Displaying publications 1 - 20 of 67 in total

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  1. Naicker AS, Roohi SA, Naicker MS, Zaleha O
    Med J Malaysia, 2008 Jun;63(2):104-8.
    PMID: 18942293 MyJurnal
    Bowel Dysfunction is one of the least looked at problems in Spinal Cord Injury (SCI). The goals of this study are to understand bowel dysfunction in SCI and its effects on quality of life (QOL). Cross-sectional study based on interview and assessment of 41 clients. A majority of them were dissatisfied. Bowel opening time was long in about 65% while 76.6% were incontinent. Socially, approximately half refrained from outings even though 90.3% of them carried out bowel evacuation before going out. Attention to bowel education is necessary to improve social continence.
    Matched MeSH terms: Constipation/physiopathology
  2. Lim LY, Yang SS
    Neurourol Urodyn, 2024 Jan;43(1):81-87.
    PMID: 37767698 DOI: 10.1002/nau.25294
    OBJECTIVE: To establish a normal reference value of postvoid residual (PVR) urine volume in "healthy" adults.

    METHODS: Adults were recruited to undergo uroflowmetry and PVR. Those with neurological disorders, malignancy, diabetes, known lower urinary tract dysfunction, and urinary tract infection within the previous 3 months, were excluded from the study. Constipation was defined as Rome IV ≥ 2.

    RESULTS: Of the 883 adults enrolled in this study, 194 (22.3%) did not complete the questionnaires or perform the uroflowmetry, 103 (11.7%) met ≥1 exclusion criteria and thus were excluded. In addition, 30 and 38 uroflowmetry were excluded due to artifacts and low bladder volume (BV) (<100 mL), respectively. Finally, 515 uroflowmetry and PVR data from adults aged 36-89 (mean: 59.0 ± 9.5) were examined. There was a significant nonlinear relationship between BV and PVR (p 

    Matched MeSH terms: Constipation
  3. Lee YY, Waid A, Tan HJ, Chua AS, Whitehead WE
    World J Gastroenterol, 2012 Nov 28;18(44):6475-80; discussion p. 6479.
    PMID: 23197894 DOI: 10.3748/wjg.v18.i44.6475
    To survey irritable bowel syndrome (IBS) using Rome III criteria among Malays from the north-eastern region of Peninsular Malaysia.
    Matched MeSH terms: Constipation/diagnosis; Constipation/ethnology
  4. Gundamaraju R, Vemuri R
    Euroasian J Hepatogastroenterol, 2014 Jan-Jun;4(1):51-54.
    PMID: 29264319 DOI: 10.5005/jp-journals-10018-1096
    Greedy colon which is a synonym of constipation is a serious condition in the human body which may lead to complications, like damage of the rectal tissue, cellular dehydration and colorectal cancer. Diabetes mellitus, although a systemic disease with diverse clinical symptoms, is also related with cellular dehydration. Understanding the pathophysiological aspects of diabetes mellitus and greedy colon may shed light in the management of either of these conditions. The main purpose of this article is to demonstrate an association of tissue dehydration during diabetes mellitus and constipation. The adverse side effects of atropine will be discussed due to its M3 blockage effect and reduction in peristalsis keeping in mind the importance of these facts in the context of public health importance, especially in geriatric health. How to cite this article: Gundamaraju R, Vemuri R. Pathophysiology of Greedy Colon and Diabetes: Role of Atropine in worsening of Diabetes. Euroasian J Hepato-Gastroenterol 2014;4(1):51-54.
    Matched MeSH terms: Constipation
  5. Gwee KA, Lee YY, Suzuki H, Ghoshal UC, Holtmann G, Bai T, et al.
    J Gastroenterol Hepatol, 2023 Feb;38(2):197-209.
    PMID: 36321167 DOI: 10.1111/jgh.16046
    Contemporary systems for the diagnosis and management gastrointestinal symptoms not attributable to organic diseases (Functional GI Disorders, FGID, now renamed Disorders of Gut-Brain Interaction, DGBI) seek to categorize patients into narrowly defined symptom-based sub-classes to enable targeted treatment of patient cohorts with similar underlying putative pathophysiology. However, an overlap of symptom categories frequently occurs and has a negative impact on treatment outcomes. There is a lack of guidance on their management. An Asian Pacific Association of Gastroenterology (APAGE) working group was set up to develop clinical practice guidelines for management of patients with functional dyspepsia (FD) who have an overlap with another functional gastrointestinal disorder: FD with gastroesophageal reflux (FD-GERD), epigastric pain syndrome with irritable bowel syndrome (EPS-IBS), postprandial distress syndrome with IBS (PDS-IBS), and FD-Constipation. We identified putative pathophysiology to provide a basis for treatment recommendations. A management algorithm is presented to guide primary and secondary care clinicians.
    Matched MeSH terms: Constipation/complications
  6. The Ambulatory PS
    Family Physician, 1995;7:36-37.
    Matched MeSH terms: Constipation
  7. Ng ZQ, Tan JH, Tan H
    Malays Fam Physician, 2019;14(2):32-35.
    PMID: 31827734
    Caecal volvulus has been reported to be associated with various abdominal and pelvic pathologies. Its signs and symptoms are usually non-specific and maybe overlooked in favour of benign causes, such as constipation. A high degree of suspicion is required for prompt diagnosis. Herein, we report on an unusual case of caecal volvulus after a dental procedure that was managed initially as constipation.
    Matched MeSH terms: Constipation
  8. Lim XY, Tan TYC, Muhd Rosli SH, Sa'at MNF, Sirdar Ali S, Syed Mohamed AF
    PLoS One, 2021;16(1):e0245471.
    PMID: 33465140 DOI: 10.1371/journal.pone.0245471
    INTRODUCTION: Hemp (Cannabis sativa subsp. sativa), commonly used for industrial purposes, is now being consumed by the public for various health promoting effects. As popularity of hemp research and claims of beneficial effects rises, a systematic collection of current scientific evidence on hemp's health effects and pharmacological properties is needed to guide future research, clinical, and policy decision making.

