Increased Frequency Of Bowel Movements Research Articles

Bifidobacterium animalis subsp. lactis HN019 Effects on Gut Health: A Review.

Optimal gut motility is central to bowel function and gut health. The link between the gut dysmotility related disorders and dysfunctional-intestinal barriers has led to a hypothesis that certain probiotics could help in normalizing gut motility and maintain gut health. This review investigates the roles of Bifidobacterium animalis subsp. lactis HN019 (B. lactis HN019™) on gut health, and its mechanisms of action in various pre-clinical and clinical studies. Research supports the hypothesis that B. lactis HN019™ has a beneficial role in maintaining intestinal barrier function during gastrointestinal infections by competing and excluding potential pathogens via different mechanisms; maintaining normal tight junction function in vitro; and regulating host immune defense toward pathogens in both in vitro and human studies. This has been observed to lead to reduced incidence of diarrhea. Interestingly, B. lactis HN019™ also supports normal physiological function in immunosenescent elderly and competes and excludes potential pathogens. Furthermore, B. lactis HN019™ reduced intestinal transit time and increased bowel movement frequency in functional constipation, potentially by modulating gut–brain–microbiota axis, mainly via serotonin signaling pathway, through short chain fatty acids derived from microbial fermentation. B. lactis HN019™ is thus a probiotic that can contribute to relieving gut dysmotility related disorders.

Abstract 839: Association of bowel movement frequency and laxative use with risk of hepatocellular carcinoma in US women and men

Abstract Background: Abnormal bowel movements have been associated with dyslipidemia, hypertension, diabetes, and altered metabolism of bile acids and gut microbiota, risks factors also associated with hepatocellular carcinoma (HCC). However, little is known about whether bowel movement frequency affects the risk of HCC. Methods: We followed 88,123 women in the Nurses' Health Study (NHS) and 21,084 men in the Health Professionals Follow-up Study (HPFS). The Cox proportional hazards regression model was used to calculate multivariable hazard ratios (HRs) and confidence intervals (95%CIs). In addition to age, we adjusted for race (white or non-white), gender (female or male), physical activity (lt 3, 3 to 26, ge 27 METS-hours/week), smoking status (never, 1 to 9, ge10 pack-years), alcohol consumption (lt 5, 5 to 14, get 15g/day), aspirin use (yes or no), body mass index (lt 25, 25 to 27.4, 27.5 to 29, ge 30kg/m2), and AHEI-2010 score without alcohol (in quartile) in the multivariable models. Results: We documented 101 incident HCC cases. Compared to those daily bowel movements, participants with bowel movement more than once per day had a multivariable HR of 1.88 (95% CI: 1.15 to 3.09) in the pooled cohorts. The positive association appeared stronger for men (frequent vs. daily, 2.74, 95% CI: 1.15 to 6.49) than for women (frequent vs. daily, 1.57, 95% CI: 0.83 to 2.95) (P-heterogeneity by sex=0.31). We found null associations between infrequent bowel movement and the risk of HCC (HR=1.00, 95%CI: 0.58 to 1.72). The HR (95%CI) for participants who used laxatives regularly relative to those who never used laxatives was 1.03 (0.66 to 1.60). Conclusions: Our results suggest increased bowel movement frequency is associated with a higher risk of HCC. These findings need to be confirmed and potential mechanisms underlying this association need to be elucidated. Bowel movement, laxative use and risk of hepatocellular carcinoma in NHS and HPFSFrequency of bowel movementFrequency of bowel movementFrequency of bowel movementLaxative useLaxative useMore than once per dayDailyEvery 2 days or lessNoYesWomen (NHS)Number of cases1345175322Age-adjusted model1.78 (0.95-3.31)1 (ref)0.96 (0.54-1.68)1 (ref)0.97 (0.59-1.60)Multivariable-adjusted model1.57 (0.83-2.95)1 (ref)0.94 (0.53-1.68)1 (ref)1.01 (0.61-1.68)Men (HPFS)Number of cases11132197Age-adjusted model2.89 (1.25-6.70)1 (ref)1.22 (0.27-5.58)1 (ref)1.12 (0.46-2.76)Multivariable-adjusted model2.74 (1.15-6.49)1 (ref)1.20 (0.25-5.63)1 (ref)1.11 (0.44-2.79)PooledNumber of cases2458197229Age-adjusted model2.09 (1.28-3.41)1 (ref)1.00 (0.59-1.70)1 (ref)1.00 (0.65-1.56)Multivariable-adjusted model1.88 (1.15-3.09)1 (ref)1.00 (0.58-1.72)1 (ref)1.03 (0.66-1.60) Citation Format: Lu Long, Xing Liu, Lina Jin, Tracey Simon, Wenjie Ma, Mi Na Kim, Wanshui Yang, Jefferey A. Meyerhardt, Andrew Chan, Edward Giovannucci, Xuehong Zhang. Association of bowel movement frequency and laxative use with risk of hepatocellular carcinoma in US women and men [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 839.

