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REPELLIN, PHILIPPE. "Rectocele et constipation : traitement chirurgical." Lyon 1, 1988. http://www.theses.fr/1988LYO1M376.
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Preston, David Michael. "The chronic constipation of young women." Thesis, King's College London (University of London), 1985. https://kclpure.kcl.ac.uk/portal/en/theses/the-chronic-constipation-of-young-women(72636ff6-ebe9-4aee-b0bf-db57a4b22a5d).html.
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Cheng, Chung Wah. "Chinese herbal medicine for functional constipation." HKBU Institutional Repository, 2009. http://repository.hkbu.edu.hk/etd_ra/1090.
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Lee, Eun Jin. "THE EFFECT OF ACUPRESSURE ON CONSTIPATION, QUALITY OF LIFE, AND DEPRESSIVE SYMPTOMS IN CANCER PATIENTS WITH CONSTIPATION." UKnowledge, 2010. http://uknowledge.uky.edu/gradschool_diss/14.
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Constipation is the most common gastrointestinal complaint in the United States, resulting in about 2 million annual visits to the doctor.
The purposes of this dissertation were to: 1) describe four theories of traditional Korean medicine; 2) review mechanisms of acupuncture and moxibustion and develop a conceptual model; 3) review findings from randomized controlled trials that tested the effects of acupressure used for the management of symptoms such nausea, pain, and dyspnea; 4) examine the reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) in heart failure patients with constipation compared to those with gastrointestinal disease; 5) describe how Korean women experienced constipation and how constipation affected the quality of life and the experience of using complementary and alternative medicine for constipation; 6) test the effect of acupressure on constipation and to examine the quality of life and depressive symptoms in cancer patients with constipation.
Meridian theory explains that acupressure stimulates meridians, a network of energy pathways in the body to increase the flow of bio-energy. Authors of 48 studies supported that acupressure reduced nausea and vomiting during pregnancy, pain, fatigue, and dyspnea.
The Patient Health Questionnaire-9 (PHQ-9) was used to examine the depressive symptoms in cancer patients with constipation, but has not been tested in patients with constipation. Therefore, in this study, the psychometric properties of PHQ-9 were tested in patients with constipation. Cronbach’s alphas for the Patient Health Questionnaire were .89 and the correlation between the PHQ-9 and the BDI-II (Beck Depression Inventory) was .81 (p<.01) in 382 heart failure patients with constipation.
Ten Korean women reported that living with constipation is a stressful and uncomfortable experience which impacts daily activity, lifestyle, social relationships, and diet.
In this pilot study, three out of five patients in the acupressure group reported that acupressure was effective in improving constipation. Cancer patients with less than a four-month history of constipation had less depressive symptoms and higher quality of life compared to patient with more than a four-month history of constipation. In conclusion, acupressure can be a safe and cost effective alternative medicine for constipation.
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MICHELLAND, OLIVIER. "Contribution a l'etude de la constipation terminale." Clermont-Ferrand 1, 1990. http://www.theses.fr/1990CLF13828.
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Berg, Maartje-Maria van den. "Childhood constipation abnormalities in the colorectal function /." [S.l. : Amsterdam : s.n.] ; Universiteit van Amsterdam [Host], 2007. http://dare.uva.nl/document/48517.
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Knowles, Charles H. "Slow transit constipation : clinical and aetiological studies." Thesis, Queen Mary, University of London, 2000. http://qmro.qmul.ac.uk/xmlui/handle/123456789/1515.
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Constipation is the second most commonly self-reported gastrointestinal symptom. On the basis of anorectal physiological investigations and colonic transit studies, a subgroup of patients with several intractable symptoms, but without organic disease will be found to have slow transit constipation (STC). STC is a condition of gut dysmotility which predominantly affects young women, and may result in surgical intervention with variable, often unsatisfactory results. The aetiology remains elusive. New aetiological hypotheses for STC were examined following full clinical and pathophysiological characterisation of a large cohort of 130 patients referred to our institution over the last 10 years. Aspects of nerve and muscle dysfunction were studied. A new scoring system demonstrated some ability of multiple symptoms to discriminate STC from other forms of constipation. Detailed clinical and gastrointestinal physiological studies confirmed the heterogeneity of STC patients. Some significant physiological differences were detectable between clinically defined sub-groups of patients and refuted previous assumptions based on smaller numbers. Detailed neurophysiological studies, including quantitative peripheral sensory and autonomic testing, provided evidence of a small fibre neuropathy in a proportion of patients with STC. Mutational screening of some early-onset cases for a possible congenital pathogenetic mechanism, based on the observation that some STC patients had relatives with Hirschsprung's disease demonstrated that mutation of 2 important genes now implicated in this disorder were not a frequent cause of STC. Serum immunoprecipitation assays showed that anti-neuronal ion channel autoantibodies may have an as yet unrecognised role in the development of STC in a small proportion of acquired cases. An inclusion body myopathy was identifiable in colonic tissue of patients with STC, and this appeared to arise secondary to denervation. Further knowledge of the single or multiple pathogenetic mechanisms leading to this clinical condition may allow more rational or directed therapies aimed at the correction of the disease process or processes themselves.
