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Please help improve this article by adding citations to reliable sources. Your style. The way you act. Your actions. Someone says, " man thanks for letting me hold down some loot " "you say hey thats how I roll. That is how I like to do things.
I know I'm always wearing a bathrobe but that's how I roll. Thats how I roll. Whenever you give a reason to an answer. Jane: Can I have some chips? Johnny: No! Jane: Why? Johhny : Cause thats how I roll. A phrase used to defer responsibilityakin to " it is what it is ". Patients reported less faecal incontinence documented by the Wexner scoreless use of anti-diarrhoeal drugs, fewer defecations per day, more consistent faeces and a better quality of life after surgery.
After 4. Does this procedure have a lower incidence of complications? What patients are candidates for this procedure? The greatest improvement in the quality of life was observed in patients with concomitant faecal incontinence[ ]. What is the level of evidence and recommendation grade for this procedure? What is the success or satisfaction rate with the Malone procedure? The data collection methods also varied; they were based on a questionnaire and interview in 4 studies, whereas an interview was conducted in only 3 studies.
What complications have been observed? What is the level of evidence and the recommendation grade for this procedure in patients with constipation? One of these trials was presented only in the form of an abstract at Digestive Diseases Week in [ ] and for this reason was not taken into consideration in the calculation of the mean success rate.
In a recent prospective study at five European sites, sacral nerve stimulation SNS was effective among patients with idiopathic slow and normal transit constipation resistant to conservative treatment. What is the mean success rate of percutaneous nerve evaluation followed, if indicated, by the insertion of a permanent pacemaker? Finally, the multicentre prospective study coordinated by Kamm et al[ ] reported that after a median of 28 mo rangethe frequency of defecations increased from a baseline of 2.
The management of patients affected by obstructed defecation can be challenging because of the frequent association of anatomical and functional anomalies, which makes it difficult to distinguish between the causes and consequences of excessive strain. The complexity of the syndrome and the range of available treatments make the outcome of the therapy unpredictable[ ]. Surgery is usually considered for patients with reparable anatomical defects, concomitant pathologies, or symptoms that severely impact their quality of life[ ].
Surgical treatment is indicated in cases of reparable anatomical defects, severe symptoms, symptoms leading to a poorer quality of life, or concomitant pathologies. The obstructed defecation syndrome ODS score is a tool designed to evaluate patients suffering from pure outlet obstruction without slow transit or mixed forms of constipation.
The ODS provides an index of the disease severity and can be used to monitor the efficacy of therapy[ ]. Other tools, such as the Constipation Scoring System[ ] and the KESS Score[ ], are not specific for ODS but can be employed to study other forms of constipation; some items in these scores are not influenced by the therapy[ ]. There are two approaches - abdominal rectopexy and trans-anal STARR or Delorme transrectal excision - to surgically correct internal intussusception: Which is Cant Define It - Thompson Rollets - 1986-1993 (CD) on the basis of the clinical evidence?
The results of rectopexy are uncertain. Other studies report that resection and rectopexy improve the symptoms relating to intussusception and coexisting anatomical and functional pathologies of the pelvic floor, such as enterocele, solitary ulcer of the rectum, incontinence and descending perineum syndrome[ ]. In a multicenter randomised study of patients, an actuarial analysis demonstrated a significant difference in 5-year recurrence rates between no-rectopexy and rectopexy groups 8.
A ventral instead of posterior mobilisation and fixation of the mesh have recently been advocated and popularised. Excellent results have been claimed, but no randomised comparative trials have been conducted thus far[ - ].
Although there are no studies comparing the two different approaches, there is a tendency in the literature to perform this operation laparoscopically because of the potential of this approach to shorten hospital stays, decrease the incidence of abdominal wound complications and improve cosmesis. The indications for surgery and the choice of procedure are still being debated, and a clear correlation between the correction of the anatomical problem and the improvement of symptoms has not yet been demonstrated[ ].
