Defecation Status Research Articles

Association Between Gut Microbiome Composition and Physical Characteristics in Patients with Severe Motor and Intellectual Disabilities: Perspectives from Microbial Diversity.

The human gut environment undergoes substantial changes as a host ages. This investigation centered on the gut microbiome diversity among patients with severe motor and intellectual disabilities (SMID), examining the association between the gut microbiome composition and physical characteristics with varying levels of diversity. Fourteen subjects were investigated, with physical and defecation status, blood biochemical test, gut microbiome profiling, and fecal metabolites used to divide the patients into a high-diversity group (HD, eight patients) and a low-diversity group (LD, six patients). Findings indicated that the microbiome of the LD group showed delayed maturation reminiscent of neonates and lactating infants. Analysis of the fecal bile acids (BAs) revealed a markedly diminished proportion of deoxycholic acid in the secondary BAs in the LD group, suggestive of inadequate conversion from primary to secondary BAs. Furthermore, the LD group presented with loose stools. The LD group exhibited a higher degree of physical severity, with all patients bedridden and fed via gastrostomy with only enteral formula received. The composition of the gut microbiome and BAs in the LD group was found to differ from those of healthy individuals and the HD group, indicating a potentially immature gut environment for these individuals.

Open defecation among Kenyan households: an analysis of demographic and health survey 2022 and census report of 2019

BackgroundOpen defecation (OD) is the disposal of human excreta in the fields, bushes, water bodies and other open spaces. It poses a public health risk as it can lead to the spread of diarrhoea, cholera, soil-transmitted helminths and trachoma. Kenya aims to achieve 100% open defecation free status by 2030 in line with Sustainable development goal number 6. This study sought to determine factors influencing OD at the household level as well as quantify the number of households practicing OD in each of the 47 Kenyan counties.MethodsData from the household questionnaire of the Kenya Demographic and Health Survey, 2022 was analysed. Bivariate logistic regression was done with open defecation status as the dependent variable. Independent variables were poverty status, place of residence, ownership of farm animals, gender and educational level of household head. The number of households practicing OD per county were determined using the Kenya Census report of 2019.ResultsPoverty was the strongest predictor of a household practicing OD (OR 43.8 95% CI 26.1–73.8) followed by educational status of the household head (OR 3.3 95% CI 2.3–4.6 ) and the household not owning livestock ( OR 0.7 95% CI 0.6–0.9). An estimated 7.4% of households practice OD. These are estimated to be 814,223 households. Out of these, 686,051 households (84.3%) are found in the 15 counties ranked as having a high population practicing OD. Five counties have managed to eliminate OD and another nine have OD rates of less than 0.5%.ConclusionKenya has made commendable progress in eliminating OD. Poverty is a significant predictor of OD at the household level. To eliminate OD, it is advised that more efforts be targeted towards poor households as well as the 15 counties having a high number of OD-practicing households.

Development and Validation of a Simple and Multifaceted Instrument, Chronic Constipation-Therapeutic Efficacy and Satisfaction Test, for the Clinical Evaluation of Patients with Chronic Constipation

Introduction: This study evaluated the psychometric properties of the newly developed chronic constipation-therapeutic efficacy and satisfaction test (CC-TEST) among patients with chronic constipation. Methods: Japanese patients with moderate or severe chronic constipation underwent a 4-week remedy. The baseline, 2-week, and 4-week assessments included the CC-TEST, Constipation Scoring System (CSS), Medical Outcome Study Short Form-8 Health Survey (SF-8), and Hospital Anxiety and Depression Scale (HADS). The CC-TEST comprises three domains: (1) symptoms; chronic constipation symptom severity (seven items), defecation status (five items), (2) impact for daily life; dissatisfaction with daily life level (DS; four items), and (3) therapeutic response; therapeutic efficacy measured by patients and medication compliance (four items). Results: Of 201 eligible patients at baseline, 110 completed the 4-week treatment and the survey responses. Cronbach’s α values for the stool, defecation, and abdominal symptom subscales, as well as the total symptom score and DS subscale, showed good internal consistency reliability (0.72–0.80). Pearson’s r for comparisons between corresponding items (CC-TEST symptoms with CSS, and CC-TEST DS with SF-8 physical and mental component summary scores) was significant. After 4 weeks, scores for symptoms, defecation status, and DS items/subscales notably decreased, with a significant effect size (p < 0.005, Cohen’s d; 0.30–1.16). Statistically significant differences emerged between treatment responders and nonresponders using the three responder definitions, in changes in scores for most CC-TEST symptoms, defecation status, and DS items/subscales (p < 0.05). Conclusion: CC-TEST demonstrates commendable reliability, convergent and known-group validity, and responsiveness to treatment effects. As a simple, comprehensive, and versatile patient-reported outcome measure, CC-TEST may be well suited for clinical trials and primary care of Japanese patients with chronic constipation.

