Average Defecation Frequency Research Articles

Silk-derived sericin/fibroin mixture drink fermented with plant-derived Lactococcus lactis BM32-1 improves constipation and related microbiota: a randomized, double-blind, and placebo-controlled clinical trial.

We previously showed through clinical trials that one plant-derived lactic acid bacteria (LAB) can improve constipation. We preliminarily found that the plant-derived LAB Lactococcus lactis BM32-1 can grow in a mixture of sericin and fibroin, which are extracted from silk and have been reported to help promote health. Thus, in the present study, we evaluated the favorable effect of a sericin/fibroin mixture (S/F-M), which was extracted from silk prepared from cocoons reared in an aseptic rearing system using an artificial diet, fermented with the BM32-1 strain through a clinical trial. The trial was conducted at Hiroshima University from June to October 2022 as a double-blind, placebo-controlled, randomized parallel-group comparative study with 50 eligible subjects (aged 23-71) who had an average defecation frequency of less than 5 times per week. The subjects were instructed to drink 100 mL of fermented S/F-M or placebo every day. After the 12 weeks of the clinical trial period, the average defecation frequency increased significantly-1.4 times higher than that at baseline in the test group-as compared with the placebo group. Furthermore, the fecal microbiota was also compared before and after treatment, revealing that intake of the fermented S/F-M significantly multiplied the relative abundance of the genera Enterococcus and Clostridium, which have been reported to contribute to the amelioration of constipation by improving the gut microbiota and producing butyric acid, respectively. In conclusion, the S/F-M fermented using the BM32-1 strain improves defecation frequency through alteration of the gut microbiota.

Easy modified wells method for rectal prolapse with using bilayer mesh.

In recent years, many laparoscopic procedures have been reported for the treatment of rectal prolapse, and the Wells method is safe and has relatively good results for rectal prolapse, which is common in the elderly. In this report, we have developed a simpler method to perform the Wells method. In our procedures, easy modified Wells method is performed laparoscopically, but the use of a bilayer mesh makes it easier to perform without the need to suture the retroperitoneum. We performed the method for six cases. All patients are female and average age is 86 ± 4.6. Max length of rectal prolapse is 3cm-7cm. The median operative time was 191 ± 26min. No recurrent rectal prolapse was encountered during follow-up period. The average defecation frequency per week before surgery was 5.3 ± 1.9 and after surgery was 3.7 ± 2.1. Easy modified Wells method can be performed with safety and without difficulty. This method has shown acceptable results in recurrence rates and defecation frequency after surgery.

Sacral Neuromodulation Versus Conservative Treatment for Refractory Idiopathic Slow-transit Constipation: The Randomized Clinical No.2-Trial.

Assess the effectiveness of sacral neuromodulation (SNM) versus personalized conservative treatment (PCT) in patients with refractory idiopathic slow-transit constipation (STC). Evidence on SNM for idiopathic STC is conflicting and of suboptimal methodological quality. The No.2-Trial was a multicenter, open-label, pragmatic, randomized trial performed in 2 Dutch hospitals. Sixty-seven patients with idiopathic STC, a defecation frequency <3 per week and refractory (ie, unresponsive) to maximal conservative (nonoperative) treatment were included. Exclusion criteria included outlet obstruction, rectal prolapse, and previous colon surgery. Patients were randomized (3:2) to SNM (n=41) or PCT (n=26) with randomization minimization between February 21, 2017 and March 12, 2020. In SNM patients, an implantable pulse generator was implanted after a successful 4-week test stimulation. PCT patients received conservative treatment such as laxatives or retrograde colonic irrigation. The primary outcome was treatment success (defined as average defecation frequency ≥3 per week) after 6 months. Secondary outcomes included constipation severity, fatigue, quality of life, and adverse events. Analysis was according to intention-to-treat. After 6 months, 22 (53.7%) patients were successfully treated with SNM versus 1 (3.8%) patient with PCT (odds ratio 36.4, 95% CI 3.4-387.5, P =0.003). At 6 months, SNM patients reported lower constipation severity and fatigue scores ( P <0.001) and improved quality of life compared with PCT ( P <0.001). Eight serious adverse events (6 SNM, 2 PCT) and 78 adverse events (68 SNM, 10 PCT) were reported. SNM is a promising surgical treatment option in a homogeneous group of adults and adolescents with refractory idiopathic STC. No.2-Trial registered at ClinicalTrials.gov NCT02961582.

