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References: Laxative

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OBJECTIVE: The aim of this retrospective non-randomized study was to evaluate the short-term functional outcome following elective resectional surgery for complicated sigmoid diverticular disease, and to compare results of patients having hand-sewn or stapled end-to-end colonic anastomosis to the proximal rectum. PATIENTS AND METHODS: Between 1983 and 1995, of 182 consecutive patients referred to our Institution for surgical treatment of complicated sigmoid diverticular disease, 137 underwent elective left hemicolectomy with primary colonic anastomosis to the proximal rectum, at a level above the peritoneal reflection. Twenty-one patients were excluded from the study because of a covering stoma (n=15), or a side-to-end (n=5) or side-to-side (n=1) anastomosis. All remaining 116 patients had an end-to-end anastomosis without covering stoma. Two groups were compared according to the type of anastomosis performed. Group I comprised the 67 patients who had a hand-sewn anastomosis, and group II the 49 patients whose anastomosis was stapled. Outcome was assessed at 6 months after surgery and compared in the two groups. Assessment included specific morbidity (anastomotic leakage, haemorrhage, fistulation and stenosis, pelvic sepsis), faecal incontinence, constipation, dyschesia, daily stool frequency, and stool consistency. RESULTS: Preoperative patient details were comparable in both groups. There was no post-operative mortality, and the general morbidity rate was similar in both groups (P=0.85). There was no anastomotic leakage or haemorrhage, and no fistulation or pelvic sepsis in either group. One patient in group I, and tw

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Dis Colon Rectum. 2003 May;46(5):661-6.
Gas volume analysis and postoperative bowel functional disorders in patients who received anterior resection for rectal cancer.

Seike K, Koda K, Takiguchi N, Oda K, Miyazaki M.

Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

PURPOSE: Colon gas analysis using abdominal radiography has been reported as a reliable method for assessing functional bowel disorders. The aim of this study was to clarify the relevance of colon gas distribution in postoperative disorders such as constipation and feelings of incomplete evacuation following rectal cancer operation. METHODS: Colon gas volume score was calculated using plain abdominal radiographs and evaluated in 50 patients who had received low anterior resections. Twenty-one constipated patients who required laxatives and 29 patients who did not were compared in terms of colon gas distribution. In addition, 32 patients with postoperative feelings of incomplete evacuation and 18 patients without such feelings were assessed in similar fashion. RESULTS: Left colon gas scores in patients who required laxatives were significantly higher (2.82 +/- 3.23 percent) than in nonusers (1.21 +/- 0.96 percent; P < 0.01). Patients with feelings of incomplete evacuation displayed significantly higher left side colon gas scores (2.51 +/- 2.66 percent) than those without such feelings (0.77 +/- 0.81 percent; P < 0.0001). CONCLUSION: Patients with postoperative functional bowel disorders such as constipation or feelings of incomplete evacuation may experience relatively high volumes of gas in the left colon.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12792444&dopt=Abstract

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J Fam Health Care. 2003;13(2):32.
Children who soil: guidelines for good practice.

Bonner L, Dobson P.

Bedfordshire Heartlands Primary Care Trust.

The need for a more coherent and integrated national service for children with constipation and soiling has been recognised for some years. It became clear to the team at the voluntary organisation Enuresis Resource & Information Centre (ERIC) as a result of the experiences of the many parents and professionals who contacted them. They responded by setting up a multidisciplinary working group to begin the process of reviewing the research. The group then went on to oversee the publication of the first national minimum standard guidelines for service delivery in this area of child health.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12793299&dopt=Abstract

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