Constipation Research Today is a free monthly online journal that collates and summarizes the latest research about Constipation, including details on infant, child, baby and toddler constipation, symptoms, causes, remedies.

Management of complex pelvic floor disorders in a multidisciplinary pelvic floor clinic.

Kapoor DS, Sultan AH, Thakar R, Abulafi MA, Swift RI, Ness W

Mayday University Hospital, Department of Urogynaecology and Colorectal Surgery, London Road, Croydon, Surrey, UK.

OBJECTIVE: To identify symptom clusters, management strategies and survey patient satisfaction in our combined multidisciplinary pelvic floor clinic (PFC). METHOD: Retrospective cohort study, patient satisfaction questionnaire. SAMPLE: Secondary and tertiary referrals with complex pelvic floor disorders. MAIN OUTCOME MEASURES: symptom clusters and treatment received; patient satisfaction. RESULTS: A total of 113 new cases over a 3-year period. There were two main symptom clusters: (i) obstructed defaecation with rectoceles (n = 55); of these, 23 had abdominal sacrocolpopexy with rectopexy, six had transvaginal rectocele repairs; and (ii) of the 33 with double incontinence, 10 had anal sphincter repairs, five had tension-free vaginal tapes and two had colposuspensions. Patient satisfaction audit: 73% found the care to be excellent/good, 12% satisfactory and 6% unsatisfactory. CONCLUSION: Combined PFCs led to a more pragmatic approach in treating patients' symptoms. Combined surgery was undertaken in one-fourth of patients and is associated with cost savings and a single recuperation period. Overall, patients rated this service very highly.

Published 17 January 2008 in Colorectal Dis, 10(2): 118-23.
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Articles on Constipation published 21 December 2007:

Clinical aspects of bowel symptoms in Parkinson's disease.   Acta Neurol Scand, 117(1): 60-4.

BACKGROUND: The clinical importance of bowel symptoms in Parkinson's disease (PD) remains to be described in detail. METHODS: A 33-item questionnaire including background parameters, the Cleveland Constipation Score (CCS), and items from the Neurogenic Bowel Dysfunction score was sent to 468 PD patients. Results were compared to a control group (CG) (n = 45). A CCS of at least 15 was used to define severe constipation. RESULTS: Four hundred and sixteen subjects (89%) responded. Median CSS was ... [Abstract] [Full-text]

Articles on Constipation published 17 December 2007:

Functional outcomes of two types of subtotal colectomy for slow-transit constipation: ileosigmoidal anastomosis and cecorectal anastomosis.   Am J Surg, 195(1): 73-7.

BACKGROUND: Some patients with severe slow-transit constipation may benefit from subtotal colectomy, but there is no consensus on standard operative mode. The aim of the study was to compare the functional outcomes of subtotal colectomy with cecorectal anastomosis (CRA) with those of subtotal colectomy with ileosigmoidal anastomosis (ISA) in patients with severe slow-transit constipation. METHODS: Records of 79 patients who received preoperative investigation to confirm slow transit at our ... [Abstract] [Full-text]

Articles on Constipation published 14 December 2007:

Set-up and statistical validation of a new scoring system for obstructed defaecation syndrome.   Colorectal Dis, 10(1): 84-8.

OBJECTIVE: There is no objective means to assess the obstructed defaecation syndrome (ODS), to allow evaluation of outcome or to compare the efficacy of treatment including surgery. The study aimed to validate a disease-specific index to quantify severity to allow assessment of the results of treatment in clinical trials, to permit comparison between them. METHOD: Seventy-six patients with ODS and 30 healthy controls entered the study after proctologic and ano-rectal physiological ... [Abstract] [Full-text]

Articles on Constipation published 13 December 2007:

Severe symptoms of gastro-oesophageal reflux disease are associated with cardiovascular disease and other gastrointestinal symptoms, but not diabetes: a population-based study.   Aliment Pharmacol Ther, 27(1): 58-65.

BACKGROUND: Few population-based studies have examined comorbidity in relation to gastro-oesophageal reflux disease (GERD). AIM: To study the association between cardiovascular disease, diabetes, gastrointestinal symptoms and GERD. METHODS: Population-based, cross-sectional, case-control study based on a large Norwegian health survey conducted in 1995-97. Among 65,333 participants, 3153 persons reporting severe reflux symptoms were defined as cases, and 40,210 persons without such symptoms were ... [Abstract] [Full-text]

Intermediate-term outcome of the simplified laparoscopic antegrade continence enema procedure: less is better.   J Urol, 179(1): 299-303.

PURPOSE: The Malone antegrade continence enema procedure revolutionized the surgical management of fecal incontinence. Open and laparoscopic antegrade continence enemas are often performed with cecoplication and mesenteric manipulation. Since our initial laparoscopic antegrade continence enema description, we have simplified our technique. We present our series of laparoscopic antegrade continence enema procedures, discuss technique and outcomes, and review the literature. MATERIALS AND ... [Abstract] [Full-text]

Articles on Constipation published 28 November 2007:

Laxation of critically ill patients with lactulose or polyethylene glycol: a two-center randomized, double-blind, placebo-controlled trial.   Crit Care Med, 35(12): 2726-31.

OBJECTIVE: To study whether lactulose or polyethylene glycol is effective to promote defecation in critically ill patients, whether either of the two is superior, and whether the use of enteral laxatives is related to clinical outcome. DESIGN: Double-blind, placebo-controlled, randomized study. SETTING: Two tertiary intensive care units. PATIENTS: Three hundred and eight consecutive patients with multiple organ failure were included when receiving mechanical ventilation and intravenous ... [Abstract] [Full-text]

Articles on Constipation published 27 November 2007:

Cumulative incidence of chronic constipation: a population-based study 1988-2003.   Aliment Pharmacol Ther, 26(11): 1521-8.

AIM: To estimate the cumulative incidence of chronic constipation and evaluate potential risk factors. METHODS: In previous cross-sectional studies in 1988, random samples of Olmsted County, MN residents were mailed valid gastrointestinal symptoms surveys. A similar survey was mailed in 2003 to all the remaining eligible subjects who had been mailed to previously. An incident case of chronic constipation was defined as no reported constipation or irritable bowel syndrome on their initial survey ... [Abstract] [Full-text]

Articles on Constipation published 26 November 2007:

Familial Currarino syndrome presenting with peripheral primitive neuroectodermal tumour arising with a sacral teratoma.   Pediatr Blood Cancer, 50(1): 172-5.

This report illustrates a rare genetic disorder, Currarino syndrome, in association with an unusual malignant transformation to a peripheral primitive neuroectodermal tumour within a sacral teratoma. The triad of features consists of a presacral mass, partial sacral agenesis and anorectal anomalies. The most common presentation is constipation. In this case there was a history of constipation, teratomas and spinal abnormalities in many of the family members over three generations. Detailed ... [Abstract] [Full-text]

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