Search Our Scientific Publications & Authors

Dig Dis Sci 2021 Jun 15. Epub 2021 Jun 15.

Division of Gastroenterology and Hepatology, University of Michigan School of Medicine, Ann Arbor, MI, USA.

Background: Biofeedback therapy is highly effective and safe in treating dyssynergic defecation, which affects more than half of patients with chronic constipation. However, conventional biofeedback training has limitations.

Aims: This study aims to modify the adaptive biofeedback (ABF) previously established by the investigators and evaluate its efficacy for dyssynergic defecation. Read More

Am Fam Physician 2021 Jun;103(12):745-752

Travis Air Force Base Family Medicine Residency, Travis Air Force Base, CA, USA.

Obstetric lacerations are a common complication of vaginal delivery. Lacerations can lead to chronic pain and urinary and fecal incontinence. Perineal lacerations are defined by the depth of musculature involved, with fourth-degree lacerations disrupting the anal sphincter and the underlying rectal mucosa and first-degree lacerations having no perineal muscle involvement. Read More

J Pediatr Gastroenterol Nutr 2021 Jun 11. Epub 2021 Jun 11.

Discipline of Pediatric Gastroenterology, Pediatric Department, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil, Rua dos Otonis, 839, São Paulo - SP, Brazil, CEP 04025-002 Discipline of Pediatric Specialties, Division of Pediatric Pneumology, Pediatric Department, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil, Rua Borges Lagoa, 760, São Paulo, SP, Brazil, CEP 04038-002.

Background: Constipation is prevalent in pediatric cystic fibrosis patients and colonic motility has not been studied in this population. In this study, we aimed to evaluate the total and segmental colonic transit time in children and adolescents with cystic fibrosis based on the presence of constipation and radiological fecal impaction.

Methods: In this case series, all patients aged 3 to 20 years of a cystic fibrosis reference center were invited to participate. Read More

Neurogastroenterol Motil 2021 Jun 14:e14180. Epub 2021 Jun 14.

Division of Gastroenterology and Hepatology, University of Calgary, Calgary, AB, Canada.

Background: There are little data evaluating the performance of the 3-dimensional high-definition anorectal manometry (3D-HDAM) system in the diagnosis of dyssynergic defecation. Physical properties of the thicker, rigid, 3D-HDAM probe may have implications on the measurements of anorectal pressures.

Aim: Our aim was to compare 3D-HDAM to balloon expulsion test and magnetic resonance (MR) defecography. Read More

JGH Open 2021 Jun 4;5(6):643-646. Epub 2021 May 4.

Department of Gastroenterology and Hepatology Digestive Disease and Surgical Institute, Cleveland Clinic Foundation Cleveland Ohio USA.

Pseudomelanosis coli is historically associated with anthraquinone laxatives and is often used as a surrogate marker for chronic laxative use. The opioid epidemic has seen an increase in laxative use for chronic constipation. Anthraquinone laxatives have demonstrated tumorigenic potential in animal studies due to their apoptotic effects on colonic epithelial cells. Read More

J Family Med Prim Care 2021 Apr 29;10(4):1785-1788. Epub 2021 Apr 29.

College of Medicine Chattanooga, The University of Tennessee Health Science Center, Chattanooga, TN 37403, USA.

We report a case of a 51-year-old male with minimal past medical history who presented to his primary care provider with nausea, vomiting and constipation in the outpatient setting. Concomitantly, he was found to have a renal injury, anemia and lytic lesions which were confirmed to be due to multiple myeloma. After further investigation of the gastrointestinal symptoms, he was diagnosed with gastroparesis. Read More

Cureus 2021 Jun 8;13(6):e15533. Epub 2021 Jun 8.

Department of Medicine, State University of New York (SUNY) Downstate, Health Science University, Brooklyn, USA.