    OBJECTIVE: To provide an overview and identify the present landscape of hemp research topics, trends, and gaps.

    METHODS: A systematic search and analysis strategy according to the preferred reporting items for systematic review and meta-analysis-ScR (PRISMA-ScR) checklist on electronic databases including MEDLINE, OVID (OVFT, APC Journal Club, EBM Reviews), Cochrane Library Central and Clinicaltrials.gov was conducted to include and analyse hemp research articles from 2009 to 2019.

    RESULTS: 65 primary articles (18 clinical, 47 pre-clinical) were reviewed. Several randomised controlled trials showed hempseed pills (in Traditional Chinese Medicine formulation MaZiRenWan) improving spontaneous bowel movement in functional constipation. There was also evidence suggesting benefits in cannabis dependence, epilepsy, and anxiety disorders. Pre-clinically, hemp derivatives showed potential anti-oxidative, anti-hypertensive, anti-inflammatory, anti-diabetic, anti-neuroinflammatory, anti-arthritic, anti-acne, and anti-microbial activities. Renal protective effects and estrogenic properties were also exhibited in vitro.

    CONCLUSION: Current evidence on hemp-specific interventions are still preliminary, with limited high quality clinical evidence for any specific therapeutic indication. This is mainly due to the wide variation in test item formulation, as the multiple variants of this plant differ in their phytochemical and bioactive compounds. Future empirical research should focus on standardising the hemp plant for pharmaceutical use, and uniformity in experimental designs to strengthen the premise of using hemp in medicine.

