Application Of Enemas Research Articles

Management of Amavata Through Vaitarana Basti w.s.r to Rheumatoid Arthritis

Amavata is one of the crippling disease- causing serious agonizing painful conditions. Some of the symptoms of Amavata can correlated with Rheumatoid arthritis. Rheumatoid arthritis is a common form of inflammatory arthritis, occurring throughout the world and in all ethnic groups. The prevalence of RA is approximately 0.8-1.0% in Europe and South Asia, with a female to male ratio 3:1. Acharya Chakradatta mentioned treatment modalities for Amavata are Langhana, Swedana, Tikta, Deepana, Katu Dravya, purgatives, intake of Sneha and Application of enemas. Teekshna basthi such as Vaitarana basti is indicated in the treatment of Amavata since it possesses qualities like Amapachana, Srotoshodhana and Vatakaphahara. It has Vata kapha pacifying properties and helps in removing Avarana of Vata by Kapha. By using this Chikitsa Siddanta a case of Amavata was successfully treated and marked improvement was observed in signs and symptoms after treatment. Here a case report on Amavata has been discussed along with its effective management with Vaitarana Basti.

Thyroxine replacement by colonic route and absorption kinetics: case report

In the literature there are only 2 reports of replacement of thyroid hormones by colonic route. The objective of this study is to present a clinical case where thyroid hormone replacement was performed through the application of enemas with levothyroxine. 78-year-old patient with hypothyroidism is presented who attended to the emergency room with intestinal occlusion, which presented refractory hypothyroidism secondary to intestinal occlusion and she underwent hormone replacement with enemas with levothyroxine. The kinetics of colonic absorption of thyroid hormones takes twice as long to reach the plateau of serum levels with respect to absorption in jejunum and ileum.

The Effect of Informing Patients Who Will Undergo a Colonoscopy via Short Messaging Service on the Procedure Quality and Satisfaction: An Endoscopist-Blinded, Randomized Controlled Trial

PurposeThe present research was carried out to determine the impact of informing patients who would undergo a colonoscopy via short messaging service (SMS) on the procedure quality and satisfaction. DesignThe study was designed as a randomized controlled experimental and single-blind. MethodsThe study was completed with 170 patients (87 in the control group and 83 in the intervention group). Verbal and written information about bowel preparation was provided to all patients at the first appointment. Additionally, a total of nine informative SMS, including the time of colonoscopy, dietary restrictions to be followed, purgative drugs to be used, and the time of taking the drugs, were sent to the patients in the intervention group starting 2 days before the procedure. Data were collected using a patient questionnaire, Boston Bowel Preparation Scale (BBPS), and postcolonoscopy follow-up form. FindingsThe mean score of each colon segment and the total BBPS mean score of the patients in the intervention group were higher compared to the control group, and the difference between them was statistically significant. The percentage of patients with adequate bowel preparation was significantly higher in the intervention group (84.3%) in comparison with the control group (71.3%). The intervention group had high compliance with a clear diet, enema application, and oral medication intake (P < .05). The cecum was reached in 85.5% of the intervention group. The majority of the patients (89.2%) in the intervention group reported that the information provided via SMS was adequate, and 91.6% were satisfied with the information provided by SMS. ConclusionsThe study shows that, in addition to written and verbal information provided before colonoscopy, SMS information positively impacts the quality of patients' bowel preparation, increases their compliance with the preparation instructions, the rate of reaching the cecum, and their satisfaction. Patient education with this practice can help ensure adequate bowel preparation quality and increase patient comfort in the colonoscopy procedure.

Effect of high volume enema in children with abdominal pain: Pediatric emergency department experience.

