Enteral Nutrition ; methods ; Humans ; Intestines ; pathology ; physiopathology

The article puts forward the treatment of irritable bowel syndrome through regulating heart vitality since it is held that the pathological factors of the disease lay in dysfunction of heart and intestines as well as disorder of qi circulation. At the same time, the internal-external relationship between the heart the small intestine is discussed from the theory of Brain-gut Axis in modern medicine, which provides theoretical base of modern medicine for the treatment of irritable bowel syndrome through regulation of the heart functions.
Acupuncture Therapy ; Adult ; Female ; Heart ; physiopathology ; Humans ; Intestines ; physiopathology ; Irritable Bowel Syndrome ; physiopathology ; therapy ; Middle Aged

Most studies provide strong support for an etiologic role of stressful life events in irritable bowel syndrome (IBS). Consistent with the observations in both patients and doctors that psychosocial disturbances seem to precede the onset or exacerbation of gut symptoms, researches have consistently found high levels of emotional distress in a proportion of patients with IBS and other functional gastrointestinal disorders. Moreover, a variety of other potentially psychiatric diseases such as anxiety, depression, and sleep disorder also coexist frequently with IBS. In recent literatures, some studies have shown altered mechanoelastic properties such as colonic tone, compliance, and accommodation. The demonstrated differences in colonic compliance and accommodation suggest peripheral neuromuscular substrate contributing to the pathogenesis of IBS. However, until now, attention has focused on the disturbances of visceral hypersensitivity rather than on gastrointestinal motor function as a hallmark of IBS pathophysiology. But not all IBS patients show decreased rectosigmoid pain thresholds. Recent advances in brain imaging have allowed investigators to measure changes in regional cerebral blood flow during stimulation. Those methods have extended our understanding of brain function and brain-gut interaction. IBS is characterized by hypersensitivity to visceral sensation and augmented response to stress. Studies on the disorders of sensori-motor function have also contributed to understand the knowledge of neurotransmitters involved in the function of the enteric nervous system and to identify targets for the development of new treatments for IBS.
Brain/physiology ; Humans ; Intestines/innervation/physiopathology ; Irritable Bowel Syndrome/physiopathology/*psychology ; Stress, Psychological/complications/physiopathology

Acupuncture Therapy ; Adult ; Aged ; Female ; Hiccup ; physiopathology ; therapy ; Humans ; Intestines ; physiopathology ; Male ; Middle Aged ; Qi ; Stomach ; physiopathology ; Young Adult

OBJECTIVETo observe the improvements in constipation differentiated as intestine system syndrome and lung system syndrome treated with electroacupuncture (EA) and explore their correlation.

METHODSSeventy cases of severe functional constipation were randomized into an EA group and a pseudo-EA group, 35 cases in each one. In the EA group, the needles were inserted deeply at Tianshu (ST 25) and Fujie (SP 14) on bilateral sides, and directly went to parietal peritoneum. EA was attached to the needles, dense-disperse wave, 2 Hz/15 Hz, and 0.1 to 1.0 mA. The perpendicular insertion was done at Shangjuxu (ST 37), 25 mm in depth. After qi arrival, the needle was lifted, thrusted and rotated once every 10 min, for 3 times totally. The needles were retained for 30 min. In the pseudo-EA group, the pseudo-points lateral to Tianshu (ST 25), Fujie (SP 14) and Shangjuxu (ST 37) on bilateral sides were punctured shallowly. The electric stimulation was pretended to connect but with the electric wire cutting off. The needles were retained for 30 min. The treatment was given 5 times weekly in the first two weeks and 3 times weekly in the later 6 weeks. Totally, 28 treatments were required. TCM intestine and lung syndrome scale was used for evaluation. The changes in TCM syndromes were observed before and after treatment in the patients of the two groups.