Surgery should only be considered when conservative therapy has failed. Options include trans-vaginal posterior colporraphy and trans-rectal or trans-perineal repair[ ]. In terms of an improvement in symptoms, Arnold et al[ ] did not find any difference between the trans-anal and the trans-vaginal approaches.
Post-surgical complications include faecal incontinence and sexual dysfunction. Numerous surgical procedures using different approaches abdominal, vaginal, trans-anal or perineal are available for the treatment of ODS, but none has been identified as the gold standard[ ].
Slow colonic transit is often observed in patients with a symptomatic rectocele. The obstructed defecation in these patients does not appear to exclusively result from the rectocele Level V evidence.
Although improved rectal emptying may be observed after surgical correction, this effect is not likely to affect colonic function. It has been demonstrated that patients with poor functioning after repair of the rectocele still have a prolonged colonic transit time[ ]. Furthermore, patients with a slow transit time before the operation show little improvement after surgery[ ] Level V evidence. This study showed a reduction of the ODS score in However, other options, such as pelvic floor rehabilitation or the internal Delorme procedure[ ], could be considered instead to prevent any potential risk associated with the stapling procedure.
All of the symptoms relating to obstructed defecation improved following both procedures. Abdominal rectopexy with sigmoidectomy and plain rectopexy with mesh are safe and effective procedures for the treatment of complete rectal prolapse[ ]. Is abdominal rectopexy with sigmoidectomy associated with higher rates of morbidity than simple rectopexy in patients with complete rectal prolapse?
Should this procedure be Cant Define It - Thompson Rollets - 1986-1993 (CD) in cases of slow transit constipation or only in patients with dolicocolon? Sigmoid resection with rectopexy is effective in reducing post-operative constipation arising from outlet obstruction without increasing the rate of morbidity[ ].
SNS may be effective in the treatment of chronic constipation when other approaches have failed[ ]. In a recent prospective study at five European sites, SNS was effective in patients with idiopathic slow and normal transit constipation who failed conservative treatment.
Solitary rectal ulcer may be associated with paradoxical contraction of the puborectal muscle, recto-anal intussusception, rectal prolapse and descending perineum syndrome. Treatment of this condition must be conservative. The procedure selected must be safe and balance the risk of morbidity with an acceptable recurrence rate[, ]. The surgical options include repair of the rectal prolapse with or without resection of the lesion, although the long-term results of this procedure were found to be uncertain.
Anterior resection and proctocolectomy have shown satisfactory long-term results[ ], Cant Define It - Thompson Rollets - 1986-1993 (CD). Surgery is indicated for symptomatic patients with third-degree sigmoidocele below the ischiococcygeal line or patients who require other pelvic surgery with an abdominal or vaginal approach hysterectomy, rectal prolapse, rectocele repair.
The surgery consists of sigmoid resection and rectopexy with obliteration of the Douglas pouch. There has been considerable debate regarding the surgical treatment for megarectum. In megarectum with megacolon, colectomy and ileo-rectal anastomosis is the procedure with the best functional results and the lowest morbidity[ ]. In patients who do not experience satisfactory results, total proctocolectomy and ileo-pouch-anal anastomosis is the treatment of choice to avoid permanent ileostomy Level V evidence.
In idiopathic megarectum, this procedure is associated with the persistence of symptoms and often with the need for a repeat operation[ ]. A posterior colpocele in pelvic organ prolapse POP may be linked to anatomical conditions such as a rectocele, enterocele or sigmoidocele[ ]. The literature is sparse on this point. A significant correlation was noted between constipation and posterior genital prolapse Level IV evidence.
Similar data have been reported by other authors[ - ]. At present we do not know whether constipation is a symptom caused by anatomic functional defects of the pelvic floor[ ], or whether it is the cause of static and dynamic changes in the pelvis. Pudendal neuropathy arising from stretching of the pudendal nerve while straining in patients with chronic constipation[ ] Level III evidence may explain the prolapse of the posterior wall and the overall weakening of the pelvic floor Level IV evidence.