Abdominal pain is one of the most common reasons for admission to the pediatric emergency clinic. The appropriate evaluation of clinical and laboratory clues to make the correct diagnosis is of great importance in terms of directing the treatment medically or surgically and preventing unnecessary investigations. The aim of our study was to evaluate the contribution of high-volume enema application among pediatric patients with abdominal pain in terms of clinical and radiological findings. Among the pediatric patients who applied to the pediatric emergency clinic of our hospital between January 2020 and July 2021 with abdominal pain, those who had intense gas stool image on abdominal X-ray and abdominal distension on physical examination and who underwent high-volume enema treatment were included in the study. The physical examination and radiological findings of these patients were evaluated. During the study period, 7819 patients were admitted to the pediatric emergency outpatient clinic with abdominal pain. Classic enema was performed in 3817 of these patients who had a dense gaseous stool image and abdominal distention on abdominal X-ray graphy. Defecation occurred in 3498 (91.6%) of 3817 patients who underwent classical enema, and the complaints regressed after enema. High-volume enema was applied to 319 (8.4%) patients who did not find relief with classical enema. Complaints of 278 (87.1%) patients regressed after the high-volume enema. Control ultrasonography (US) was performed in the remaining 41 (12.9%) patients, 14 (34.1%) patients were diagnosed with appendicitis. US results of 27 (65.9%) patients who had repeated US were evaluated as normal. High volume enema treatment is an effective and safe method in children with abdominal pain who are unresponsive to classical enema application in the pediatric emergency department.

Faecal microbiota transplantation in the treatment of Clostridioides difficile infection

Faecal microbiota transplantation (FMT) represents a unique procedure targeted to restoring the natural diversity of the gastrointestinal microbiome and prevent recurrence of a key nosocomial disease, namely, Clostridioides difficile infection (CDI). The aim of the present study was assessing the success rate and clinical efficacy of FMT at a clinic that introduced this procedure in Czechia in 2010 and still leads in the number of transplantations performed to date. Patients enrolled in the study received primary targeted antibiotic therapy, and after the CDI episode treatment, FMT administered as a secondary prophylaxis. After the procedure, patients were followed up. The treatment was defined as successful if colitis did not recur within 8 weeks. Logistic regression analysis was used for determining the odds ratios for the individual factor variants (patient age and sex, number of previous recurrences, severity of the treated CDI episodes, presence of chronic comorbidities, performance status, initial antibiotic treatment, mode of faecal-transplant application and use of fresh or frozen stool). In the 4-year interval involved (2015–2018), 172 patients were treated using faecal microbiota transplantation. The overall success rate was 76%. Subgroup analysis identified higher age, higher Charlson Comorbidity Index reflecting the presence and severity of long-term comorbidities and higher Eastern Cooperative Oncology Group (ECOG) performance scores as risk factors for treatment failure. In the period monitored, two serious adverse events were observed: Both were rectal-wall perforations occurring during the application of enemas of stool suspension. There was no lethality.

Influence of preoperative enema application on the return of gastrointestinal function in elective Cesarean sections: a randomized controlled trial

Aim There is an extensive literature on the mechanical bowel preparation by an enema in colorectal, abdominal, and gynecologic surgeries that provide evidence against the use of enema. There are, however, few studies investigating the effect of enema prior to elective Cesarean sections. The aim of this study is to investigate whether preoperative enema facilitates the return of gastrointestinal activity in pregnant women undergoing elective Cesarean section. Materials and methods The surgeon-blinded prospective randomized controlled study included 225 elective Cesarean patients between the ages of 18 and 44. The patients were randomized into two groups: those who had enema preoperatively (n = 114) and those who did not (n = 111). The outcome measures were first bowel sound time and first flatus time, the length of hospital stay, the rate of mid ileus symptoms, and additional analgesic and antiemetic need. Results In the non-enema group, the time of the first bowel sound, flatus time, length of hospital stay, the rates of additional analgesic need, additional antiemetic need, and mild ileus symptoms were respectively 10.5 ± 5.8 hours, 16.0 ± 7.6 hours, 1.9 ± 0.3 days, 8.1%, 7.2%, and 2.7%. For the enema group, the same parameters were respectively 11.6 ± 4.7 hours, 17.5 ± 6.5 hours, 1.8 ± 0.3 days, 7%, 6.1% ,and 1.8%. For all parameters, the difference between the groups was not statistically significant (p values were respectively .09, .12, .8, .79, .68, and .26). Conclusions The study suggests that preoperative enema in elective cesarean sections does not prevent postoperative gastrointestinal complications and does not shorten the recovery of bowel movements or length of hospital stay.

