Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042024 (incontinence)
 13,409 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A controlled radiologic study of anorectal function was performed with the use of defecography in 19 patients with constipation and 13 with incontinence. All patients were age and sex matched to control subjects who were referred for barium enema study and who had no defecation disorder. There were no statistically significant differences between either patient group and the control group in anorectal angle and excursion of the anorectal junction. In the 32 patients and 155 consecutive patients referred for defecography because of a variety of defecation disturbances, approximately twice as many rectal wall abnormalities were seen compared with findings in the control group. These findings included intussusception, rectal prolapse, rectocele, mucosal prolapse, spastic pelvic floor, descending perineum syndrome, and solitary rectal ulcer syndrome. In conclusion, the main role of defecography is to document rectal wall changes during defecation straining as possible causes of evacuation difficulties. Clinical symptoms should also be taken into account when treatment is contemplated.
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PMID:Anorectal function in patients with defecation disorders and asymptomatic subjects: evaluation with defecography. 229 37

Stenosis of the rectum after surgery is a rare complication of low anastomosis. Infection, ischemia, foreign body reaction, technical faults or recurrence of neoplasms are the most important causes. Dilatation is attempted either manually or by instrument, if the stenosis causes discomfort and in particular if diarrhea results. Rarely resection of the stenosed segment is necessary. Stenosis in conjunction with incontinence is the most feared complication of anorectal surgery. It develops exceptionally after scarring of a large mucocutaneous defect after hemorrhoidectomy, correction of an anal fistula, a mucosal prolapse, electro-resection, infection or trauma. Anal stenosis leads to increasing constipation, a reduction of stool volume, abdominal cramps and rectal bleeding.
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PMID:[Postoperative anorectal stenosis]. 236 80

Rectal compliance (dV/dP) was studied in 31 patients with fecal incontinence, 8 patients with constipation, and 16 control subjects. Patients with fecal incontinence experienced a constant defecation urge at a lower rectal volume and also had a lower maximal tolerable volume and a lower rectal compliance than control subjects (median 126 vs. 155 ml, 170 vs. 220 ml, and 9 vs. 15 ml/mm Hg, respectively; P less than 0.05). Constipated patients had a higher constant defecation urge volume and maximal tolerable volume than controls (median, 266 ml and 300 ml; P less than 0.05). There was no differences in the parameters between patients with idiopathic fecal incontinence and patients with incontinence of traumatic origin, indicating that a poorly compliant rectum in patients with fecal incontinence may be secondary to anal incontinence due to the lack of normal reservoir function.
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PMID:Rectal compliance in the assessment of patients with fecal incontinence. 237 21

A retrospective review of 64 rectocele repairs done over a four-year period was performed. The most common indication for repair was constipation. Thirty-five patients were repaired transanally, and 29 were repaired transvaginally. The overall morbidity was 34 percent, and the overall mortality was 0 percent. The most common complication was urinary retention in 12.5 percent. There was no difference in complications between techniques. Of 46 patients contacted for follow-up, 25 (54 percent) still complained of constipation, 17 (34 percent) had partial incontinence, 8 (17 percent) noted persistent rectal pain, 15 (32 percent) mentioned occasional rectal bleeding, and 10 (22 percent) complained of vaginal tightness or sexual dysfunction. Thirty-seven (80 percent) patients stated that they had improved after surgery. Except for persistent rectal pain, there was no difference in results between transanal and transvaginal repairs. Those undergoing transvaginal repair had a much greater problem with pain. Our relatively poor results may be due to an unselective approach to rectocele repair. The presence of both constipation and a rectocele does not imply an association, and a complete anorectal physiologic examination should precede repair. There is no functional difference between transvaginal and transanal rectocele repair.
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PMID:Rectocele repair. Four years' experience. 237 25

Children with myelomeningocele have a variety of health and psychosocial needs that must be dealt with by the family, by health care providers, and by school staff. Bowel and bladder dysfunction are problems that are common in most of these children. Bladder dysfunction can lead to renal complications and, ultimately, may threaten the child's life. Bowel problems, including constipation and incontinence, can lead to medical complications and to severe social problems. This article discusses the pathophysiology of these problems and suggests nursing interventions, especially as they apply to children in the school setting.
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PMID:Bowel and bladder management of the child with myelomeningocele in the school setting. 237 11