RESULTSThe total score of intestine and lung syndrome and the score of individual syndrome were all reduced after treatment as compared with those before treatment in the two groups (both P<0.01). The improvements of the EA group in the total score of intestine system syndrome, the scores of large. intestine syndrome and stomach syndrome, the total score of lung system syndrome and the score of lung dysfunction in dispersing and descending syndrome were superior to those of the pseudo-EA group (P<0.01, P<0.05). The differences in the scores of lung qi deficiency syndrome and throat syndrome were not significant between the two groups (all P>0.05). Simultaneously, the very strong positive correlation (P<0.01) and positive linear correlation (P<0.01) were presented in the total score of intestine and lung syndrome of the two groups.

CONCLUSIONEA obviously improves in intestine system syndrome (including large intestine syndrome and stomach syndrome), as well as lung system syndrome (lung dysfunction in dispersing and descending) in the treatment of constipation. But the improvements are not apparent in the treatment of lung qi deficiency and throat disorder. Additionally, the obvious correlation is displayed in the improvements in intestine and lung syndrome.

Acupuncture Points ; Adult ; Aged ; Constipation ; physiopathology ; therapy ; Electroacupuncture ; Female ; Humans ; Intestines ; physiopathology ; Lung ; physiopathology ; Male ; Middle Aged ; Young Adult

Chronic radiation enteritis(CRE) is a common complication after pelvic radiotherapy, which severely affects patients' quality of life. Surgical treatment of CRE is challenging both for surgical skills and perioperative treatment strategy. Proper preoperative nutrition support therapy can reduce the morbidity of postoperative complication and the use of stoma, while postoperative nutrition support therapy can avoid the intestinal failure. Enteral nutrition should be the primary route of perioperative nutrition support therapy in CRE as possible. Pharmaconutrients aiming at intestinal commensal microbiota and its metabolites may play a role in the management of radiation enteritis.
Humans ; Intestines ; physiopathology ; Nutritional Support ; Postoperative Complications ; Quality of Life ; Radiation Injuries ; therapy

OBJECTIVETo investigate a new bowel management program for children patients with fecal incontinence.

METHODSClinical data of 19 children with fecal incontinence undergoing bowel management program in our center between January 2012 and January 2013 were retrospectively analyzed. The main outcome measure was clinical efficacy of this program.

RESULTSFifteen out of 19 cases were genuine fecal incontinence and required continuous treatment by enema. The other 4 cases were false fecal incontinence. After treatment with this program, stool dirty and constipation were improved in genuine incontinence. Two cases of false continence could control defecation independently by oral administration of antispasmodic drug. Two cases of false continence were cured and did not need medical interference.

CONCLUSIONSBowel management program is an effective treatment for pediatric patients with fecal incontinence. The key of success is maintenance of perianal hygiene for 24 hours by continual adjustment of the elements and volumes of enemas.

Child ; Constipation ; Enema ; Fecal Incontinence ; therapy ; Humans ; Intestines ; physiopathology ; Retrospective Studies

BACKGROUND/AIMS: Increased intestinal permeability has been possible contributing factors to the pathogenesis of alcoholic liver disease. Moreover, it can contribute to the development of bacterial infection and intestinal endotoxemia in patients with liver cirrhosis. This study aimed to examine the difference of intestinal barrier dysfunction between alcoholic and viral liver disease patients through the comparison of the intestinal permeabilities of patients with clinical characteristics. METHODS: Intestinal permeabilities were measured in 18 healthy controls, 41 patients with alcoholic liver disease (17 cases of alcoholic liver disease without cirrhosis and 24 cases of alcoholic liver cirrhosis) and 46 patients with viral liver disease (14 cases of chronic viral hepatitis and 32 cases of viral liver cirrhosis) by measuring 24 hour urine excretion of 51Cr-EDTA. RESULTS: The intestinal permeability was significantly increased in the patients with alcoholic liver disease without cirrhosis (5.62 +/- 2.80%), alcoholic liver cirrhosis (5.29 +/- 2.48%) and viral liver cirrhosis (3.15 +/- 1.39%) compared with that in control subjects (1.99 +/- 0.53%). On the contrary, it was not increased in the patients with chronic viral hepatitis (2.05 +/- 0.57%) versus controls. The significant correlation was not found between intestinal permeability and clinical and laboratory findings. CONCLUSIONS: The intestinal permeability was elevated in patients with alcoholic liver disease compared to those with viral liver cirrhosis. The pathophysiology of liver injury secondary to intestinal epithelial damage may be different between alcoholic and viral liver diseases.
Aged ; Chronic Disease ; English Abstract ; Female ; Hepatitis, Viral, Human/*physiopathology ; Humans ; Intestines/*physiopathology ; Liver Cirrhosis, Alcoholic/physiopathology ; Liver Diseases, Alcoholic/*physiopathology ; Male ; Middle Aged ; Permeability