Euglycemic diabetic ketoacidosis (eu-DKA) is an uncommon and serious adverse event associated with the use of sodium-glucose cotransporter (SGLT-2) inhibitors. It is a state of increased anion gap metabolic acidosis with ketosis but in the setting of normal serum glucose levels. Diagnosis of this serious entity could easily be missed given the non-specific symptoms and the normal glucose measurements. Read More

World J Gastrointest Surg 2021 May;13(5):443-451

Department of Anorectal Disease, Shenyang Coloproctology Hospital, Shenyang 110000, Liaoning Province, China.

Background: The most common causes of outlet obstructive constipation (OOC) are rectocele and internal rectal prolapse. The surgical methods for OOC are diverse and difficult, and the postoperative complications and recurrence rate are high, which results in both physical and mental pain in patients. With the continuous deepening of the surgeon's concept of minimally invasive surgery and continuous in-depth research on the mechanism of OOC, the treatment concepts and surgical methods are continuously improved. Read More

Pan Afr Med J 2021 18;38:284. Epub 2021 Mar 18.

Service de Néphrologie et d'Hémodialyse, Centre Hospitalier Universitaire Yalgado Ouedraogo, Ouagadougou, Burkina Faso.

Purple urine bag syndrome (PUBS) is an uncommon complication of urinary tract infection. It mainly affects elderly patients with constipation, chronic urinary catheter and prolonged bed rest. Several bacteria belonging to two different groups, the group converting indoxyl urinary sulphate into indoxyl and the group alkalizing urine by the production of urease, are associated with it. Read More

Front Neurol 2021 26;12:666737. Epub 2021 May 26.

Department of Physiology, School of Medicine, Trinity College Dublin, Trinity Biomedical Sciences Institute, Dublin, Ireland.

Parkinson's disease (PD), the second most common neurodegenerative disease, is characterised by the motor symptoms of bradykinesia, rigidity and resting tremor and non-motor symptoms of sleep disturbances, constipation, and depression. Pathological hallmarks include neuroinflammation, degeneration of dopaminergic neurons in the substantia nigra pars compacta, and accumulation of misfolded α-synuclein proteins as intra-cytoplasmic Lewy bodies and neurites. Microglia and astrocytes are essential to maintaining homeostasis within the central nervous system (CNS), including providing protection through the process of gliosis. Read More

Neurogastroenterol Motil 2021 Jun 14:e14195. Epub 2021 Jun 14.

Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

Background: Early adverse life events (EALs) and post-traumatic stress disorder (PTSD) are associated with irritable bowel syndrome (IBS). Disordered defecation (DD) presents with symptoms of IBS or functional constipation (FC) and is associated with psychological distress. However, the role of trauma and stress in chronic constipation is poorly defined. Read More

Gene Ther 2021 Jun 14. Epub 2021 Jun 14.

Department of Haematology, UCL Cancer Institute, University College London, London, WC1E 6DD, United Kingdom.

Hirschsprung disease (HSCR) is a congenital anomaly of the colon that results from failure of enteric nervous system formation, leading to a constricted dysfunctional segment of the colon with variable lengths, and necessitating surgical intervention. The underlying pathophysiology includes a defect in neural crest cells migration, proliferation and differentiation, which are partially explained by identified genetic and epigenetic alterations. Despite the high success rate of the curative surgeries, they are associated with significant adverse outcomes such as enterocolitis, fecal soiling, and chronic constipation. Read More

Support Care Cancer 2021 Jun 13. Epub 2021 Jun 13.

Gastroenterology and Digestive Oncology Department, Avicenne Hospital, AP-HP, Bobigny, France.

Purpose: Naloxegol, an oral once-daily peripherally acting mu-opioid receptor antagonist, is indicated for the treatment of opioid-induced constipation (OIC) with inadequate response to laxative(s), in cancer and non-cancer patients. This study mainly aimed to assess in real-life conditions the efficacy and safety of naloxegol in cancer pain patients and the evolution of their quality of life.

Methods: A non-interventional, 4-week follow-up study was conducted in 24 French oncology and pain centers between 2018 and 2019. Read More

Food Res Int 2021 Aug 19;146:110428. Epub 2021 May 19.

Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Republic of Korea; Department of Nutritional Science and Food Management, Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Republic of Korea. Electronic address:

The spore-forming Bacillus coagulans has attracted attention for their therapeutic action in the colon. However, the mechanism of this action remains unclear. In this study, healthy subjects with mild intermittent constipation were supplemented with B. Read More

Biophys Chem 2021 Jun 3;277:106628. Epub 2021 Jun 3.

Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781 039, India. Electronic address:

Parkinson's disease (PD) is a progressive neurodegenerative disorder caused by the loss of dopaminergic neurons. It is characterised by the deposition of insoluble α-synuclein aggregates in the brain. Constipation is a common PD-associated condition, and the treatment of constipation with certain antibiotics seem to improve the PD symptoms. Read More

Int J Surg 2021 Jun 10:105993. Epub 2021 Jun 10.

Department of Orthopedics, The First People's Hospital of Qinzhou, Qinzhou, Guangxi, 535000, China. Electronic address:

Int J Gynaecol Obstet 2021 Jun 12. Epub 2021 Jun 12.

Department of gynecological pelvic floor and oncology, Chongqing health center for women and children, Chongqing, China.

Objective: To explore the safety and efficiency of modified sacrospinous ligament fixation (MSSF) for apical prolapse.

Methods: It's a retrospective cohort study. Patients diagnosed with apical prolapse from 2014 to 2019 were recruited and divided into three groups, those are sacrospinous ligament fixation (SSF), MSSF and laparoscopic sacral hysteropexy (LSH). Read More

Psychosom Med 2021 Jun 11. Epub 2021 Jun 11.

Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, China State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi 710032, China Department of Radiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, Shaanxi 710038, China Department of Psychiatry, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi 710032, China.

Objective: Functional constipation (FC) is a common gastrointestinal disorder. Anxiety and/or depressive disorders are common in patients with FC (FCAD). Brain dysfunction may play a role in FC, but the contribution of comorbid anxiety and/or depression in patients with FC is poorly understood. Read More

Aliment Pharmacol Ther 2021 Jun 11. Epub 2021 Jun 11.

Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK.

Background: Although bloating is a highly prevalent and troublesome symptom in irritable bowel syndrome with constipation (IBS-C), treatment is empirical with no specific guidelines for its management.

Aim: To conduct a pairwise and network meta-analysis, using a frequentist approach, of Food and Drug Administration-licensed drugs for IBS-C comparing their efficacy for abdominal bloating as a specific endpoint.

Methods: We searched the medical literature through December 2020 to identify randomised controlled trials (RCTs) in IBS-C, with abdominal bloating reported as a dichotomous assessment. Read More

Autism Res 2021 Jun 11. Epub 2021 Jun 11.

Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR.

Children with autism commonly suffer from comorbid functional gastrointestinal disorders (FGID) and anxiety. The raised prevalence of both conditions in autism suggests complex reciprocal relationships, which are seldom explored in non-treatment-seeking FGID. The relationships between subtypes of FGID and anxiety are also unclear. Read More

Front Endocrinol (Lausanne) 2021 24;12:604070. Epub 2021 May 24.

Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Objective: To evaluate the small intestinal bacterial overgrowth (SIBO) of subclinical hypothyroidism of pregnant women, and explore their possible relevance.

Methods: In total, 224 pregnant women with subclinical hypothyroidism during pregnancy (study group) and 196 pregnant women whose thyroid function was normal (control group) were enrolled in this study. Lactulose-based hydrogen and methane breath test was performed to evaluate the growth of intestinal bacteria. Read More

Sci Rep 2021 Jun 9;11(1):12170. Epub 2021 Jun 9.

Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Kinderspitalgasse 6, 1090, Vienna, Austria.

