BACKGROUND/AIMS: A colon transit time test using radio-opaque markers (CTTRM) is considered the gold standard for evaluating colon transit function. A 24-hour delayed film of barium enema (BE) has been used as a supplementary method in structural evaluations. The aim of this study was to evaluate the utility of a 24-hour delayed BE film for assessing colon transit function in young children with constipation. METHODS: In total, 93 children with constipation who performed both single-contrast BE and CTTRM were enrolled in this study. Of these, the data from 70 children were analyzed (males 33, females 37; mean age [range], 5.63 ± 2.94 [2-14] years). The basic principle of the study is "velocity = distance/time". Time values were identified in both studies, and the colon length and distance of barium movement were measured on the 24-hour delayed BE film. Thus, colon transit velocity values could be calculated using both methods. The correlation between colon transit velocity using a 24-hour delayed BE film versus CTTRM was analyzed statistically. RESULTS: Median value (interquartile range) of colon transit velocity using CTTRM was 1.57 (1.07-2.89) cm/hr, and that using BE of that was 1.58 (0.94-2.07) cm/hr. The Spearman correlation coefficient was 0.438 (P < 0.001) for the overall group. The correlation was strongest in children younger than 4 years (r = 0.537, P = 0.032). CONCLUSIONS: Although the correlation between BE and CTTRM was not very strong, the 24-hour delayed BE film could provide broad information about colon transit function in young children, especially those under 4 years who usually cannot undergo CTTRM.
Barium* ; Child* ; Colon* ; Constipation* ; Enema* ; Female ; Humans ; Methods

In the past several years of 21 century, there are many updates of concepts on the diagnosis and treatment of colorectal cancer, which indicates the era of experience-based medicine has been gradually replaced by that of evidence-based medicine. Despite emerging evidence from randomized controlled trials(RCT) and meta-analyses questioning its use, concurrent suggestion on the indication of preoperative bowel preparation has not been reached. The authors agree with the opinion of The Huang Jia-si Textbook of Surgery(7th Edition). Preoperative bowel preparation should be emphasized before the consensus is confirmed, though there are so many trials showing that bowel preparation before elective colorectal surgery was unnecessary. In the authors' consideration, compared with the Westerner, the Chinese prefer to the food style of low fat and high cellulose, which would make more food residue. So whether the oversea finding of the preoperative bowel preparation is fit for the colorectal patients in China is questioned. Therefore large-sample, multi-centre, prospective RCT is expected to be carried out by the national academic organization, by which high-ranking evidence suitable for the Chinese could be obtained.
Colorectal Surgery ; Elective Surgical Procedures ; Enema ; adverse effects ; methods ; Humans ; Preoperative Care

The incidence of colorectal cancer of Korea is much lower than that of Western countries, but has shown a tendency to a slight increase recently Barium enema is the most valuable, noninvasive and inexpensive method available to evaluate the size, shape and site of colorectal cancer. The authors reviewed and radiologically classified barium enema studies of 232 cases of colorectal cancer from Aug. 1967 to July 1982 at Presbyterian Medical Center, Jeon-ju , Confirmed clinically, operatively and pat hologically. The results were as follows; 1. The ratio of male and female was 1.3:1, and youngest was 13 year-old and the oldest 86 year-old. 2. The peak incidence occurred from 5th to 7th decades, accounting for 78% of all cases (181/232), and there was a relatively high incidence of the disease in patients below 30 years of age at 7.8% (18/232). 3. Rectum and rectosigmoid region are the most frequently involved regions (127/23 2:54.8%). 4. The positivity of barium enema examination was 4.0% (232/5807), and its accuracy was 96.5% (224/232) . 5. The radiologic findings were classified into 4 groups, and they were annular encircling 62.9% (146/232), polypoid fungating 26.8% (62/232), infiltrating 8.6% (20/232), and primary ulcerating 1.7% (4/232) in order of frequency. 6. The linear length of the cancer ranged from 1.5 Cm to 15 Cm , and the average length was 5.5 Cm. 7. There was no statistical correlation between the length of lesion, the site, and the radiologic findings, and stages of the lesion (P:0.750-0.250). 8. The majority of colorectal cancers was adenocarcinoma (217/232:93.6%).
Adenocarcinoma ; Barium ; Colorectal Neoplasms ; Enema ; Female ; Humans ; Incidence ; Jeollabuk-do ; Korea ; Male ; Methods ; Protestantism ; Rectum ; Ulcer