OBJECTIVESTo investigate intestinal permeability in patients with portal hypertension and to search for a relationship with portal pressure.

METHODSTwenty patients with portal hypertension were divided two groups (A, B), 10 patients per group. In group A patients were treated with combined TIPS and modified Sugiura. In group B, patients were treated with modified Sugiura only. Intestinal permeability was assessed before operation, two weeks after TIPS, and two weeks after modified Sugiura, and 20 healthy control subjects were also assessed.

RESULTSIntestinal permeability was significantly higher in patients with portal hypertension than in healthy controls (0.132 +/- 0.110 vs. 0.032 +/- 0.018, P < 0.01). In group A, portal pressure and intestinal permeability decreased two weeks after TIPS (P < 0.05) and no obvious change was noted two weeks after modified Sugiura; but they were significantly lower than those before TIPS (P < 0.05). In group B intestinal permeability was not different before and after operation. Intestinal permeability in group A was not different from that in group B before treatment, but significantly lower after modified Sugiura (P < 0.05). Portal pressure was significantly correlated with intestinal permeability (r = 0.627, P < 0.01).

CONCLUSIONSThis study shows that combined TIPS and modified Sugiura can lower portal pressure and intestinal permeability, and enhance the therapeutic efficacy on portal hypertension.

Female ; Humans ; Hypertension, Portal ; physiopathology ; surgery ; Intestines ; physiopathology ; Male ; Middle Aged ; Permeability ; Portal Pressure ; physiology ; Portasystemic Shunt, Surgical

Intestinal failure (IF) is defined as the critical reduction of functional intestines below the minimum needed to absorb nutrients and fluids, so that intravenous supplementation with parenteral nutrition (PN) is required to maintain health and/or growth. Although the benefits are evident, patients receiving PN can suffer from serious cholestasis due to lack of enteral feeding and small intestinal bacterial overgrowth (SIBO). One such complication that may arise is intestinal failure-associated liver disease (IFALD). Evidences from recent studies suggest that alterations in the intestinal microbiota, as well as intraluminal bile acid driven signaling, may play a critical role in both hepatic and intestinal injury. Since Marshall first proposed the concept of the gut-liver axis in 1998, the role of gut-liver axis disorders in the development of IFALD has received considerable attention. The conversation between gut and liver is the key to maintain liver metabolism and intestinal homeostasis, which influences each other and is reciprocal causation. However, as a "forgotten organ" , intestinal microbiota on the pathogenesis of IFALD has not been well reflected. As such, we propose, for the first time, the concept of gut-microbiota-liver axis to emphasize the importance of intestinal microbiota in the interaction of gut-liver axis. Analysis and research on gut-microbiota-liver axis will be of great significance for understanding the pathogenesis of IFALD and improving the prevention and treatment measures.
Bacterial Infections/physiopathology* ; Bile Acids and Salts/physiology* ; Cholestasis/physiopathology* ; Enteral Nutrition ; Gastrointestinal Microbiome/physiology* ; Humans ; Intestinal Diseases/physiopathology* ; Intestines/physiopathology* ; Liver/physiopathology* ; Liver Diseases/physiopathology* ; Parenteral Nutrition/adverse effects* ; Short Bowel Syndrome/physiopathology* ; Signal Transduction