Stool Weight Research Articles

Effect of electroacupuncture on gastrointestinal motility in rats with slow transit constipation based on GDNF methylation modification

To observe the effect of electroacupuncture (EA) of "Tianshu"(ST25) and "Dachangshu"(BL25) on the intestinal transit function， expression level of glial cell-derived neurotrophic factor (GDNF) and methylation level of GDNF gene promoter region in colon tissue of rats with slow transit constipation (STC)， so as to explore its mechanisms underlying improvement of STC. Male Sprague-Dawley (SD) rats were randomized into control， saline， model and EA groups (n=16 in each group). The STC model was replicated by gavage of compound diphenoxylate suspension (10 mL· kg-1· d-1) for 28 days. Rats of the saline group received the same dose of normal saline via gavage. EA (2 Hz/15 Hz， 0.1-1 mA) was applied to bila-teral ST25 and BL25 for 15 min， once daily for 14 days. The intestinal transmission function (the intestinal propulsion rate) was assessed by recording the first black grain stool discharge time and the number and weight of the discharged stool grains in 30 min after gavage of the activated carbon suspension (1 mL/100 g， 150 g/L). The score of fecal trait and the weight of stool within 24 h were recorded. The ultrastructural changes of Cajal interstitial cells in the colon tissue were observed by transmission electron microscope. The expression levels of GDNF protein and mRNA in the colon tissue were detected by using Western blot and real-time fluorescent quantitative PCR， separately， and changes of methylation level in the promoter region of GDNF gene detected by using Bisulfite sequencing method. Compared with the control group， the time of the 1st black stool grain discharging was obviously prolonged， and the number and weight of the discharged black stool grains were significantly decreased in the mo-del group (P<0.05)， suggesting a success of STC. The weight and trait score of stool in 24 h， intestinal propulsive rate， and the expression levels of GDNF protein and mRNA were significantly lower in the model group than in the control group (P<0.01， P<0.05). After EA， the weight and trait score of stool within 24 h， intestinal propulsive rate，and the expression levels of GDNF protein and mRNA were significantly increased in the EA group in contrast to the model group (P<0.01，P<0.05). The total CpGs methylation level of GDNF gene in colon tissue was considerably higher in the model group than in the control group (P<0.05)， and markedly lower in the EA group than in the model group (P<0.05). No significant differences were found between the control and saline groups in all the above-mentioned indexes (P>0.05). EA of back-shu and front-mu acupoints can effectively improve symptoms of constipation and intestinal transport function in STC rats， which may be related to its function in up-regulating the expression of GDNF and down-regulating the methylation level in the promoter region of GDNF gene in colon tissue.

Comparison Between The Suspension and Capsule Preparation from Waste of Avocado Seeds As Antidiarrhea in Induced Mouse

Diarrhea is one type of disease with the most sufferers every year. Thus, it is considered an endemic disease in Indonesia and the potential disease of Extraordinary Events accompanied by mortality. One of the plants that can be used as a traditional medicine for diarrhea is the avocado seed, as it contains tannins, alkaloids, flavonoids, steroids and glycosides, which act as antidiarrheals. This study aims to determine the antidiarrheal effect of avocado seed extract suspension on mice induced by Oleum ricini and the optimum concentration of avocado seed extract suspension and capsules with an antidiarrheal effect in white male mice induced by Oleum ricini. The dosage forms chosen were suspension and capsules. This study used an experimental method with a test sample of the avocado seed. Avocado seed Simplicia was extracted by the percolation method, then an oral suspension and capsule formulation were made from the avocado seed methanol extract. It was evaluated and tested for its effectiveness with mice to cure diarrhea. Normal data were analyzed by One Way ANOVA and Post Hoc Tuckey Method. The results of this study showed that the administration of a suspension of avocado seed methanol extract at a dose of 800 mg/KgBB had the most optimum effect as an antidiarrheal against white male mice with a stool weight of 0.39 grams and a duration of diarrhea for 74 minutes. Furthermore, the administration of avocado seed extract capsules at a dose of 75 mg/KgBB had the most optimum effect as antidiarrheal against white male mice with Loperamide as a positive control. Therefore, it can be concluded that all suspension formulations and capsules of avocado seed methanol extract met the requirements for preparation evaluation. Suspension and avocado seed methanol extract capsules can cure diarrhea in white male mice.