Acute appendicitis is a rare gastrointestinal complication of anti-cancer chemotherapy and hematopoietic stem cell transplantation. Among a cohort of 2341 hemato-oncologic patients at a pediatric tertiary care cancer center, we identified 21 patients (0.9%) with 23 episodes of acute appendicitis, based on pathological imaging of the appendix and clinical findings. Read More

Dis Colon Rectum 2021 Jun 8. Epub 2021 Jun 8.

Division of General Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah.

Case Summary: A 46-year-old male with no significant past medical or surgical history presented to the emergency department with a 1-week history of worsening constipation, abdominal distension, nausea, and non-bloody, non-bilious emesis. Workup included a computed tomography (CT) scan which was notable for a 5.3 x 3. Read More

Clin Ther 2021 Jun 6. Epub 2021 Jun 6.

Lexicon Pharmaceuticals Inc, The Woodlands, Texas. Electronic address:

Purpose: For neuropathic pain, current therapies do not provide relief for most patients; less than half achieve a 50% pain reduction. Current analgesics have adverse effects. We present 2 Phase I studies of LX9211, a new small-molecule AP2-associated kinase 1 inhibitor with preclinical effectiveness in pain relief. Read More

BMC Surg 2021 Jun 9;21(1):289. Epub 2021 Jun 9.

Department of General Surgery, Amiri Medical Complex, Qargha Road, Afshar, Kabul, Afghanistan.

Background: Wandering spleen is a rare clinical entity with a less than 0.2% reporting incidence rate. In this case, the spleen is present abnormally in the abdominal or pelvic cavity instead of its normal anatomical location. Read More

Andes Pediatr 2021 Feb 24;92(1):86-92. Epub 2021 Feb 24.

Hospital Dr. Mario Catarino Rivas, San Pedro Sula, Honduras.

Introduction: According to Latin American popular culture, empacho is a gastrointestinal disease caused by ex cessive intake of cold or under-cooked food. Abdominal manipulation or sobada is one of the popular treatments used for empacho and consists of an abdominal massage, where the skin is rubbed and stretched, applying pressure on the abdomen.

Objectives: To characterize clinical evolution and complications secondary to diagnostic delay in pediatric patients with acute appendicitis, with history of empacho and abdominal manipulation. Read More

Int J Clin Pract 2021 Jun 9:e14451. Epub 2021 Jun 9.

Department of Pulmonary Medicine, Medicana International Istanbul Hospital, Istanbul, Turkey.

Aim: The aim of the study is to determine the effects of constipation symptoms and nutritional status on disease-related parameters, such as disease duration, spirometry test and quality of life, of COPD patients.

Methods: The research was performed with 48 COPD patients attending the center from January 2019 to August 2019. Assessment of constipation symptoms were done by Constipation Severity Instrument (CSI), while for quality of life assessment St George Respiratory Questionnaire (SGRQ) was used. Read More

Ginekol Pol 2021 Jun 9. Epub 2021 Jun 9.

Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland.

Objectives: Our study evaluates the impact of adjuvant treatment with external beam radiotherapy (EBRT) combined with vaginal high-dose-rate brachytherapy (HDR BT) on health-related quality of life (HRQL) in patients with early-stage endometrioid endometrial carcinoma.

Material And Methods: We assessed HRQL of patients based on the EORTC QLQ-C30 questionnaire, with endometrial cancer specific HRQL module - EORTC QLQ-EN24. From March 2019 to April 2020 we enrolled 20 patients with early-stage endometrioid endometrial carcinoma, qualified for adjuvant treatment after hysterectomy. Read More

Glob Pediatr Health 2021 31;8:2333794X211022265. Epub 2021 May 31.

Department of Pediatrics, Umm Al-Qura University, Makkah, Saudi Arabia.

Functional gastrointestinal disorders are characterized by absence of anatomical and biochemical alterations, and are diagnosed and classified based on symptomatology. We aim to explore the prevalence of functional abdominal pain disorders and Functional constipation using Rome IV criteria. An online questionnaire was distributed randomly via social media targeting the general population of the western region of Saudi Arabia. Read More