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Nutrients 2022 Apr 24;14(9). Epub 2022 Apr 24.

Department of Paediatrics, Gastroenterology, Allergology and Paediatric Nutrition, Faculty of Medicine, Medical University of Gdańsk, Nowe Ogrody 1-6, 80-803 Gdańsk, Poland.

Lactose intolerance and constipation are common in children and impact everyday life, not only for patients but also their families. Both conditions can be comorbid with other diseases or form a part of their clinical presentation, but constipation is not usually associated with lactose intolerance. The typical symptoms of lactose intolerance include abdominal pain, bloating, flatus, diarrhoea, borborygmi, and less frequently nausea and vomiting. Read More

FASEB J 2022 May;36 Suppl 1

MetroHealth Medical Center, Cleveland, OH.

Hypothesis: The mechanical and neurological mechanisms contributing to intractable chronic constipation and fecal incontinence are not yet fully understood, in part because of challenges in measuring the slow actions of the bowel. To enable multimodal data collection with a route to endoscopic implantation, we developed the Colonic Monitor of Conscious Activity (ColoMOCA). The ColoMOCA was designed for use with electrophysiology tools and to be affixed to the colon wall. Read More

Sci Rep 2022 May 12;12(1):7838. Epub 2022 May 12.

Department of Proctology, China-Japan Friendship Hospital, No 2 Yinghua East Street, Chaoyang District, Beijing, 100029, China.

This study aimed to compare the efficacy between decompression and drainage seton (DADS) and cutting seton (CS) in the treatment of high complex anal fistula. Patients were randomly assigned 1:1 to DADS or CS group. The primary outcome was the rate of wound healing. Read More

Cir Esp (Engl Ed) 2022 May 7. Epub 2022 May 7.

Unidad Cirugía Colorrectal, Complejo Hospitalario Navarra, Pamplona, Navarra, Spain.

Introduction: Find out the long-term economic cost associated with the treatment of severe fecal incontinence by SNS versus symptomatic conservative treatment and definitive colostomy.

Methods: Detailed descriptive study of the costs of the healthcare process (interventions, consultations, devices, complementary tests, hospitalization, etc.) of 3 treatment alternatives for fecal incontinence using analytical accounting tools of the Health Service based on clinical activity data. Read More

J Pediatr Surg 2022 Apr 23. Epub 2022 Apr 23.

Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, 611 E. Livingston Ave., FB Suite 6B1, 700 Children's Drive, Columbus, OH 43205, USA. Electronic address:

Objective: To assess outcomes of children with functional constipation after antegrade continence enemas (ACEs) and determine if pre operative anorectal manometry (AMAN) findings, including dyssynergic defecation, are associated with outcomes.

Methods: A retrospective review of pediatric patients with functional constipation who received a Malone appendicostomy or cecostomy after failed medical management was conducted. Patients were included if they had AMAN data prior to their operation. Read More

Health Qual Life Outcomes 2022 May 7;20(1):75. Epub 2022 May 7.

ICON Plc, Gaithersburg, MD, USA.

Background: Ulcerative colitis (UC) and Crohn's disease (CD) are associated with a range of symptoms that adversely affect health-related quality of life. This research aimed to develop and validate two patient-reported outcome (PRO) tools to assess signs and symptoms in patients with moderate-to-severe UC or CD.

Methods: PRO-UC and PRO-CD Diaries were developed in accordance with US Food and Drug Administration (FDA) recommendations. Read More

Sci Rep 2022 05 5;12(1):7315. Epub 2022 May 5.

Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.

The objective was to investigate the effect of delivery mode on anal incontinence 1-2 years after delivery in primiparous women with prolonged second stage of labor. This population-based cohort and questionnaire study performed in Stockholm Region, Sweden, included 1302 primiparous women with a second stage ≥ 3 h from December 1st, 2017 through November 30th, 2018. Background characteristics and outcome data were retrieved from computerized records. Read More

Cureus 2022 Apr 1;14(4):e23737. Epub 2022 Apr 1.

Medicine, Najah National University, Ramallah, PSE.

Cloacal malformation (CM) is a severe, complex, and extremely rare category of anorectal and urogenital tract malformations. Prenatal diagnosis is illusory and vague; therefore, magnetic resonance imaging (MRI) is the most effective test point toward an accurate diagnosis. Thus, careful investigation and evaluation are mandatory since they could be associated with syndromes and other anomalies, including urogenital tract, vertebral, and cord abnormalities. Read More

Gastroenterol Hepatol (N Y) 2022 Mar;18(3):169-171

J. Harold Harrison, MD, Distinguished University Chair in Gastroenterology Professor of Medicine Director, Neurogastroenterology & Motility Director, Digestive Health Clinical Research Center Augusta University Medical Center Medical College of Georgia Augusta, Georgia.

Clin Gastroenterol Hepatol 2022 Apr 30. Epub 2022 Apr 30.

Clinical and Translational Epidemiology Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address:

Int Braz J Urol 2022 May 10;48. Epub 2022 May 10.

Unidade de Pesquisa Urogenital, Universidade do Estado do Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brasil.