The alga Euglena gracilis stimulates Faecalibacterium in the gut and contributes to increased defecation

The alga Euglena gracilis (E. gracilis) has recently gained attention as a health food, but its effects on human gut microbiota remain unknown. This study aimed to determine the effect of E. gracilis on gut microbiota and defecation due to modulation of microbiota composition in vitro and in vivo. The in vitro model simulating human colonic microbiota revealed that E. gracilis addition stimulated the growth of commensal Faecalibacterium. Further, E. gracilis addition enhanced butyrate production by Faecalibacterium prausnitzii. Paramylon, an insoluble dietary fibre that accumulates in E. gracilis and is the main component of E. gracilis, did not stimulate Faecalibacterium growth in vitro. Daily ingestion of 2 g of E. gracilis for 30 days increased bowel movement frequency as well as stool volume in 28 human participants. Collectively, these findings indicate that E. gracilis components other than paramylon, stimulate the growth of Faecalibacterium to improve digestive health as well as promote defecation by increasing butyrate production.

SAT-517 A Rare Case of Lithium-Induced Thyroiditis

BACKGROUND: Lithium is known to cause both hypo- and rarely hyper- thyroidism. It inhibits release of thyroid hormone and reduces the intrathyroidal iodothyronine/iodothyrosine ratio. Due to direct toxic or immunostimulatory effect, lithium can also cause thyroiditis. Lithium-induced thyroiditis is a rare entity with an incidence rate of about 1.3 cases per 1000 person-years. Given its generally painless and transient nature, symptoms of thyrotoxicosis may erroneously be attributed to an exacerbation of mania. Clinical Case: We report the case of a 29 y/o man with bipolar disorder on lithium therapy who presented with a 2 week history of intermittent palpitations, increased irritability, racing thoughts, insomnia, tremors, increased bowel movement frequency, and 8 lbs weight loss despite an excellent appetite. He denied ocular symptoms, and did not have any recent illness, or new stressors. He had been on a stable dose of lithium for four years.The physical exam was notable for: pulse 78 bpm and regular, exophthalmos, and a palpable, non-tender, non-nodular, thyroid. Labs: TSH 0.008 uIU/ml [0.350 - 5.50], FT3 6.5 pg/ml [2.0 - 4.4], T3 2.08 ng/mL [0.6–1.94] and FT4 1.96 ng/dl [0.8 - 2.7]. TPO, TSI and anti-thyroglobulin antibodies were negative. The lithium level was in the therapeutic range. Thyroid Uptake Scan showed decreased uptake of 2.6 % [normal 10–35%]. He was started on methimazole 20mg daily and atenolol, lithium was changed to risperidone by Psychiatry.After 2 months, hyperthyroid symptoms had resolved, and he was biochemically hypothyroid (FT4 0.85 ng/dl, TSH 20uIU/ml). Methimazole and atenolol were discontinued, with sustained euthyroid state. Conclusion: Hyperthyroidism may develop after several years of lithium therapy. It may be mistaken for aggravation of mania, or for Grave’s disease, especially since lithium and Graves’ are both associated with exophthalmos. Key issues for management are whether to continue lithium and deciding if the incorporation of antithyroid medications is necessary. Of utmost importance is regular monitoring of thyroid function tests to ensure resolution of thyroiditis and to avoid the development of overt hypothyroidism.