RETRACTED ARTICLE]: EVALUATION OF ENEMAS CONTAINING SUCRALFATE IN TISSUE CONTENT OF MUC-2 PROTEIN IN EXPERIMENTAL MODEL OF DIVERSION COLITIS

ABSTRACTBackground: The effects of topical application of sucralfate (SCF) on the tissue content of MUC-2 protein have not yet been evaluated in experimental models of diversion colitis. Aim: To measure the tissue content of MUC-2 protein in the colonic mucosa diverted from fecal stream submitted to the SCF intervention. Methods: Thirty-six rats underwent derivation of intestinal transit through proximal colostomy and distal mucous fistula. The animals were divided into three groups which were submitted application of enemas with saline, SCF 1 g/kg/day and SCF 2 g/kg/day. Each group was divided into two subgroups, according to euthanasia was done after two or four weeks. The colitis diagnosis was established by histopathological study and the inflammatory intensity was evaluated by previously validated scale. The MUC-2 protein was identified by immunohistochemistry and the tissue content was measured computerized morphometry). Results: The application of enemas with SCF in the concentration of 2 g/kg/day reduced inflammatory score of the segments that were diverted from fecal stream. The content of MUC-2 in diverted colon of the animals submitted to the intervention with SCF, independently of intervention period and the used concentration, was significantly greater than animals submitted to the application of enemas containing saline (p< 0.01). The content of MUC-2 after the intervention with SCF in the concentration of 2 g/kg/day was significantly higher when compared to the animals submitted to the application containing SCF at concentration of 1.0 g/kg/day (p<0.01). The tissue content of MUC-2 reached the highest values after intervention with SCF in the concentration of 2 g/kg/day for four weeks (p<0.01). Conclusion: The preventive application of enemas containing SCF reduces the inflammatory score and avoids the reduction of tissue content of MUC-2, suggesting that the substance is a valid therapeutic strategy to preserve the mucus layer that covers the intestinal epithelium.

Influence of the application of enemas with oily extract of curcumin (Curcuma longa) on the tissue content of neutral and acidic mucins in the colonic mucosa without fecal stream

PurposeTo verify if the application of enemas containing oily extracts of curcumin preserves the tissue content of mucins in the glands of the colonic mucosa without fecal stream. MethodThirty-six Wistar rats were submitted to diversion of the fecal stream by proximal colostomy and distal mucous fistula. The animals were subdivided into three groups, and accordingly received enemas with saline and oily extract of curcumin at concentrations of 50mg/kg/day or 200mg/kg/day. After two or four weeks of intervention, the irrigated colic segments were removed. Neutral and acidic mucins were identified by Periodic-acid Schiff and Alcian-Blue techniques, respectively. The content of both mucin subtypes was measured by computerized morphometry. Mann–Whitney test was used to analyze the results, adopting a significance level of 5% (p≤0.05). ResultsThere was an increase in the tissue content of neutral mucins in animals treated with curcumin at a concentration of 50mg/kg/day for four weeks, whereas in the group treated with 200mg/kg/day there was an increase independent of the time of intervention. The content of acidic mucins increased in animals treated with 200mg/kg/day regardless of the intervention time, whereas in those treated with 50mg/kg/day an increase was observed only after four weeks. ConclusionEnemas with curcumin preserve the content of neutral and acidic mucins in the colonic epithelium without fecal stream.