Introduction: Access represents one of the main challenges in performing posterior urethroplasty (1, 2). Several approaches and tactics have been previously described (3). This video demonstrates the Anterior Sagittal Transrectal Approach (ASTRA), which allows better visualization of the deep perineum (4). Read More

Int Urogynecol J 2022 May 3. Epub 2022 May 3.

Department of Obstetrics, Gynecology, and Reproductive Sciences, The University of Texas Health Science Center, Houston, TX, USA.

Introduction And Hypothesis: The objectives were to determine whether a difference exists in the duration of pelvic floor disorder (PFD) symptoms among patients presenting to urogynecologists in two healthcare systems: private and county; and to elucidate differences in baseline characteristics, type of PFDs, symptom severity and management, stratified by healthcare plans.

Methods: A multi-center retrospective study was conducted including new patients presenting to three urogynecology clinics between March 2016 and May 2018: one private clinic (site A) and two public clinics in the same county healthcare system (sites B and C). Baseline data included age, race, BMI, parity, and comorbidities. Read More

BMJ Open Gastroenterol 2022 May;9(1)

NIHR Innovation Observatory, Newcastle University, Newcastle upon Tyne, UK.

Objective: This rapid priority setting exercise aimed to identify, expand, prioritise and explore stakeholder (patients, carers and healthcare practitioners) topic uncertainties on faecal incontinence (FI).

Design: An evidence gap map (EGM) was produced to give a visual overview of emerging trial evidence; existing systematic review-level evidence and FI stakeholder topic uncertainties derived from a survey. This EGM was used in a knowledge exchange workshop that promoted group discussions leading to the prioritisation and exploration of FI stakeholder identified topic uncertainties. Read More

Front Med (Lausanne) 2022 15;9:863945. Epub 2022 Apr 15.

Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.

Pelvic organ prolapse (POP) affects many women and contributes significantly to a decrease in their quality of life causing urinary and/or fecal incontinence, sexual dysfunction and dyspareunia. To better understand POP pathophysiology, prevention and treatment, many researchers resorted to evaluating animal models. Regarding this example and because POP affects principally older women, our aim was to provide an overview of literature on the possible biomechanical changes that occur in the vaginas of animal models and their supportive structures as a consequence of aging. Read More

Support Care Cancer 2022 Apr 29. Epub 2022 Apr 29.

Division of Clinical Research and Technological Development, INCA, Rio de Janeiro, Brazil.

Background: Neoadjuvant chemoradiotherapy (neoCRT) followed by surgery is the standard of care for locally advanced rectal cancer (LARC), but the emergence of different drug regimens may result in different response rates. Good clinical response translates into greater sphincter preservation, but quality of life (QOL) may be impaired after treatment due to chemoradiotherapy and surgical side effects.

Objective: To prospectively evaluate the impact of clinical response and surgical resection on QOL in a randomized trial comparing two different neoCRT regimens. Read More

J Paediatr Child Health 2022 Apr 29. Epub 2022 Apr 29.

Department of Pediatric Surgery, Pediatric Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

Aim: Many patients with anorectal malformations (ARM) experience a long-lasting problem with faecal incontinence (FI). We assessed the effectiveness of a pelvic floor rehabilitation program including transcutaneous functional electrical stimulation (TFES) in combination with pelvic floor muscle (PFM) exercises on post-surgical FI in children with ARM.

Methods: Data of 40 children at the age of 4 years or older who had undergone surgical correction for ARM and suffered from persistent FI referring for pelvic floor rehabilitation were analysed respectively. Read More

Neurogastroenterol Motil 2022 Apr 25:e14383. Epub 2022 Apr 25.

Division of Gastroenterology and Hepatology, Clinical and Enteric Neuroscience Translational and Epidemiological Research Program (C.E.N.T.E.R.), Mayo Clinic, Rochester, Minnesota, USA.

Background: The optimal methods for measuring and analyzing anal resting and squeeze pressure with high-resolution manometry (HRM) are unclear.

Methods: Anal resting and squeeze pressures were measured with HRM in 90 healthy women, 35 women with defecatory disorders (DD), and 85 with fecal incontinence (FI). Pressures were analyzed with Manoview™ software and a customized approach. Read More

J Ayub Med Coll Abbottabad 2022 Jan-Mar;34(1):8-11

Khyber Teaching Hospital, Peshawar, Pakistan.

Background: VAAFT (Video Assisted Anal Fistula Treatment) is a novel minimally invasive technique for treatment of Fistula in Ano, which claims superior results compared to current treatment modalities due to the added advantage of real time visualization of the fistula tract and internal opening of the fistula using a fistuloscope.

Methods: This is cross sectional study in which 84 patients were selected using consecutive non probability sampling. They underwent VAAFT and were followed to assess for primary healing and continence at 6 weeks, and recurrence at 1 year. Read More

Int J MS Care 2022 Mar-Apr;24(2):81-89. Epub 2021 Jun 15.

Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK (SW, MC, CN).