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Hogan, Georgiana, Janice Lazear, Jean Croce Hemphill, Catherine Hebert, and Emily Wood. "Constipation in the Long-Term Care Resident." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/asrf/2020/presentations/4.
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An evidence-based clinical practice guideline was developed to prevent and manage constipation in the long-term care (LTC) resident. Constipation is a prevalent condition in the LTC resident. Guidelines do not address this vulnerable population. Constipation may result in poor nutritional status, quality of life along with increased health care costs and hospitalizations. A literature review was completed and evidence was evaluated and included into the initial draft recommendations. The guideline was reviewed for content validity using a Delphi Committee of clinical experts in gastroenterology, geriatrics, and pharmacy. The updated guidelines were presented to an interdisciplinary team of long-term care residents. Participants were asked to review and complete a survey regarding clinical applicability of the guideline. Thirty-one interdisciplinary members participated in the education session and 30 surveys were received. Overall, the interdisciplinary team members agreed or strongly agreed the guideline was clinically applicable. Finally, the guideline was evaluated by a group of doctoral prepared practicing nurse practitioners using the AGREE II instrument. The scores were >80% in every domain, with an overall score of 91%, indicating the guideline is high in quality. Development of this guideline signifies an initial step in the management and prevention of constipation in the LTC resident.
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Werth, Barry Lewis. "Constipation and Laxative Use in the Community." Thesis, The University of Sydney, 2019. https://hdl.handle.net/2123/21314.
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Introduction Constipation is a common health problem, often self-diagnosed and self-managed with laxatives without healthcare professional involvement. To improve diagnosis and management, it is important to understand constipation prevalence, associated factors, and laxative utilisation among community-dwelling adults. Aim The research aimed to determine the prevalence of constipation and laxative use, to investigate factors associated with constipation and describe laxative utilisation in Australia. Methods The first part explored constipation and laxative use in the general adult population. A cross-sectional survey was conducted online using a large nationally representative sample. The study focused on constipation prevalence, associated factors and laxative utilisation as well as examining the impact of constipation definitions on prevalence. The second part explored constipation and laxative use in an older adult cohort. Using Australian Longitudinal Study of Ageing data, the prevalence of constipation, associated factors and laxative use were examined over time. Results The online survey was completed by 2,024 participants. The constipation definition had considerable impact on prevalence estimates. As per Rome III criteria, 24% of participants had chronic constipation. Ten factors were significantly associated with it. One third (37%) reported using laxatives for either constipation treatment or prevention with 56% using laxatives recommended by healthcare professionals. In the older adult study, 239 participants were followed for 11 years. Self-reported constipation (14% to 21%) and laxative use (6% to 15%) increased over this period. Conclusion Constipation and laxative use are common among community-dwelling adults. Increased healthcare professional involvement in diagnosis and management, particularly laxative choice and use, may improve health outcomes. Development of guidelines addressing laxative use for both treatment and prevention should be considered.
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McCrea, G. Lindsay. "Gender and age differences in constipation characteristics, bowel symptoms, and bowel and dietary habits in patients evaluated for constipation." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3311335.
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Proffit, Pascale. "Constipations : les causes, les traitements médicamenteux et les dangers, rôle de l'hygiène de vie." Paris 5, 1999. http://www.theses.fr/1999PA05P089.
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Schmidt, Fernanda Mateus Queiroz. "Prevalência e fatores associados à constipação intestinal em adultos no município de Londrina, Paraná, Brasil." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-28082014-144608/.