Extraction of Pectin from Orange Peel and Study of Its Protective Effect Against Loperamide-Induced Impaired Gastrointestinal Motor Functions and Oxidative Stress in Rats.

Pectin is a polysaccharide attached to carbohydrates. These are substances exclusively of plant origin. The aim of the present study is to evaluate the laxative effects of orange peel pectin extract (OPPE) against constipation induced by loperamide (LOP) in rats. Rats were equally divided into six groups and treated daily 1 week as follows: Control, LOP (3 mg/kg, body weight [b.w.], Per Os [p.o.]), LOP+yohimbine (2 mg/kg, b.w., i.p.), and LOP+OPPE (6.25, 12.5, and 25 mg/kg, b.w., p.o.). At the end of the experiment, the effects of OPPE were assessed by fecal parameters (numbers, weight, and water content), gastrointestinal transit, gastric emptying, serum metabolic parameter changes, intestinal and colon mucosa oxidative stress, and the histological examination. The defecation test showed that administration of LOP (3 mg/kg, b.w., p.o.) leads to the production of remarkable constipation. Indeed, the number and water content of stools decreased (25.50 [n/24 h] and 29.86%) significantly (P < .05). Acute pretreatment with OPPE significantly and dose dependently accelerated the stool moistening and allowed an increase of stool weight (2.85, 3.61, 3.93 [g/24 h/rat]) as well as the frequency of defecation (47.36, 54.54, and 56.26 [n/24 h]). OPPE also significantly (P < .05) and dose dependently increased the intestinal motility (70.78%, 73.33%, and 75.01%) and gastric emptying. LOP-induced reduction (P < .05) of intestinal secretion was accompanied by a colonic and small bowel oxidative stress status and histological changes, which was attenuated by OPPE treatment. The findings of this study indicate that OPPE possesses an important role in the gastrointestinal motility regulation, and thus lend pharmacological credence to the suggested use of the natural pectin for the treatment, management, and/or control of constipation.

Antidiarrheal and Antisecretory Effect of 80% Hydromethanolic Leaf Extract of Moringa stenopetala Baker f. in Mice.

Introduction In Ethiopia, different medicinal plants have been claimed and used to treat diarrheal diseases. However, these claimed effects for most medicinal plants have not been scientifically verified. One of such plants in Ethiopian folkloric medicine is Moringa stenopetala, which is usually consumed as a vegetable in southern Ethiopia. Thus, this study aimed to evaluate the antidiarrheal and antisecretory effects of 80% methanolic leaf extract of Moringa stenopetala in different mice models. Method Using Swiss albino mice, castor oil-induced diarrhea, charcoal meal-based gastrointestinal motility, and castor oil-induced secretion models were employed to assess antidiarrheal activity. In all of the test models, animals were randomly assigned into five groups consisting of six animals in each group. Group I received 0.5 ml of the vehicle (2% tween-80), while group II was treated with standard drug (3 mg/kg loperamide) in the respective models, whereas groups III to V received 150, 300, and 450 mg/kg of the methanolic leaf extracts of Moringa stenopetala. Onset, frequency, consistency, and weight of stool (diarrhea) were recorded, and different parameters and percentage proportions were calculated. Data were analyzed using one-way ANOVA followed by Tukey's test, and p < 0.05 was considered statistically significant at 95% confidence of interval. Result In the castor oil-induced diarrheal model, the percentage inhibition of diarrhea was 48.5, 58.6, and 60% for the respective doses of 150, 300, and 450 mg/kg of the extract. And, the extract showed a 36.8, 54.4, and 55.9% reduction of peristalsis in charcoal meal-based gastrointestinal motility test compared to the negative control group. Moreover, in the antisecretory assay, the 150, 300, and 450 mg/kg doses of MEMS inhibited fluid contents of the stool by 11.5, 54.54, and 61.82%, respectively, relative to the vehicle-treated group. Conclusion The findings revealed that the 80% methanolic leaf extract of Moringa stenopetala extract has shown antidiarrheal activity.