Associations of Bowel Movement Frequency with Risk of Cardiovascular Disease and Mortality among US Women.

Emerging evidence suggests a potential impact of gastrointestinal function on cardiometabolic risk. Abnormal bowel movements have been related to various cardiovascular risk factors such as dyslipidemia, hypertension, diabetes, and altered metabolism of bile acids and gut microbiota. However, little is known about whether bowel movement frequency affects risk of cardiovascular disease (CVD) and mortality. In the Nurses’ Health Study, bowel movement frequency was self-reported in 1982 by 86,289 women free from CVD and cancer. During up to 30 years of follow-up, we documented 7,628 incident CVD cases and 21,084 deaths. After adjustment for dietary intake, lifestyle, medication use, and other risk factors, as compared with women with daily bowel movement, having bowel movements more than once daily was significantly associated with increased risk of CVD (hazard ratio [HR]: 1.13; 95% confidence interval [CI]: 1.05–1.21), total mortality (HR: 1.17; 95% CI: 1.12–1.22), and cardiovascular mortality (HR: 1.17; 95% CI: 1.07–1.28). With further adjustment for body mass index and diabetes status, the association with total mortality remained significant (HR: 1.10; 95% CI: 1.06–1.15), whereas the associations with incident CVD and cardiovascular mortality were no longer significant. Our results suggest increased bowel movement frequency is a potential risk factor for premature mortality.

Clinical study on treatment of chronic viral cholestatic hepatitis with Chishaodanpi decoction

ObjectiveTo observe the therapeutic effect of Chishaodanpi decoction (CSDPD) on chronic viral cholestatic hepatitis. MethodsA total of 107 subjects with chronic viral cholestatic hepatitis were enrolled in our hospital from March 2007 to November 2012. Patients were randomly divided into treatment (54 cases) and control groups (53 cases). The control group was treated with potassium magnesium aspartate, diammonium glycyrrhizinate, glucurolactone, vitamin C, and lamivudine, once a day. The treatment group was treated with modified CSDPD, 100 mL a time, twice a day, in addition to the treatment given to the control group. The patients in both groups were treated for 8 weeks. The main symptoms and signs were recorded every day throughout the clinical trial. Before and after the trial, changes in liver function including total bilirubin (TBil), direct bilirubin (DBil), total bile acid (TBA), and the activities of alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and γ-glutamyl transferase (γ-GT), were all detected. Adverse reactions were also recorded. ResultsThere were no differences in gender, age, disease duration, symptoms, signs, or laboratory findings between the two groups (P>0.05). After an 8-week treatment, improvements in jaundice, weakness, poor appetite, abdominal distention, and skin itching were significantly better in the treatment group than in the control group (P<0.05). In the treatment group, 43 patients had a significant response to the treatment, seven patients had a response, and four patients had no response, with 21, 12, and 20 patients in the control group, respectively. The total effective rate was 92.6% in the treatment group and 62.3% in the control group, which was a significant difference (P<0.05). The levels of TBil, DBil, TBA, ALP, ALT, AST, and γ-GT in both groups were significantly lower after treatment, and were significantly different between the two groups (P<0.05). A few patients in the treatment group had mild adverse effects such as increased bowel movement frequency and mild stomachache. No other adverse reactions were observed in either group. ConclusionCSDPD has a satisfactory therapeutic effect on chronic viral cholestatic hepatitis.

Non-diarrhoeal increased frequency of bowel movements (IFoBM-ND): enterovirus association with the symptoms in children

ObjectiveInfectious and non-infectious causes are associated with increased frequency of bowel movements (IFoBM). But, a viral aetiology to non-diarrhoeal IFoBM (IFoBM-ND) has not been described. Owing to an accidental infection...