    Matched MeSH terms: Constipation
  9. Resshaya Roobini Murukesu, Devinder Kaur Ajit Singh, Suzana Shahar
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):227-227.
    MyJurnal
    Urinary incontinence (UI) is a common disorder among older adults, with a global prevalence between 2% to 58%. UI has been associated with social isolation, increased morbidity and reduced quality of life (QoL). The aim of this study was to investigate the sociodemographic, clinical, cognitive and physical function risk factors of UI among Malaysian community dwelling older adults. This study is part of a larger scale population based longitudinal study on neuroprotective model for healthy longevity among older adults (LRGS TUA). A total of 1560 Malaysian community dwelling older adults aged 60 years and above were screened in this phase III LRGS study. Participants sociodemographic and clinical history were obtained. Mini Mental State Examination (MMSE), Rey Auditory Verbal Learning Test (RAVLT) and Digit Span tested cognitive function. Timed Up and Go Test (TUG), Hand Grip Strength Test, Chair Stand Test and Lawton Instrumental Activities of Daily Living tested physical function. The overall prevalence of UI was 15.7% (n = 245) in this study, with 11.8% (n = 88) in men and 19.3% (n = 157) in women. Logistic regression analysis showed that TUG (Adjusted odds ratio [OR], 1.071; 95% confidence interval [CI], 1.02-1.13), MMSE (OR, 0.93; CI, 0.90-0.97), weight (OR, 1.02; CI, 1.00-1.03), and constipation (OR 0.60; CI, 0.46-0.78) (p < 0.005) were significant risk factors of UI. The results indicate, decreased physical and cognitive function; increase in weight and having constipation increased the risk of UI. Maintaining optimum mobility, cognitive function, body weight and constipation prevention are vital in the prevention and management of UI among older adults.
    Matched MeSH terms: Constipation
  10. Hutson JM, Hynes MC, Kearsey I, Yik YI, Veysey DM, Tudball CF, et al.
    Pediatr Surg Int, 2020 Jan;36(1):11-19.
    PMID: 31673760 DOI: 10.1007/s00383-019-04587-x
    Children with chronic idiopathic constipation (CIC) often end up at the surgeon when medical treatments have failed. This opinion piece discusses a recently described pattern of CIC called 'Rapid transit constipation (RTC)' first identified in 2011 as part of surgical workup. RTC was identified using a nuclear medicine gastrointestinal transit study (NMGIT or nuclear transit study) to determine the site of slowing within the bowel and to inform surgical treatment. Unexpectedly, we found that RTC occured in 29% of 1000 transit studies in a retrospective audit. Irritable bowel syndrome (IBS) occurs in 7-21% of the population, with a higher prevalence in young children and with constipation type dominating in the young. While 60% improve with time, 40% continue with symptoms. First-line therapy for IBS in adults is a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols which reduces symptoms in > 70% of patients. In children with functional gastrointestinal disorders, fructose intolerance occurs in 35-55%. Reducing fructose produced significant improvement in 77-82% of intolerant patients. In children with RTC and a positive breath test upon fructose challenge, we found that exclusion of fructose significantly improved constipation, abdominal pain, stool consistency and decreased laxative use. We hypothesise that positive breath tests and improvement of pain and bowel frequency with sugar exclusion diets in RTC suggest these children have IBS-C. These observations raise the possibility that many children with CIC could be treated by reducing fructose early in their diet and this might prevent the development of IBS in later life.
    Matched MeSH terms: Constipation/diet therapy*; Constipation/physiopathology
  11. Yik YI, Stathopoulos L, Hutson JM, Southwell BR
    Neuromodulation, 2016 Jul;19(5):515-21.
    PMID: 27293084 DOI: 10.1111/ner.12451
    AIM: As transcutaneous electrical stimulation (TES) increased defecation in children and adults with Slow-Transit Constipation (STC), we performed a pilot study to test if TES can improve symptoms (defecation and soiling) in children with chronic constipation without STC and transit delay in the anorectum.

    METHODS: Children with treatment-resistant constipation presenting to a tertiary hospital had gastrointestinal nuclear transit study (NTS) showing normal proximal colonic transit and anorectal holdup of tracer. TES was administered at home (1 hour/day for 3 months) using a battery-powered interferential stimulator, with four adhesive electrodes (4 × 4 cm) connected so currents cross within the lower abdomen at the level of S2-S4. Stimulation was added to existing laxatives. Daily continence diary, and quality-of-life questionnaires (PedsQL4.0) were compared before and after TES.

    RESULTS: Ten children (4 females: 5-10 years, mean 8 years) had holdup in the anorectum by NTS. Nine had <3 bowel motions (BM)/week. After three months TES, defecation frequency increased in 9/10 (mean 0.9-4.1 BM/week, p = 0.004), with 6/9 improved to ≥3 BM/week. Soiling reduced in 9/10 from 5.9 to 1.9 days/week with soiling, p = 0.004. Ten were on laxatives, and nine reduced/stopped laxative use. Quality-of-life improved to within the normal range.

    CONCLUSION: TES improved symptoms of constipation in >50% of children with treatment-resistant constipation with isolated holdup in the anorectum. Further studies (RCTs) are warranted in these children.

    Matched MeSH terms: Constipation/psychology; Constipation/therapy*
  12. Yik YI, Hutson J, Southwell B
    Neuromodulation, 2018 Oct;21(7):676-681.
    PMID: 29164818 DOI: 10.1111/ner.12734
    BACKGROUND: Transcutaneous electrical stimulation (TES) for one to two months has produced some improvement in treatment-resistant slow-transit constipation (STC) in children. Optimal parameters for treatment are not known. It is possible that more improvement would occur with stimulation for longer. This study examined the effectiveness of stimulation for six months.