EVALUATION OF ENEMAS CONTAINING SUCRALFATE IN TISSUE CONTENT OF MUC-2 PROTEIN IN EXPERIMENTAL MODEL OF DIVERSION COLITIS

ABSTRACTBackground: The effects of topical application of sucralfate (SCF) on the tissue content of MUC-2 protein have not yet been evaluated in experimental models of diversion colitis. Aim: To measure the tissue content of MUC-2 protein in the colonic mucosa diverted from fecal stream submitted to the SCF intervention. Methods: Thirty-six rats underwent derivation of intestinal transit through proximal colostomy and distal mucous fistula. The animals were divided into three groups which were submitted application of enemas with saline, SCF 1 g/kg/day and SCF 2 g/kg/day. Each group was divided into two subgroups, according to euthanasia was done after two or four weeks. The colitis diagnosis was established by histopathological study and the inflammatory intensity was evaluated by previously validated scale. The MUC-2 protein was identified by immunohistochemistry and the tissue content was measured computerized morphometry). Results: The application of enemas with SCF in the concentration of 2 g/kg/day reduced inflammatory score of the segments that were diverted from fecal stream. The content of MUC-2 in diverted colon of the animals submitted to the intervention with SCF, independently of intervention period and the used concentration, was significantly greater than animals submitted to the application of enemas containing saline (p< 0.01). The content of MUC-2 after the intervention with SCF in the concentration of 2 g/kg/day was significantly higher when compared to the animals submitted to the application containing SCF at concentration of 1.0 g/kg/day (p<0.01). The tissue content of MUC-2 reached the highest values after intervention with SCF in the concentration of 2 g/kg/day for four weeks (p<0.01). Conclusion: The preventive application of enemas containing SCF reduces the inflammatory score and avoids the reduction of tissue content of MUC-2, suggesting that the substance is a valid therapeutic strategy to preserve the mucus layer that covers the intestinal epithelium.

Clinical study of enema aplication of Yiyi-Fuzi-Baijiang powder combined with oral sulfasalazine in treating ulcerative colitis

Objective Evaluation of enema application of Yiyi-Fuzi-Baijiang powder combined with oral sulfasalazine enteric-coated tablets in treating ulcerative colitis. Methods The patients with ulcerative colitis were randomly divided into 2 groups, 42 cases in each group. The control group was treated with sulfasalazine, and the observation group with sulfasalazine and Yiyi-Fuzi-Baijiang powder. Both groups were treated for 4 weeks. ELISA method was used to detect the levels of IL-6, IL-8 and TNF-. The changes of disease activity index (Sutherland DAI) were observed before and after treatment, and the clinical efficacy was evaluated. Results After treatment, the Sutherland DAI (3.89 ± 0.91 vs. 4.91 ± 1.08, t=3.082) in the observation group was significantly lower than that in the control group (P=0.042). The level of TNF- (20.82 ± 4.31 ng/L vs. 26.51 ± 5.25 ng/L, t=3.602), IL-6 (31.73 ± 4.82 ng/L vs. 40.18 ± 5.63 ng/L, t=3.817), and IL-8 (35.39 ± 4.62 ng/L vs. 40.59 ± 5.35 ng/L, t=3.341) in the observation group were significantly lower than those in the control group (P<0.05). The total efficiency of observation group was 92.9% (39/42), and the control group was 73.8% (31/42). There was significant difference between the two groups (χ2=4.200, P=0.040). Conclusions The Yiyi-Fuzi-Baijiang powder combined with sulfasalazine could relieve the clinical symptoms of ulcerative colitis patients with spleen-kidney yang deficiency, and inhibition inflammatory response. Key words: Colitis, ulcerative; Yiyi-Fuzi-Baijiang powder; Retention enema; Interleukin-6; Interleukin-8; Tumor necrosis factor-alpha

Claudin-3 and occludin content in the glands of colonic mucosa devoid from fecal stream submitted to topical intervention with oil extract of Curcuma longa.

