Introduction: Yakult contains Lactobacillus casei strain Shirota (LcS). It has several protective effects on our digestive system which include preventing diarrhoea and improving constipation. The objective of our study was to determine the effect of a single dose of Yakult on whole gut transit time (WGTT) among young adults. Methods: A cross-sectional study of 73 students who did not have any gastrointestinal disorder was performed. Subjects were given 4 carbon pills as a visual indicator to measure their WGTT in the normal setting of their usual activities. They then repeated measurement while consuming one dose of commercially available Yakult and 4 carbon pills (visual indicator). In the 2 settings, subjects were instructed to consume carbon pills and carbon pills with Yakult within 1 hour after bowel motion. Results: The WGTT decreased in 48 of the 73 subjects (65.8%) after consuming Yakult. The mean WGTT was reduced by 4.4±14.6 hours. There was no significant effect of Yakult on the form of stools. Conclusion Yakult which contains Lactobacillus casei strain Shirota (LcS) is well known for helping in digestion and preventing constipation. A single dose of Yakult produces a reduction in the WGTT.
Defecation ; Constipation

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

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

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

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

OBJECTIVETo assess the efficacy of sacral neuromodulation (SNM) in patients with intractable constipation.

METHODSA total of 7 patients with intractable constipation were treated with pereutaneous test stimulation of the S3 nerve root and were assessed by sacral never stimulation system in our department from January 2013 to January 2014. Four of these 7 patients received operation for constipation before. The efficacy was assessed by bowel habit diary, clinic constipation scores, subjective questionnaire and clinical signs.

RESULTSThe constipation symptoms were improved significantly in all the 7 patients. The frequency and volume of defecation per week were increased obviously, and the average urine was increased. Six patients underwent permanent implantation of the SNS system. After a median 4 months follow-up, the defecation frequency increased from 0.6 ± 0.5 to 8.0 ± 2.5 per week (P<0.01), and the defecation time decreased from (22.9 ± 11.5) to (3.7 ± 0.8) min (P<0.01). The Cleveland clinic constipation score decreased from 24.6 ± 4.2 to 9.0 ± 0.9 (P<0.01), and the visual analogue scale(VAS) score increased from 8.1 ± 0.9 to 82.5 ± 5.2 (P<0.01).

CONCLUSIONSNM is a clinically efficacious, minimally invasive and safe new technique, which offers an alternative treatment for the patients with intractable constipation resistant to conservative treatment, especially for the patients refractory to traditional operations.

PURPOSE: To determine optimal maintenance dose and to evaluation the efficacy and safety of polyethylene glycol 4000 (PEG4000) in children with chronic functional constipation. METHODS: This study enrolled 41 children with chronic functional constipation at the Konkuk university hospital August 2005, then June, 2007. Effective maintenance dose was designed as initial amount of PEG4000 that improved frequency, bowel movement, stool consistency for 2 months. Clinical outcome was analysed on the basis of defecation diary. Adverse effect was monitored clinically and biochemically. RESULTS: As a whole group effective maintenance dose of PEG4000 was 0.550.16 g/kg/day (0.25-0.86). With respect to age, 3-5 years (0.600.15), 6-8 years (0.570.16), 9-13 years (0.440.14) (P=0.024). With respect to body weight, <30 kg (0.620.14), 30 kg (0.410.10) (P=0.001). One child comlained apigastric soreness on medication. CONCLUSION: PEG4000 is effective and safe in children with chronic constipation. Initial maintenance dose of PEG4000 was 0.55 g/kg/day.
Body Weight ; Child* ; Constipation* ; Defecation ; Humans ; Polyethylene Glycols* ; Polyethylene*