According to DeLancey[ ], the tonic contraction of the levator ani, the perineal membrane and the endopelvic fascia provide the main support for the posterior vaginal wall. Under physiologic conditions, the levator ani has a double vector. The muscle exerts forward force closing the vaginal walls and then extends downward to the perineal body, supported by the perineal membrane, which anteriorly is anchored to the ischiopubic branches.
This compensating balance eliminates any traction on the endopelvic fascia corresponding to the middle third of the vagina or DeLancey level II. Pudendal neuropathy reduces the strength of the levator ani, and the downward vector will tend to be toward the posterior vaginal wall rather than the perineal body.
A weak endopelvic fascia leads to posterior vaginal wall prolapsed, which may explain both the high and low rectoceles involving the middle vagina and the perineal body, respectively. Increasingly, prostheses are replacing fascial surgery in the treatment of POP. The synthetic prosthesis is set in a tension-free position and connected to structures such as the obturator membrane, the arcus tendineous of the pelvic fascia, the sacrospinous ligaments or the perineal body.
However, the efficacy and safety of the prostheses used for the posterior vaginal wall have not yet been established[ ] Level II evidence. Surgical treatment for rectocele has been evaluated in 4 randomised studies Cochrane Review, [ - ]. The transvaginal approach was associated with the lowest number of recurrences, the use of biologic prostheses did not reduce the recurrence rate, and there was no significant difference between trans-anal and trans-vaginal procedures in terms of effects on defecation.
Few studies have considered the effect of surgery for posterior colpocele on posterior compartment dysfunction. The presumption that a dysfunction such as constipation can be treated simply by correcting an anatomic defect is probably incorrect.
We do not yet understand the pathophysiology of these conditions, particularly with respect to the role of the CNS and ENS. The severity of the obstructed defecation is also not correlated with the results of the pelvic organ prolapse quantification[ - ] or to the anatomic-functional data provided by defecography[ ] Level V evidence, Grade C recommendation.
Voltocele affects The incidence of enteroceles after hysterectomy is between 0. Voltocele is caused by damage to the supporting uterosacral and cardinal ligaments. Enterocele, a herniation of the Douglas pouch between the vagina and the rectum, is caused by damage to the perineal membrane, which supports the posterior vaginal wall and connects the ischiopubic branches to the perineal body Level V evidence .
The levator ani muscle is also important because it is connected to the middle of the vagina by the endopelvic fascia. Three procedures designed to prevent enterocele and posterior colpocele after hysterectomy, i. Many techniques have been proposed to correct a voltocele associated with an enterocele. In a Cochrane review of 22 controlled randomised studies, abdominal sacrocolpopexy appeared to be superior to the transvaginal approach vault sacrospinous fixationwith fewer recurrences and less dyspareunia[ ], but it is a longer and more painful procedure that involves a longer hospital stay and higher costs[ ].
No data are available on the effects of these procedures on constipation. This section will focus on the treatment of this condition. The first part of the paper was published in the World Journal of Gastroenterology April 14 ISSN and describes the materials and methods used to generate these recommendations. National Center for Biotechnology InformationU. Journal List World J Gastroenterol v.
World J Gastroenterol. Published online Sep Author information Article notes Copyright and License information Disclaimer. Renato Bocchini, Gastroenterology Unit, M. Bufalini Hospital, Cesena, Italy. All rights reserved. This article has been cited by other articles in PMC. Abstract The second part of the Consensus Statement of the Italian Association of Hospital Gastroenterologists and Italian Society of Colo-Rectal Surgery reports on the treatment of chronic constipation and obstructed defecation.
Keywords: Laxatives, Prokinetics, Biofeedback, Pelvic floor rehabilitation, Outlet obstruction, Stapled trans-anal rectal resection, Delorme operation, Colectomy, Pelvic organ prolapse, Mesh.