To evaluate the inflammatory intensity and measure the tissue content of the proteins claudin-3 and occludin in the colonic mucosa without fecal stream submit to intervention with curcumin. Thirty-six rats were submitted to a proximal colostomy and a distal mucous fistula and divided into two groups according to sacrifice to be performed two or four weeks. Each group was divided into three subgroups according daily application of enemas containing saline, curcumin at 50 mg/kg/day or 200 mg/kg/day. Colitis was diagnosed by histological analysis. Claudin-3 and occludin were determined by immunohistochemistry. The tissue content of claudin-3 and occludin were quantified by computer-assisted image analysis. Mann-Whitney, Student t and ANOVA tests were used to analyze the results establishing the level of significance of 5% for both (p<0.05). Curcumin at both concentrations reduces the inflammation and preserves the tissue content of the proteins claudin-3 and occludin, which was related to the concentration used and to the time of the intervention. The application of enemas with curcumin reduces inflammation and preserves the tissue content of the proteins claudin-3 and occludin in the colonic mucosa devoid from the fecal stream.

Difficulties in Performing Mesalazine Enemas and Factors Related to Discontinuation Among Patients With Ulcerative Colitis.

Current first-line treatment of ulcerative colitis consists of a combination of mesalazine enemas and oral mesalazine; however, many patients may discontinue mesalazine enemas. In this single-center, cross-sectional study, 165 outpatients with ulcerative colitis completed a self-administered questionnaire regarding the frequency of mesalazine enemas, difficulties in performing these enemas, and factors possibly associated with their discontinuation, as well as patient clinical and demographic characteristics. Of 165 patients, 34 (20.6%) discontinued mesalazine enemas because of a lack of efficacy. Five of the 13 items assessing difficulties were answered affirmatively by the majority of patients. Discontinuation of enema application was associated with a perceived lack of efficacy, four or more bowel movements per day, and lower scores on measurement of the doctor-patient relationship. Application of mesalazine enemas by patients with ulcerative colitis may be improved by discussions with peers and healthcare professionals and by adjusting the frequency of application or the time of starting the enema based on worsening of ulcerative colitis.

Tissue content of sulfomucins and sialomucins in the colonic mucosa, without fecal stream, undergoing daily intervention with sucralfate.

To measure the content of acidic mucin, sialomucin, and sulfomucins in the colonic mucosa without fecal stream submit to intervention with sucralfate (SCF). Thirty-six rats were submitted to a right colostomy and a distal mucous fistula and divided into two groups according to sacrifice to be performed two or four weeks. Each group was divided into three subgroups according daily application of enemas containing saline, SCF at 1.0 g/kg/day or 2.0 g/kg/day. Colitis was diagnosed by histological analysis. Acid mucins were determined with the Alcian-Blue and sulfomucin and sialomucin by high iron diamine-alcian blue (HID-AB) techniques. The mucins were quantified by computer-assisted image analysis. Mann-Whitney and ANOVA tests were used to analyze the results establishing the level of significance of 5% for both (p<0.05). SCF enemas decreased the inflammation score and was related to the concentration used and time of the intervention. SCF at both concentrations increased the content of acid mucin, which was related to the concentration used and to the improvement in the inflammatory score. There was an increase in the content of sulfomucins and sialomucins in SCF groups. SCF increased sulfomucins from 2 weeks of intervention, which was not related to the dose or time of application. The increase in sialomucin content was related to the time and dose used in the intervention. Sucralfate increased the content of acidic mucins, primarily at the expense of sialomucin, which was affected by the dose and time of intervention.