The effects of lactulose on constipation in patients with Parkinson's disease: An exploratory pilot study

IntroductionConstipation is one of the most common non-motor symptoms of Parkinson's disease (PD) and is associated with reduced quality of life in patients with PD. The aim of this study was to evaluate the effect of lactulose on defecation status in patients with PD. MethodsIn this open-label, single-center, exploratory pilot study, twenty-nine patients with PD received lactulose for three weeks for the treatment of constipation. The primary endpoint was the number of spontaneous bowel movements (SBMs). The secondary endpoints were stool consistency (Bristol Stool Form Scale [BSFS]) and the number of rescue laxatives used. ResultsTwenty-five patients with PD completed the study. The number of SBMs recorded during the lactulose intervention period was significantly increased compared with that recorded during the pre-intervention period. During the intervention period, the BSFS scores of the patients increased significantly, whereas the number of rescue laxatives they used decreased significantly. No serious adverse events were observed during the study period. Lactulose was well-tolerated. ConclusionsThe results of this study suggest that lactulose may be effective in improving defecation status in patients with PD. Further randomized controlled trials are needed to confirm the effects of lactulose on constipation in patients with PD.

The effect of abdominal massage and in-bed ROM exercise on gastrointestinal complications and comfort in intensive care unit patients receiving enteral nutrition: A randomized controlled trial.

Abdominal massage facilitates gastric and colonic motility, reduces intra-abdominal distension and increases circulation. In-bed range of motion (ROM) exercise has effects on muscle strength, cardiac parameters and excretion. The aim of this study was to assess the effects of abdominal massage and in-bed ROM exercise on gastrointestinal complications and patient comfort in intensive care patients receiving enteral nutrition. This randomized controlled trial was conducted in the internal intensive care units of two tertiary public hospitals. The sample consisted of 130 patients randomly assigned to three groups (abdominal massage = 44, in-bed ROM exercise = 43, control = 43). The individuals received abdominal massage and in-bed ROM exercises every morning before enteral feeding for 3 days. We assessed gastrointestinal complications and comfort levels of the patients 24 h after each intervention. While the differences in abdominal distention, defecation status, constipation, and gastric residual volume complications were significant (p < .05), there was no significant difference in diarrhea and vomiting (p > .05). Comfort level showed a statistically significant change in the experimental groups in the in-group comparison (p < .05). Abdominal massage and in-bed ROM exercise reduce abdominal distention, constipation and gastric residual volume. Abdominal massage affects the frequency of defecation; and, both interventions increase the comfort while reducing the pain level over time.

Investigation of Expanded Human Adipose-derived Stem Cell Dosage and Timing for Improved Defecation Function.

Although certain treatment options exist for intestinal incontinence, none are curative. Adipose-derived stem cells (ADSCs) have emerged as promising therapeutic agents, but most preclinical studies of their effectiveness for anal function have used autologous or allogeneic ADSCs. In this study, the effectiveness, timing of administration, and required dosage of human ADSCs were investigated for clinical application. A 10-mm balloon catheter was used to induce anal sphincter injury in immunodeficient mice in the following experimental groups (n=4 per group): ADSC (injected ADSCs after injury), PBS (injected phosphate-buffered saline after injury), and control (uninjured). The effects of different timing (immediately after injection and 30 days following injury) and number of human ADSCs administered was compared among groups based on defecation status and pathological evaluation. In terms of defecation status, groups receiving ≥1×104 human ADSCs after injection showed improvement. Pathological images showed that compared to the PBS group, the thinnest part of the sphincter was thicker for animals that received ≥1×104 human ADSCs, and fibrosis of the sphincter was notable in those treated with 1×103 human ADSCs or PBS. Furthermore, defecation status was improved by administration of human ADSCs, not only immediately after injury, but also at 30 days following injury. Human ADSC administration in a mouse model of anal sphincter injury was effective. Injection of ≥1×104 human ADSCs was the amount necessary to improve defecation status, an effect detected in both the acute and chronic phases.