Behavioural modification Recommendations for lifestyle changes in patients with chronic constipation are based on the widespread Cant Define It - Thompson Rollets - 1986-1993 (CD) that constipation is associated with low physical activity, reluctance to defecate whenever the need is felt, and poor fluid intake.
Can behavioural changes help the patient with chronic constipation? Table 1 Classes of drugs used to treat chronic constipation. Open in a separate window.
Bulking laxatives Bulking laxatives consist of fibre. What evidence is there for the effectiveness of added fibre intake? Trials of insoluble fibre There have been only two well-conducted placebo-controlled trials of insoluble fibre[ 18 ]; the first used bran and the second used rye bread. Trial of soluble fibre Placebo-controlled trials of psyllium: Psyllium fibre is partially soluble and is the most studied type of fibre.
Osmotic laxatives Osmotic laxatives attract water into the colon by osmosis. How effective are osmotic laxatives? Stimulant laxatives Stimulant laxatives are not absorbed and have a prokinetic effect in the colon; they stimulate the production of secretions and reduce the absorption of water and electrolytes.
How effective are the stimulant laxatives? Softening laxatives Softening laxatives make the stool softer by forming an emulsion of the faeces with lipids and water. What evidence is there for the effectiveness of softening laxatives? Serotoninergic enterokinetic agents Serotonin 5-HT is a critical component in the regulation of gut motility, visceral sensitivity, and intestinal secretion.
What evidence is there for the effectiveness of these drugs? Prosecretory agents Prosecretory agents stimulate the secretion of fluid into the intestinal lumen by activating intestinal chloride channels lubiprostone or the guanylate-cyclase receptors of enterocytes linaclotide. What evidence is there for the effectiveness of the prosecretory agents? Probiotics Probiotics are orally administered living microorganisms that can reach and colonise the bowel.
How effective are probiotics in the treatment of chronic constipation? Colchicine Colchicine is effective in the treatment of a variety of inflammatory syndromes. Procedures to empty the rectum and sigmoid colon There is no controlled randomised trial in the literature addressing the chronic use of suppositories or enemas, which are commonly used for relief from occasional constipation and to empty the rectum in bedridden patients or those with impacted faeces.
What is the evidence confirming the effectiveness of transanal irrigation in chronic constipation? Table 2 Levels of evidence and grades of recommendation of medical treatment in chronic constipation. At what point and on what grounds should we judge a treatment to be ineffective? When should RT be prescribed for obstructed defecation? What is the recommended RT for obstructed defecation? Is RT the first therapeutic option? Is RT Cant Define It - Thompson Rollets - 1986-1993 (CD) effective than drug therapy?
What factors may influence the efficacy of RT? Does surgery make RT superfluous? How should patients who do not respond to RT be managed? Should RT be prescribed before or after ano-rectal surgery? What are the medium- and long-term effects of RT? Total or subtotal colectomy with ileorectal anastomosis What are the levels of evidence and grades of recommendation for this procedure? Post-operative complications What is the incidence of small bowel obstruction, diarrhoea, faecal incontinence and abdominal pain, and what is the re-operation rate?
Segmental colectomy Can segmental colectomy lead to better functioning? Malone antegrade continence enema What patients are candidates for this procedure? Sacral nerve stimulation What is the level of evidence and the recommendation grade for this procedure in patients with constipation? Indications for surgery in constipation arising from obstructed defecation Surgical treatment is indicated in cases of reparable anatomical defects, severe symptoms, symptoms leading to a poorer quality of life, or concomitant pathologies.
What criteria are there for evaluating treatment efficacy severity score, defecography, quality of life? Sutureless rectal mobilisation, suture rectopexy, and mesh rectopexy: Which is better? Laparoscopy or laparotomy for rectopexy? Which approaches to repair a rectocele trans-anal, trans-vaginal, perineal, etc. Is there a technique that can be considered the gold standard for the treatment of ODS? In cases of ODS arising from rectal intussusception or rectocele, can stapled trans-anal prolapsectomy with perineal levatorplasty alleviate the symptoms?