Perineal colostomy: An option in the treatment of inferior rectal and anal canal cancer

IntroductionThe surgical treatment of anorectal cancer is considered a challenging topic. Colostomy, temporary or permanent, can be a serious limiting factor with respect to the quality of life of cancer patients. Our goal is to study the clinical and surgical experience in patients with anorectal cancer, in whom we proceeded to abdominoperineal resection with a perineal colostomy at the anterior border of the incision resulting from the ampu- tation of the rectum. MethodsThe medical records of patients undergoing abdominoperineal resection with perineal colostomy from January 1st, 1998 to July 1st, 2012 were analyzed retrospectively. ResultsTwenty-seven patients were studied; 15 (55.56%) were male and 12 (44.44%) fe- males, with a mean age of 56.3 years. The average length of hospital stay was 7.4 days. Complications included four (14.8%) prolapses of the perineal colostomy, which were surgically treated after the sixth month postoperatively, two (7.4%) partial suture dehis- cences of the perineal colostomy, treated with hyperbaric oxygen therapy, two (7.4%) ste- noses of the perineal colostomy, treated with dilation, two (7.4%) incisional hernias and one (3.7%) urinary incontinence. ConclusionThe perineal colostomy is a relatively new proposition, with acceptable mor- bidity rates. We understand that the perineal colostomy dismisses the use of a collection device, leaves no odor and allows the periodic application of enemas for colon cleansing, which prevents stoma incontinence. Another advantage is to enable the patient's return to a good social and work interaction; thus, it will be possible his (her) reintroduction into society.

Evaluation of sucralfate enema in experimental diversion colitis

Diversion colitis (DC) is an inflammatory disease that develops in segments with fecal di- version. Sucralfate (SCF) complex, which consists of sucrose octasulfate and polyaluminum hydroxide, has been demonstrated to be effective in the treatment of different forms of colitis. However, until now, the effects of SCF have not been evaluated in DC. Objectiveto evaluate whether the use of enemas containing SFC improves histological find- ings in experimental DC. MethodsThirty-six rats underwent right colon bypass procedure through the creation of a proximal colostomy and a distal mucous fistula. The animals were divided into two groups according to the euthanization procedure to be performed two to four weeks after sur- gery. Each experimental group was divided into three subgroups of six animals, which were submitted to daily application of enemas containing saline solution 0.9% or SCF at con- centrations of 1.0g/kg/day or 2.0g/kg/day, respectively. The diagnosis of DC in segments with fecal diversion was established by histopathological study considering the following variablesepithelial loss, formation of crypt abscesses, the population of goblet cells, in- flammatory infiltrate and presence of fibrosis. For statistical analysis, the nonparametric Mann-Whitney and Kruskal-Wallis tests were used, with a significance level of 5% (p <0.05). ResultsIt was observed that the daily application of SCF enemas decreased epithelial loss, formation of colon crypt abscesses, inflammatory infiltrate and tissue fibrosis (p <0.05), un- related to time of intervention. The intervention with SCF preserves the goblet cell popula- tion. The effects of the substance on the preservation of colonic epithelium; the decrease in the inflammatory process and subsequent abscess formation in the colon crypts are associated with the concentration used, whereas tissue fibrosis decrease is associated with the concentration and time of intervention. ConclusionPreventive application of SCF enemas reduces the inflammatory process in the colon with fecal diversion

Medicinal plants used for the treatment of various skin disorders by a rural community in northern Maputaland, South Africa

BackgroundSkin diseases have been of major concern recently due to their association with the Human Immunodeficiency Virus and Acquired Immunity Deficiency Syndrome (HIV/AIDS). The study area (northern Maputaland) has the highest HIV infection rate in South Africa, which made them more prone to a wide range of skin conditions. Fungal infections due to the hot climate and overcrowding households are common in this area, as well as burn accidents due to the use of wood as the major fuel for cooking. It is known that the lay people in this area depend on medicinal plants for their primary health care. However no survey has been done in northern Maputaland to document the medicinal plants used to treat various skin disorder.MethodsInterviews were undertaken at 80 homesteads, using structured questionnaires. The focus was on plants used for dermatological conditions and information regarding vernacular plant names, plant parts used, preparation (independently and in various combinations) and application was collected.ResultsA total of 87 lay people, both male (22%) and female (78%) were interviewed on their knowledge of medicinal plants used to treat disorders of the skin. Forty-seven plant species from 35 families were recorded in the present survey for the treatment of 11 different skin disorders including abscesses, acne, burns, boils, incisions, ringworm, rashes, shingles, sores, wounds and warts. When searching the most frequently used scientific databases (ScienceDirect, Scopus and Pubmed), nine plant species (Acacia burkei, Brachylaena discolor, Ozoroa engleri, Parinari capensis, subsp. capensis, Portulacaria afra, Sida pseudocordifolia, Solanum rigescens, Strychnos madagascariensis and Drimia delagoensis) were found to be recorded for the first time globally as a treatment for skin disorders. Fourteen plant combinations were used. Surprisingly, the application of enema’s was frequently mentioned.ConclusionsThe preference of traditional medicine over allopathic medicine by most of the interviewees strengthens previous studies on the importance that traditional medicine can have in the primary health care system in this rural community. Studies to validate the potential of these plants independently and in their various combinations is underway to provide insight into the anti-infective role of each plant.

