BACKGROUND Irritable bowel syndrome(IBS)is a bowel disorder involving abdominal pain or discomfort along with irregularity of stool form and passage frequency.The pathophysiology is poorly understood and seems to be m...BACKGROUND Irritable bowel syndrome(IBS)is a bowel disorder involving abdominal pain or discomfort along with irregularity of stool form and passage frequency.The pathophysiology is poorly understood and seems to be multifactorial.Investigations of possible causes of IBS have included only a few colonic transit studies and no simultaneous determination of the colonic faecal content.AIM To compare colon transit time and faecal load between IBS-patients and healthy control subjects.METHODS The study included 140 patients with IBS,with a mean age of 50.0 years.The control group comprised 44 healthy persons with a mean age of 43.4 years,who were selected at random from the National Civil Register.Both the patient group and the control group underwent a marker study to measure colon transit time(CTT)and to calculate a faecal loading score.The patient group underwent treatment with a combined prokinetic regime,after which their CTT and faecal loading were reassessed.Analyses were performed to compare measurements between the control group and the patient group before and after treatment.RESULTS Compared to healthy controls,IBS-patients exhibited a significantly prolonged mean CTT(45.48 h vs 24.75 h,P=0.0002)and significantly greater mean faecal loading scores in all colonic segments(P<0.001).Among IBS patients,we found no significant differences between the 48 h and 96 h radiographs.Among patients exhibiting increased CTT and faecal loading,approximately half exhibited a palpable mass in the right iliac fossa.After intervention with a prokinetic treatment,the mean CTT among IBS patients was reduced from 45.48 h to 34.50 h(P=0.091),with the post-treatment CTT not significantly differing from the CTT among control subjects(P=0.095).The faecal loading score among IBS patients did not significantly differ before and after treatment(P=0.442).The posttreatment faecal loading score in IBS patients remained significantly higher compared to that in controls(5.3 vs 4.3,P=0.014).After treatment,half of the IBSpatients were relieved of bloating,while the majority no longer experienced abdominal pain and achieved a daily consistent stool.CONCLUSION IBS-patients exhibited prolonged CTT and heavier faecal loading.These assessments may aid in diagnosis.Faecal retention may contribute to IBS symptoms,which can be treated using a prokinetic regime.展开更多
AIM:To investigate factors contributing to the colon transit time(CTT),physical activity and characteristics were examined.METHODS:Forty-seven Korean adults(males,n=23;females,n=24) took a capsule containing 20 radioo...AIM:To investigate factors contributing to the colon transit time(CTT),physical activity and characteristics were examined.METHODS:Forty-seven Korean adults(males,n=23;females,n=24) took a capsule containing 20 radioopaque markers to measure the CTT.The subjects used an accelerometer to measure the physical activity and underwent a bioelectrical impedance analysis to determine the physical characteristics.Macro-nutrient was also surveyed.RESULTS:The mean total CTTs(TCTT) in the males and females were 8.8 and 24.7 h(P=0.002),respectively.In the male subjects,the right CTT(3.5±4.9 h vs 10.0±11.6 h,P=0.023) and recto-sigmoid CTT(4.4±4.7 vs 13.6±12.5 h,P=0.004) were significantly shorter and the total energy expenditure(637.6±44.3 kcal vs 464.3±64.9 kcal,P=0.003),total activity count(247 017±75 022 count vs 178 014±75 998 count,P=0.003),energy expenditure of light intensity(148.5±6.9 kcal vs 120.0±16.8 kcal,P=0.006),energy expenditure of moderate intensity(472.0±36.2 kcal vs 281.4±22.2 kcal,P < 0.001),fat intake(65.5±23.3 g vs 51.2±17.4 g,P=0.010),and water consumption(1714.3±329.4 g vs 1164.7±263.6 g,P=0.009) were significantly higher than in the female subjects.Regarding correlations,when adjusted for gender,fiber(r =-0.545,P < 0.001) and water intake(r =-0.257,P < 0.05) correlated significantly with the TCTT in all subjects.In addition,the body mass index(r =-0.424,P < 0.05) and fiber intake(r =-0.417,P < 0.05) in the males as well as the fiber intake(r =-0.655,P < 0.001) in the females showed significant correlations with the TCTT.CONCLUSION:The subjects showed significant gender differences in the TCTT,right CTT,and recto-sigmoid CTT.Furthermore,the intake of the fiber and water contributed to the CTT.展开更多
