert Review of Clinical Pharmacology, 2019
Gabrio Bassotti, Paolo Usai Satta, Massimo Bellini
Concerning traditional laxatives, lactulose is an indigestible synthetic disaccharide passing unchanged into the colon. This saccharide is osmotically active and hence draws water to the lumen of the colon [12]. Polyethylene glycol with a molecular weight of 3500–4000 (macrogol) is a non-absorbable macromolecule that maintains isoosmolarity in the lumen of the gut while drawing water, and is well investigated [13,14], superior to placebo [15] and recommended as a first choice treatment for CIC patients [16]. Polyethylene glycol is more effective than lactulose in increasing stool frequency and decreasing stool consistency [17]. Overall, stimulating laxatives have less literature evidence compared to polyethylene glycol because adequate placebo-controlled trials are lacking [15], even though most traditionally used laxatives are more effective than placebo for the treatment of CIC [15].
Effects of a Laxation and Probiotic Bowel Preparation Regimen: A Randomized Controlled Trial in Patients Undergoing Prostate Radiation Therapy
Published in Nutrition and Cancer, 2020
Nicole Weston, Georgina Luscombe, Kerith Duncanson
Patients were randomly assigned to the intervention group (IG) or standard care (SC). Randomization was performed by administrative personnel outside the research project. Patients in the IG were allocated to take Metamucil®, providing the equivalent of 10 g soluble fiber per day, and Nutralife Probiotic 50 Billion, 11 strain® probiotic, in addition to a standard low gas diet. Patients in the SC group were advised to take Movicol half strength® (Macrogol 3350 6.563 g) with a standard low gas diet. The low gas diet used was identical for each treatment arm and was low in fermentable carbohydrates, gastric irritants, and carbonated beverages. The standardized dietary advice involved distinctions between foods that should be eaten and foods to avoid, and was provided to patients by a qualified dietitian prior to the radiation planning appointment then weekly throughout treatment. Patients completed a 3-day food and bowel habit diary before the radiation planning appointment and during weeks one, four and seven of treatment.
Related Knowledge Centers
- Colonoscopy
- Constipation
- Excipient
- Flatulence
- Gastrointestinal Tract
- Kidney Failure
- Polyethylene Glycol
- Pregnancy
- Oral Administration
- Seizure