Evaluation of topical n-acetylcysteine in diversion colitis

ABSTRACT : Introduction: Diversion colitis (DC) is a benign condition characterized by the appearance of inflammation in the mucosa of the colon or rectum devoid of fecal stream. Oxidative stress has been associated with the etiopathogenesis of the disease. N-acetylcysteine (NAC) is a substance with antioxidant properties, used in different treatments of inflammatory diseases. The purpose of this study was to evalu-ate the effects of topical applications of NAC in an experimental model of DC. Methods: Thirty-six Wistar rats were submitted to deviation of fecal stream by proximal colostomy and a distal mucosal fistula. They were distributed into 3 experimental groups of 12 animals accord-ing to the daily application of enemas containing 0.9% saline or 2 doses of NAC, 25 mg/kg and 100 mg/kg, respectively. In each group, half of the animals were sacrificed after two weeks of irrigation and half after four weeks of irrigation. The diagnosis of colitis was assessed by histopathological analysis and the grade of inflammation by inflammatory grading scale. The results were evaluated with the Mann-Whitney test, adopting significance level of 5% (p<0.05).

자원봉사자에 의한 아로마 복부경락마사지 제공이 입원 뇌 병변 장애환자의 변비완화에 미치는 효과

본 연구는 배변 문제가 있는 뇌 병변 장애 입원 환자에게 자원봉사자들이 주 3회의 아로마 복부경락마사지 중재(7분/1회)를 4주간 적용하여 변비완화에 미치는 효과를 검정하고자 시도되었다. 연구 설계는 단일군 전후설계의 원시실험연구이며, 연구대상은 5개월 이상 입원중이며 배변문제가 있는 뇌 병변 장애환자 38명이었다. 연구기간은 2011년 5월 9일부터 6월 19일까지 총 6주간 이었다. 변비완화 효과는 좌약 또는 관장 적용 횟수, 배변 횟수, 배변 양으로 측정 하였으며, 수집된 자료를 SPSS 19.0을 이용하여 기술통계와 Repeated Measures ANOVA로 분석한 결과는 다음과 같다. 첫째, 시간의 경과에 따라 좌약 또는 관장횟수가 감소한 것으로 나타났으나 통계적으로 유의하지 않았다(F=1.03, p=.361). 둘째, 시간의 경과에 따라 배변 횟수가 증가한 것으로 나타났으나 통계적으로 유의하지 않았다(F=2.14, p=.133). 셋째, 시간의 경과에 따라 배변 양이 유의하게 증가한 것으로 나타났다(F=3.56, p=.033). 시점 간을 비교 분석한 결과 사전시기 보다 중재 1-2주(p<.05)와 중재 3-4주(p<.01)에 배변 양이 증가하여 유의한 차이가 있었다. 이상의 결과를 통해 자원봉사자에 의한 주 3회의 아로마 복부경락마사지는 입원 뇌 병변 장애 환자의 변비완화에 효과가 있는 비 침습적인 간호중재라고 결론지을 수 있으며, 간호실무 현장에서 아로마 복부경락마사지 중재를 적용할 수 있는 경험적 근거와 지침을 제공한 점에서 그 의의가 있다. 추후 본 연구결과의 확산을 위해 다양한 대상자에게 반복 연구를 실시하여 경험적 증거를 축적할 것을 제언한다. The purpose of this study was to evaluate the effects of 7 minutes a day, 3 times a week, for 4 weeks of abdominal meridian massage with aroma oils (AMMAO) by Volunteers on the relief of constipation among hospitalized disability patients with brain lesions. One group pretest-posttest quasi experimental research design was used. Subjects were 38 hospitalized disability patients with brain lesions. Data were collected from May 9 to June 19, 2011. Frequencies, mean, standard deviation and Repeated Measures ANOVA with SPSS 19.0 were used to evaluate the effects of AMMAO. The results were as follows; 1. There were significant difference noted in the amount of defecation(F=3.56, p=.033) by time. 2. There were no significant difference was noted in the frequency of defecation, the frequency of suppository or enema application by time. Accordingly, it is concluded that AMMAO would be an effective nursing intervention in relief of constipation among hospitalized disability patients with brain lesions. Therefore it is recommended that AMMAO be used in clinical practice as an effective nursing intervention for hospitalized disability patients with brain lesions.