    METHODS: Children with STC confirmed by nuclear transit study (NTS) were enrolled prospectively. All had chronic constipation for greater than two years and had failed medical treatment. TES was performed for one hour/day for six months using the INF 4160 (Fuji Dynamics) portable stimulator and 4 cm × 4 cm electrodes near the belly button and on the back. Families kept bowel diaries and completed PEDSQLCore QOL (4.0) questionnaires before and at end of treatment.

    RESULTS: Sixty-two children (34 females; seven years, 2-16 year) with STC were studied. Defecation frequency increased in 57/62 (91%, mean ± SEM pre- 1.49 ± 0.20 vs. post- 3.25 ± 0.25 defecation/week, p 

    Matched MeSH terms: Constipation/therapy*
  13. Murukesu RR, Singh DKA, Shahar S
    BMC Public Health, 2019 Jun 13;19(Suppl 4):529.
    PMID: 31196015 DOI: 10.1186/s12889-019-6870-6
    BACKGROUND: Urinary incontinence (UI) is known to be more prevalent among women and is associated with decline in quality of life. The aim of our study was to investigate the prevalence, risk factors of urinary incontinence and its impact on quality of life among community dwelling older women living in urban and rural populations.

    METHODS: This study was conducted based on secondary data analysed from the third phase of the longitudinal study "Neuroprotective Model for Health Longevity among Malaysian Elderly" (LRGS TUA). Stratification of urban and rural study areas were in accordance to that determined by the Department of Statistics. A total of 814 community dwelling older women (53% urban, 47% rural), aged 60 years and above, across four states within Peninsular Malaysia were included in this analysis. Interview-based questionnaires were used to obtain respondents' sociodemographic details and clinical characteristics. The Timed Up and Go test and Handgrip Strength tests were used to assess physical function. Urinary incontinence was self-reported, and quality of life of those with incontinence was assessed using the King's Health Questionnaire (KHQ).

    RESULTS: Prevalence of urinary incontinence was 16% and 23% among older women living in urban and rural areas, respectively. Ethnicity was significantly associated with incontinence among older women in both urban and rural population (p 

    Matched MeSH terms: Constipation/complications; Constipation/epidemiology
  14. Ghafar MYA, Yaakup H, Ali RAR, Shah SA
    J Nutr Health Aging, 2020;24(10):1066-1072.
    PMID: 33244562 DOI: 10.1007/s12603-020-1494-1
    OBJECTIVES: To evaluate the impact of a microbial cell preparation (MCP®) (Hexbio®; comprising MCP® BCMC® strains) on stool frequency, consistency, and constipation-related symptoms in elderly patients with multiple chronic medical conditions.

    DESIGN: Randomised control trial.

    SETTING: Medical outpatient and medical/surgical in-patient unit in single tertiary center.

    PARTICIPANT: Patients aged ≥ 60 years who experience constipation and have multiple chronic medical conditions.

    METHODS: Participants with constipation were blindly randomized into either a treatment (MCP® BCMC® strains) or a placebo group. The treatment was administered twice daily.

    MEASUREMENT: Gastrointestinal symptoms and stool habits were assessed over a week during the intervention via the use of a questionnaire and stool diary.

    RESULTS: Stool frequency was seen to be higher and the improvement in stool consistency was more significant in the treatment group than in the placebo group (p =<0.001). A significant improvement in symptoms was demonstrated in patients who received MCP® BCMC® strains,specifically with respect to straining (p = < 0.001) and a sensation of incomplete evacuation (p = < 0.001). reduction in anorectal blockage symptoms and the need for manual stool evacuation was also demonstrated, but this finding was not statistically significant. Significant adverse events were not observed.

    CONCLUSIONS: An improvement in stool frequency and consistency was reported in elderly patients with chronic medical conditions following the administration of MCP® BCMC® strains.

    Matched MeSH terms: Constipation/drug therapy*
  15. Tan YM, Goh KL, Muhidayah R, Ooi CL, Salem O
    J Gastroenterol Hepatol, 2003 Dec;18(12):1412-6.
    PMID: 14675271 DOI: 10.1046/j.1440-1746.2003.03212.x
    BACKGROUND AND AIMS: Irritable bowel syndrome (IBS) is a common functional bowel disease in the West. Information on the prevalence of IBS in the Asian population is relatively scanty. The aims of the present study were to determine the prevalence of IBS and to assess the symptom subgroups based on the predominant bowel habit in a young adult population of Asian origin.