Efficacy of Probiotic Compounds in Relieving Constipation and Their Colonization in Gut Microbiota.

A number of studies have confirmed the relationship between constipation and gut microbiota. Additionally, many human and animal experiments have identified probiotics as effectors for the relief of constipation symptoms. In this study, probiotic compounds, including Lactobacillus acidophilus LA11-Onlly, Lacticaseibacillus rhamnosus LR22, Limosilactobacillus reuteri LE16, Lactiplantibacillus plantarum LP-Onlly, and Bifidobacterium animalis subsp. lactis BI516, were administered to mice with loperamide-induced constipation, and the impacts of these strains on constipation-related indicators and gut microbiota were evaluated. The effects of probiotic compounds on constipation relief were associated with various aspects, including gastrointestinal transit rate, number and weight of stools, serum and intestinal gastrointestinal regulatory hormones, and serum cytokines. Some of the probiotic compounds, including Limosilactobacillus reuteri, Lactiplantibacillus plantarum, and Lacticaseibacillus rhamnosus, were found to colonize the intestinal tract. Furthermore, higher dosages promoted the colonization of specific strains. This study yields a new perspective for the clinical use of probiotics to improve constipation symptoms by combining strains with different mechanisms for the alleviation of constipation.

Chemical composition of Zhumeria majdae essential oil and its effects on the expression of morphine withdrawal syndrome and tolerance to the anticonvulsant effect of morphine on pentylenetetrazole-induced seizures in mice

Regarding the proven anticonvulsant effect of Zhumeria majdae essential oil (ZMEO) in previous studies we were prompted to investigate the ZMEO effects on the tolerance to the anticonvulsant effects of morphine and the morphine withdrawal syndrome. Tolerance to the morphine anticonvulsant effect was induced in mice by subcutaneous injection of 2.5 mg/kg of morphine for 4 days. Subsequent doses of ZMEO (20 mg/kg) were used to study the expression and development of morphine tolerance. Clonidine was used as the standard drug to inhibit the morphine withdrawal syndrome symptoms. To study the ZMEO effect on withdrawal syndrome, mice received appropriate morphine values for 4 days and on the fifth day, 60 min before administration of naloxone. The effective dose of ZMEO was determined and the number of jumps, stands and changes in the dry stool weight, as symptoms of withdrawal syndrome were evaluated. The dose of 20 mg/kg of ZMEO decreased the tolerance in development and expression groups significantly. Counting the number of jumping, standing and defecation were assessed 30 min after morphine and 1 h after the vehicle and clonidine. The dose of 40 mg/kg ZMEO decreased all the signs of withdrawal syndrome significantly. ZMEO was analyzed by GC/MS and linalool (53.1%) and camphor (23.8%) were characterized as the main components. The results suggest that ZMEO possesses constituent(s) that have activity against tolerance to the anticonvulsant effects of morphine and the morphine withdrawal symptoms.

In vivo anti-diarrheal activity of jujube honey on castor oil-induced diarrhea in mice.

To evaluate the antidiarrheal effect of jujube honey on experimentally castor oil-induced diarrhea in mice by using different testing models (diarrhea, enteropooling and gastrointestinal motility). The mice intragastric administration castor oil was post-treated after 30 min with jujube honey, diluted jujube honey and loperamide or vehicles in different experimental groups. The onset and number of wet defecation on the absorbent paper was recorded for each animal for 4 h. Plasma was examined for C-reactive protein (CRP) and nitric oxide (NO) for clinical inflammation evaluation. The oxidative stress was investigated by superoxide dismutase (SOD) and catalase levels. The diluted jujube honey exhibited an important antidiarrheal activity manifested by significant delay in onset of diarrhea (P < 0.05), loss in number of wet stools (P < 0.001), total number of stools (P < 0.001) and total stool weight of fecal output (P < 0.001) in 4 h in castor oil-induced diarrheal groups. The inhibition of intestinal transit of charcoal meal (P < 0.01) is a most likely mechanism that may account for antidiarrheal effect of jujube honey. It also significantly increased SOD and catalase levels (P < 0.001) and significantly decreased CRP and NO in plasma diarrheic mice (P < 0.01). The results of this research reveal that the jujube honey contains pharmacologically active compounds with antidiarrheal properties. However, diluted honey is more effective in the treatment of diarrhea and imbalance of intestinal motility. In conclusion, these findings illustrated the antidiarrheal activity effect of jujube honey and which has the strongest evidence supporting its use in the treatment of diarrhea in traditional medicine.