The use of radio-opaque markers and abdominal X-ray is the standard method for determining colonic transit time(CTT). However, when there are deviations in the intake of these markers by participants in clinical trial...The use of radio-opaque markers and abdominal X-ray is the standard method for determining colonic transit time(CTT). However, when there are deviations in the intake of these markers by participants in clinical trials it is desirable to improve observations by introducingcorrections, where possible. To date, there is no standard procedure to adjust for such deviations. This report proposes a series of alternatives based on possible scenarios for deviations from the intended intake of radio-opaque markers. The proposed method to correct for missed or delayed consumption of radioopaque markers can help to increase the accuracy of the CTT measurements in clinical trials.展开更多
BACKGROUND Slow transit constipation(STC)has traditionally been considered as a functional disorder.However,evidence is accumulating that suggests that most of the motility alterations in STC might be of a neuropathic...BACKGROUND Slow transit constipation(STC)has traditionally been considered as a functional disorder.However,evidence is accumulating that suggests that most of the motility alterations in STC might be of a neuropathic etiology.If the patient does not meet the diagnosis of pelvic outlet obstruction and poorly response to conservative treatment,surgical intervention with subtotal colectomy may be effective.The most unwanted complication of the procedure is anastomotic leakage,however,preservation of the superior rectal artery(SRA)may reduce its incidence.AIM To evaluate the preservation of the SRA in laparoscopically assisted subtotal colectomy with ileorectal anastomosis in STC patients.METHODS This was a single-center retrospective observational study.STC was diagnosed after a series of examinations which included a colonic transit test,anal manometry,a balloon expulsion test,and a barium enema.Eligible patients underwent laparoscopically assisted total colectomy with ileorectal anastomosis and were examined between January 2016 and January 2018.The operation time,blood loss,time to first flatus,length of hospital days,and incidence of minor or major complications were recorded.RESULTS A total of 32 patients(mean age,42.6 years)who had received laparoscopic assisted subtotal colectomy with ileorectal artery anastomosis and preservation of the SRA.All patients were diagnosed with STC after a series of examinations.The mean operative time was 151 min and the mean blood loss was 119 mL.The mean day of first time to flatus was 3.0 d,and the mean hospital stay was 10.6 d.There were no any patients conversions to laparotomy.Post-operative minor complications including 1 wound infection and 1 case of ileus.There was no surgical mortality.No anastomosis leakage was noted in any of the patients.CONCLUSION Laparoscopically assisted subtotal colectomy with ileorectal anastomosis and preservation of the SRA can significantly improve bowel function with careful patient selection.Sparing the SRA may protect against anastomosis leakage.展开更多
AIM To explore the relationship between colonic secretory function and colonic motility.METHODS Using a rat model chronically implanted with intracerebroventricular(ICV) and cecal catheters, we validated the correlati...AIM To explore the relationship between colonic secretory function and colonic motility.METHODS Using a rat model chronically implanted with intracerebroventricular(ICV) and cecal catheters, we validated the correlation between colonic secretion and colonic motor functions, as well as the role of ICV injection volume.RESULTS Compared to saline controls(5 μL/rat), ICV acyl ghrelin at 1 nmol/5 μL enhanced the total fecal weight, accelerated the colonic transit time, and increased the fecal pellet output during the first hour post-injection, while ICV des-acyl ghrelin at 1 nmol/5 μL only accelerated the colonic transit time. These stimulatory effects on colonic motility and/or secretion from acyl ghrelin and des-acyl ghrelin disappeared when the ICV injection volume increased to 10 μL compared with saline controls(10 μL/rat). Additionally, the ICV injection of 10 μL of saline significantly shortened the colonic transit time compared with the ICV injection of 5 μL of saline. The total fecal weight during the first hour post-injection correlated with the colonic transit time and fecal pellet output after the ICV injection of acyl ghrelin(1 nmol/5 μL), whereas the total fecal weight during the first hour post-injection correlated with the fecal pellet output but not the colonic transit time after the ICV injection of des-acyl ghrelin(1 nmol/5 μL).CONCLUSION Colonic secretion does not always correlate with colonic motility in response to different colonic stimulations. Acyl ghrelin stimulates colonic secretion.展开更多