Background: Bowel dysfunction, including constipation and fecal incontinence, is prevalent in individuals with multiple sclerosis (MS), adversely affecting quality of life and increasing caregiver burden. How health care professionals (HCPs) identify, assess, and manage people with MS with bowel dysfunction is understudied. This study explored how HCPs think about, assess, and manage bowel dysfunction in individuals with MS. Read More

Int J MS Care 2022 Mar-Apr;24(2):67-73. Epub 2021 Jun 10.

Department of Urology, Erasmus Medical Center, Rotterdam, the Netherlands (TvD, IMG, JRS, BFMB).

Background: Neurogenic bowel dysfunction (NBD), like fecal incontinence and constipation, is a common symptom of disease in patients with multiple sclerosis (MS). The NBD score is a validated symptom-based questionnaire consisting of 10 multiple-choice questions. The aim of this study was to validate the Dutch version of the NBD score in patients with MS, creating an objective measuring tool of bowel dysfunction. Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2022 Apr;25(4):348-356

Department of General Surgery, Peking Union Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

To investigate quality of life (QoL) of patients with locally advanced rectal cancer (LARC) who underwent low anterior resection with protective stoma under neoadjuvant therapy mode, and to explore the changes of QoL of patients from before neoadjuvant therapy to 12 months after stoma reversal. A descriptive case series study was carried out. A retrospective study was performed on patients with mid and low LARC who received complete neoadjuvant long course radiotherapy and chemotherapy, followed by radical low anterior resection (LAR) combined with protective stoma at Peking Union Medical College Hospital from December 2017 to January 2020. Read More

Pediatr Blood Cancer 2022 Apr 23:e29739. Epub 2022 Apr 23.

Hematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padua, Italy.

Background/objectives: Rhabdomyosarcoma of the perianal/perineal region (PRMS) is rare, with poor survival and limited understanding of the functional consequences of treatment.

Design/methods: International Society of Pediatric Oncology (SIOP) malignant mesenchymal tumor (MMT) 95, Italian RMS 96, and European paediatric Soft tissue sarcoma Study Group (EpSSG) RMS 2005 studies were interrogated to identify factors that impact survival; in RMS 2005, functional outcomes were analyzed.

Results: Fifty patients (nonmetastatic) were identified, median age 6. Read More

BMC Surg 2022 Apr 21;22(1):147. Epub 2022 Apr 21.

Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, Hirosaki, 036-8562, Japan.

Background: Determine whether robotic surgery is more effective than transanal and conventional laparoscopic surgery in preserving bowel and urinary function after total mesorectal excision (TME).

Methods: Of 79 lower rectal cancer patients who underwent function-preserving TME between 2016 and 2020, 64 patients consented to a prospective questionnaire-based functional observation study (52 responded). At 6 months post-resection or ileostomy closure, Wexner, low anterior resection syndrome (LARS), modified fecal incontinence quality of life, and international prostate symptom scores were used to evaluate bowel and urinary function, comparing robotic surgery (RTME) with transanal (taTME) or conventional laparoscopic surgery (LTME). Read More

Int J Surg 2022 Apr 15;101:106617. Epub 2022 Apr 15.

Department of General, Abdominal and Vascular- and Transplant Surgery, Otto-von-Guericke University Hospital, Magdeburg, Germany. Electronic address:

Introduction: Fecal incontinence refers to the inability to pass stool in a localized and timely manner resulting in the involuntary loss of intestinal contents such as air, intestinal mucus or stool. The prevalence of fecal incontinence in the general population is approximately 2-21%. Women are more frequently affected than men. Read More

Colorectal Dis 2022 Apr 15. Epub 2022 Apr 15.

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Aim: The aim of this study was to investigate whether the application of nanofat containing stem cells improves continence in women who had previously undergone anal sphincteroplasty with unsatisfactory long-term outcomes.

Method: This prospective pilot study included nine women with various degrees of anal incontinence who had previously undergone anal sphincteroplasty due to obstetric trauma. In all patients, the Wexner Incontinence Score (WS) and Faecal Incontinence Quality of Life Score (FIQLS), as well as anal manometry and endoanal ultrasound measurements, were performed before the procedure and during follow-up. Read More

Front Surg 2022 28;9:869923. Epub 2022 Mar 28.

II Surgery Unit, Regional Hospital Treviso, Treviso, Italy.

The treatment of cryptoglandular anal fistula (AF) is often a challenge for surgeons. Several sphincter-saving procedures have been described as an alternative to fistulotomy, with the common goal of promoting healing and preserve anal continence. The aim of this proof of concept study was to assess the outcomes of human amniotic membrane (HAM) implantation in cryptoglandular transphincteric AF. Read More

Ann Coloproctol 2022 Apr 14. Epub 2022 Apr 14.

Department of Colorectal Surgery, Bankstown-Lidcombe Hospital, Bankstown, Australia.

Purpose: Anastomotic leak (AL) is an uncommon but potentially devastating complication after rectal resection. We aim to provide an updated assessment of bowel function and quality of life after AL, as well as associated short- and long-term outcomes.

Methods: A retrospective audit of all rectal resections performed at a colorectal unit and associated private hospitals over the past 10 years was performed. Read More