Evaluation and treatment of constipation in pregnancy:Examination using the Japanese version of the constipation evaluation scale.

No study has examined the effects of new constipation treatment drugs released in recent years in pregnant women. This prospective cohort study aimed to examine and compare the perinatal prognosis, efficacy rate, and safety of drugs frequently used to treat constipation. The study included 211 perinatally managed individuals who answered a self-administered questionnaire during the second trimester and after delivery. The Japanese version of the constipation evaluation scale (Constipation Assessment Scale [CAS] long-term [LT] version) was used for the subjective evaluation of defecation status. Participants aware of constipation had significantly higher CAS scores than those who were unaware. Some participants with a CAS score of 5 points (treatment range) had no subjective symptoms of constipation, whereas some participants with a CAS score of ≤ 5 points were aware of constipation. Regarding the time of onset, 60% of those who had constipation before pregnancy had a high rate of constipation during pregnancy and after delivery. No significant difference was noted in conventional magnesium oxide and polyethylene glycol, a relatively new daily treatment drug, in perinatal prognosis or side effects. Polyethylene glycol preparations alleviate constipation without inducing diarrhea, making them an appropriate therapeutic option for pregnant women.

Controlling Gut Microbiota by Twendee X® May Contribute to Dementia Prevention.

The human gut microbiota (GM) is a complex and dynamic ecosystem that hosts trillions of commensal and potentially pathogenic microorganisms. It is crucial in protecting humans from pathogens and in maintaining immune and metabolic homeostasis. Numerous studies have demonstrated that GM has a significant impact on health and disease, including Alzheimer's disease (AD). AD is a progressive neurodegenerative disorder characterized by impaired short-term memory and cognitive deficits. Patients with AD have been reported to exhibit abnormalities in GM density and species composition. Oxidative stress (OS) has been implicated in the onset and progression of AD; however, the relationship between OS and gut microbiota in AD onset and progression is not clear. Twendee X® (TwX), an oral supplement consisting of eight active ingredients, has been shown to prevent dementia in mild cognitive impairment (MCI) in humans and substantially improve cognitive impairment in mouse models of AD. This positive effect is achieved through the potency of the combined antioxidants that regulate OS; therefore, similar results cannot be achieved by a single antioxidant ingredient. To examine the impact of long-term OS elevation, as seen in AD on the body and GM, we examined GM alterations during the initial OS elevation using a two-week OS loading rat model, and examined the effects of TwX on OS and GM. Furthermore, using a questionnaire survey and fecal samples, we analyzed the impact of TwX on healthy individuals' gut bacteria and the associated effect on their quality of life (QOL). TwX was found to increase the number of bacteria species and their diversity in GM, as well as butyrate-producing bacteria, which tend to be reduced in AD patients. Additionally, TwX improved defecation condition and QOL. The gut bacteria function as part of the homeostatic function during OS elevation, and the prophylactic administration of TwX strengthened this function. The results suggest that the preventative effect of TwX on dementia may involve the GM, in addition to the other previously demonstrated effects.

Combined, elobixibat, and colestyramine reduced cholesterol toxicity in a mouse model of metabolic dysfunction-associated steatotic liver disease.

Cholesterol levels and bile acid metabolism are important drivers of metabolic dysfunction-associated steatohepatitis (MASH) progression. Using a mouse model, we investigated the mechanism by which cholesterol exacerbates MASH and the effect of colestyramine (a bile acid adsorption resin) and elobixibat (an apical sodium-dependent bile acid transporter inhibitor) concomitant administration on bile acid adsorption and MASH status. Mice were fed a high-fat high-fructose diet with varying concentrations of cholesterol to determine changes in fatty liver according to liver status, water intake, defecation status, insulin resistance, bile acid levels, intestinal permeability, atherosclerosis (in apolipoprotein E knockout mice), and carcinogenesis (in diethylnitrosamine mice). Using small interfering ribonucleic acid (siRNA), we evaluated the effect of sterol regulatory element binding protein 1c (SREBP1c) knockdown on triglyceride synthesis and fatty liver status following the administration of elobixibat (group E), colestyramine (group C), or both (group EC). We found greater reductions in serum alanine aminotransferase levels, serum lipid parameters, serum primary bile acid concentrations, hepatic lipid levels, and fibrosis area in EC group than in the monotherapy groups. Increased intestinal permeability and watery diarrhea caused by elobixibat were completely ameliorated in group EC. Group EC showed reduced plaque formation rates in the entire aorta and aortic valve of the atherosclerosis model, and reduced tumor counts and tumor burden in the carcinogenesis model. Excessive free cholesterol in the liver can promote fatty liver disease. Herein, combination therapy with EC effectively reduced free cholesterol levels in MASH model mice. Our study provides strong evidence for combination therapy as an effective treatment for MASH.