We have extended our experience of restorative proctocolectomy and ileoanal anastomosis to include 13 patients with functional bowel disorders. Eight had recurrent constipation after colectomy for slow transit constipation and five had constipation and overflow incontinence associated with megarectum and megacolon. In all cases the only alternative was a permanent stoma. Despite a high complication rate, 11 patients (85 per cent) felt that the operation had been worthwhile with improvement of their symptoms and quality of life. The operation led to a mean frequency of defaecation of 4.8 times (range 2-8) during the day, and 1.2 times (range 0-4) during the night. There was no frank incontinence and, while only one patient experienced soiling during the day, six patients suffered from night-time soiling. Two patients have had the pouch converted to an ileostomy due to persistent complications and a poor functional result.
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PMID:Constipation: another indication for restorative proctocolectomy. 238 56

The intraluminal pressure of the rectum and anal canal were measured in patients with Hirschsprung's disease before and after Ikeda's Z-shaped anastomosis, and the association of the pressure with postoperative capability of fecal continence was assessed. Radical operation did not alter rectal pressure but did decrease anal-canal pressure. Rhythmical anal contractions increased in frequency until a normal level was attained. The rectoanal relaxation reflex became distinct with time, and 45% of patients eventually attained the reflex after operation. In patients who postoperatively attained satisfactory fecal continence or, at least, only soiling, resting pressure in the anorectum and the frequency of rhythmical anal-canal contractions were similar to those for normal children. The rectoanal relaxation reflex was induced in 58% of the former and 27% of the latter. In patients with postoperative constipation, the intraluminal resting pressure of the anorectum was elevated without the relaxation reflex response. In patients with incontinence, the pressure of the anal canal was low, without a reflex response. These findings indicate that the high and low values of the resting pressure of the anal canal are responsible for constipation and incontinence, respectively, and that the presence of rectoanal relaxation reflex may represent one aspect of a normal defecation function.
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PMID:Anorectal manometry after Ikeda's Z-shaped anastomosis in Hirschsprung's disease. 251 14

In the last 10 years biofeedback training (BFT) has been used in 72 patients with anal continence disturbances following rectoanal agenesis, constipation, MMC, etc. Using the BF-method we treated 35 children with incontinence following rectoanal agenesis (5 infralevator, 30 supralevator). Visual analog feedback was used in the first 10 cases. Since 1982 simultaneous audiovisual analog signals have been preferred. The detailed analysis and personal followup over 6.5 years of these patients suggests that BFT improves the threshold of rectal sensation, voluntary contraction and thereby benefits anal continence.
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PMID:[Improving continence by biofeedback conditioning]. 257 78

Twenty-one pregnant women with nasal congestion, verified by rhinomanometry, did not differ significantly from 8 pregnant women without nasal congestion regarding the serum levels of the hormones oestradiol, progesterone and VIP. The congested group had a significantly lower serum level of oxytocin than the reference group. There were no differences in the symptoms urinary incontinence, constipation, and heartburn between the groups. The pathophysiology of nasal congestion during pregnancy is still veiled in obscurity.
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PMID:Nasal congestion during pregnancy. 258 32

The authors discuss the changing role of gastrointestinal endocrinology during the last twenty years starting from the early sixties when techniques such as radioimmunoassay and immunocytochemistry allowed major advances of our knowledge on this field. Using these techniques several regulatory peptides have been identified and the concept of the diffuse neuroendocrine system as a morphofunctional apparatus regulating the majority of physiological activities, was postulated. Therefore gut endocrinology was enclosed as a part of neuroendocrinology and similarly the importance of peptidergic substances in neural physiology was recognized. Nevertheless, the usefulness of gut endocrinology in the clinical management of gastrointestinal diseases, following an emphatic start, is now restricted to gastrointestinal neuroendocrine tumours. In these pathological conditions some regulatory peptides have been shown to be responsible for the associated symptoms and can be useful markers in the diagnosis and follow-up. However, recent advances in gut endocrinology make us think to new possibilities of clinical applications of gut hormones, at least in the understanding of the pathophysiology of some diseases (i.e. constipation, incontinence, short-bowel syndrome, etc.). Moreover, new events are now occurring in gut endocrinology since major improvements in molecular biology and genetic engineering can now allow us to sequence and clone DNA strands encoding several regulatory peptides and their precursors. Similarly membrane receptors and intracellular messengers have been characterized elucidating the complex metabolic pathways of neuroendocrine cells. Using advanced molecular biology techniques we can obtain today large amount of different regulatory peptides highly purified that can be employed in the diagnosis and therapy of several diseases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Digestive endocrinology, today]. 263 39


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