Laparoscopic total colectomy with ileorectal anastomosis and subtotal colectomy with antiperistaltic cecorectal anastomosis for slow transit constipation.

To investigate the clinical efficacy of laparoscopic total colectomy with ileorectal anastomosis (TC-IRA) and laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis (SC-ACRA) on adults with slow transit constipation (STC). One hundred and three patients with STC were assigned to the TC-IRA group (n = 53) and the SC-ACRA group (n = 50). The clinical data were analyzed. The surgery was successful in all patients (100%). Significantly (P = 0.03) more patients took anti-laxatives during hospitalization in the TC-IRA than the SC-ACRA group (39.62% vs. 20.00%). Abdominal pain and distension was present in 33.96% and 32.00% patients in the TC-IRA and SC-ACRA group, respectively, which decreased insignificantly (P > 0.05) to 18.87% and 18.00% 24months after surgery, respectively. The postoperative Wexner and gastrointestinal quality of life (GIQLI) scores were not significantly different (P > 0.05) at all times after surgery in both groups. The defecation frequency decreased in both groups, and the average defecation frequency was significantly (P < 0.05) higher in the TC-IRA than the SC-ACRA group (3.91 ± 1.23 vs. 3.14 ± 1.15 times/day) at 3months. Three months after surgery, significantly (P < 0.05) fewer patients were satisfied with defecation frequency in the TC-IRA than the SC-ACRA group (29 vs. 37 patients), whereas the number of patients who were willing to choose the same procedure again was not significantly (P > 0.05) different between the two groups. The WIS score of patients was significantly (P = 0.035) higher in the TC-IRA than the SC-ACRA group (6 vs. 5) 3months later. TC-IRA and SC-ACRA are both safe and effective for adult slow transit constipation, and can significantly improve the quality of life of patients. Even though SC-ACRA has better early defecation frequency, postoperative antidiarrheal application and satisfaction, the long-term follow-up effects are similar.

PENINGKATAN EFEKTIFITAS METODE KANGURU TERHADAP KECUKUPAN ASI PADA BAYI CUKUP BULAN DI DESA SUKARAME BARU KEC. KUALUH HULU KAB. LABUHAN BATU UTARA

PENINGKATAN EFEKTIFITAS METODE KANGURU TERHADAP KECUKUPAN ASI PADA BAYI CUKUP BULAN DI DESA SUKARAME BARU KEC. KUALUH HULU KAB. LABUHAN BATU UTARA

PENGARUH PEMBERIAN JUS ALPUKAT (PERSEA GRATISSIMA) TERHADAP PERUBAHAN KONSTIPASI PADA LANSIA DI PANTI TRESNA WERDHA TERATAI KOTA PALEMBANG TAHUN 2016

International Database Us Census Bureau menyatakan bahwa 3.857.327 masyarakat Indonesia mengalami keluhan konstipasi dan sebagian besar hanya melakukan pengobatan sendiri. Menurut hasil penelitian, serat berperan dalam proses defekasi penderita konstipasi dengan jumlah 100 mg/kg BB/hari. Tujuan penelitian ini adalah untuk mengetahui pengaruh pemberian jus alpukat (persea gratissima) terhadap perubahan konstipasi pada lansiadi Panti Tresna Werdha Teratai Kota Palembang. Jenis penelitian ini adalah kuasi eksperimen dengan rancangan penelitian pretest dan postest dengan kelompok pembanding. Sampel berjumlah 44 orang yang dibagi menjadi 2 kelompok yang diambil dengan metode purposive sampling dengan kriteria inklusi dan ekslusi. Sampel yang diperoleh adalah 20 orang untuk setiap kelompok, terdiri dari 22 orang kelompok perlakuan dan 22 orang kelompokpembanding. Hasil penelitian menunjukkan bahwa rata-rata defekasi lansia penderita konstipasi mengalami peningkatan setelah mendapatkan pemberian jus alpukat. Pada kelompok perlakuan rata-rata defekasi sebelum adalah 0,82 kali, setelah mendapatkan perlakuan meningkat menjadi 1,45 kali. Hasil uji t dependen pada kelompok perlakuan adalah p value &lt; 0,05 yaitu 0,02. Sedangkan pada kelompok kontrol tidak terdapat perubahan yang signifikan dengan nilai p value &gt; 0,05 yaitu 0,83. Berdasarkan hasil penelitian, jus alpukat mampu meningkatkan frekuensi defekasi pada lansia yang menderita konstipasi.