899 Td-1211 Phase 2B Study Demonstrates Increased Bowel Movement Frequency and Constipation-Related Symptom Improvement in Patients With Opioid Induced Constipation (OIC)

899 Td-1211 Phase 2B Study Demonstrates Increased Bowel Movement Frequency and Constipation-Related Symptom Improvement in Patients With Opioid Induced Constipation (OIC)

Surgical innovation for refractory constipation (Jinling procedure): a long-term follow-up of its safety and efficacy

To propose a novel surgical procedure for refractory constipation, namely Jinling procedure, and to explore its safety and efficacy through long-term follow-up. A total of 614 patients with refractory constipation were admitted to the Department of General Surgery between February 2000 and June 2011. Five hundred and fifty-four patients received Jinling procedure and were included in this study. The general clinical data, complications after Jinling procedure, gastrointestinal quality of life index (GIQLI), Wexner constipation scale and satisfaction rate during follow-up were collected. No operation-associated death occurred. Increased bowel movement frequency was observed during the perioperative period. Temporary difficulty in urination occurred in 24.5% of the patients. Other complications included small bowel obstruction (9.6%), anastomotic bleeding (8.1%), anastomotic leakage (3.1%), sexual dysfunction (3.1%), and wound infection (3.1%). Most postoperative complications were managed conservatively. The most recent follow-up was on August 2011, and the follow-up rate was 100%, 88.8%, 75.1%, 56.3% at 3, 6, 12, and 24 months after surgery. GIQLI temporarily increased from 78.1±9.4 preoperatively to 92.0±9.5 at 3 months follow-up, but continued to decrease during the follow-up at the 6 months (48.4±14.1), 12 months (21.0±4.3), and 24 months (20.0±3.4). Wexner constipation scale decreased from 19.9±4.3 preoperatively to 8.4±2.1 at 3 months follow-up (P<0.01). The low Wexner scale sustained until 24 months after operation. The satisfaction rate at the 3, 6,12 and 24 months follow-up was 78.1%, 91.1%, 94.2% and 94.6%, respectively. Jinling procedure provides refractory constipation patients with a novel, safe and effective surgical option.

The Pharmacology of TD-8954, a Potent and Selective 5-HT(4) Receptor Agonist with Gastrointestinal Prokinetic Properties.

This study evaluated the in vitro and in vivo pharmacological properties of TD-8954, a potent and selective 5-HT4 receptor agonist. TD-8954 had high affinity (pKi = 9.4) for human recombinant 5-HT4(c) (h5-HT4(c)) receptors, and selectivity (>2,000-fold) over all other 5-hydroxytryptamine (5-HT) receptors and non-5-HT receptors, ion channels, enzymes and transporters tested (n = 78). TD-8954 produced an elevation of cAMP in HEK-293 cells expressing the h5-HT4(c) receptor (pEC50 = 9.3), and contracted the guinea pig colonic longitudinal muscle/myenteric plexus preparation (pEC50 = 8.6). TD-8954 had moderate intrinsic activity in the in vitro assays. In conscious guinea pigs, subcutaneous administration of TD-8954 (0.03–3 mg/kg) increased the colonic transit of carmine red dye, reducing the time taken for its excretion. Following intraduodenal dosing to anesthetized rats, TD-8954 (0.03–10 mg/kg) evoked a dose-dependent relaxation of the esophagus. Following oral administration to conscious dogs, TD-8954 (10 and 30 μg/kg) produced an increase in contractility of the antrum, duodenum, and jejunum. In a single ascending oral dose study in healthy human subjects, TD-8954 (0.1–20 mg) increased bowel movement frequency and reduced the time to first stool. It is concluded that TD-8954 is a potent and selective 5-HT4 receptor agonist in vitro, with robust in vivo stimulatory activity in the gastrointestinal (GI) tract of guinea pigs, rats, dogs, and humans. TD-8954 may have clinical utility in patients with disorders of reduced GI motility.