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A partir do desenvolvimento dos Critérios de Roma, muitos estudos têm sido realizados para o conhecimento da epidemiologia da constipação intestinal (CI). Porém, a maioria é realizada em grupos populacionais específicos e poucos são aqueles de base populacional. Os objetivos do presente estudo foram estimar a prevalência de CI em adultos da população geral na área urbana de Londrina, Paraná, e identificar os fatores demográficos e clínicos associados à ocorrência de CI nessa população. Trata-se de uma análise secundária, desenvolvida a partir de um estudo epidemiológico de base populacional, descritivo, exploratório e com coleta transversal dos dados, sobre o hábito intestinal da população de Londrina, Paraná, em 2008. Dois mil cento e sessenta e dois indivíduos, residentes nas ruas selecionadas por meio de amostragem probabilística por conglomerados, foram entrevistados utilizando-se dois instrumentos: dados sócio-demográficos e Hábito Intestinal na População Geral (em sua versão adaptada e validada para o Brasil). No presente estudo, foram utilizadas as variáveis necessárias para o cálculo da prevalência de CI, de acordo com os Critérios de Roma III, e identificação dos fatores associados. Os dados foram analisados por meio do Teste de Qui-Quadrado (X²) de Pearson e regressão logística multivariada. Foram estimadas as prevalências de CI, com intervalos de confiança (IC) a 95%. As associações foram medidas pelo Odds Ratio ajustado, por análise de regressão. A prevalência total de CI foi 14,6%, sendo maior entre as mulheres (21,9%) comparativamente aos homens (5,3%), crescente com a idade em ambos os sexos e inversamente proporcional ao aumento da renda familiar. Para a amostra total de constipados (n=315), os fatores que apresentaram associação com CI foram: sexo feminino, baixa renda familiar, história de fístula, fissura anal, prolapso retal, hemorróidas, cirurgias anorretais, AVE e doenças do sistema nervoso. Para o sexo feminino, as variáveis significativamente associadas à CI foram: baixa renda familiar, história de fístula, fissura anal, cirurgia anorretal, trauma ou ferimento ao redor do ânus, retocele, hemorróidas e AVE. Para o sexo masculino, CI foi estatisticamente associada a: idade avançada, baixa renda familiar, fissura anal, cirurgia anorretal, AVE e doença do sistema nervoso. As variáveis baixa renda familiar, AVE, história de fissura anal e cirurgia anorretal permaneceram nos três modelos testados. Este estudo contribui para o conhecimento da epidemiologia da CI na população geral brasileira, ao constituir-se em um dos poucos estudos nacionais de base populacional sobre o tema. Além disso, os seus resultados agregam novos conhecimentos, ao terem sido testadas algumas variáveis que não são usualmente analisadas em estudos de base populacional sobre prevalência de CI na população geral, como fístula, fissura, cirurgias anorretais, hemorróidas, doenças do sistema nervoso, entre outros.Since the Rome Criteria were developed a lot of studies have been done to determine general constipation epidemiology. However, most of the studies consider only specific groups of people and only a few of them consider a general population analysis. The current study is a population-based study that aimed to estimate the prevalence of constipation in adults from the general population at Londrina city, Paraná State, Brazil and also to identify the clinical and demographic factors associated to occurrence of constipation in this population. This study is a secondary analysis from the epidemiological population-based study about bowel habit, that was descriptive and exploratory, cross sectional, and it was performed in 2008 at the urban area of Londrina city. Two thousand one hundred sixty two individuals living at the selected streets through cluster sampling were interviewed. Two instruments were used for data collection: social-demographic data and the adapted and validated version of Bowel Function in the Community for Brazil. In the current study the original database variables were used to calculate the prevalence of constipation, according to the Rome Criteria III, and also to determine the associated factors. The data were analyzed using chi-square test (X²) and multivariate logistic regression. The prevalence of constipation was estimated with a 95% confidence interval. The adjusted odds ratio was used to measure the association between variables, using regression analysis. The total prevalence of constipation was 14,6%, higher among women (21,9% women; and 5,3% men), growing with age in both genders, and inverse proportion to the family income. The factors that presented statistically significant association to the constipated sample (n=315) were: female gender, low social economic status, fistulae history, anal fissure, rectal prolapse, hemorrhoids, anus-rectal surgery, stroke and nervous system disease. Among the women, the statistically significant associated factors were: low social economic status, fistulae history, anal fissure, anus-rectal surgery, trauma or wound around the anus, rectocele, hemorrhoids, and stroke. Among the men, the statistically significant associated factors were: higher ages, low social economic status, anal fissure, anus-rectal surgery, stroke, and nervous system disease. The variables low social economic status, stroke, anal fissure history and anus-rectal surgery were statistically significant in all three tested statistical models. This study is important because it shows the epidemiology of constipation in the general Brazilian population, and it is one of the very few national based-population studies about the subject. It also shows associations between constipation and fistulae history, anal fissure, anus-rectal surgery, hemorrhoids, stroke, nervous system disease, and other factors that have not been often analyzed in based-population studies about prevalence of constipation.
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Lundin, Erik. "Slow Transit Constipation : Aspects of Diagnosis and Treatment." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-5770.
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Violent, Sabine. "La constipation et ses traitements en pratique officinale." Bordeaux 2, 1997. http://www.theses.fr/1997BOR2P016.
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LAVAUD, LUC. "Manometrie anorectale dans la constipation terminale : etude retrospective." Clermont-Ferrand 1, 1993. http://www.theses.fr/1993CLF1M024.