Selenium and functional constipation in children

Background Constipation is a common problem in children, with approximately 90 to 95% of constipation cases having functional constipation. Oxidative stress may be a causative factor in gastrointestinal diseases, alleved by intervention with antioxidants. Selenium is an essential trace element and acts as a cofactor of gluthathione peroxidase, which protects membranes from oxidative damage.Objective To determine the effect of selenium on functional constipation in children.Methods We conducted a single-blind, randomized clinical trial from November to December 2012 at the Al-Kautsar Al-Akbar Islamic Boarding School in Medan, North Sumatra. Subjects were children aged 12 to 17 years with functional constipation, diagnosed according to the ROME III criteria. Patients were randomly allocated into either the selenium group (n=57) or the placebo group (n=57). Subjects were clinically evaluated for frequency of defecation, stool consistency, severity of abdominal pain, and side effects during the 2 weeks of treatment (days 7 and 14) and 1 week after treatment had stopped (day 21).Results A total of 114 subjects were eligible to participate. The average frequency of defecation observed on day 14 was 1.5 (SD 0.75) days per defecation (P=0.0001) in the selenium group and 2.4 (0.84) days per defecation in the placebo group, a statistically significant difference (P=0.0001). There was no significant difference in frequency of defecation on the 7th day of treatment. But after day 7, there were significant differences between the groups at days 14 and 21. Normal stool consistency was found in 45 subjects (78.9%) on day 7 and in 57 subjects (100%) on day 14 of treatment in the selenium group, significantly more than those in the placebo group (P&lt;0.05). In placebo group, normal stool consistency was found in 27 subject (47.4%) with (P=0.001) on day 7 and in 38 subject (66.7%) on day 14 of treatment (P=0.0001). On day 14, the selenium group had significantly more subjects without pain than the placebo group [47 subjects (82.5%) vs. 10 subjects (17.5%), respectively (P=0.0001)]. Severity of abdominal pain after 14th day of treatment is without pain 47 subject (82.5%) and mild pain 10 subject (17.5%) (P=0.0001). We found no side effects of selenium treatment in our subjects.Conclusion Selenium is effective in improving clinically functional constipation, in terms of increased frequency of defecation, normalization of stool consistency, and less severe abdominal pain.

Effect of the probiotic strainBifidobacterium animalissubsp.lactis, BB-12®, on defecation frequency in healthy subjects with low defecation frequency and abdominal discomfort: a randomised, double-blind, placebo-controlled, parallel-group trial