Laxative Effects of Phlorotannins Derived from Ecklonia cava on Loperamide-Induced Constipation in SD Rats.

This study investigated the laxative effects of phlorotannins (Pt) derived from Ecklonia cava (E. cave) on chronic constipation by evaluating alterations in stool parameters, gastrointestinal motility, histopathological structure, mucin secretion, gastrointestinal hormones, muscarinic cholinergic regulation, and fecal microbiota in SD rats with loperamide (Lop)-induced constipation subjected to Pt treatment. Stool-related parameters (including stool number, weight, and water contents), gastrointestinal motility, and length of intestine were significantly enhanced in the Lop+Pt-treated group as compared to the Lop+Vehicle-treated group. A similar recovery was detected in the histopathological and cytological structure of the mid-colon of Lop+Pt-treated rats, although the level of mucin secretion remained constant. Moreover, rats with Lop-induced constipation subjected to Pt treatment showed significant improvements in water channel expression, gastrointestinal hormone secretions, and expression of muscarinic acetylcholine receptors M2/M3 (mAChRs M2/M3) and their mediators of muscarinic cholinergic regulation. Furthermore, the Lop+Pt-treated group showed a significant recovery of Bifidobacteriaceae, Muribaculaceae, Clostridiaceae, and Eubacteriaceae families in fecal microbiota. Taken together, these results provide the first evidence that exposure of SD rats with Lop-induced constipation to Pt improves the constipation phenotype through the regulation of membrane water channel expression, GI hormones, the mAChR signaling pathway, and fecal microbiota.

World Gastroenterology Organisation Global Guidelines: Diet and the Gut.

World Gastroenterology Organisation Global Guidelines: Diet and the Gut.

UJI EFEKTIVITAS ANTIDIARE EKSTRAK ETANOL DAUN GELUGUR (Garcinia atroviridis Griff ex. T Anderson)TERHADAP TIKUS JANTAN PUTIH (Rattus norvegicus) DENGAN LOPERAMIDE SEBAGAI PEMBANDING

Gelugur leaf (Garcinia atroviridis Griff ex T. Anderson) is a kind of nadir is believed to origanate from the wild forest of Peninsular Malaysia. Gelugur leaves have antidiarrheal compounds in the shapes of tannins and flavonoids to reduce diarrhea. The purpose of this study was to find out the antidiarrheal activity of the ethanolic extract of gelugur leaf in white male rats. The antidiarrheal effect was tested on 15 white male rats with 5 treatment groups, namely, a negative control group of 1% CMC Na, a positive control group of loperamidee hcl, and a treatment group of ethanol extract of gelugur leaves at a dose of 150 miligrams/kgBW, a dose of 300 miligrams/kgBW, and 600 miligrams/kg body weight. Each group was given oral treatment and observations were made on the onset of diarrhea, frequency of diarrhea, and stool consistency. Tests were carried out using an experimental method. The ethanol extract of gelugur leaves was made by maceration method using 96% ethanol. The results of the study on the onset of diarrhea were EEDG 600 miligrams/kgBB (60 minutes), a good decrease in diarrhea frequency was indicated by EEDG 600 miligrams/kgBB (4 times), a good decrease in stool weight was shown by EEDG 600 miligrams/ kgBB (0,7757 grams), good consistency was also shown in the EEDG 600 miligrams/kgBB (soft stools. The data were statistically analyzed using One Way Anova. The results of data analysis from the three EEDG groups affected the decrease in diarrhea because the sig value &lt;0.05 Based on One Way Anova analysis, the five most effective treatments were loperamidee, 600 miligrams/kgBB, EEDG at 300 miligrams/kgBB, EEDG at 150 miligrams/kgBB, and CMC Na 1%. The conclusion in this study is that EEDG 600 miligrams/kgBB has antidiarrheal activity induced by oleum recini when compared with EEDG concentrations of 150 miligrams/kgBB and 300 miligrams/kgBB.

