Treatment Of Constipation Research Articles

Xuanhuang Runtong Tablets Relieve Slow Transit Constipation in Mice by Regulating TLR5/IL-17A Signaling Mediated by Gut Microbes.

This study aims to investigate the regulation effects of Xuanhuang Runtong tablets (XHRTs) on intestinal microbes and inflammatory signal toll receptor 5 (TLR5)/interleukin-17A (IL-17A) in STC mice. First, high-performance liquid chromatography (HPLC) was used to verify the composition of XHRT and quality control. Then, the defecation ability of STC mice was evaluated by measuring fecal water content and intestinal transit function. The pathological examination of colonic mucosa was observed by Alcian Blue and periodic acid Schiff (AB-PAS) staining. 16S ribosomal DNA (16S rDNA) genes were sequenced to detect the fecal microbiota. Western blotting, immunofluorescence, and real-time fluorescence quantitative PCR (qRT-PCR) were applied to detect the expression of aquaporin 3 (AQP3), connexin 43 (Cx43), TLR5, and IL-17A. The defecation function of the STC mice was significantly decreased. The amount of mucus secretion and the thickness of the colonic mucus layer were decreased, and the number of microbial species in the intestinal wall, such as Firmicutes/Bacteroidetes, anaerobic bacteria, and Alistipes, were also decreased. In addition, the expression of AQP3 and Cx43 was disordered, and the inflammatory factorsTLR5 and IL-17A were activated in the colon. The changes in the above indicators were significantly reversed by XHRT. This study demonstrates that XHRT provides a new strategy for the treatment of slow transit constipation by regulating the activation of the intestinal inflammatory signal TLR5/IL-17A mediated by gut microbes.

Study on the mechanism of JiChuanJian in the treatment of slow-transmission constipation based on network pharmacology

Study on the mechanism of JiChuanJian in the treatment of slow-transmission constipation based on network pharmacology

Effect of Electroacupuncture with Different Current Intensities on the Serum Metabolomics of Functional Constipation.

The aim of the study is to investigate the serum metabolomics of electroacupuncture (EA) with different current intensities in the treatment of functional constipation (FC). The total number of FC patients was 19, (7, 6, 6, in the low current intensity group (LCI), high current intensity group (HCI), and mosapride citrate tablet control group (MC), respectively). Patients in the EA groups received 16 sessions of acupuncture treatments. Patients in the MC group were orally administered 5 mg mosapride citrate tablets 3 times daily, and serum samples were collected from the patients before and after treatment. Orthogonal partial least square-discriminant analysis (OPLS-DA) was used to assess the metabolic data. The significant differences before and after FC treatment are shown in the OPLS-DA score plot. Variable importance plots (VIPs) and T tests were used to identify significant metabolites. Among the three groups, the number of metabolites with VIP > 1 was 11, 7, and 21 (in LCI, HCI and MC groups, respectively). Compared with those before treatment, the serum metabolites of patients were characterized by increased levels of L-ornithine (p < 0.05) and glyceric acid in the LCI group (p < 0.05), increased levels of vanillic acid in the MC group (p < 0.05), and decreased levels of arabinonic acid in the MC group (p < 0.05). The effects of EA treatment on the serum metabolomics of FC may involve fatty acid and amino acid metabolism.

Retracted: Qibin Tongbian Decoction in the Treatment of Diabetic Constipation and Its Influence on the Intestinal Environment and the Incidence of Adverse Reactions: A Randomized Trial.

[This retracts the article DOI: 10.1155/2022/5373765.].

Retracted: Clinical Acupoint Selection for the Treatment of Functional Constipation by Massage and Acupuncture Based on Smart Medical Big Data Analysis.

[This retracts the article DOI: 10.1155/2021/9930412.].

