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Query: UMLS:C0432222 (SEM)
 47,337 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Inadequate fluid intake is though to be one frequent cause of chronic constipation, although this has never been shown. In order to test whether fluid deprivation has an influence on colonic function, we studied eight healthy male volunteers (median age 23 y, range 21-28 y) with respect to stool frequency, stool weight and mean oroanal transit of radiopaque markers in a control week with a fluid intake of more than 2500 ml beverages per day and in a week with a fluid intake of less than 500 ml beverages per day. The two weeks followed each other in randomised order (with a wash out week in-between) and were standardised as to nutrition and physical activity. Stool frequency diminished from 6.9 +/- 0.9 to 4.9 +/- 0.3 (mean +/- SEM) defaecations per week (p = 0.041) and stool weight from 1.29 +/- 0.20 to 0.94 +/- 0.17 kg per week (p = 0.048) during fluid restriction. Mean oroanal transit times were similar in the two weeks. In conclusion, our study shows that a relatively short period of fluid deprivation decreases stool frequency and stool weight in healthy volunteers. Therefore, a low fluid intake may well be an aetiologic factor for chronic constipation in some patients and too low a fluid intake should be corrected. There is no evidence, however, that an increase of fluid intake within feasible limits has a beneficial effect on chronic constipation.
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PMID:Low fluid intake lowers stool output in healthy male volunteers. 228 38

We describe here a depletion of peptide containing nerves and cells in Hirschsprung's disease, in comparison with specimens of bowel taken from age-matched neonates with no evidence of chronic constipation. VIP content in the diseased specimens was reduced by almost 80%, from 110/+-10.6 (mean +/- SEM) pmol VIP/g wet weight of tissue in controls to 23.8 +/- 3.5 pmol/g in the mid-portion of the diseased specimens. In addition, the numbers of enteroglucagon and somatostatin cells in the mucosa were significantly reduced in the aganglionic portions. Enteroglucagon cells were reduced from 55 +/- 7 in controls to 27 +/- 2 in proximal portions rising to 44 +/- 3 and 49 +/- 4 cells/mm2 in middle and distal areas. Somatostatin cell numbers also fell, from 5.5 +/- 1.9 to 1.8 +/- 0.8, 2.5 +/- 0.7 and 3.8 +/- 0.9 cells/mm2 in similar areas. Further investigation of the abnormalities of the diffuse neuroendocrine system in Hirschsprung's disease may help in understanding the nature of this condition and provide additional information on the role of these peptides in the control of gut function.
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PMID:Abnormalities of the colonic regulatory peptides in Hirschsprung's disease. 617 58

The establishment of a linear relationship between perineal descent (PD) and pudendal nerve motor terminal latency (PNMTL) is important in understanding the pathophysiology of pudendal neuropathy. The amount of stretching of the pudendal nerve resulting from the extent of PD, should correlate with the amount of injury sustained (PNMTL). The two key previous studies which used different techniques to measure PD, have differed on this vital issue. A prospective study was undertaken in 141 consecutive patients with PD (M:F = 57:84; mean age 46.3 SEM 1.6 years) to clarify this discrepancy. The patients had chronic constipation (81), neurogenic faecal incontinence (31), rectal mucosal prolapse (17) or female urinary stress incontinence (9). All underwent measurements of PD (by perineometry), anal sphincter pressures, single fibre anal sphincter electromyography and PNMTL. These variables, as well as age were analyzed for a linear relationship with PD by multiple regression analysis. Age was the only independent variable predicting PD at rest (T = -3.2; p < 0.005). PNMTL was the only independent variable predicting PD on straining (T = -3.0; p < 0.005). In conclusion, a linear relationship between PD on straining and PNMTL was confirmed, supporting the previous study which also measured PD by perineometry. The other study which refuted such a relationship measured PD radiologically, and it is likely that the difference was in the measurement technique.
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PMID:The neurophysiological significance of perineal descent. 763 69

Clinical and manometric results of Delorme's operation and sphincteroplasty were assessed retrospectively in patients undergoing this procedure for fecal incontinence and rectal prolapse. A series of 33 patients (11 males, 22 females; aged 18-83 years, mean 59) with external rectal prolapse were treated by Delorme's operation between 1989 and 1996. Mean follow-up was 39 months (range 7-84). Sphincteroplasty was associated in 12 cases with severe fecal incontinence due to striated muscle defects. Good results were achieved in 27 patients (79%); prolapse recurrence was observed in 6 (21%), the mean recurrence time being 9 months (range 1-24 months). There were no postoperative deaths. Minor complications occurred in 15 patients. Changes in preoperative and postoperative manometric patterns were as follows (mean +/- SEM): voluntary contraction from 59 +/- 6.9 to 66 +/- 7.1 mmHg (P = 0.05), resting tone from 33 +/- 5 to 32 +/- 4.3 mmHg, rectal sensation from 59 +/- 5 to 61 +/- 5.2 ml of air (n.s.). A solitary rectal ulcer syndrome was detected in five patients. The histological pattern demonstrated pathological changes in 40% of cases. Fecal incontinence was resolved in 6 of 20 cases (30%) and chronic constipation in 4 of 9 (44%). Failure (n = 3) was related primarily to postoperative sepsis. The incontinence score showed a mean improvement of 35% decreasing, from 4.5 +/- 0.39 to 2.9 +/- 0.44 after surgery (P < 0.01). In conclusion, Delorme's procedure did not lead to constipation and improved anal continence when associated with sphincteroplasty.
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PMID:Delorme's operation and sphincteroplasty for rectal prolapse and fecal incontinence. 987 Jan 65