Isolation of the antidiarrhoeal tiliroside and its derivative from Waltheria indica leaf extract

The antidiarrhoeal effect of Waltheria indica methanol extract and fractions have been reported earlier but, the present work examined the intestinal relaxant effects of two flavonoid-phenyl propanoids isolated from the methanol extract. The active aqueous fraction was subjected to vacuum liquid chromatography using dichloromethane with increasing concentration of ethyl acetate, and that of methanol and water successively. The ten (10) fractions obtained were combined to give seven (7). The fraction 2 (C, D) was subjected to preparative thin layer chromatography on silica gel GF254 (10-40μm) using CHCl3-CH3OH (8:2) to obtain compound coded F2. Fraction 4 (F) was subjected to column chromatography using silica gel (60-120μm mesh) and eluted with dichloromethane with increasing concentrations of methanol. Fractions 9-28 were combined and subjected to column chromatography using chloroform with increasing concentration of methanol. The fractions 1-16 of these were purified on Sephadex LH-20 to obtain compound BAA. The identities of the two compounds were established using spectroscopic methods. The antidiarrheal effect of compound F2 was evaluated on mice using charcoal transit (100,200, 400mg/kg), castor oil (40, 60 mg/kg) while the two compounds were examined for their inhibitory effects on Ach-induced ileum contraction. The effects of the compounds were compared with loperamide (3mg/kg) and atropine (80μg). Compounds F2 and BAA were identified as tiliroside and 3’’’, 5’’’-dimethoxy tiliroside respectively. Tiliroside inhibited the charcoal transition in the animals in a dose dependent pattern with 400mg/ mL eliciting 63.41% inhibition compared to 59.23% produced by loperamide. The compound also elicited significantly (P&lt;0.05) prolonged onset of stooling and reduced the number and weight of stools produced lower than the control. The two compounds drastically inhibited the Ach-induced contractions of the ileum. The compound, tiliroside at 10mg, completely abolished the contraction by Ach unlike 3’’’, 5’’’-dimethoxy tiliroside which reduced the contraction to 1.92% at 20mg. The identified compounds seem to be responsible for the ethnomedicinal use of the plant in treating diarrhea.

Therapeutic effect of Cistanche deserticola on defecation in senile constipation rat model through stem cell factor/C-kit signaling pathway.

BACKGROUNDConstipation is one of the chronic gastrointestinal functional diseases. It seriously affects the quality of life. Cistanche deserticola (C. deserticola) can treat constipation obviously, but its mechanism has not been clarified. We supposed that mechanism of it improved the intestinal motility by stimulating interstitial Cajal cells (ICC). Activation of the C-kit receptor on the surface of ICC is closely related to ICC function, and the stem cell factor (SCF)/C-kit signaling pathways plays an important role on it. To investigate the mechanism of how C. deserticola treats constipation, this study aimed to establish a constipation model in rats and explore the role of SCF/C-kit signaling pathway in the treatment. AIMTo explore the SCF/C-kit signaling pathways in the role of C. deserticola for treatment of constipation by a constipation rat model.METHODSForty-eight 8-mo-old Sprague–Dawley rats were divided into 4 groups by random weight method: Normal group (n = 12), model group (n = 12), C. deserticola group (n = 12) and blocker group (n = 12). The normal group received normal saline by gavage; the model group received loperamide by gavage; the blocker group received loperamide and C. deserticola by gavage, and STI571 was injected by intraperitoneally. During treatment, the weight, fecal granules and fecal quality were recorded every 10 d. On day 20 after model induction, the colon tissues of each group were removed. Hematoxylin and eosin staining was used to observe pathological changes. Expression levels of SCF, C-kit and Aquaporin genes were detected by immunohistochemistry, western blotting, and real-time-quantitative polymerase chain reaction. The colonic epithelial mitochondria and goblet cells were observed by transmission electron microscopy.RESULTSCompared with the normal group, as treatment progressed, the weight of rats in the model and blocker groups decreased significantly, the stool weight decreased, and the stool quality was dry (P < 0.05). C. deserticola reversed the decrease in body weight and stool weight and improved stool quality. Histopathological analysis indicated that the colonic mucosal epithelium in the model group was incomplete, and the arrangement of the glands was irregular or damaged. Treatment with C. deserticola improved the integrity and continuity of the epithelial cells and regular arrangement of the glands. The blocking agents inhibited the effects of C. deserticola Immunohistochemistry and real-time-quantitative polymerase chain reaction showed that expression of SCF and C-kit protein or genes in the colonic tissue of the model group was decreased (P < 0.05), while treatment with C. deserticola increased protein or gene expression (P < 0.05). Western blotting showed that expression of aquaporin APQ3 was increased, while the expression of Cx43 decreased in the model group. Treatment with C. deserticola inhibited expression of APQ3 and promoted expression of Cx43. Transmission electron microscopy showed that the mitochondria of the colonic epithelium in the model group were swollen and arranged disorderly, and microvilli were sparse. The condition was better in the C. deserticola group. Mice treated with STI571 blocker confirmed that blocking the SCF/C-kit pathway inhibited the improvement of constipation by C. deserticola.CONCLUSIONC. deserticola improved defecation in rats with constipation, and the SCF/C-kit signaling pathway, which is a key link of ICC function, played an important role of the treatment.