The efficacy and mechanism of fecal microflora transplantation in the treatment of slow transit constipation based on metabonomics anion mode

The efficacy and mechanism of fecal microflora transplantation in the treatment of slow transit constipation based on metabonomics anion mode

Comparative efficacy of polyethylene glycol 3350 and psyllium in treatment of pediatric functional constipation: A randomized and controlled trial

Background: Functional constipation (FC) is a common childhood problem worldwide. At present, polyethylene glycol (PEG) is considered as standard therapy in pediatric FC patients. Aims and Objectives: The aim of the study was to compare the efficacy of PEG 3350 versus psyllium in treatment of pediatric FC. Materials and Methods: All children (aged &gt;1 year) diagnosed with FC according to Rome IV criteria and presenting to the outpatient department of Pediatric Gastroenterology, Hepatology, and Nutrition Unit of a tertiary health center in North Indian Himalayan state were randomized into two open label, prospective, parallel groups, namely, Group A (receiving PEG 3350) and Group B (receiving psyllium), over a period of 16 months. The comparative efficacy was evaluated by comparing the percent of patients with successful outcomes in two groups at 4, 8, and 12 weeks of therapy and the rate of recurrence of impaction in two groups was also assessed and compared over same period. Results: Eighty-one patients were randomized into two groups. A significantly higher number of patients in Group A was successfully treated after 4 weeks (Group A 68.3% vs. Group B 42.5%; P = 0.026), 8 weeks (Group A 80.0% vs. Group B 57.9%; P = 0.049), and 12 weeks (Group A 92.3% vs. Group B 67.6%; P = 0.009) of treatment compared with Group B. Impaction recurred in two patients in Group B while no recurrence was observed in any of the Group A patients but the difference observed was not statistically significant (P = 0.494). No significant adverse events were reported in either groups. Conclusion: PEG 3350 was found to be significantly more effective than psyllium in improving the symptoms of constipation in pediatric patients.

Treatment of chronic constipation using abdominal X-ray

Treatment of chronic constipation using abdominal X-ray

Clinical Progress of Acupuncture in Treating Post-stroke Constipation

Constipation is one of the complications after stroke, which not only seriously affects the life quality of patients but may even induce secondary stroke if not appropriately handled. Regarding the treatment of post-stroke constipation, western medicine has an immediate effect. However, its effective time is short, the frequency of medication is high, and the long-term effect is not promising. Therefore, traditional Chinese medicine has gradually attracted attention in clinical practice due to its unique advantages. Mainly, acupuncture for treating symptoms of post-stroke constipation is widely used in the clinic because of its convenient operation and no noticeable adverse reactions. Therefore, after summarizing and studying relevant literature in recent years, it is found that acupuncture, warm acupuncture, and other therapies have apparent therapeutic effects on post-stroke constipation.

Retracted: Network-Based Elaboration of the Efficacy of the Dachangshu (BL25) and Tianshu (ST25) Points in the Treatment of Functional Constipation in Children through Inflammation, Adipocytokine, or Leptin Pathways.

[This retracts the article DOI: 10.1155/2022/5315927.].

ИРУРГИЧЕСКИЙ СПОСОБ ЛЕЧЕНИЯ ХРОНИЧЕСКОГО КОПРОСТАЗА У БОЛЬНЫХ ДОЛИХОСИГМОЙ

The study refers to medicine, namely to surgery: endovideosurgery. Colon pathology is one of the most urgent and socially significant problems of modern health care, because. leads to a decrease in the working capacity of the population employed in production. Minimally invasive colon surgery has a big advantage: faster recovery, shorter hospital stays and better cosmetic results, faster return of patients to work. The purpose: to improve the results of endovideosurgical treatment of patients with chronic colostasis and dolichosigma. Practical significance: improving the quality of life by developing selection criteria for performing the developed method of operation and its implementation in the complex treatment of colostasis in dolichosigmoid. The results of the proposed endovideosurgical method for the treatment of chronic constipation in dolichosigmoid: the number of postoperative patients referred for MSEC decreased by 2 times; the average stay of patients in the clinic was 8-9 days, the activation of patients is carried out on the 2nd day after the operation; control after a month: normalization of stool up to 1 time per day (before the operation, delays reached up to a month), improvement in general well-being, improvement in memory, attention, absence of signs of chronic fatigue, improvement in general appearance (hair shine, improvement in color and skin condition); significant improvement in quality of life; control after a year: complete restoration of the passage of intestinal contents. Weight gain by 10-12 +/- 0.7 kg. Indicators of clinical and laboratory researchers are within the normal range. Full social rehabilitation. Conclusions. The authors proposed a new method of surgical treatment of chronic colostasis in patients with dolichosigma. The results of the scientific study can be used in the surgical treatment of chronic constipation with dolichosigmoid (dolichocolon) by the laparoscopic method. In the postoperative period, starting from the 3rd day, the restoration of the colon microflora is noted. The dynamics of the immunological status indicates a positive effect of the restoration of the microflora and physiology of the colon in the postoperative period.