文摘BACKGROUND Irritable bowel syndrome(IBS)is a bowel disorder involving abdominal pain or discomfort along with irregularity of stool form and passage frequency.The pathophysiology is poorly understood and seems to be multifactorial.Investigations of possible causes of IBS have included only a few colonic transit studies and no simultaneous determination of the colonic faecal content.AIM To compare colon transit time and faecal load between IBS-patients and healthy control subjects.METHODS The study included 140 patients with IBS,with a mean age of 50.0 years.The control group comprised 44 healthy persons with a mean age of 43.4 years,who were selected at random from the National Civil Register.Both the patient group and the control group underwent a marker study to measure colon transit time(CTT)and to calculate a faecal loading score.The patient group underwent treatment with a combined prokinetic regime,after which their CTT and faecal loading were reassessed.Analyses were performed to compare measurements between the control group and the patient group before and after treatment.RESULTS Compared to healthy controls,IBS-patients exhibited a significantly prolonged mean CTT(45.48 h vs 24.75 h,P=0.0002)and significantly greater mean faecal loading scores in all colonic segments(P<0.001).Among IBS patients,we found no significant differences between the 48 h and 96 h radiographs.Among patients exhibiting increased CTT and faecal loading,approximately half exhibited a palpable mass in the right iliac fossa.After intervention with a prokinetic treatment,the mean CTT among IBS patients was reduced from 45.48 h to 34.50 h(P=0.091),with the post-treatment CTT not significantly differing from the CTT among control subjects(P=0.095).The faecal loading score among IBS patients did not significantly differ before and after treatment(P=0.442).The posttreatment faecal loading score in IBS patients remained significantly higher compared to that in controls(5.3 vs 4.3,P=0.014).After treatment,half of the IBSpatients were relieved of bloating,while the majority no longer experienced abdominal pain and achieved a daily consistent stool.CONCLUSION IBS-patients exhibited prolonged CTT and heavier faecal loading.These assessments may aid in diagnosis.Faecal retention may contribute to IBS symptoms,which can be treated using a prokinetic regime.
文摘AIM:To investigate factors contributing to the colon transit time(CTT),physical activity and characteristics were examined.METHODS:Forty-seven Korean adults(males,n=23;females,n=24) took a capsule containing 20 radioopaque markers to measure the CTT.The subjects used an accelerometer to measure the physical activity and underwent a bioelectrical impedance analysis to determine the physical characteristics.Macro-nutrient was also surveyed.RESULTS:The mean total CTTs(TCTT) in the males and females were 8.8 and 24.7 h(P=0.002),respectively.In the male subjects,the right CTT(3.5±4.9 h vs 10.0±11.6 h,P=0.023) and recto-sigmoid CTT(4.4±4.7 vs 13.6±12.5 h,P=0.004) were significantly shorter and the total energy expenditure(637.6±44.3 kcal vs 464.3±64.9 kcal,P=0.003),total activity count(247 017±75 022 count vs 178 014±75 998 count,P=0.003),energy expenditure of light intensity(148.5±6.9 kcal vs 120.0±16.8 kcal,P=0.006),energy expenditure of moderate intensity(472.0±36.2 kcal vs 281.4±22.2 kcal,P < 0.001),fat intake(65.5±23.3 g vs 51.2±17.4 g,P=0.010),and water consumption(1714.3±329.4 g vs 1164.7±263.6 g,P=0.009) were significantly higher than in the female subjects.Regarding correlations,when adjusted for gender,fiber(r =-0.545,P < 0.001) and water intake(r =-0.257,P < 0.05) correlated significantly with the TCTT in all subjects.In addition,the body mass index(r =-0.424,P < 0.05) and fiber intake(r =-0.417,P < 0.05) in the males as well as the fiber intake(r =-0.655,P < 0.001) in the females showed significant correlations with the TCTT.CONCLUSION:The subjects showed significant gender differences in the TCTT,right CTT,and recto-sigmoid CTT.Furthermore,the intake of the fiber and water contributed to the CTT.