Novel Characterization of Constipation Phenotypes in ICR Mice Orally Administrated with Polystyrene Microplastics.

Indirect evidence has determined the possibility that microplastics (MP) induce constipation, although direct scientific proof for constipation induction in animals remains unclear. To investigate whether oral administration of polystyrene (PS)-MP causes constipation, an alteration in the constipation parameters and mechanisms was analyzed in ICR mice, treated with 0.5 μm PS-MP for 2 weeks. Significant alterations in water consumption, stool weight, stool water contents, and stool morphology were detected in MP treated ICR mice, as compared to Vehicle treated group. Also, the gastrointestinal (GI) motility and intestinal length were decreased, while the histopathological structure and cytological structure of the mid colon were remarkably altered in treated mice. Mice exposed to MP also showed a significant decrease in the GI hormone concentration, muscarinic acetylcholine receptors (mAChRs) expression, and their downstream signaling pathway. Subsequent to MP treatment, concentrations of chloride ion and expressions of its channel (CFTR and CIC-2) were decreased, whereas expressions of aquaporin (AQP)3 and 8 for water transportation were downregulated by activation of the mitogen-activated protein kinase (MAPK)/nuclear factor (NF)-κB signaling pathway. These results are the first to suggest that oral administration of PS-MP induces chronic constipation through the dysregulation of GI motility, mucin secretion, and chloride ion and water transportation in the mid colon.

Effect of atractylenolide III on interstitial cells of Cajal and C-kit/SCF pathway of rats with loperamide-induced slow transit constipation

Purpose: To determine the effect of atractylenolide-III (ATL-III) on loperamide-induced slow transit constipation (STC) in a rat STC model, and to elucidate the mechanisms involved.&#x0D; Methods: Male Wistar rats were divided into five groups (n=6 per group): normal control group (NG), model group, and three STC rat groups treated with different doses of ATL-III, viz, 5, 10 and 15 mg/kg. The rats were treated for 15 days. Feed consumption, fecal excretion and intestinal transit rate were determined. Nitric oxide synthase (NOS), somatostatin (SS), serotonin (5-HT), and vasoactive intestinal peptide (VIP) were measured with enzyme-linked immunosorbent assay (ELISA). The protein and mRNA expressions of C-kit, SCF, PKC, and PI-3K were assayed using Western blot analysis and realtime reverse transcription polymerase chain reaction (RT-PCR), respectively.&#x0D; Results: The amount, weight, and moisture content of stool, and water consumption were significantly higher in ATL-III-treated groups than in the untreated (model) group (p &lt; 0.05), whereas no difference was observed in feed intake. Intestinal transit rate was higher in the ATL-III-treated groups (p &lt; 0.05). Decreased NOS, SS and VIP levels and increased 5-HT level were seen in the ATL-III-treated groups (p &lt; 0.05). ATL-III treatment also induced increases in smooth muscle cells, neuronal cells, and mucous layer (p&lt;0.05). Results from RT-PCR and Western blot revealed that ATL-III–treated groups had elevated c-kit, SCF, PKC, as well as PI-3K mRNA and protein expressions (p &lt; 0.05).&#x0D; Conclusion: These results suggest that ATL-III mitigates loperamide-induced STC in rats via stimulation of NOS, SS, VIP, and 5-HT secretions. It also increases smooth muscle cells, neuronal cells, and mucous layer, and regulates the signaling pathways involving PKC, PI3K, SCF, and c-kit.