&lt;i&gt;Chimonanthus salicifolius&lt;/i&gt; S. Y. Hu Extract improve constipation symptoms and regulate intestinal microbiota in mice

Chimonanthus salicifolius S. Y. Hu (C. salicifolius) is a unique medicinal plant of Magnolia in China, it could inhibit pathogens and prevent flu, which has been extensively applied for drinking tea. The purpose of this study was to analyze the main components of ethyl acetate extract of C. salicifolius (EAECS) and explore the effect of extract on loperamide-induced constipation in mice. The mice with constipation induced by loperamide were given different concentrations of C. salicifolius extract once a day for 14 days. The constipation-related parameters, stool particles, the time of the first black stool defecation and gastrointestinal (GI) transit rate were determined. In addition, the change of abundance and diversity in intestinal microbiota were analyzed. The results indicated that the main components in EAECS were rutin, nicotiflorin, quercetin and kaempferol. After administration, EAECS treatment relieved loperamide-induced constipation in mice, as evidenced by reduced defecation time and significantly increased GI transit rate, fecal particles and water content. At genus level, the extract also remarkably reduced Ruminococcus and increased the abundance of Lactobacillus and Bifidobacterium in intestinal tract of mice (all p ＜ 0.05). These findings indicated that EAECS effectively improved loperamide-induced constipation in mice and could be considered as a candidate treatment for constipation.

Gut indigenous Ruminococcus gnavus alleviates constipation and stress-related behaviors in mice with loperamide-induced constipation.

Refractory constipation is the most severe form of constipation, and its etiology remains unknown. The symptoms of constipation occur repeatedly, which brings great pain to the patient's body and psychology. Accumulating studies suggest that constipation patients present a significant dysbiosis of the gut microbiota compared with healthy individuals. In this study, we analyzed the gut microbiota composition of fresh feces and accumulated feces (old feces) of patients with refractory constipation and found that there was a significant difference between them. Through a mouse model of loperamide-induced constipation, it was proved that the old feces of patients with refractory constipation could aggravate the constipation symptoms in mice, while the fresh feces could alleviate the symptoms, which is consistent with the effect of feces from healthy volunteers in a mouse model of loperamide-induced constipation. We identified an indigenous strain Ruminococcus gnavus (R. gnavus), which is highly enriched in the fresh feces of patients with refractory constipation, and found that oral administration of R. gnavus could effectively improve the constipation symptoms in mice with constipation induced by loperamide and fecal bacteria transplanted from patients with constipation and significantly improve the stress-related behaviors of mice. This result may be related to the regulation of intestinal muc2, c-kit, sert and other gene expression by R. gnavus and the control of somatostatin (SS) and motilin (MTL) production. Our results suggest that gut microbe intervention with indigenous strains such as R. gnavus is a potential and promising alternative for the treatment of constipation, especially for refractory constipation.

Probiotic responder identification in cross-over trials for constipation using a Bayesian statistical model considering lags between intake and effect periods

Recent advances in microbiome research have led to the further development of microbial interventions, such as probiotics and prebiotics, which are potential treatments for constipation. However, the effects of probiotics vary from person to person; therefore, the effectiveness of probiotics needs to be verified for each individual. Individuals showing significant effects of the target probiotic are called responders. A statistical model for the evaluation of responders was proposed in a previous study. However, the previous model does not consider the lag between intake and effect periods of the probiotic. It is expected that the lag exists when probiotics are administered and when they are effective. In this study, we propose a Bayesian statistical model to estimate the probability that a subject is a responder, by considering the lag between intake and effect periods. In synthetic dataset experiments, the proposed model was found to outperform the base model, which did not factor in the lag. Further, we found that the proposed model could distinguish responders showing large uncertainty in terms of the lag between intake and effect periods.

