Importance of colonic transit evaluation in the management of fecal incontinence

Bouchoucha, Michel; Devroede, Ghislain; Faye, Alain; Arsac, M

doi:10.1007/s00384-002-0428-1

Cited by 26 publications

(10 citation statements)

References 38 publications

(24 reference statements)

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“…Altogether, the work of Bouchoucha et al [1] is a very important contribution. Colonic transit time measurement is far too often forgotten.…”

Section: Anton J Kroesenmentioning

confidence: 98%

“…Bouchoucha et al [1] simplify this problem to one of moderate and severe incontinence, although numerous other authors have composed many reports on different incontinence scores. If the very complicated problem of incontinence is examined by a method of still doubtful sensitivity and specificity, such as measuring radiographic colonic transit time, and is treated by approaches that are not particularly promising, such as medical treatment and biofeedback training, the changes in continence should at least be documented by a more sophisticated score.…”

mentioning

confidence: 98%

“…Only after the exclusion of all other reasons for incontinence can conservative treatment be initiated by biofeedback training or, as Bouchoucha et al [1] postulate, by medical regulation of colonic transit time. Hence prior to every conservative treatment a detailed diagnostic exclusion is essential.…”

mentioning

confidence: 98%

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Importance of colonic transit evaluation in the management of fecal incontinence

Kroesen

2002

Int J Colorectal Dis

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“…Altogether, the work of Bouchoucha et al [1] is a very important contribution. Colonic transit time measurement is far too often forgotten.…”

Section: Anton J Kroesenmentioning

confidence: 98%

mentioning

confidence: 98%

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Importance of colonic transit evaluation in the management of fecal incontinence

Kroesen

2002

Int J Colorectal Dis

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“…Small intestinal transit time is more reproducible and has a range of about 3 -4 h [1,61]. Colonic transit time, on the other hand, is highly variable and is typically 10 -20 h [62][63][64].…”

Section: Physiological Parametersmentioning

confidence: 99%

Drug release from matrix tablets: physiological parameters and the effect of food

Nokhodchi

Asare-Addo

2014

Expert Opinion on Drug Delivery

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Introduction: As dissolution plays an important and vital role in the drug-delivery process of oral solid dosage forms, it is, therefore, essential to critically evaluate the parameters that can affect this process. Areas covered:The consumption of food as well as the physiological environment and properties of the gastrointestinal tract, such as its volume and composition of fluid, the fluid hydrodynamics, properties of the intestinal membrane, drug dose and solubility, pK a , diffusion coefficient, permeability and particle size, all affect drug dissolution and absorption rate. There are several dissolution approaches that have been developed to address the conditions as experienced in the in vivo environment, as the traditional dissolution being a quality control method is not biorelevant and as such do not always produce meaningful data. This review also describes the development of a systematic way that differentiates between robust and non-robust formulations by varying the effects of agitation and ionic strength through the use of the automated United States Pharmacopeia type III Bio-Dis apparatus. Expert opinion:With the improved understanding of the physiological parameters that can affect the oral bioperformance of dosage forms, strides have, therefore, been made in making dissolution testing methods more bio-logically based with the view of obtaining more in vitro--in vivo correlations.Keywords: agitation rate, biodissolution, drug release, effect of food, hydrophilic matrices, ionic strength Highlights -Understanding all the physiological parameters can serve as a basis for designing dissolution testing methods and systems that can more fully represent the gastrointestinal (GI) tract in humans and allow more in vitro-in vivo (IVIVC) correlations to be obtained thereby improving the oral bioperformance of dosage forms.-Simulation of GI conditions is essential to adequately predict the in vivo behaviour of drug formulations.-The choice of appropriate media for in vitro tests is crucial to their ability to correctly forecast the food effect in pharmacokinetic studies.-Several methods of dissolution testing have been conducted and are still ongoing that seek to further understand and develop media and dissolution methods to better represent the in vivo conditions and to aid in the better prediction of in vivo drug release.-Systematic change of agitation method and ionic strength evaluation may be used as additional tools in allowing for the identification of potential fed and fasted effects on drug release from hydrophilic matrices in the drive for developing dissolution methodologies that are more relevant in helping to achieve more IVIVC.

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“…Tag eine Röntgenübersichtsaufnahme des Abdomens angefertigt und vom Patienten ein Stuhltagebuch geführt. Die retinierten Pellets wurden lokalisiert, gezählt und mit dem Stuhlprotokoll abgeglichen [3].…”

Section: Untersuchungstechnikenunclassified

Korrelation von Symptomen und objektiven Befunden bei Patienten mit Beckenbodendysfunktionen

Bussen¹,

Sailer²,

Thiede³

et al. 2007

Coloproctol

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Zusammenfassung Fragestellung: Ziel dieser Arbeit war es zu ermitteln, welcher Zusammenhang zwischen der Symptomatik von Patienten mit Darmentleerungsstörungen und nachweisbaren morphologischen Veränderungen besteht. Patienten und Methodik: In dieser Studie wurden retrospektiv die Befunde von 116 Patienten analysiert, die sich zur Abklärung einer Darmentleerungsstörung vorstellten. Bei allen Patienten wurden folgende Untersuchungen durchgeführt: klinisch-proktologische Untersuchung, Prokto-und Rektoskopie, Defäkographie, anorektale Endosonographie, Sphinktermanometrie, Röntgendoppelkontrastuntersuchung des Kolons und Kolontransitzeitmessung. Ergebnisse: Durch eine klinisch-proktologische Untersuchung wurde bei 96% der Patienten ein pathologischer Befund wie Marisken, Narben, Rektozelen, Rektumprolaps oder Descensus perinei diagnostiziert. Mittels Defäkographie konnte gezeigt werden, dass 74% der untersuchten Patienten mit einer Beckenbodendysfunktion Rektozelen aufwiesen. Der anorektale Winkel lag bei 35% der untersuchten Patienten außerhalb des Normbereichs. Die endosonographisch darstellbaren anatomischen Strukturen zeigten bei 57% Auffälligkeiten. Bei 29% des Studienkollektivs ergab sich ein auffälliger manometrischer Befund. Mit Hilfe der Röntgendoppelkontrastuntersuchung des Kolons wurde bei 70% der untersuchten Patienten ein Colon elongatum oder ein Sigma elongatum nachgewiesen. Bei 58% des Studienkollektivs war eine pathologische Kolontransitzeit darstellbar. Schlussfolgerung: Bei der überwiegenden Anzahl untersuchter Patienten mit Symptomen einer Darmentleerungsstörung ermöglichen eine sorgfältige Anamneseerhebung und eine routinierte klinisch-proktologische Untersuchung die zuverlässige Detektion pathologischer Befunde. Durch weitergehende apparative Diagnostik lässt sich nur vereinzelt ein zusätzlicher Erkenntnisgewinn erzielen.

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Importance of colonic transit evaluation in the management of fecal incontinence

Abstract: We conclude that evaluation of CTT is useful in the management of fecal incontinence, and that medical therapy is sufficient to treat most incontinent patients. This implies the use of a careful selection algorithm prior to surgery for fecal incontinence.

Cited by 26 publications

References 38 publications

Importance of colonic transit evaluation in the management of fecal incontinence

Importance of colonic transit evaluation in the management of fecal incontinence

Drug release from matrix tablets: physiological parameters and the effect of food

Korrelation von Symptomen und objektiven Befunden bei Patienten mit Beckenbodendysfunktionen

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