Relationship between defecation status and blood pressure level or blood pressure variability.

Blood pressure variability is an independent predictor of cardiovascular disease. Defecation status has also been associated with the risk of developing cardiovascular disease. This study aimed to investigate the association between blood pressure variability and defecation status. A total of 184 participants who could measure their home blood pressure for at least 8 days monthly, both at baseline and 1 year later, were included in this study. All participants had their home blood pressure measured using HEM-9700T (OMRON Healthcare). Day-to-day variability of systolic blood pressure was assessed using the coefficient of variation of home systolic blood pressure during 1 month. Data on defecation status was obtained using a questionnaire survey. Eighty-nine patients had an elevated coefficient of variation at 1 year. The proportion of participants with elevated coefficient of variation at 1 year was significantly higher in the no daily bowel movement group than in the daily bowel movement group (72% vs. 42%, P = 0.001). In multivariable logistic regression analysis with the elevated coefficient of variation at 1 year as the objective variable and age, sex, no daily bowel movement, taking medications, including antihypertensive drugs, laxatives, and intestinal preparations, and coefficient of variation at baseline as independent variables, no daily bowel movement was independently associated with the elevated coefficient of variation at 1 year (odds ratio: 3.81, 95% confidence interval: 1.64-8.87, P = 0.0019). In conclusion, no daily bowel movement was independently associated with elevated day-to-day blood pressure variability at 1 year. Relationship between defecation status and blood pressure level or blood pressure variability.

A rare case of pyosalpinx in adolescent girl with Hirschsprung’s disease who underwent transvaginal ultrasound-guided drainage

BackgroundHydrosalpinx and pyosalpinx are rare gynecologic problems during adolescence, especially in girls without a history of sexual activity. They are even rarer in women with Hirschsprung’s disease (HD). We herein report a case of pyosalpinx in an adolescent girl with HD treated by transvaginal ultrasound-guided drainage.Case presentationThe present patient was a 12-year-old girl (weight 83 kg; height 159 cm; body mass index 32.8 kg/m2). She had undergone five laparotomies for long-segment HD by 2 years. Her menarche had occurred at 10 years. She was admitted with lower abdominal and anal pain. Computed tomography (CT), magnetic resonance imaging (MRI), and transvaginal ultrasound showed left pyosalpinx and abdominal abscess. Surgical drainage was necessary; however, she had a history of polysurgery and was severely obese, so laparotomy was considered to carry a high risk. Transvaginal ultrasound was deemed more likely to reach the abscess safely. Therefore, she was treated with transvaginal ultrasound-guided drainage by a gynecologist skilled in the procedure. She was discharged home after 52 days. One year and nine months after discharge, there was no reformation of either the abscess or pyosalpinx.ConclusionsAdolescent girls with HD are at risk of developing hydrosalpinx. Depending on the defecation status, pyosalpinx may also develop. As a less-invasive surgical treatment, transvaginal ultrasound-guided drainage can avoid laparotomy. Collaboration with a gynecologist is essential for the diagnosis and treatment of this clinical condition. Pediatric surgeons should communicate with gynecologists for such cases beginning around puberty for continuous follow-up.