Reduction in oxidative stress levels in the colonic mucosa without fecal stream after the application of enemas containing aqueous Ilex paraguariensis extract

To evaluate the antioxidant effects of enemas containing aqueous extract of Ilex paraguariensis, comparing segments with and without fecal stream and correlating the segments with the duration of intervention. Twenty-six Wistar rats were subjected to a diversion of the fecal stream in the left colon by a proximal colostomy and distal mucosal fistula. The rats were distributed randomly into two experimental groups of 13 animals each based on the time of sacrifice after surgical procedure (two or four weeks). Each group was then divided into two experimental subgroups that received either second daily enemas containing 0.9% saline solution or aqueous extract of Ilex paraguariensis at 0.2g/100g. Colitis was diagnosed by histopathological analysis and the detection of oxidative tissue damage by measuring the levels of malondialdehyde. The Mann-Whitney test was used to compare the tissue levels of malondialdehyde between colon segments with and without fecal stream in each experimental group, and the Kruskal-Wallis test was used to verify the variance between the levels of oxidative stress according the duration of the irrigation; both tests determined significance at 5% (p<0.05). The levels of malondialdehyde in the animals subjected to intervention in the colon with saline with and without fecal stream after two and four weeks of irrigation were 0.05±0.006 and 0.06±0.006, and 0.05± 0.03 and 0.08 ±0.02, respectively. The malondialdehyde levels in the animals irrigated with Ilex paraguariensis with and without fecal stream after two and four weeks of irrigation were 0.010±0.002 and 0.02±0.004, and 0.03±0.007 and 0.04±0.01, respectively. After two and four weeks of intervention, the levels of malondialdehyde were lower in the animals irrigated with Ilex paraguariensis regardless of the time of irrigation (p=0.0001 and p=0.002, respectively). The daily rectal application of enemas containing aqueous extract of Ilex paraguariensis decreases oxidative tissue damage in the colon without fecal stream regardless of the time of irrigation.

Effect of nursing intervention on the constipation and pressure sores of the orthopaedic patients

ObjectiveTo discuss the effect of nursing intervention on the constipation of the orthopaedic patients. MethodsComparisons of constipation knowledge score, constipation times were made between the intervention group and the controlled group. ResultsThere were differences of the score of abdominal massage(t=39.215, t=0.000),constipation times(x2=72.713,P=0.000)and the application of enema(x2=10.701, P=0.001)between the two groups. ConclusionsThe nursing intervention was effective on improving the constipation knowledge score and decreasing the rate of constipation of the orthopaedic patients.[Key words]Constipation; Nursing intervention; Cognition