The balloon expulsion test is a simple and useful method for investigating a defecatory disorder assessing the subject's ability to evacuate a simulated stool. However, there is no standard methodology and varying interpretations have been reported. This review discusses the techniques, interpretation and clinical utility of the balloon expulsion test.
Constipation ; Defecation ; Gastrointestinal Diseases

No abstract available.
Biofeedback, Psychology* ; Defecation* ; Humans

PURPOSE: Rectoceles are often associated with anorectal symptoms. Various surgical techniques have been described to repair rectoceles, but the surgical results vary. The aim of this study was to compare transanal repair (TAR) and transanal repair with posterior colporrhaphy (TAR+PC). METHODS: The records of 58 patients operated on during a 56-month period were reviewed. Of those 26 patients had a TAR, and 32 patients had a TAR+PC. Interviews and anorectal physiologic studies were performed preoperatively and postoperatively. RESULTS: The recurrence rate after a TAR+PC was lower than the recurrence rate after a TAR (TAR 19.2% vs. TAR+PC 3.1%). The rectal sensation (sensory threshold: TAR 64.8+/-18.9 ml vs. TAR+PC 56.1+/-23.67 ml; earliest defecation urge: TAR 116.4+/-29.5 ml vs. TAR+PC 104.8+/-31.2 ml) was more improved after a TAR+PC. CONCLUSIONS: A TAR+PC for treatment of a rectocele is safe and effectively corrects obstructed defecation. The improvement probably relates, at least in part, to rectal sensational factors other than the dimensions of the rectocele.
Defecation ; Humans ; Rectocele* ; Recurrence ; Sensation

PURPOSE: The final aim of operation for anorectal malformations (ARMs) is acquisition of normal bowel habit by preserving an anorectal function. This study was performed to assess the functional results after definite correction of the malformations. METHODS: 37 patients (Group 1) without rectocutaneous fistula and 23 patients (Group 2) with rectocutaneous fistula were Included in the study. The authors examined functional assessment of children over 3-years-old, according to Krickenbeck classification, and analyzed the results. RESULTS: Group 1 showed significant soiling in 24.3% and constipation requiring management in 35.1%.But Group 2 showed constipation in only 8.7%. The results of Krickenbeck assessment are as follows: Group 1 showed good results in 64.9% and poor results in 35.1% with improvement over time. Group 2 showed 91.3%, 8.7%, respectively. CONCLUSION: Constipation rather than soiling was the main functional problem after surgical repair of anorectal malformations but improved over time. It seems that more aggressive management of constipation warrants good results after definite surgical repair.
Child ; Constipation ; Defecation ; Fistula ; Humans ; Soil

PURPOSE: This study has carried out to clarify the relationship between changes in the anal sphincter muscle thickness and pressure. Also, this study shows the effect of vaginal delivery and benign anal disease on the function and structure of the anal sphincter. METHODS: Women (n=42; mean age: 33.2 +/- 9.6 years old) without defecation problems or history of anal surgery, who came to Ewha Womans University Hospital between July 1999 and October 1999, were chosen. We measured the resting and the squeezing pressure with anal manometry and the thickness of the internal anal sphincter (IAS) and external anal sphincter (EAS) by endoanal sonography. RESULTS: The mean squeezing and resting pressures were 98.3 +/- 38.2 and 53.9 +/-17.4 cmH2O, and the mean EAS and IAS thicknesses were 4.9+/-0.9 and 1.9+/-0.3 mm, respectively. The thickness of the EAS and squeezing pressure did not correlate. Neither did the IAS thickness and the resting pressure. In cases with a history of vaginal delivery (n=15), the squeezing and the resting pressures were 94.0+/-43.0 and 57.1+/-22.2 cmH2O, and the thicknesses of the EAS and the IAS, 4.6+/-0.9 and 2.0+/-0.4 mm, respectively. The number of deliveries had no correlation with the thickness or the pressure of the anal sphincter. In patients with benign anal lesions (n=11), the squeezing and the resting pressure was 113.0+/-42.9 and 57.0+/-14.0 cmH2O, and the thicknesses of the EAS and the IAS were 5.0+/-1.3 and 2.1+/-0.4 mm, respectively. CONCLUSION: Our data suggest that the function and the structure of the anal sphincter are independent. In adult women, the thickness of the anal sphincter, the history of vaginal delivery, and the existence of benign anal lesions had no effect on anal sphincter function.
Adult* ; Anal Canal* ; Defecation ; Female ; Humans ; Manometry

OBJECTIVE: We report six patients with tuboovarian abscess (TOA) drained through sonographically guided transrectal route, in whom percutaneous or transvaginal approach was not accessible due to the risk of pelvic organ. METHOD: This procedure was performed under the guidance of transrectal ultrasound. Six patients with aged 25-42 years (mean 31.6 years), who had appendectomy(1), C/S(2), hyterectomy(1) and no operaion Hx(2). Size of abscess cavity was variable from three to eight centimeter. Catheter was removed when drainage amount was reduced less than 10 cc and the patient becomes afebrile. RESULT: Drainage was successfully done in all patients without any complication to the procedure. Fecal contamination was not occurred after transrectal drainage due to abdominal pressure and gravity ought to empty the abscess cavity. There was no problem in defecation due to the catheter and in its expulsion by defecation. Catheter was removed after 3-8 days (mean 6 days) without recurrent abscess. CONCLUSION: Transrectal drainage of abscess performed with ultrasound guidance is a safe, feasible procedure, which is well tolerated by patient and relatively easy procedure.
Abscess* ; Catheters ; Defecation ; Drainage* ; Gravitation ; Humans ; Ultrasonography