文摘The use of radio-opaque markers and abdominal X-ray is the standard method for determining colonic transit time(CTT). However, when there are deviations in the intake of these markers by participants in clinical trials it is desirable to improve observations by introducingcorrections, where possible. To date, there is no standard procedure to adjust for such deviations. This report proposes a series of alternatives based on possible scenarios for deviations from the intended intake of radio-opaque markers. The proposed method to correct for missed or delayed consumption of radioopaque markers can help to increase the accuracy of the CTT measurements in clinical trials.
基金This study protocol was reviewed and approved by the Institutional Review Board of the Taiwan Adventist Hospital(TAHIRB No.:105-E-10).
文摘BACKGROUND Slow transit constipation(STC)has traditionally been considered as a functional disorder.However,evidence is accumulating that suggests that most of the motility alterations in STC might be of a neuropathic etiology.If the patient does not meet the diagnosis of pelvic outlet obstruction and poorly response to conservative treatment,surgical intervention with subtotal colectomy may be effective.The most unwanted complication of the procedure is anastomotic leakage,however,preservation of the superior rectal artery(SRA)may reduce its incidence.AIM To evaluate the preservation of the SRA in laparoscopically assisted subtotal colectomy with ileorectal anastomosis in STC patients.METHODS This was a single-center retrospective observational study.STC was diagnosed after a series of examinations which included a colonic transit test,anal manometry,a balloon expulsion test,and a barium enema.Eligible patients underwent laparoscopically assisted total colectomy with ileorectal anastomosis and were examined between January 2016 and January 2018.The operation time,blood loss,time to first flatus,length of hospital days,and incidence of minor or major complications were recorded.RESULTS A total of 32 patients(mean age,42.6 years)who had received laparoscopic assisted subtotal colectomy with ileorectal artery anastomosis and preservation of the SRA.All patients were diagnosed with STC after a series of examinations.The mean operative time was 151 min and the mean blood loss was 119 mL.The mean day of first time to flatus was 3.0 d,and the mean hospital stay was 10.6 d.There were no any patients conversions to laparotomy.Post-operative minor complications including 1 wound infection and 1 case of ileus.There was no surgical mortality.No anastomosis leakage was noted in any of the patients.CONCLUSION Laparoscopically assisted subtotal colectomy with ileorectal anastomosis and preservation of the SRA can significantly improve bowel function with careful patient selection.Sparing the SRA may protect against anastomosis leakage.
基金Supported by the Taiwan Ministry of Science and Technology No.NSC 95-2314-B-075-013-MY2 and No.NSC 95-2314-B-010-098-MY2 to Chih-Yen Chen
文摘AIM To explore the relationship between colonic secretory function and colonic motility.METHODS Using a rat model chronically implanted with intracerebroventricular(ICV) and cecal catheters, we validated the correlation between colonic secretion and colonic motor functions, as well as the role of ICV injection volume.RESULTS Compared to saline controls(5 μL/rat), ICV acyl ghrelin at 1 nmol/5 μL enhanced the total fecal weight, accelerated the colonic transit time, and increased the fecal pellet output during the first hour post-injection, while ICV des-acyl ghrelin at 1 nmol/5 μL only accelerated the colonic transit time. These stimulatory effects on colonic motility and/or secretion from acyl ghrelin and des-acyl ghrelin disappeared when the ICV injection volume increased to 10 μL compared with saline controls(10 μL/rat). Additionally, the ICV injection of 10 μL of saline significantly shortened the colonic transit time compared with the ICV injection of 5 μL of saline. The total fecal weight during the first hour post-injection correlated with the colonic transit time and fecal pellet output after the ICV injection of acyl ghrelin(1 nmol/5 μL), whereas the total fecal weight during the first hour post-injection correlated with the fecal pellet output but not the colonic transit time after the ICV injection of des-acyl ghrelin(1 nmol/5 μL).CONCLUSION Colonic secretion does not always correlate with colonic motility in response to different colonic stimulations. Acyl ghrelin stimulates colonic secretion.