What procedure should be performed in cases of complete rectal prolapse? When surgery is indicated for solitary rectal ulcer syndrome, what procedure should be adopted? When is surgery indicated for sigmoidocele? What is the best surgical treatment for megarectum with or without megacolon? Is there a correlation between POP and chronic constipation?
How does the physiopathologic correlation between POP and obstructed defecation contribute to posterior colpocele and rectocele? What are the most recent anatomical and functional developments in pelvic reconstructive surgery? Does obstructed defecation improve after the correction of a posterior colpocele with mesh?
What is the recommended surgical procedure for post-hysterectomy voltocele? References 1. Constipation in the elderly living at home. Definition, prevalence, and relationship to lifestyle and health status. J Am Geriatr Soc.
Effects of acute graded exercise on human colonic motility. Am J Physiol. Effects of regular physical activity on defecation pattern in middle-aged patients complaining of chronic constipation.
Scand J Gastroenterol. The call to stool and its relationship to constipation: a community study. Eur J Gast Hepatol. Effect of increased fluid intake on stool output in normal healthy volunteers. J Clin Gastroenterol.
Myths and misconceptions about chronic constipation. Am J Gastroenterol. Systematic review on the management of chronic constipation in North America. Johanson JF, Kralstein J. Chronic constipation: a survey of the patient perspective. Aliment Pharmacol Ther. Glia A, Lindberg G. Quality of life in patients with different types of functional constipation.
Health-related quality of life in functional GI disorders: focus on constipation and resource utilization. Wald A. Chronic constipation: advances in management. Neurogastroenterol Motil. Why is it so difficult to define constipation? Constipation: a different entity for patients and doctors. Fam Pract. Clinical utility of diagnostic tests for constipation in adults: a systematic review.
Functional bowel disorders. Functional anorectal disorders. World Gastroenterology Organisation global guideline: Constipation--a global perspective. Systematic review: the effects of fibre in the management of chronic idiopathic constipation.
Effect of wheat bran in treatment of chronic nonorganic constipation. A double-blind controlled trial. Dig Dis Sci. A combination of fibre-rich rye bread and yoghurt containing Lactobacillus GG improves bowel function in women with self-reported constipation. Eur J Clin Nutr. Water supplementation enhances the effect of high-fiber diet on stool frequency and laxative consumption in adult patients with functional constipation. Mantle J. Research and serendipitous secondary findings.
Can Nurse. Effects of psyllium therapy on stool characteristics, colon transit and anorectal function in chronic idiopathic constipation. A general practice study of the efficacy of Regulan in functional constipation. Br J Clin Pract. Mechanisms of constipation in older persons and effects of fiber compared with placebo. Comparative laxation of psyllium with and without senna in an ambulatory constipated population. Dettmar PW, Sykes J. A multi-centre, general practice comparison of ispaghula husk with lactulose and other laxatives in the treatment of simple constipation.
Curr Med Res Opin. Bass P, Dennis S. The laxative effects of lactulose in normal and constipated subjects. Cant Define It - Thompson Rollets - 1986-1993 (CD) of chronic constipation with lactulose syrup: results of a double-blind study. Sanders JF. Lactulose syrup assessed in a double-blind study of elderly constipated patients.
Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation. Lactulose versus Polyethylene Glycol for Chronic Constipation. Cochrane Database Syst Rev. A comparison of Agiolax and lactulose in elderly patients with chronic constipation. Safety and efficacy of a bulk laxative containing senna versus lactulose in the treatment of chronic constipation in geriatric patients. Chronic constipation in long stay elderly patients: a comparison of lactulose and a senna-fibre combination.
An open, randomised, parallel group study of lactulose versus ispaghula in the treatment of chronic constipation in adults.
Cost-effective treatment of constipation in the elderly: a randomized double-blind comparison of sorbitol and lactulose. Am J Med. Kinnunen O, Salokannel J. Constipation in elderly long-stay patients: its treatment by magnesium hydroxide and bulk-laxative. Ann Clin Res. Hypermagnesemia-induced paralytic ileus. Andorsky RI, Goldner F. Colonic lavage solution polyethylene glycol electrolyte lavage solution as a treatment for chronic constipation: a double-blind, placebo-controlled study.