In Kampo, “lung medicines” are usually used to treat patients with bronchial asthma, according to the type of cough and sputum, and the degree of dyspnea which presents. However, it is also important to exclude exacerbating factors. In Kampo, the lungs and large intestine are thought to have a close relationship. We report three bronchial asthma patients whose cough and dyspnea were ameliorated by improving bowel movements. We discuss the types of bronchial asthma patients who might be effectively treated by controlling their defecation. We suggest that, when patients with mild bronchial asthma who have not previously had trouble with their bowel movements complain of respiratory distress with abnormal bowel movement, it might be effective to apply “large intestine medicines” to relieve their respiratory problems. (122 words)
Asthma ; Respiratory ; Bowel action ; Defecation ; Cases

OBJECTIVE: To report the defecation patterns of brain-injured patients and evaluate the relationship between functional ability and colon transit time (CTT) in stroke patients. METHOD: A total of 55 brain-injured patients were recruited. Patient interviews and medical records review of pattern of brain injury, anatomical site of lesion, bowel habits, constipation score, and Bristol scale were conducted. We divided the patients into constipation (n=29) and non-constipation (n=26) groups according to Rome II criteria for constipation. The CTTs of total and segmental colon were assessed using radio-opaque markers Kolomark(R) and functional ability was evaluated using the functional independence measure (FIM). RESULTS: Constipation scores in constipation and non-constipation groups were 7.32+/-3.63 and 5.04+/-2.46, respectively, and the difference was statistically significant. The CTTs of the total colon in both groups were 46.6+/-18.7 and 32.3+/-23.5 h, respectively. The CTTs of total, right, and left colon were significantly delayed in the constipation group (p<0.05). No significant correlation was found between anatomical location of brain injury and constipation score or total CTT. Only the CTT of the left colon was delayed in the patient group with pontine lesions (p<0.05). CONCLUSION: The constipation group had significantly elevated constipation scores and lower Bristol stool form scale, with prolonged CTTs of total, right, and left colon. In classification by site of brain injury, we did not find significantly different constipation scores, Bristol stool form scale, or CTTs between the groups with pontine and suprapontine injury.
Brain Injuries ; Colon ; Constipation ; Defecation ; Humans ; Medical Records ; Rome ; Stroke

PURPOSE: To investigate the effects of the intake of xylooligosaccharide-sugar mixture (XOS) on defecation frequency and symptoms in 56 young women (mean age of 22.1 years old) with constipation. METHODS: Two experiments were conducted. In experiment 1, a randomized double-blind study was performed to evaluate the effect of 6 weeks' intake of 10 g sucrose containing 7% xylooligosaccharide or 10 g sucrose on constipation. In experiment 2, 24 g coffee mixture containing 12.8 g plant cream and 11.2 g xylooligosaccharide-sugar mixture was consumed by the subjects. During the study, the clinical efficacy was assessed by using a daily diary. The subjects indicated the number of frequencies they defecated in a day and the clinical symptom scores. RESULTS: In experiment 1, the mean frequency of defecations was 2.07 in the pretreatment week and increased significantly to 4.05, 4.42, 4.84, 4.84, and 4.05 in weeks 2 to 6 of XOS intake, in comparison with the 3-3.67 with sucrose intake (sucrose, SUC). In experiment 2, the mean frequency of defecations significantly increased from 2.47 in the pretreatment week to 4.11-5.67 in weeks 1-6 of XOS intake. The occurrence of very loose or loose stools in the XOS group was significantly increased in weeks 5 and 6, compared with the pretreatment week and SUC group. XOS intake significantly alleviated the abdominal displeasure and feeling of residual stool leftness in weeks 2, 3, 5, and 6, while SUC did so in weeks 4 and 6 (p < 0.05). The coffee mixture containing xylooligosaccharide-sugar mixture reduced the abdominal displeasure and feeling of residual stool leftness from week 3 until the end of the experiment (p < 0.05). CONCLUSION: Our results suggest that xylooligosaccharide-sugar mixture intake was effective, without adverse effects, for the alleviation of constipation in the young women in this study.
Coffee ; Constipation* ; Defecation* ; Double-Blind Method ; Female ; Humans ; Plants ; Sucrose

We report a case of a superficial femoral artery pseudoaneurysm in 52-year old patient with a history of having renal allograft. The pseudoaneurysm spontaneously developed while standing up from squatting position after defecation, and it was successfully managed by an endovascular repair with an endograft. This case suggests that an atherosclerotic superficial femoral artery is vulnerable to torsion and tension movement during changing position from squatting to standing, which is repeatedly practiced by the people using the Korean traditional toilet. The endovascular therapy is also recommended for elderly patients with poor clinical conditions such as having a renal allograft and diffuse atherosclerosis of peripheral arteries.
Aged ; Allografts* ; Aneurysm, False* ; Arteries ; Atherosclerosis ; Defecation ; Femoral Artery* ; Humans