    METHODS: Basic demographic data and symptoms of IBS using the Rome I criteria were sought using a questionnaire administered to all apparently healthy students in a medical school. Other questions asked related to alcohol intake, smoking, chili consumption, dietary fiber intake, and to psychological and psychosomatic symptoms of anxiety, depression, insomnia, headache, and backache. The health-care seeking behavior of the subjects was also analyzed.

    RESULTS: Of the 610 questionnaires administered, 533 complete responses were received (response rate of 87.4%). The responders comprised 229 men (43.0%) and 304 (57.0%) women with a mean age of 22 +/- 1.8 years. The ethnic distribution was Malays 278 (52.2%), Chinese 179 (33.6%), Indians 46 (8.6%), and others 30 (5.6%). Eighty-four (15.8%) reported symptoms consistent with the diagnosis of IBS, predominantly women. Sixty-five (77.4%) and six (7.1%) were of the constipation-predominant and diarrhea-predominant IBS subgroups, respectively. Thirteen (15.5%) subjects fell into the non-specific IBS subgroup. The self-reported psychological and psychosomatic symptoms of anxiety (P = 0.02), depression (P = 0.002), insomnia (P = 0.006), headache (P = 0.04), and backache (P = 0.006) were encountered more frequently in the subjects with IBS. Only 13.1% of the IBS group had consulted their health-care practitioner, and 20.2% reported self-medication.

    CONCLUSIONS: Symptoms supportive of the diagnosis of IBS were common among young Malaysians, with a prevalence rate of 15.8%. There were significantly more women with IBS than men. Within the IBS population, the majority (77.4%) was of the constipation-predominant IBS subgroup. A significantly higher prevalence of psychological and psychosomatic symptoms was found in individuals with IBS. Only a minority sought medical advice for their symptoms.
    Matched MeSH terms: Constipation/etiology; Constipation/epidemiology
  16. Nur Azurah, A.G., Ani Amelia, Z., Sagap, I.
    MyJurnal
    We report the case of a 34-year-old Malay, admitted for constipation and abdominal pain at 35 weeks of gestation. Initially, she was diagnosed to have paralytic ileus and was managed conservatively. As her condition did not improve, emergency laparotomy was performed for suspected intestinal obstruction. She delivered a baby boy weighing 2.84kg with good Apgar score through a caesarean section. Intra-operatively, she was noted to have sigmoid volvulus and sigmoidopexy was performed. Post-partum, colonoscopy and bowel decompression was performed. She recovered well and was discharged on day 5. This case illustrates the need to diagnose or suspect volvulus in pregnant woman presenting with severe constipation as early surgical intervention can reduce morbidity to both mother and fetus.
    Matched MeSH terms: Constipation
  17. Teh, Y.W., Teh, E.E., Russell, V.
    MyJurnal
    Clozapine is an atypical antipsychotic medication, used primarily as the drug of choice in treatment resistant schizophrenia. Despite its considerable advantages, clozapine’s licence is restricted because of its potential to induce agranulocytosis. Hence, white blood cell count monitoring is mandatory in patients receiving clozapine treatment. A side effect of clozapine that has received relatively less attention is constipation, which is caused by the drug’s anticholinergic effect. This potentially serious problem can result in life- threatening bowel obstruction, ischemia, necrosis, perforation, and pulmonary aspiration. Despite this evidence, routine inquiry about constipation in clozapine treated patients is not emphasised in current clinical guidance. We report a case to highlight constipation as both a potentially serious side effect and as a factor, insufficiently recognised, in non-adherence to clozapine.
    Matched MeSH terms: Constipation
  18. Das, Priscilla, Naing, NyiNyi, Nadiah Wan-Arfah, Naing Noor Jan, K.O., Yee, Cheng Kueh, Rasalingam, Kantha
    JUMMEC, 2019;22(1):50-57.
    MyJurnal
    Background: This paper investigates the quality of life of brain pathology patients in relation to their sociodemographic
    profiles and clinical factors.

    Methods: This is a cross-sectional study done at a tertiary referral hospital in Kuala Lumpur. A total of 100
    patients were recruited in the study after excluding 22 patients who did not met the exclusion criteria. The
    European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) self-administered
    questionnaire was utilized in the study. The Global health status/QoL, Physical functioning, Role functioning,
    Emotional functioning, Cognitive functioning, Social functioning, Fatigue, Nausea and vomiting, Pain, Dyspnoea,
    Insomnia, Appetite loss, Constipation, Diarrhoea, and Financial difficulties were assessed in this study.

