Search results for "Stipa"

A concise review of opioid-induced esophageal dysfunction: is this a new clinical entity?

2017

Opioids have become the most widely prescribed analgesics in Western countries. Opioid-induced bowel dysfunction is a widely known adverse effect, with constipation the most common manifestation. Most of the opioid-related effects occur in the stomach, small intestine, and colon and have been widely studied. However, the effects related to esophageal motility are less known. Recently published retrospective studies have suggested that long-term use of opioids can cause esophageal motility dysfunction, reflecting symptoms similar to motility disorders, such as achalasia and functional esophagogastric junction outflow obstruction. The most common manometric findings, as reported in the litera…

Constipation severity is associated with productivity losses and healthcare utilization in patients with chronic constipation

2014

OBJECTIVE: We sought to evaluate the association between constipation severity, productivity losses and healthcare utilization in a national sample of Italian patients with chronic non-organic constipation (CC). METHODS: We enrolled 878 outpatients with CC. Clinical and demographic data were collected by physicians during clinical examinations. Patients completed a self-administered questionnaire (Patient Assessment of Constipation-Symptoms, PAC-SYM; Work Productivity and Activity Impairment; healthcare utilization, and Symptoms Checklist 90 Revised - Somatization Scale, SCL-90 R). RESULTS: Mean PAC-SYM score was 1.62 ± 0.69. Mean weekly sick time due to constipation was 2.7 ± 8.6 h and pro…

Is biofeedback therapy an effective treatment for patients with constipation?

2005

Discriminant analysis in diagnosing carcinoma of the pancreas and of the papilla of Vater

1994

The clinical and biochemical presentation of carcinoma of the pancreas (PC) and of the papilla of Vater (CPV) are very similar, and, consequently, detailed investigations are required to correctly distinguish between them. The aim of the present study was to select the clinical and biochemical variables that would most efficiently discriminate the precise site of tumor origin. The study group consisted of 72 patients with PC and 22 patients with CPV consecutively hospitalized in our department. The following clinical parameters were considered: age, asthenia, anorexia, vomiting, weight loss, pain, fever, pruritis, and constipation; the biochemical parameters considered were total, direct, a…

Opioid-induced Lower Esophageal Sphincter Dysfunction

2015

The adverse gastrointestinal effects of opioids have been extensively described in medical literature.1 Their effect takes place mainly on the enteric nervous system, through receptors in the myenteric and submucosal plexuses. There are 3 recognized main opium receptors (μ, δ, and κ) that are expressed in the central and enteric nervous systems, which mediate the gastrointestinal effects.2 The mainly studied adverse gastrointestinal effect of opioids is constipation, due to the greater understanding of opium receptor physiology in the colon.3 However their effect on esophageal motility has seldom been studied. Our study’s objective was to assess esophageal motility, using high-resolution ma…

Akutschmerztherapie in Pädiatrie und Geriatrie – Akutschmerztherapie im Alter –ein ganzheitlicher Ansatz

2011

Post-operative pain management of elderly patients requires special attention. In addition to the organic functional impairments, age-related changes in psychological and social factors play an important role. Also life experiences, painful medical history and a range of different complaints of old age influence the expectations to the treatment of pain. Several factors have to be considered, so 1) age-appropriate preoperative assessment of organic, psychological and social factors, 2) a selection of regularly administered non-opioid, or combination of two different effective non-opioids, notably on the contra-indications and dose limits, 3) if necessary careful titration of the strong opio…

Indications for Performing a Proctologic Examination and Endoscopy

1979

Complaints from the patient about discomfort in the anal region, rectal bleeding, and change in bowel habits — especially recent occurrence of constipation or diarrhea or a change in either symptom — as well as tenesmus are obligatory reasons for conducting a proctologic examination. These symptoms should never be ignored or treated by prescription of hemorrhoid suppositories, antispasmodics, analgesics, or laxatives.

Rektumprolaps bei Erwachsenen - Ursache, Diagnostik, Therapie

2005

Despite progress in modern surgery, the choice of the surgical procedure of rectal prolapse is regarded with controversy. Selection criteria between the abdominal or perineal approach or between rectopexy and resection rectopexy are not yet proven. This article gives a review of the literature about rectal prolapse and an analysis of the outcome of posterior rectopexy and resection rectopexy--partly conventionally and partly laparoscopically--in 25 patients with rectal prolapse III degrees and IV degrees. All except for one patient were examined during a mean follow-up of 5.5 (3.1) years for the rectopexy group and 2.1 (0.7) years for the resection rectopexy group. Recurrence occurred in on…

Hydro-MRT in der Darmdiagnostik bei Kindern

2001

Purpose A clinical evaluation of hydro-MRI as an alternative method to barium studies in children with abdominal pain of unknown origin is presented. Patients and methods 20 children with abdominal pain of unknown origin aged from 9 - 16 years were examined after oral bowel opacification using 1000 ml of 2.5 % mannitol solution with a 1.0 T MRI system. The investigation was done in 2 planes (coronal and axial) under breath-hold conditions. Imaging procedures included various sequences (T2W HASTE + FS, contrast-enhanced T1W FLASH FS). Suspicious findings in bowel segments and extra-intestinal changes were assessed. Results In 21/24 examinations the small bowel was completely visualized, in 1…

Differences Between Conventional Anorectal Manometry and High Resolution/High Definition Anorectal Manometry

2020

The book provides a comprehensive overview of high-resolution and high-definition anorectal manometry (HRAM/HDAM), showing the possible benefits of a wider use of these techniques in clinical practice, as well as their limitations. Although these techniques provide fresh insights into anorectal function and offer a new perspective on the pathophysiologic mechanisms of many defecation disturbances, there is a need to clarify whether their use has beneficial effects on clinical management compared to conventional manometry. There is still a considerable way to go to gain the clinical diffusion of esophageal HRM, which has become the gold standard in studying esophageal motility. Indeed, many …