Therapeutic effects of Bombax ceiba flower aqueous extracts against loperamide-induced constipation in mice

Context Bombax ceiba Linnaeus (Bombacaceae) is known as silk cotton tree, the flowers of which are used in many medicinal applications. Objective To investigate the therapeutic effect of B. ceiba flower aqueous extracts (BCE) against loperamide-induced constipation and characterize the chemical composition of BCE. Materials and methods Sixty male Kunming mice were divided into control (saline), model (10 mg/kg loperamide + saline), phenolphthalein (10 mg/kg loperamide + 10 mg/kg phenolphthalein) and different dosage of BCE (10 mg/kg loperamide + 40, 80 and 160 mg/kg BCE, respectively) groups, and received intragastric administrations for eight days. Faecal water content, number of faeces, first black-stool defecation time and gastrointestinal transit rates were evaluated. Various biochemical and molecular biomarkers were assessed in blood and colon. UPLC-ESI-QTOF-MS/MS was used to tentatively identify the composition of the BCE. Results BCE treatment (160 mg/kg) could increase faecal water (15.75%), faeces number (11.65%), gastrointestinal transit rate (25.37%) and decrease first black-stool defecation time (24.04%). The BCE (80 mg/kg) increased the serum level of motilin (30.62%), gastrin (54.46%) and substance P (18.99%), and decreased somatostatin (19.47%). Additionally, the BCE (160 mg/kg) reduced the mucosal damage, restored colonic goblet cell function, down-regulated the protein expression of AQP3 (33.60%) and increased c-kit protein expression (11.63%). Twelve known compounds, including protocatechuic acid, chlorogenic acid and rutin, previously reported in B. ceiba, were identified in the BCE. Discussion and conclusions This study suggested that BCE is a promising agent for the treatment of constipation.

Chinese expert consensus on the diagnosis and treatment of outlet obstructive constipation (2022 edition)

In recent years, professional societies in China including the Chinese Medical Doctor Association Anorectal Branch have issued many clinical practice guidelines and expert consensus on constipation, which played a positive role in the standardization of diagnosis and surgical treatment of chronic constipation in China. However, the diagnosis and treatment of outlet obstructive constipation (OOC) remain controversial. OOC, the most common subtype of functional constipation, is featured by various clinical symptoms, complex pelvic floor anatomy, functional and psychological aspects. We need a gold standard supported by high-level clinical research evidence. To standardize the diagnosis and treatment process of OOC in China, Chinese Medical Doctor Association Anorectal Branch and its Clinical Guidelines Committee, and jointly sponsored by Professional Committee on Anorectal Diseases of Chinese Society of Integrated Traditional Chinese and Western Medicine, Anorectal Disease Committee of Chinese Medical Women's Association and Chinese Constipation Medical Association, and the Chinese Journal of Gastrointestinal Surgery organized and summoned a Chinese expert taskforce to focus on OOC diagnosis, classification, examination, evaluation, and various treatments (e.g. diet modification, medication, biofeedback therapy, pelvic floor function training, psychological intervention, traditional Chinese medicine and surgical treatment). Based on the latest relevant evidence in China and abroad and experts' clinical experience, the taskforce produced the " Chinese expert consensus on the diagnosis and treatment of outlet obstructive constipation (2022 edition)" after rounds of discussion and revision. The aim is to help anorectal surgeons make clinical decisions, standardize the process of diagnosis and treatment, reduce complications and improve clinical efficacy in OOC.

Exploring GI Diseases Across the Lifespan.

Exploring GI Diseases Across the Lifespan.

Naloxegol for Treatment of Opioid-Induced Constipation in the Pediatric Intensive Care Unit.