Following on from diagnosis using ultrasound, hydrostatic reduction using saline enema under ultrasoundguidance was tried in 20 cases of childhood intussusception. The conclusions were as follows: 1. Success rates ofsaline enema under ultrasound guidance during a frist-8 month period(P1) and a second 10 month period(P2) were55.6%(5/9) and 54.5%(6/11) respectively. Average succes rate was 55%(11/20). 2. During the periods of P1 and P2,no case was reduced by barium enema in 6 cases of failed reduction with saline enema. 3. During the period of P2, 5 cases of successful redution with saline enema were confirmed by clinical follow-up without barium enema. 4.During the periods of P1 and P2, 9 cases of failed reduction with saline enema were operated, resulting in 6 casesof segmental resection and 3 cases of manual reduction. 5. The obvious advantages of this method are: 1. Noradiation hazard. 2. No fear of barium peritonitis. 3. Detection of leading point. 6. With above results, thismethod could completely replace barium enema. And ultrasonography should be the initial study in the evaluation ofintussusception in children and then if necessary, saline enema under ultrasound guidance should be done.
Barium ; Child ; Diagnosis ; Enema ; Follow-Up Studies ; Humans ; Intussusception ; Methods ; Peritonitis ; Ultrasonography

Recently, the availability of multidetector-row CT (MDCT) and continuous refinement in three-dimensional (3D) imaging process have greatly expanded the role of CT in evaluating patients with gastrointestinal diseases. MDCT is the latest advancement in CT technology and is now more readily available. This imaging modality can offer full examination of the entire intestinal tract as well as powerful information about the bowel itself and its surrounding structures, which are inherent advantages of CT over conventional barium or optical endoscopic studies. In most cases, MDCT with various 3D technologies can make an easy, rapid, and accurate diagnosis by one-stop imaging, and enables to avoid other examinations. Therefore, knowledge and awareness of valuable clinical applications and proper scan technique of MDCT imaging is essential to achieve the diagnostic goal of one-step imaging.
Barium Sulfate/diagnostic use ; Colonic Neoplasms/diagnosis/radiography ; Colonic Polyps/diagnosis/radiography ; Colonography, Computed Tomographic/instrumentation/*methods ; *Enema ; Humans ; Imaging, Three-Dimensional ; Tomography, Spiral Computed/instrumentation/*methods

OBJECTIVETo compare the impact of traditional and fast bowel preparation on the changes of gut flora in the patients following colorectal resection.

METHODSSixty patients undergoing colorectal resection from March 2010 to March 2011 in the Nanfang Hospital were randomly divided into the control group(n=27, 3 days of bowel preparation) and the experimental group(n=33, 1 day of bowel preparation). Fresh feces were collected before bowel preparation and on the first defecation after surgery. The postoperative changes in gut flora and septic complications were observed.

RESULTSGut flora disturbance was found in both groups. The postoperative population of Bifidobacterium and Lactobacillus decreased significantly(P<0.05), and the decrease was more significant in the experimental group compared to the control group(P<0.05), while E.coli and Staphylococcus were much higher than the preoperative level(P<0.05), which was more significant in the control group. The incidence of postoperative infection was 9.1%(3/33) in the experimental group, which was significantly lower than 29.6%(8/27) in the control group(P<0.05).

CONCLUSIONFast bowel preparation is effective in reducing gut flora disturbance and the incidence of postoperative infection.

Colorectal Neoplasms ; microbiology ; surgery ; Digestive System Surgical Procedures ; Enema ; methods ; Feces ; microbiology ; Female ; Humans ; Male ; Microbiota ; Middle Aged ; Postoperative Period ; Preoperative Care ; Prospective Studies

OBJECTIVETo investigate the efficacy and mechanisms of Bawei Xilei Powder (BXP) in treating ulcerative colitis (UC).

METHODSTotally 103 patients with left hemicolon mild to moderate UC in the active phase at the outpatient clinics of West China Hospital from June 2009 to October 2010 were randomly assigned to the treatment group (55 cases) and the control group (48 cases). Patients in the treatment group were treated with BXP (adding 1 g in 60 mL worm boiled water) and those in the control group received by 50 mg/60 mL hydrocortisone edema solution (once every evening before sleep). The therapeutic course for all was 4 weeks. The disease activity degree (Mayo scoring), endoscopic, and histologic manifestations were compared between post-and pre-treatment in the two groups. The expression of toll-like receptor-4 (TLR4), nuclear factor-kappaB (NF-kappaB), and Occludin were detected.

RESULTSThe clinical remission rate and the response rate in the treatment group were 78.2% and 89.1% respectively, higher than those of the control group (58.3% and 72.9%, P < 0.05).The endoscopically mucosal healing rate was 50.9% in the treatment group and 31.3% in the control group (P < 0.05). The histological remission rate and the effective rate in the treatment group were 32.7% and 65.5% respectively, but higher than those of the control group (27.1% and 58.3%, P > 0.05). The rate of adverse events was 3.8% in the treatment (occurred in 2 cases) and 4.3% in the control group (occurred in 2 cases, P > 0.05). Compared with pre-treatment, the expression of TLR4 and NF-kappaB p65 significantly decreased (P < 0.05), while the expression of Occludin significantly increased (P < 0.05).