The aim of the present study was to investigate the effect of Bifidobacterium animalis subsp. lactis, BB-12®, on two primary end points - defecation frequency and gastrointestinal (GI) well-being - in healthy adults with low defecation frequency and abdominal discomfort. A total of 1248 subjects were included in a randomised, double-blind, placebo-controlled trial. After a 2-week run-in period, subjects were randomised to 1 or 10 billion colony-forming units/d of the probiotic strain BB-12® or a matching placebo capsule once daily for 4 weeks. Subjects completed a diary on bowel habits, relief of abdominal discomfort and symptoms. GI well-being, defined as global relief of abdominal discomfort, did not show significant differences. The OR for having a defecation frequency above baseline for ≥50% of the time was 1·31 (95% CI 0·98, 1·75), P=0·071, for probiotic treatment overall. Tightening the criteria for being a responder to an increase of ≥1 d/week for ≥50 % of the time resulted in an OR of 1·55 (95% CI 1·22, 1·96), P=0·0003, for treatment overall. A treatment effect on average defecation frequency was found (P=0·0065), with the frequency being significantly higher compared with placebo at all weeks for probiotic treatment overall (all P<0·05). Effects on defecation frequency were similar for the two doses tested, suggesting that a ceiling effect was reached with the one billion dose. Overall, 4 weeks' supplementation with the probiotic strain BB-12® resulted in a clinically relevant benefit on defecation frequency. The results suggest that consumption of BB-12® improves the GI health of individuals whose symptoms are not sufficiently severe to consult a doctor (ISRCTN18128385).

Risk factors associated with lower defecation frequency in hospitalized older adults: a case control study.

BackgroundConstipation is highly prevalent in older adults and may be associated with greater frequency of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We investigated the prevalence of lower defecation frequency (DF) and risk factors (including AECOPD) associated with lower DF among hospitalized elderly patients.MethodsWe conducted a retrospective case–control study in a community hospital of Southeast Ohio. Adults aged 65 years or older admitted during 2004 and 2006 were reviewed (N = 1288). Patients were excluded (N = 212) if their length of stay was less than 3 days, discharge diagnosis of Clostridium difficile-associated diarrhea, death or ventilator- dependent respiratory failure during hospitalization. Lower DF was defined as either an average DF of 0.33 or less per day or no defecation in the first three days of hospitalization; cases (N = 406) and controls (N = 670) were included for the final analysis.ResultsApproximately 38% had lower DF in this patient population. Fecal soiling/smearing of at least two episodes was documented in 7% of the patients. With the adjustment of confounders, AECOPD (adjusted odds ratio [AOR] =1.47, 95% confidence interval [CI] =1.01-2.13) and muscle relaxant use (AOR =2.94; 95% CI =1.29-6.69) were significantly associated with lower DF. Supplementation of potassium and antibiotic use prior to hospitalization was associated with lower risk of lower DF.ConclusionsApproximately 38% of hospitalized older adults had lower DF. AECOPD and use of muscle relaxant were significantly associated with lower DF; while supplementation of potassium and antibiotic use were protective for lower DF risk after adjusting for other variables.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-015-0041-0) contains supplementary material, which is available to authorized users.

Temperature-driven river utilisation and preferential defecation by cattle in an English chalk stream

Cattle have the potential to be important geomorphic and ecological agents in the low-energy, high biodiversity chalk rivers of southern England. To improve our understanding of cattle–river interactions, a unique high temporal resolution study of cattle behaviour and distribution was conducted across 500h on a chalk river in Hampshire, England (UK) between April and October 2010. It was observed that cattle spent approximately 2% of their time in the aquatic environment and approximately 7% of their time in the riparian zone. Cattle activity and distribution varied according to the time of day and the time of year. A statistically significant correlation was recorded between the amount of time spent in-stream by cattle and air temperature. Cattle also defecated five times more frequently in-stream than the average defecation frequency, contributing greater than expected direct organic matter and nutrient inputs. The study suggests that the impacts of cattle in chalk river environments may have been underestimated, particularly at a time of global warming.

Efficacy of polyethylene glycol 4000 on constipation of posttraumatic bedridden patients