Antidiarrheal Activity Test of White Pomegranate (Punica granatum L.) Infusion on Swiss Webster Male with Oleum Ricini Method

Diarrhea is a condition in which a person defecates with a soft or liquid consistency, which can evenbe water. Diarrhea can be treated with drugs derived from plants, one of which is white pomegranate skin. Theskin of white pomegranate (Punica granatum L.) is thought to have anti-diarrheal activity because it has fl avonoidsand tannins. This study aims to determine the activity and optimal dose of pomegranate skin infusion.Mice were grouped into 5 groups: negative control (Na CMC 0.5%), positive control (Loperamid HCl), andpomegranate peel infusion test group with a dose of 8 mg / 20 g mice BW, 16 mg / 20 g weight mice and 32 mg./ 20 gr BB mouse. Mice induced diarrhea with Oleum ricini, 30 minutes later the mice were given a test preparation.The onset of diarrhea, stool consistency, diarrhea frequency, duration of diarrhea and stool weight weremeasured every 30 minutes for 6 hours. The results showed that the fi rst dose (8 mg / 20 gr BW of mice) wasthe optimal dose for the initial parameters of diarrhea and fecal weight, which means that there was a signifi cantdiff erence with negative control and positive control (&lt;0.05). The parameters of stool consistency, frequency ofdiarrhea and duration of occurrence of diarrhea showed no signifi cant diff erence between groups of 8 mg / 20 gmice BW, 16 mg / 20 g mice BW and 32 mg / 20 g mice BW, negative control and positive control (p&gt; 0, 05).

A Rare Presentation of Lower Abdominal Pain

Question: A 69-year-old woman presented to our hospital with lower abdominal pain, especially left lower quadrant of abdomen for 1 month. She did not have bowel habit change, blood-tingled stool, or body weight loss during this episode. In the clinic, 1 firm and nonmobile tumor at the left lower abdomen was palpated. A computed tomography scan revealed a huge (9 × 7 × 6 cm) and ill-defined tumor over left ovary and sigmoid colon area (Figure A). The initial tumor marker survey found carcinoma antigen 125 was 17.4 U/mL (reference value, <35.0 U/mL) and carcinoembryonic antigen was 307 ng/mL (reference value, <4.70 ng/mL).

Increased Fecal Bile Acid Excretion in a Significant Subset of Patients with Other Inflammatory Diarrheal Diseases.

Increased fecal bile acid excretion (IBAX) occurs in a third of patients with functional diarrhea. To assess the prevalence of IBAX in benign inflammatory intestinal and colonic diseases presenting with chronic diarrhea. All patients with known inflammatory diseases or resections who underwent 48h fecal fat and BA testing for chronic diarrhea at a single center were included. Quiescent disease was based on clinical evaluation and serum, endoscopic and imaging studies. IBAX was defined by: > 2337µmol total BA/48h; or primary fecal BAs > 10%; or > 4% primary BA plus > 1000µmol total BA /48h. Demographics, fecal weight, fecal fat, stool frequency and consistency were collected. Nonparametric statistical analyses were used for group comparisons. Sixty patients had celiac disease (51 quiescent, 9 active), 66 microscopic colitis (MC: 34 collagenous, 32 lymphocytic), 18 ulcerative colitis (UC), and 47 Crohn's disease (CD). Overall, fecal fat, 48h stool weight, frequency and consistency were not different among subgroups except for inflammatory bowel disease (IBD) based on disease location. Almost 50% patients with celiac disease and MC had IBAX, with a greater proportion with increased primary fecal BA. Among UC patients, rates of IBAX were higher with pancolonic disease. A high proportion of patients with ileal resection or CD affecting ileum or colon had IBAX. IBAX was present even with quiescent inflammation in UC or CD. A significant subset of patients with MC, quiescent celiac disease and IBD had increased fecal BA excretion, a potential additional therapeutic target for persistent diarrhea.