Faktor-Faktor Yang Berhubungan Dengan Perilaku BABS Di Wilayah Kerja Puskesmas Siulak Gedang

Open Defecation Free (ODF) is an activity directed at changing the behavior of Open defecationtoward latrines. Based on the data obtained, there are 10 villages with a total of 457 households that have not been verified as open defecation free. The purpose of this study was to determine the factors related to open defecation behavior in the Siulak Gedang Health Center Work Area, Kerinci Regency in 2022. This research was a quantitative study with the approach cross sectional conducted in two villages in the Siulak Gedang Health Center Work Area. . The population in this study were all households in the village with high open defecation status, namely Siulak Gedang Village and Pelak Naneh Village as many as 515 families, with a sample of 100 families. Data was collected through interviews using a questionnaire. Data analysis with univariate and bivariate with statistical chi-square test. The results showed that there was a relationship between knowledge (p = 0.003), attitude (p = 0.000), socioeconomic (p = 0.002), and latrine ownership (p = 0.000) with open defecation behavior. There was no relationship between the support of health workers (p=1) with open defecation behavior. To reduce the number of open defecation (OD), it is hoped that the community always participates in implementing clean and healthy living behaviors, especially in the ownership and use of healthy family latrines.

A novel model of adenine-induced chronic kidney disease-associated gastrointestinal dysfunction in mice: The gut-kidney axis

Although constipation is a common complication of chronic kidney disease (CKD), there is no animal model that can be used to study the association between renal impairment and gastrointestinal function without interfering with the gastrointestinal tract of the model. Therefore, we determined whether adenine could induce CKD in association with gastrointestinal dysfunction. Six-week-old ICR mice were intraperitoneally injected with saline, 25, 50, or 75 mg adenine/kg body weight for 21 days. Blood urea nitrogen (BUN), plasma creatinine, and renal histopathology were evaluated. Defecation status was evaluated from defecation frequency and fecal water content. Colonic smooth muscle contraction was measured by the organ bath technique, and transepithelial electrical resistance (TEER) was measured using an Ussing chamber. In the 50 mg/kg treatment group, BUN and creatinine were significantly increased compared with control, and inflammatory cell infiltration, glomerular necrosis, tubular dilatation, and interstitial fibrosis were observed in renal tissues. Mice in this group also showed a significant decrease in defecation frequency, fecal water content, colonic motility index, and TEER. Overall, 50 mg/kg of adenine was the best dose to induce CKD with associated constipation and intestinal barrier impairment. Therefore, this adenine administration model can be recommended for CKD-associated gastrointestinal dysfunction research.

Effects of Additional Granola in Children's Breakfast on Nutritional Balance, Sleep and Defecation: An Open-Label Randomized Cross-Over Trial.

The contribution of breakfast to daily nutrient intake is low, particularly among children, at only about 20%, and it is difficult to determine whether children are receiving adequate nutrients at breakfast. Although alterations in breakfast content are considered to affect lifestyle habits such as sleep and defecation, there have been few intervention studies in children. The relationship between nutritional balance, dietary intake, and lifestyle habits in children remains unclear. We conducted an intervention study on elementary school children's breakfasts and observed the effects of improving the nutritional balance of breakfast on sleep parameters and defecation status. An intervention study was conducted with 26 elementary school students in Tokyo. The study design was an open-label randomized cross-over trial. Subjects consumed their usual breakfast during the control period and a granola snack containing soy protein in addition to their usual breakfast during the intervention period. Questionnaires regarding breakfast, sleep, and bowel movements were administered during each period. Based on the answers to these questionnaires, we compared the nutritional sufficiency of macronutrients, vitamins, and minerals (29 in total), as well as changes in sleep parameters and defecation status. The additional consumption of granola snacks increased the breakfast intake of 15 nutrients. The changes were particularly significant for iron, vitamin B1, vitamin D, and dietary fiber. During the intervention, sleep duration was decreased and wake-up time became earlier. In terms of defecation, the intervention did not change stool characteristics, but the frequency of defecations per week increased on average by 1.2 per week. These results suggest that the nutritional balance and the amount of breakfast are linked to sleep and defecation and that improving breakfast content can lead to lifestyle improvements in children.