CONCLUSIONSBXP was effective and safe in patients with active mild to moderate UC. Its effects might be involved in regulating the expression of inflammatory factors and enhancing mucosa barrier functions. ulcerative colitis; Bawei Xilei Powder; enema therapy

Colitis, Ulcerative ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Enema ; Humans ; NF-kappa B ; metabolism ; Occludin ; metabolism ; Phytotherapy ; methods ; Toll-Like Receptor 4 ; metabolism

OBJECTIVESTo investigate the feasibility and safety of one-day bowel preparation for colorectal surgery.

METHODSForty patients undergone colorectal surgery were divided randomly into the Control group and the Experimental group and received 3-day magnesium sulfate and 1-day sodium phosphate bowel preparations before the operation, respectively. The levels of hemoglobin, hematocrit, serum electrolytes, and anaerobe counts in the stool prior and post bowel preparation were examined. The general status, surgical complications, and structure of intestinal mucosa in the patients were observed after the operation.

RESULTSThere was no significant difference in the anastomoses healing, infectious complications, serum tests and intestinal mucosa structures between the two groups. Less diarrhea occurred prior and post the surgery in the experimental group, and they felt better with the bowel preparation. The anaerobe counts in stool were higher after the bowel preparation than before in both groups.

CONCLUSIONSOne-day bowel preparation with sodium phosphate is a safe and reliable method for colorectal surgery. The shortening of preparation time can reduce the degrees of uncomfortable feeling and disruptions of intestinal micro-ecology and barrier.

Colorectal Neoplasms ; surgery ; Enema ; Humans ; Intestinal Mucosa ; drug effects ; microbiology ; Magnesium Sulfate ; administration & dosage ; Middle Aged ; Phosphates ; administration & dosage ; Postoperative Complications ; Preoperative Care ; methods ; Prospective Studies

OBJECTIVETo study the clinical efficacy of Chinese herbal retention enema combined with intrauterine douching for patients with endometritis diagnosed by hysteroscopy. They failed in in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI)-embryo transfer (ET) treatment.

METHODS131 patients received hysteroscopy after they failed in routine IVF/ICSI-ET treatment. Of them, 66 patients diagnosed as endometritis were enrolled as the test group and 65 patients without endometritis were enrolled as the control group. Chinese herbal retention enema combined with intrauterine douching was performed on patients in the test group before the next IVF/ICSI, while direct IVF/ICSI was performed on those in the control group. The embryo implantation rate and the clinical pregnancy rate were compared between the two groups.

RESULTSThe clinical pregnancy rate and the embryo implantation rate were 48.5% and 24.2% respectively, while they were 29.2% and 14.9% respectively in the control group, showing significant difference (P < 0.05).

CONCLUSIONChinese herbal retention enema combined with intrauterine douching could improve the embryo implantation rate and the clinical pregnancy in patients with endometritis.

Adult ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Embryo Transfer ; Endometritis ; therapy ; Enema ; methods ; Female ; Fertilization in Vitro ; Humans ; Hysteroscopy ; methods ; Pregnancy ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic ; Therapeutic Irrigation ; methods ; Treatment Failure

OBJECTIVETo observe the effect of the clysters No. 1 of Traditional Chinese Medicine (TCM) in inflammatory bowel disease on rats and search the new way and evidence for IBD cures.

METHODThe rats were divided into four groups: normal control group (I), model control group (II), Sulfasalazine( SASP) treating control group (III) and traditional Chinese medicine clysters No. 1 group (IV). There were 20 rats per group. Trinitrobenzenesulfonic Acid was used to induce the experimental models. The WBC, RBC, platelets of peripheral blood were monitored. The animals are put to death by dislocation in 4, 7, 14 and 21 d after giving the medicine respectively. The pathological changes of the intestines were observed in different times.

RESULTCompared with group II, the counting of platelets of group IV got rise in seventh day after administration, as of well as the group III. There were no statistical differences in WBC and RBC, compared with group II after the medicine administration for two weeks. There was no witness in effect of SASP for IBD on rats on organize pathology in this experiment. The enema No.1 lightened pathological injure and promoted the effect of restoration of IBD on rats obviously.

CONCLUSIONThe TCM enema No. 1 has anti-IBD activities on inflammatory bowel disease in rats. The foundation is established that the IBD cure on clinic and the basis have been provided the action mechanism of Chinese medicine which is utilized to IBD further.

Animals ; Colon ; pathology ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Enema ; methods ; Hemoglobins ; metabolism ; Inflammatory Bowel Diseases ; blood ; pathology ; Leukocyte Count ; Lymphocyte Count ; Plants, Medicinal ; chemistry ; Platelet Count ; Random Allocation ; Rats ; Rats, Wistar ; Sulfasalazine ; pharmacology