Inhibitory Effects of Dexmedetomidine and Propofol on Gastrointestinal Tract Motility Involving Impaired Enteric Glia Ca2+ Response in Mice.

Propofol and dexmedetomidine are popular used for sedation in ICU, however, inadequate attention has been paid to their effect on gastrointestinal tract (GIT) motility. Present study aimed to compare the effect of propofol and dexmedetomidine on GIT motility at parallel level of sedation and explore the possible mechanism. Male C57BL/6 mice (8-10weeks) were randomly divided into control, propofol and dexmedetomidine group. After intraperitoneal injection of propofol or dexmedetomidine, comparable sedative level was confirmed by sedative score, physiological parameters and electroencephalogram (EEG). Different segments of GIT motility in vivo (gastric emptying, small intestine transit, distal colon bead expulsion, stool weight and number of fecal pellets, gastrointestinal transit and whole gut transit time) and colonic migrating motor complexes (CMMCs) pattern in vitro were evaluated. The Ca2+ response of primary enteric glia was examined under the treatment of propofol or dexmedetomidine. There is little difference in physiological parameters and composite permutation entropy index (CPEI) between administration of 50mg/kg propofol and 40μg/kg dexmedetomidine, indicated that parallel level of sedation was reached. Data showed that propofol and dexmedetomidine had significantly inhibitory effect on GIT motility while dexmedetomidine was stronger. Also, the amplitude (ΔF/F0) of Ca2+ response in primary enteric glia was attenuated after treated with the sedatives while the effect of dexmedetomidine was greater than propofol. These findings demonstrated that dexmedetomidine caused stronger inhibitory effects on GIT motility in sedative mice, which may involve impaired Ca2+ response in enteric glia. Hence, dexmedetomidine should be carefully applied especially for potential GIT dysmotility patient.

COVID concerns highlight the importance of adequate fecal immunochemical test sample collection.

COVID concerns highlight the importance of adequate fecal immunochemical test sample collection.

Effects of curd on diarrhea treatment in patients with head trauma receiving enteral feeding in intensive care units

BACKGROUND: Diarrhea in patients on enteral feeding is a common complication with serious clinical outcomes. In Eastern and Southern Mediterranean regions, using curd as a food for the treatment of diarrhea is a common practice. OBJECTIVE: This study aimed to investigate whether curd could reduce the duration or severity of diarrhea in critically ill tube-fed patients with head trauma. METHODS: A total of 42 patients on enteral feeding who had diarrhea after starting enteral feeding, admitted to the intensive care unit, were randomly assigned to either to receiving curd and standard enteral formula or standard enteral formula only groups. The intervention period for each patient was three days. The primary outcome was the duration of diarrhea, while the secondary outcomes were the frequency and weight of stool per day in each patient. RESULTS: This study showed a significantly higher stool weight in patients receiving enteral curd (588.76±266.88 vs 390.60±171.82 gr/day). There was no significant difference between the groups in duration of diarrhea (9 v 8 days) and episodes of diarrhea per day (2.20±1.00 vs 2.00±0.70) in intervention and control groups. incidence of liquid or loose stools on days 1–4 of the intervention (P1 = 0.43, P2 = 0.16, P3 = 0.45, P4 = 0.62). Feeding with curd did not change the APACHE score in intervention and control groups. This study showed no significant difference in 28 days of mortality in intervention and control groups. CONCLUSION: The findings showed that supplementary enteral feeding with curd did not improve diarrhea, the severity of the disease, or 28 days mortality in critically ill patients with diarrhea receiving enteral nutrition.