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Query: UMLS:C0027497 (nausea)
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Polyethylene glycol electrolyte lavage solution was compared with a 10 percent mannitol solution for preoperative colonic cleansing. Eighty patients were prepared randomly with one of these solutions on the afternoon prior to surgery. Colonic cleansing was better with polyethylene glycol electrolyte lavage (90 percent optimal cleansing vs. 75 percent). Analysis of hematologic, biochemical, and weight changes before and after the bowel preparation, demonstrated a mild subclinical dehydration with the use of mannitol. Evaluation of patient tolerance demonstrated more nausea, cramps, and abdominal pain with mannitol. Other symptoms were similar with both preparations. Colonic hydrogen gas was sampled during surgery, and two patients in the mannitol group had combustible levels. This study confirms that both 10 percent mannitol and polyethylene glycol electrolyte lavage are safe, effective methods of preoperative bowel cleansing. Better cleansing, patient tolerance, and lower hydrogen gas level make polyethylene glycol electrolyte lavage the preferred method.
Dis Colon Rectum 1986 Nov
PMID:Comparison of oral lavage methods for preoperative colonic cleansing. 309 80

An oral colonic lavage solution containing sodium sulfate and polyethylene glycol was compared with whole-gut irrigation using saline via a nasogastric tube in a randomized blinded study of 34 consecutive well-matched patients undergoing elective colorectal surgery. Both methods were safe and rapid. Patients receiving oral colonic lavage, however, had significantly less (P less than 0.05) water retention, overall distress, cramps, and other complaints. No significant differences were found with regard to fullness, nausea, and rectal discomfort. The bowel cleansings were equally adequate, and most patients achieved a good-to-excellent preparation. Surgical complications appeared not to be related to the preparation used, and wound sepsis were equally frequent. Oral colonic lavage proved to be the most attractive preoperative cleansing method.
Dis Colon Rectum 1987 May
PMID:Preparation for elective colorectal surgery. A randomized, blinded comparison between oral colonic lavage and whole-gut irrigation. 355 4

In the search for a superior alternative to conventional bowel preparation which often gives unsatisfactory results in children, we have introduced whole-gut irrigation for pediatric use. After a pilot study on 15 children during which adjustments on the technique were made, we settled on an intensive regimen with some notable modifications from conventional adult practice: the use of warm Hartmann's solution, a relatively large fluid load (mean volume 5.3 l/kg body weight, range 3.0 - 12.0 l/kg) and a rapid infusion rate (1.5 ml/kg/min). We then evaluated its safety, effectiveness, and acceptability prospectively on 45 patients undergoing colonoscopy or colorectal surgery, age ranging from 4 months to 11 years, with a mean of 3.9 years. Subjective complaints were mild and included nausea/vomiting, 12 cases (26.7 percent); abdominal colic, two (4.4 percent); and distending discomfort, three (6.7 percent). There was a mean weight gain of 4.0 percent but no gross electrolyte disturbances. Results of bowel preparation were satisfactory in 33 (73.3 percent), adequate in ten (22.2 percent) and poor in two (4.4 percent). Compared with our previous method, in which inadequate preparation occurred in 4/20 patients, (20 percent) by conventional measures, whole-gut irrigation represents a statistically significant improvement (P less than 0.05). In addition, whole-gut irrigation shortened hospital stay and obviated the traditional need of two to three days' dietary restrictions.
Dis Colon Rectum 1986 Apr
PMID:Whole-gut irrigation in infants and young children. 394 16

Strictureplasty recently has been advocated in the treatment of obstructive strictures of the small bowel in patients with Crohn's disease. In contrast to conventional methods of treatment, such as conservative therapy with total parenteral nutrition (TPN) or surgical resection of the involved bowel, strictureplasty eliminates the obstruction without loss of small bowel. The possibility of creating a short-bowel syndrome is of special concern in patients with diffuse Crohn's jejunoileitis. These patients usually present for surgery with chronic obstruction, anemia, weight loss, and malnutrition with folate and other vitamin deficiencies. The authors report the results of 12 strictureplasties for extensive Crohn's jejunoileitis in three patients presenting with chronic obstruction secondary to multiple small-bowel strictures. Both Heineke-Mikulicz and Finney strictureplasties were performed. In two patients, resection of an acutely inflamed phlegmonous segment was also performed. Symptoms (pain, abdominal distention, and nausea) were markedly improved postoperatively in all patients. Nutritional parameters, including serum albumin and total lymphocyte count, improved postoperatively. Dramatic rises in weight were noted also. All three patients were symptom-free six months postoperatively.
Dis Colon Rectum 1985 Jul
PMID:Strictureplasty in diffuse Crohn's jejunoileitis. 401 13

Three cases of benign duodenocolic fistula are presented, and the diagnosis and treatment reviewed. Patients with benign duodenocolic fistulas usually complain of diarrhea, and occasionally nausea and feculent vomiting. Physical examinations are nonspecific, revealing wasting from the chronic diarrhea. Barium enemas are usually diagnostic. Therapy consists of excision of the fistula and repair of the duodenal and colonic defects.
Dis Colon Rectum 1985 Nov
PMID:Benign duodenocolic fistula. 405 98

A 50-year-old woman presented with a long history of nausea, abdominal pain, weight loss, and intermittent watery diarrhea. All investigations were negative except for the finding, on five separate colonoscopic biopsies, of a layer of band-like collagen beneath the surface epithelium, diagnostic of collagenous colitis.
Dis Colon Rectum 1984 Feb
PMID:Collagenous colitis. Report of a case. 669 27

Serotonin (5-HT) is most commonly thought of as a neurotransmitter in the central nervous system. However, the predominant site of serotonin synthesis, storage, and release is the enterochromaffin cells of the intestinal mucosa. Within the intestinal mucosa, serotonin released from EC cells activates neural reflexes associated with intestinal secretion, motility, and sensation. Two important receptors for serotonin that are located in the neural circuitry of the intestines are the 5-HT(3) and 5-HT(4) receptors; these are the targets of drugs designed to treat gastrointestinal disorders. 5-HT(3) receptor antagonists are used to treat nausea and emesis associated with chemotherapy and for functional disorders associated with diarrhea. 5-HT(4) receptor agonists are used as promotility agents to promote gastric emptying and to alleviate constipation. Because of the importance of serotonin in normal gut function and sensation, a number of studies have investigated potential changes in mucosal serotonin signaling in pathologic conditions. Despite the inconsistencies in the current literature, changes in serotonin signaling have now been demonstrated in inflammatory bowel disease, irritable bowel syndrome, postinfectious irritable bowel syndrome, and idiopathic constipation. Emerging evidence has led to many contradictory theories regarding serotonin signaling and its roles in the pathology of gut disorders. This review summarizes the current medications affecting serotonin signaling and provides an overview of our current knowledge of the changes in serotonin that occur in pathologic conditions.
Dis Colon Rectum 2007 Mar
PMID:Serotonin and its role in colonic function and in gastrointestinal disorders. 1719 2