Defecation status, intestinal microbiota, and habitual diet are associated with the fecal bile acid composition: a cross-sectional study in community-dwelling young participants

PurposeBile acid (BA) metabolism by intestinal bacteria is associated with the risk of gastrointestinal diseases; additionally, its control has become a modern strategy for treating metabolic diseases. This cross-sectional study investigated the influence of defecation status, intestinal microbiota, and habitual diet on fecal BA composition in 67 community-dwelling young participants.MethodsFeces were collected for intestinal microbiota and BA analyses; data about defecation status and dietary habits were collected using the Bristol stool form scales and a brief-type self-administered diet history questionnaire, respectively. The participants were categorized into four clusters based on their fecal BA composition, according to cluster analysis, and tertiles based on deoxycholic acid (DCA) and lithocholic acid (LCA) levels.ResultsThe high primary BA (priBA) cluster with high fecal cholic acid (CA) and chenodeoxycholic acid (CDCA) levels had the highest frequency of normal feces, whereas the second BA (secBA) cluster with high levels of fecal DCA and LCA had the lowest. Alternately, the high-priBA cluster had a distinct intestinal microbiota, with higher Clostridium subcluster XIVa and lower Clostridium cluster IV and Bacteroides. The low-secBA cluster with low fecal DCA and LCA levels had the lowest animal fat intake. Nevertheless, the insoluble fiber intake of the high-priBA cluster was significantly higher than that of the high-secBA cluster.ConclusionHigh fecal CA and CDCA levels were associated with distinct intestinal microbiota. Conversely, high levels of cytotoxic DCA and LCA were associated with increased animal fat intake and decreased frequency of normal feces and insoluble fiber intake.Clinical trial registryUniversity Hospital Medical Information Network (UMIN) Center system (UMIN000045639); date of registration: 15/11/2019.

PS-C12-6: ASSOCIATION BETWEEN DEFECATION STATUS AND BLOOD PRESSURE VARIABILITY

Background: Blood pressure variability (BPV) is an independent predictor for cardiovascular disease. Defecation status has also been linked to the risk of developing cardiovascular disease. Aim: To investigate the association between BPV and defecation status Methods: A total of 184 participants who were able to measure their home blood pressure at least 8 days per month at both baseline and 1 year later were included in the study. All participants measured home blood pressure (BP) using HEM-9700T (OMRON Healthcare). Day-to-day variability of systolic BP were evaluated by coefficient of variation (CV) of home systolic BP during one month. Data on defecation status was obtained by questionnaire survey and good defecation status was defined as having a bowel movement every day. Results: In multivariate regression analysis with the change of CV from baseline to 1 year later as the objective variable and age, gender, Good defecation status, taking medication including antihypertensive drugs, laxatives, intestinal preparations, and CV at baseline as independent variables, good defecation status is independently negatively associated with the elevated CV (β;: -0.669, P = 0.0019). Conclusion: Good defecation status is shown to be significantly associated with decreased BPV.

Combination of poly-γ-glutamic acid and galactooligosaccharide improves intestinal microbiota, defecation status, and relaxed mood in humans: a randomized, double-blind, parallel-group comparison trial.

The genus Bifidobacterium comprises beneficial intestinal bacteria that play a crucial role in the regulation of human health. Traditional prebiotics are known to increase intestinal bifidobacteria by supplying a carbon source necessary for their growth. However, intestinal bifidobacteria need not only a carbon source but also a nitrogen source for growth. Moreover, the growth of bifidobacteria is known to be inhibited in a culture medium that does not contain glutamic acid. Based on these reports, we hypothesized that the combined intake of traditional prebiotics and glutamic acid would be beneficial for growth of bifidobacteria in the gut. In this study, we investigated the effects of the combination of galactooligosaccharide (GOS; traditional prebiotic material) and poly-γ-glutamic acid (γ-PGA; source of glutamic acid) and only GOS on the intestinal microbiota and health conditions (including intestinal regulation, mood status, gastrointestinal condition, skin condition, and sleep quality) in a randomized, double-blind, parallel-group comparison trial in healthy subjects. The combined intake of GOS and γ-PGA significantly increased the prevalence of B. longum compared to the intake of GOS alone. A minimum effective dose of 2.0 g GOS and 0.3 g γ-PGA improved defecation and mood status. We revealed the combined effects of GOS and γ-PGA on intestinal microbiota as well as physical condition and concluded that the delivery of glutamic acid to the large intestine with traditional prebiotics is useful as an advanced prebiotic.

An experimental study: the effect of S. boulardii on abemaciclibinduced diarrhea.

