J Pediatr. 1982 Feb;100(2):213-8.
Abnormal and sphincter response in chronically constipated children.
Loening-Baucke VA, Younoszai MK.
Using a strain gauge, we measured anal sphincter function in 116 chronically constipated and 18 healthy children. Eighteen constipated children were re-evaluated two months later (receiving laxative), and 15 were again studied seven to 12 months later. The anal resting tone varied along the length of the anal canal and was highest at 1 to 1.5 cm from the anal verge. This region was used to study the resting motor activity of the internal anal sphincter, the amplitude of the rectosphincteric reflex after 30 and 60 ml rectal distension, and the rectosphincteric reflex threshold. The mean and resting tone was significantly lower in constipated than in control children (P less than 0.001), but normalized in patients who recovered. Resting motor activity of the internal anal sphincter and the amplitude of RSR were significantly lower in constipated patients than were the corresponding values in control children (P less than 0.001), and remained lower during and after treatment, even in patients who recovered. The length of the anal canal and the RSR threshold were comparable in control and constipated children. Thus, the basic problem in chronically constipated children appears to be an abnormal internal anal sphincter, which is weaker and less responsive to rectal distension than in nonconstipated children.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7057328&dopt=Abstract constipation laxative
Gastroenterology. 1982 Sep;83(3):529-34.
Bowel patterns among subjects not seeking health care. Use of a questionnaire to identify a population with bowel dysfunction.
Drossman DA, Sandler RS, McKee DC, Lovitz AJ.
To understand the disorders of bowel motility, it is important to know the range of bowel patterns in the general population. We have devised a brief self-administered questionnaire which, when used among a group of 789 students and hospital employees, disclosed that 94.2% had stool frequencies between three per day and three per week, and that 17.1% had bowel dysfunction. When compared with the remaining sample, the bowel dysfunction group was predominantly female. This group also reported more often that stress influenced their bowel function, and more often used laxatives and visited physicians for bowel complaints. Further medical evaluation to characterize this subgroup is needed. We believe that selection, for psychologic and physiologic study, of subjects with bowel dysfunction not seeking health care will provide a needed comparison group in our understanding of patients with irritable bowel syndrome.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7095360&dopt=Abstract constipation laxative
Kidney Int. 1982 May;21(5):739-43.
Low risk of contrast media-induced acute renal failure in nonazotemic type 2 diabetes mellitus.
Shieh SD, Hirsch SR, Boshell BR, Pino JA, Alexander LJ, Witten DM, Friedman EA.
The risk of developing contrast media-induced acute renal failure was studied in 49 randomly selected nonazotemic type 2 adult diabetic patients subjected to IVU. There were 19 men and 30 women in the group whose mean age was 62 +/- 10 years (range, 38 to 82 years). In preparation for IVU, patients were neither dehydrated nor given a laxative. The IVU was performed in the morning, using sodium diatrizoate and meglumine diatrizoate. Serum creatinine levels were measured pre-IVU and on days 1, 3, and 6 after the IVU. A total of three patients (6%) had an elevation of serum creatinine greater than 25% above the baseline by post-IVU day 3. One patient developed oliguria (less than 400 ml/24 hr) that lasted 2 days. Creatinine clearances of the three patients showing contrast media toxicity were 74, 60, and 105 ml/min pre-IVU. In each of the three patients, a return to pre-IVU serum creatinine concentration was noted within 2 weeks. It is concluded that the risk of acute renal failure post-IVU is small in hydrated nonazotemic type 2 diabetic patients.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7109460&dopt=Abstract constipation laxative
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