Small volume isosmotic polyethylene glycol electrolyte balanced solution PMF in treatment of chronic nonorganic constipation. Long term efficacy, safety, and tolerabilitity of low daily doses of isosmotic polyethylene glycol electrolyte balanced solution PMF in the treatment of functional chronic constipation.
A randomized, placebo-controlled, multicenter study of the safety and efficacy of a new polyethylene glycol laxative. New polyethylene glycol laxative for treatment of constipation in adults: a randomized, double-blind, placebo-controlled study.
South Med J. Comparison of efficacy and safety of two doses of two different polyethylene glycol-based laxatives in the treatment of constipation. A randomized, multicenter comparison of polyethylene glycol laxative and tegaserod in treatment of patients with chronic constipation.
Long-term efficacy and cost-effectiveness of polyethylene glycol plus electrolytes in chronic constipation: a retrospective study in a disabled population. The role of intestinal bacteria in the transformation of sodium picosulfate. Jpn J Pharmacol. Multicenter, 4-week, double-blind, randomized, placebo-controlled trial of sodium picosulfate in patients with chronic constipation.
Oral bisacodyl is effective and well-tolerated in patients with chronic constipation. Clin Gastroenterol Hepatol. Curr Med Res Opin ; 2 — Is chronic use of stimulant laxatives harmful to the colon? Constipation prevention: empiric use of stool softeners questioned. Dioctyl sodium sulphosuccinate as a laxative in the elderly.
Aug 14, · Ron Thompson with Poor House Bistro Allstars Big Easy Festival - Duration: Bobbi Goodman 4, views. Ron Thompson - Baby Please Don't balnalatelesupprosivadisbere.coinfo - . Aug 11, · balnalatelesupprosivadisbere.coinfo Supplier Search - Supplier discovery platform for procurement professionals, engineers, plant & facility management personnel, small business owners and other occasional buyers. Apr 20, · Alex Thompson – We wanted this film to have a score that was as original and inspirational as the trip itself. So, it totally made sense to bring the musician along! Alex is a . In fact, both augen and granitic gneisses do not define real trends but rather plot on the medium-K to high-K calc-alkaline trends. Consequently, they are clearly different from typical Archean TTG, which have low-K affinity (Martin, , ). This album is from , which I had on vinyl, and felt the need to have on CD. The title track is a good example of whats to come later - Rock with a little R&B/Funk mixed in. It also has a ballad called "One More Morning" which starts with Vocal and Piano that shows the diversity of Steve Winwood/5(). Thompson Rollets // Publié le 11 décembre par Surchauffe. Entre l'album "Thompson Rollets, Brutal Deluxe", paru en , Thompson Rollets-Can't define it Thompson Rollets-Rollets blues (yeah yeah Thompson Rollets) Retour à La Une de. Tweet. History Formation and move to UK. The group, whose style was based upon the sounds of Sun Records artists and other artists from the s, were heavily influenced by Eddie Cochran, Carl Perkins, Gene Vincent, and Bill Haley & His Comets. The Stray Cats quickly developed a large following in the New York music scene playing at CBGB and Max's Kansas City as well as venues on Long Island. Mar 02, · Excellent cd! Buy it, you will like it! I recommend this new country singer as a great addition to your library! Read more. Helpful. Comment Report abuse. Alesha Howard. out of 5 stars fun song. Reviewed in the United States on March 27, Verified Purchase. fun sweet song to listen to. Easton is a great singer and would recommend this /5(18). Jan 01, · Check out Roll Over by The Thompson Twins on Amazon Music. Stream ad-free or purchase CD's and MP3s now on balnalatelesupprosivadisbere.coinfo5/5(3). View credits, reviews, tracks and shop for the Vinyl release of Roll Over on Discogs.
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