In our study, we aimed to investigate the protective effects of Saccharomyces boulardii on abemaciclib-induced diarrhea model, which is a commonly used drug in breast cancer. Thirty rats were divided into 3 groups as control (Group 1), abemaciclib (Group 2), and abemaciclib + Saccharomyces boulardii (Group 3) groups. The clinical status, body weight, and defecation status were monitored daily. At the end of the 15-day experiment period, the rats were killed with high-dose anesthesia and the resected small intestine segments were evaluated histopathologically. Lesions were classified according to thickening of the villus, inflammation and edema of mucosa and intraepithelial leukocyte accumulation. Then, mean values of both crypt depths and villi thicknesses were calculated for each rat. Normal distribution assumption was controlled with the Shapiro-Wilk test. One-way analysis of variance for normally distributed variables in the comparisons of more than two independent groups and Kruskal-Wallis test for nonnormally distributed variables were used. The significance value was accepted as 0.05. : There was one death in Group 3, but none in the others. There were no findings of mucositis in Group I. There was mild diarrhea and weight loss in only one rat in Group 1. For the comparison of the severity of diarrhea (72.5%/39%) and weight loss (72.5%/45%), a decrease was found in Group 3 according to Group 2 (p < 0.01). Histopathological findings such as edema, inflammation, and intraepithelial leukocyte accumulation also showed a decrease in Group 3 compared to Group 2 (p < 0.01). Saccharomyces boulardii should be considered as a treatment option in abaemaciclib (chemotherapy)-induced diarrhea. Further comparative studies and in vivo human randomized controlled studies can be conducted in the future.

Association of early-onset constipation and diarrhoea with patient outcomes in critically ill ventilated patients: A retrospective observational cohort study

BackgroundConstipation and diarrhoea are closely related, but few studies have examined them simultaneously. ObjectivesThe purpose of this study was to describe patient defecation status after intensive care unit (ICU) admission and determine the association between early-onset constipation and diarrhoea following ICU admission with outcomes for critically ill ventilated patients. MethodsPatients ventilated for ≥48 h in an ICU were retrospectively investigated, and their defecation status was assessed during the first week after admission. Early-onset constipation and diarrhoea were defined as onset during the first week of ICU admission. The patients were divided into three groups—normal defecation, constipation, and diarrhoea—and multiple comparisons were performed using the Kruskal–Wallis test and the Mann–Whitney U test with Bonferroni adjustment. Additionally, multivariable analysis was performed for mortality and length of stay using the linear and logistic regression models. ResultsOf the 85 critically ill ventilated patients, 47 (55%) experienced early-onset constipation and 12 (14%) experienced early-onset diarrhoea. Patients with normal defecation and diarrhoea increased from the 4th and 5th day of ICU admission. Early-onset diarrhoea was significantly associated with the length of ICU stay (B = 7.534, 95% confidence interval: 0.116–14.951). ConclusionsEarly-onset constipation and diarrhoea were common in critically ill ventilated patients, and early-onset diarrhoea was associated with the length of ICU stay.

Effects of Xiao Chengqi Formula on Slow Transit Constipation by Assessing Gut Microbiota and Metabolomics Analysis in vitro and in vivo.

The Xiao Chengqi (XCQ) formula is a newly constituted traditional Chinese medicine prescription in the treatment of intestinal motility deficiency and is effective in patients with slow transit constipation (STC). XCQ formula was reconstructed based on a “Chengqi” decoction. Astragali Radix, Angelicae Sinensis Radix, and cooked ground Salviae Miltiorrhizae Radix et Rhizoma were added to the prescription to enhance. An STC rat model was constructed and treated with the formula to understand the detailed mechanism by which XCQ promotes intestinal peristalsis. The effects of the XCQ formula on intestinal microflora and metabolic levels and the possible molecular mechanism of its regulation were explored using 16S rDNA sequencing, metabolomics sequencing, and tissue RNA sequencing. The results showed a significant decrease in the abundance of Roseburia spp. in the feces of STC rats, a significant decrease in the content of butyl aminobenzene (BAB) in feces, and an increase in the number of interstitial cells of Cajal (ICC) in the colon of STC rats. Furthermore, in vitro and in vivo experiments revealed that BAB could activate IL-21R on the ICC surface, upregulate the phosphorylation of the downstream molecules STAT3 and ERK, and inhibit loperamide-induced ICC apoptosis. Therefore, the XCQ formula can improve the defecation status of patients with STC by protecting ICC activity, promoting the colonization of Roseburia spp. to promote peristalsis, and increasing the BAB content after metabolism.