Pilot Study on the Effect of Linaclotide in Patients With Chronic Constipation

Chronic constipation is a common gastrointestinal disorder with limited treatment options. Oral administration of linaclotide, a novel peptide agonist of guanylate cyclase-C receptors, has been shown in animal studies to stimulate intestinal fluid secretion and transit. In Phase 1 studies in healthy human volunteers, linaclotide was well-tolerated, increased bowel movement frequency, and loosened stool consistency. This randomized, double-blind, placebo-controlled pilot study evaluated the safety, tolerability, and exploratory efficacy of oral linaclotide in 42 patients with chronic constipation. Patients were randomized to linaclotide (100, 300, or 1,000 microg) or placebo once daily for 2 weeks. Bowel habits (stool frequency, consistency, straining, completeness of evacuation) and degree of abdominal discomfort were monitored daily using an interactive voice response system. Patient-reported outcomes of severity of constipation and overall relief were evaluated weekly. Linaclotide treatment produced dose-dependent increases from the pretreatment baseline values in weekly complete spontaneous bowel movement frequency (range: 2.2-3.2), stool consistency scores (range: 1.1-2.6, 7-point scale), and straining scores (range: 0.4-1.5, 7-point scale); corresponding placebo increases were 1.3, 0.4, 0.4, respectively. Clinical improvements were also demonstrated in abdominal discomfort, severity of constipation, and overall relief. Compared to placebo, linaclotide 100 microg/day significantly increased spontaneous bowel movement frequency, and linaclotide 1,000 microg/day significantly improved stool consistency (P<0.05). Adverse events were primarily gastrointestinal, with diarrhea being the most common. In this pilot study, linaclotide treatment improved bowel habits and symptoms of patients with chronic constipation. Further randomized controlled trials are warranted.

The Treatment of Chronic Constipation in Adults A Systematic Review

To evaluate whether laxatives and fiber therapies improve symptoms and bowel movement frequency in adults with chronic constipation. English language studies were identified from computerized MEDLINE (1966-1995). Biological Abstracts (1990-1995), and Micromedex searches; bibliographies; textbooks; laxative manufactures; and experts. Randomized trials of laxative or fiber therapies lasting more than 1 week that evaluated clinical outcomes in adults with chronic constipation. Two independent reviewers appraised each trial's characteristics including methodologic quality. There were 36 trials involving 1,815 persons from a variety of settings including clinics, hospitals and nursing homes. Twenty-three trials were 1 month or less in duration. Several laxative and fiber preparations were evaluated. Twenty trials had a placebo, usual care, or discontinuation of laxative control group, and 16 directly compared different agents. Laxatives and fiber increased bowel movement frequency by an overall weighted average of 1.4 (95% confidence interval [CI] 1.1-1.8) bowel movements per week. Fiber and bulk laxatives decreased abdominal pain and improved stool consistency compared with placebo. Most nonbulk laxative data concerning abdominal pain and stool consistency were inconclusive, though cisapride, lactulose, and lactitol improved consistency. Data concerning superiority of various treatments were inconclusive. No severe side effects for any of the therapies were reported. Both fiber and laxatives modestly improved bowel movement frequency in adults with chronic constipation. There was inadequate evidence to establish whether fiber was superior to laxatives or one laxative class was superior to another.

The Treatment of Chronic Constipation in Adults

To evaluate whether laxatives and fiber therapies improve symptoms and bowel movement frequency in adults with chronic constipation. English language studies were identified from computerized MEDLINE (1966-1995), Biological Abstracts (1990-1995), and Micromedex searches; bibliographies; textbooks; laxative manufacturers; and experts. Randomized trials of laxative or fiber therapies lasting more than 1 week that evaluated clinical outcomes in adults with chronic constipation Two independent reviewers appraised each trial's characteristics including methodologic quality. There were 36 trials involving 1,815 persons from a variety of settings including clinics, hospitals and nursing homes. Twenty-three trials were 1 month or less in duration. Several laxative and fiber preparations were evaluated. Twenty trials had a placebo, usual care, or discontinuation of laxative control group, and 16 directly compared different agents. Laxatives and fiber increased bowel movement frequency by an overall weighted average of 1.4 (95% confidence interval [CI] 1.1-1.8) bowel movements per week. Fiber and bulk laxatives decreased abdominal pain and improved stool consistency compared with placebo. Most nonbulk laxative data concerning abdominal pain and stool consistency were inconclusive, though cisapride, lactulose, and lactitol improved consistency. Data concerning superiority of various treatments were inconclusive. No severe side effects for any of the therapies were reported. Both fiber and laxatives modestly improved bowel movement frequency in adults with chronic constipation. There was inadequate evidence to establish whether fiber was superior to laxatives or one laxative class was superior to another.