Objective To investigate the efficacy and safety of polyethylene glycol 4000 (Forlax®) on adult patients with functional constipation due to posttraumatic confinement to bed. Methods A total of 201 posttraumatic bedridden patients were studied in this prospective, open-labeled, single-group study. Polyethylene glycol 4000 was administered orally for 14 days and the dosage was adjusted according to the Bristol stool types. Demographic characteristics, disease status, treatment period and factors affecting clinical outcome, especially the concomitant medications, were recorded. Results After administration of polyethylene glycol 4000, 194 cases (96.52%) showed remission of constipation, including 153 (76.12%) persistent remission. The average defecation frequency increased significantly after treatment and the percentage of patients with stools of normal types (Bristol types 3–5) increased as well. Genders, ages and concomitant medications showed no significant influence on the persistent remission rate. After consecutive treatment for two weeks, patients with slight movement showed a significantly higher remission rate than those without movement (95% vs 80%). At the end of treatment, most accompanying symptoms were relieved obviously. Patients with a medical history of constipation or ever taking laxatives showed a lower remission rate. Sixty cases (29.85%) developed diarrhea during the observational period, among whom 6 (10%) withdrew from the clinical observation voluntarily at the first onset of diarrhea. Two cases suffered from abdominal pain. Conclusions Polyethylene glycol 4000 (Forlax®) has efficacy on functional constipation in posttraumatic bedridden patients. Further more, patients with milder symptoms, more movement in bed, and longer duration of treatment but without accompanying symptoms can achieve a higher remission rate.

Bowel Habit Reference Values and Abnormalities in Young Iranian Healthy Adults

The purpose of this study was to estimate the prevalence of self-reported, ROME II-defined constipation and determine the average defecation frequency and stool types in the Iranian population. A self-reported questionnaire was distributed to 1045 participants, including items intended to identify the presence of ROME II-defined functional constipation and the dominant form of stool based on the Bristol Scale. The weekly mean bowel movement frequency in men and women was 12.5 +/- 7.3 and 13.8 +/- 8.0, respectively (p < 0.05). A total of 87.4% of participants had a stool frequency of between 3 and 21 times per week. The prevalence of functional constipation was 32.9%, whereas only 9.6% of participants reported themselves to be constipated (level of agreement kappa = 0.21, 95% confidence interval: 0.15 to 0.27). Soft or formed stool was reported in 75.7% of individuals. Functional constipation is common in the Iranian population, but its diagnosis could not rely on subjective patient complaints. Despite a higher average of bowel frequency, the previously reported normal range of defecation frequency can be applied for the Iranian population.

Single-stage transanal endorectal pull-through for Hirschsprung's disease: perspective from a developing country

Background/Purpose The aim of this study was to evaluate the feasibility, results, and cost-effectiveness of totally transanal endorectal pull-through (TEPT) in the management of rectosigmoid and midsigmoid Hirschsprung's disease (HD) in a low-income country. Methods Between March 2004 and December 2005, 19 children underwent totally TEPT procedure. The patients' ages ranged from 6 days to 13 years. The primary diagnosis in all 19 patients was HD confined to the rectosigmoid region in 15 and midsigmoid in 4. None had a preoperative colostomy. Follow-up period ranged from 4 to 20 months (mean, 8 months). Results Ages ranged from 0.25 to 65 months, with a mean of 16.24 months. Weights ranged from 3.4 to 13 kg, with a mean of 6.5 kg. Mean time from diagnosis to pull-through procedure was 26 days (range, 6-39 days). The mean length of rectosigmoid resection was 30 cm (range, 20-50 cm). The mean operative time was 95 minutes (range, 75-140 minutes). Mean intraoperative blood loss was 25 mL (range, 15-40 mL). There was one death unrelated to the procedure. One patient had enterocolitis 3 months postoperatively. Average frequency of defecation was 3 (range, 1-6) stools per day. TEPT was associated with a shorter operating time, less blood loss, early return to feeds, and an overall reduced cost. Conclusion The safety and cost-effective benefits of transanal endorectal pull-through in the treatment of HD are of special interest for a developing country. Our data also suggest that functional outcome following TEPT is highly satisfactory and comparable with other established procedures.