    Results: The most severe impairment in functioning was with lowest score of cognitive functioning (mean
    score=61) and the most severe symptom was fatigue (mean score=45). There were significant differences in
    quality of life scores in different socio-demographic groupsand types of brain pathology patients. Patients aged
    below 40 years old or less had better physical functioning, less symptoms of fatigue and insomnia compared
    to patients who were more than 40 years old. Male patients faced more financial difficulties compared with
    female patients. Patients who were married had increased insomnia compared to the single patients. Employed
    patients had better physical functioning and less financial difficulties compared with patients who were
    unemployed. Patients who earned >RM 2500.00 monthly had better physical functioning, less symptoms of pain and less financial difficulties than patients who earned ≤RM 2500.00. Patients with qualifications lower
    than SPM tended to face more financial difficulties compared to patients with qualifications of SPM or higher.
    Meningioma patients had better social functioning compared with others, whereas Carvenoma patients had
    better physical functioning. Meningioma patients had more symptoms of insomnia compared with other
    patients. All the findings were with p value less than 0.05.

    Conclusion: The quality of life of patients with brain pathology is affected by socio-demographic factors and
    clinical diagnoses. Efforts should be made to improve the overall quality of life of these patients.
    Matched MeSH terms: Constipation
  19. Lee YY, Erdogan A, Yu S, Dewitt A, Rao SSC
    J Neurogastroenterol Motil, 2018 Jul 30;24(3):460-468.
    PMID: 29879762 DOI: 10.5056/jnm17081
    Background/Aims: Whether high-resolution anorectal pressure topography (HRPT), having better fidelity and spatio-temporal resolution is comparable to waveform manometry (WM) in the diagnosis and characterization of defecatory disorders (DD) is not known.

    Methods: Patients with chronic constipation (Rome III) were evaluated for DD with HRPT and WM during bearing-down "on-bed" without inflated rectal balloon and "on-commode (toilet)" with 60-mL inflated rectal balloon. Eleven healthy volunteers were also evaluated.

    Results: Ninety-three of 117 screened participants (F/M = 77/16) were included. Balloon expulsion time was abnormal (> 60 seconds) in 56% (mean 214.4 seconds). A modest correlation between HRPT and WM was observed for sphincter length (R = 0.4) and likewise agreement between dyssynergic subtypes (κ = 0.4). During bearing down, 2 or more anal pressure-segments (distal and proximal) could be appreciated and their expansion measured with HRPT but not WM. In constipated vs healthy participants, the proximal segment was more expanded (2.0 cm vs 1.0 cm, P = 0.003) and of greater pressure (94.8 mmHg vs 54.0 mmHg, P = 0.010) during bearing down on-commode but not on-bed.

    Conclusions: Because of its better resolution, HRPT may identify more structural and functional abnormalities including puborectal dysfunction (proximal expansion) than WM. Bearing down on-commode with an inflated rectal balloon may provide additional dimension in characterizing DD.

    Matched MeSH terms: Constipation
  20. Lee YY, Erdogan A, Rao SS
    J Neurogastroenterol Motil, 2014 Oct 30;20(4):547-52.
    PMID: 25230902 DOI: 10.5056/jnm14056
    Management of chronic constipation with refractory symptoms can be challenging. Although new drugs and behavioral treat-ments have improved outcome, when they fail, there is little guidance on what to do next. At this juncture, typically most doc-tors may refer for surgical intervention although total colectomy is associated with morbidity including complications such as recurrent bacterial overgrowth. Recently, colonic manometry with sensory/tone/compliance assessment with a barostat study has been shown to be useful. Technical challenges aside, adequate preparation, and appropriate equipment and knowledge of co-lonic physiology are keys for a successful procedure. The test itself appears to be safe with little complications. Currently, colon-ic manometry is usually performed with a 6-8 solid state or water-perfused sensor probe, although high-resolution fiber-optic colonic manometry with better spatiotemporal resolutions may become available in the near future. For a test that has evolved over 3 decades, normal physiology and abnormal findings for common phenotypes of chronic constipation, especially slow transit constipation, have been well characterized only recently largely through the advent of prolonged 24-hour ambulatory colonic manometry studies. Even though the test has been largely restricted to specialized laboratories at the moment, emerg-ing new technologies and indications may facilitate its wider use in the near future.(J Neurogastroenterol Motil 2014;20:547-552).
    Matched MeSH terms: Constipation
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