Investigation Of Constipation Research Articles

Balloon dilation of a congenital rectal stricture in a 16‐week‐old kitten

A 16‐week‐old Persian kitten was referred for investigation of constipation and failure to grow. The owner reported that the kitten had always strained to defecate. Abdominal radiographs confirmed megacolon and CT pneumocolography confirmed the presence of a caudal rectal stricture. During a single procedure and under fluoroscopic guidance, the stricture was effaced by sequentially dilating 10‐mm and 15‐mm balloons. Shortly after discharge, the owner reported complete resolution of clinical signs and oral laxatives were stopped. Repeat radiographs 1 month post dilation showed resolution of the diffuse megacolon and the cat appeared well and had gained weight. This is the first report of a congenital rectal stricture in a kitten and one of the few reports documenting balloon dilation for the treatment of stenotic anorectal lesions (congenital or acquired) in cats.

Constipation: Medical and Surgical Treatment

This review follows the general review entitled “Constipation,” which introduced the definition, classification, epidemiology, etiology, clinical evaluation, and investigation of constipation. This review addresses the medical and surgical management of constipation with a focus on surgical management. The latter is a subject of much controversy, and this review aims to provide a balanced view between those who favor radical surgery for the colon (colectomy) and rectum/pelvic floor (forms of rectopexy, rectal excision, and reinforcement) and those who have concerns that the unpredictable outcomes of such procedures push the risk–benefit analysis against surgical intervention for most patients. This review contains 5 figures, 2 tables and 80 references Key Words: chronic constipation, colectomy, constipation, ileorectal, intussusception, pelvic floor, rectocele, rectocele repair, rectopexy, slow-transit, stapled transanal rectal resection

Assessment of the clinical significance of intestinal spirochaetosis

Background:Spirochaetes are well known causative agents of diarrhoea in veterinary medicine. However, there is no agreement as to whether or not they have any clinical significance in humans.Aims:To assess the...

Rectal biopsy in the investigation of constipation

AIMSTo develop criteria to prevent unnecessary rectal biopsies in constipated children.METHODSA retrospective review of 186 rectal biopsies from 141 children, comparing the age at onset of symptoms with the diagnosis...

Oral [111In]DTPA scintigraphic assessment of colonic transit in constipated subjects

Patterns of colonic transit were assessed by a simple radioisotopic technique using 3.7 MBq of orally administered [111In]DTPA in 16 control subjects and 37 patients with intractable constipation. Normal subjects showed rapid diffuse spread of isotope through the colon resulting in low activity in all regions of interest (ROI). Activity was lost to feces at 24 hr and was virtually complete by 72 hr (median 94%, range 71-100%). Five constipated patients showed normal transit. Those with colonic inertia (N = 26) showed a significantly slowed geometric center of isotope compared to controls (P < 0.001), falling below the normal range at 48 hr. Percentage activity curves showed the major site of isotope hold-up to be in the transverse colon and splenic flexure. Other constipated patients (N = 6) showed late delay of the geometric center of isotope and accumulation of activity in the descending and rectosigmoid colon, compared to controls, at 96 hr. Oral [111In]DTPA colonic scintigraphy is a useful clinical test in the investigation of constipation.

Methods of assessment of bowel fu nction in patients with advanced cancer

Constipation is said to be a problem for most patients with advanced cancer. There has been little investigation of constipation in this group perhaps partly because of their frailty and a consequent reluctance to impose burdensome investigations on them. Mean transit time (MTT-S) was measured in 17 patients with advanced cancer admitted to a hospice and was used as a standard to evaluate the use of single stool analysis of transit time (SST) and the standardized estimation of stool form as measures of bowel function in this population. Bowel frequency, stool weight and stool water content were used as additional measures of bowel function. Transit time ranged from four to 12 days, the SST method proving accurate for transit times of 96 hours or less. MTT-S correlated more strongly with mean stool form ( r=0.83) than with any other measure of bowel function. It is suggested that standardized stool form assessment may give clinically useful information about transit time and be of particular value in assessing bowel function in ill patients.

Bowel transit studies in the elderly: radio-opaque markers in the investigation of constipation.

A simple method of measuring bowel transit quantitatively using radio-opaque markers is described. A group of asymptomatic elderly people were investigated to establish normal bowel transit times and the results compared with those in a group of people who complained of constipation on admission to hospital. All the symptomatic patients were screened to exclude an organic cause for the constipation as well as having transit studies to determine bowel function. The information obtained can be helpful in managing the symptom.