Transanal endorectal pull-through for Hirschsprung’s disease: experience with 68 patients

Background/purpose: The aim of this study was to evaluate the indications, results, and complications of transanal endorectal pull-through (TEPT) in the management of recto-sigmoid Hirschsprung’s disease (HD). Methods: Between November 1998 and March 2002, 68 TEPT procedures were performed in infants and children. The patients’ ages ranged from 6 days to 13 years. The primary diagnosis in all 68 patients was Hirschsprung’s disease confined to the recto-sigmoid region. All children had their operations done without construction of preoperative colostomy except for one. Follow-up period ranged from 3 to 39 months (mean, 21 months). Results: The mean operating time was 90 minutes, and average length of bowel resected was 25 cm. Sixty-two patients had satisfactory results without complications. Blood transfusion was needed in only 11 patients. Recovery was very fast, and patients often were hungry within 24 hours. Feeding was resumed within 48 hours. One patient required laparotomy during the procedure owing to injury to the urethra. Two patients required colostomy 3 and 5 days after surgery respectively, because of delayed leakage. Three patients suffered from attacks of enterocolitis 6 to 9 months postoperatively. There was increased frequency of defecation (5 to 15 times daily) for 4 to 6 weeks after surgery in all the patients. There was no constipation, no incontinence, no cuff abscess, and no mortality in any of the patients. Average frequency of defecation was 1 to 3 times daily after 3 months. The cost of the TEPT technique was almost half that of the open surgery. Conclusions: TEPT takes less time, has less bleeding, shorter hospital stay, less morbidity, and earlier recovery than similar open pull-through procedures. The hazards and morbidities associated with laparotomy and colostomy may be avoided with a one-stage technique in Hirschsprung’s disease confined to the recto-sigmoid region. Careful long-term follow-up is required to assess continence and sexual function.

Effect of Dietary Fiber Supplement on Antidepressant Induced Constipation in depressed inpatients

This study was designed and undertaken to test effects of dietary fiber supplement on constipation induced by antidepressants that leads to physical discomfort in depressed inpatients. This study was done with a noirequi valent pre-test / post-test experimental design using interviews, questionnaires, observational measurement.This study was conducted from December , 1994 to December 31st, 1995 using forty inpatients with major depressive disorders by the Diagnostic and statistical manual of mental disorders—IV (American Psychiatric Association, 1994) at three college hospitals. The forty inpatients (male : 19, female 21) were conveniently divided into two groups :a control group of 22 and experimental group of 18 individuals. All of the subjects was revealed to have antidepressant - induced constipation during the first two weeks of control period.All of the patients had a control period of two weeks before and after an experimental period of three weeks. The experimental groups were given daily doses of lOg of alpha—cellulose and 5g of citrus pectin during the experimental period. The data gathered during the experiment was subsequently analyzed by means of statistical methods - multiple regression, t—test, ANOVA, and repeated measures ANOVA. Analysis of the dif ference in the stool frequency, amount of feces and severity of constipation according to time sequence was done using repeated measures ANOVA. Finally, multiple regression was used to analyze the major variables that influence the duration and degrees of constipation.1. The results related to the stool frequency were as follows :a. The average frequency of defecation per week was significantly different between two groups, experimental group having significantly more than control group during experimental period and the first week after finishing treatment (p=0.0003, P=0.0001, p=0.0089, P=0,0018).b. For the change of the stool frequency between two groups over time, experimental subjects increased significantly more than control subjects (p=0.0001) c. The stool frequency was determined by the following variables : dietary fiber supplement, age, the number of admission and the amount of activity per week.2. The results related to the amount of feces were as follows :a. For the amount of feces before and after treat ment in two groups, experimental group had significantly larger amount than control group in the first, second, third weeks after beginning treatment and the first week after finishing treatment(p=0.0093, P=0.0007, p=0.0011, P=0.0025).b. For the change of the amount of feces between two groups over time, experimental subjects increased significantly higher than control subj ects (p=0.0008) c. The amount of feces was determined by the following variables : dietary fiber supplement and the amount of activity per week.3. The findings related to the severity of constipation were as folio a. The severity of constipation was significantly different between two groups, experimental group having significantly lower scores than control group in the second, third weeks after treatment and the first week after finishing treatment (p=0.0220, p=0.0012, p=0.0045).b. The severity of constipation was determined by the following variables : dietary fiber supplement and the number of admission.In the light of these results, this study implies that dietary fiber supplement is effective in relieving antidepressant induced constipation in depressed patients.