Opioid-induced constipation is a common problem in critically ill children requiring sedation. Naloxegol is an oral U.S. Food and Drug Administration (FDA)-approved peripherally acting mu-opioid receptor antagonist for chronic opioid-induced constipation use in adults, but data on its use in children are lacking. We performed a retrospective analysis of critically ill children that had received naloxegol for opioid-induced constipation at our institution. Of the 45 patients studied, mean stool frequency increased significantly from 0.63 ± 0.12 stools per day to 1.71 ± 0.13 stools per day after starting naloxegol (95% confidence interval [CI]: [0.75, 1.4], P < .001). There was no significant difference in the mean Withdrawal Assessment Tool 1 (WAT-1) score in the 24 hours before and after receiving the first dose (95% CI: [-0.25, 0.40], P = .63). This suggests naloxegol is effective in increasing stool output in critically ill children receiving opioids without an increase in opioid-withdrawal symptoms. It may be an effective adjunctive therapy for this population.

Network-Based Elaboration of the Efficacy of the Dachangshu (BL25) and Tianshu (ST25) Points in the Treatment of Functional Constipation in Children through Inflammation, Adipocytokine, or Leptin Pathways.

Constipation commonly occurs during childhood, and more than 95% of cases are classified as functional constipation. If not effectively treated, 20% of patients with childhood constipation can continue to exhibit symptoms into adulthood, which seriously affects their mental health and quality of life. The main feature of acupuncture or acupoint stimulation, a special branch of traditional Chinese medicine, is the selection of different acupoints for different diseases, and many worthy guidelines have been established for matching acupoints. The back-shu and front-mu point combination adheres to an important acupoint compatibility law that has been used since its proposal 2,500 years ago but has not yet been verified by the modern evidence-based experiments. This study focused on the back-shu and front-mu point combination using the Dachangshu (BL25) and Tianshu (ST25) points as examples to explore possible research methods for network acupoint-based stimulation based on existing evidence and to elucidate the mechanisms induced by BL25 and ST25 in the treatment of functional constipation in children (FCC). The study found that BL25 and ST25 have 20 common targets, namely, AQP8, DRD2, VIP, TAC1, IL6R, TNF, FOS, KIT, CHAT, HTR3A, GAS8, SOD3, TRPV1, MPO, CALCA, IL1B, P2RX7, NPY2R, IL10RA, and TPH1, and these targets may provide a strategy for the combined usage of BL25 and ST25. In addition, BL25 and ST25 can affect FCC treatment through inflammation-relatedTh17-cell differentiation, the NF-kappa B signaling pathway, and the Toll-like receptor signaling pathway. Adipocytokines or leptin may also comprise the mechanism through which BL25 and ST25 regulate FCC. In addition, BL25 and ST25 regulate FCC through 13 core targets, namely, NFKBIA, RELA, TNF, IKBKB, IRAK1, TLR4, MYD88, TNFRSF1A, IL1R1, TLR2, IL1B, TRAF6, and TNFRSF1B. In short, this study provides new ideas and methods for studying the mechanism of acupuncture points.

Cannabis sativa L. alleviates loperamide-induced constipation by modulating the composition of gut microbiota in mice.

MaZiRenWan (MZRW) is the most frequently used Traditional Chinese Medicine formula to treat chronic constipation, Cannabis sativa L. is regarded as a monarch drug in MZRW. However, the targets of Cannabis sativa L. that enhance colonic motility and improve constipation symptoms remain unknown. This study was designed to investigate the laxative effect and underlying mechanism of the water extract of Cannabis sativa L. (WECSL) using a loperamide-induced constipation mouse model. We found that WECSL treatment significantly improved intestinal motility and water-electrolyte metabolism, decreased inflammatory responses, prevented gut barrier damage, and relieved anxiety and depression in constipated mice. WECSL also structurally remodeled the composition of the gut microbiota and altered the abundance of bacteria related to inflammation, specifically Butyricicoccus and Parasutterella. Moreover, WECSL failed to relieve constipation symptoms following intestinal flora depletion, indicating that WECSL alleviates constipation symptoms depending on the gut microbiota. Our research provides a basis for WECSL to be further investigated in the treatment of constipation from the perspective of modern medicine.