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Bremmer, Staffan. "Peritoneocele : a radiological study with defaeco-peritoneography /." Stockholm, 1998. http://diss.kib.ki.se/1998/91-628-2786-3.
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Glia, Abdulhakim. "Constipation : symptoms and findings in relation to structural and functional abnormalities /." Stockholm, 1999. http://diss.kib.ki.se/1999/91-628-3379-0/.
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Halligan, Michael Stephen Francis. "Defining evacuation proctography." Thesis, Imperial College London, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309131.
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Tai, Siu-king Rosetti, and 戴筱荊. "An evidence-based dietary fiber enrichment programme for relieving constipation in elderly orthopaedic patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193036.
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Constipation is a multifactorial digestive disorder highly prevailing among the hospitalized elderly Orthopaedic patients. Unlike Western countries, laxative therapy is used to be the first line remedy for constipation in many hospitals of Hong Kong although fiber-rich diet has been proven by numerous studies as the best alternative with low cost and less complications.
This dissertation is a translational nursing research which aims at formulating a programme of using fiber-rich food products for relieving constipation in elderly Orthopaedic patients, based on the best available research evidences.
It was started with an integrated and systematic review of papers studying the dietary interventions for relieving constipation and reducing laxative consumption in elderly with ADL dependency. Seven relevant studies were identified and critically appraised using the methodology checklist for RCTs designed by Scottish Intercollegiate Guidelines Network (SIGN). After summarizing and synthesizing the data, three dietary interventions with 1+ level of evidence were concluded as the most effective strategies for eradicating the clinical issue.
Following assessment of the implementation potential of the proposed innovation in designated clinical setting in terms of transferability, feasibility and cost-benefit ratio, an evidence-based dietary fiber enrichment programme was developed with recommendations for patient recruitment, intervention and evaluation. Furthermore, to assure a smooth change of practice and to determine the effectiveness of the programme, comprehensive plans of communication with different stakeholders, pilot study and evaluation were also subsequently established.
With this evidence-based programme, the prevalence of functional constipation and laxative consumption are hoped to be reduced in elderly Orthopaedic patients.published_or_final_version
Nursing Studies
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Master of Nursing
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LAMIRAUD, BERTRAND. "Defecographie et constipation terminale : frequence des differents syndromes, vecu de l'examen et correlations." Nantes, 1989. http://www.theses.fr/1989NANT001M.
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MacDonald, Angus. "Aspects of colonic motility in idiopathic slow transit constipation." Thesis, University of Glasgow, 1995. http://theses.gla.ac.uk/1906/.
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This thesis sets out to examine the hypothesis that some patients with idiopathic constipation, notably those who develop their symptoms following childbirth or hysterectomy, have regional as opposed to total colonic dysmotility. Such a group may be amenable to segmental rather than total colonic resection. Several clinical studies are presented which establish postchildbirth/hysterectomy constipation as a distinct subgroup of idiopathic constipation. Studies of gastric emptying demonstrate that patients with postchildbirth/hysterectomy constipation have normal motility in the proximal gastrointestinal tract. In contrast, patients with idiopathic constipation have prolonged gastric emptying indicating that proximal GI dysmotility may form a significant component of the presenting symptoms. Having identified that the proximal GI tract appears normal in patients with postchildbirth/hysterectomy constipation the next task was to identify in which region of the colon the dysmotility was most severe. Segmental colonic transit studies, using radio-opaque markers, identify delayed transit in the left colon, while dynamic radio-isotope studies localise the area of abnormality to the sigmoid colon. Colonic manometry studies, using a water-perfusion catheter point to a region of hindgut dysmotility which manifests as an excess of low pressure waves at rest and a specific failure to generate high pressure propagative waves. The usefulness of prostigmine provocation testing is examined critically in this group of patients and the pitfalls of this technique are presented.
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Mohammed, Sahar D. Mohammed. "Colonic motility in health and in slow transit constipation." Thesis, Queen Mary, University of London, 2017. http://qmro.qmul.ac.uk/xmlui/handle/123456789/24737.
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Introduction: Our knowledge of normal human colonic motility remains incomplete. Historically, this has been due to the relative inaccessibility of this organ for study, and the lack of standardisation of methods used to investigate it. Recent device development has provided us with advanced tools by which to assess colonic motility, namely pancolonic manometry, and the wireless motility capsule (WMC). Using traditional diagnostic tests, a subgroup of patients presenting with severe intractable symptoms, but without organic disease, are found to have slow transit constipation (STC). This is believed to be primarily due to colonic dysmotility, although colonic motor functions remain poorly understood in this group also. Aims: The principal aims of this thesis were to: (1) explore the effect of pancolonic manometric recording technique on colonic motility; (2) describe pancolonic motility in STC, compared to healthy control subjects; (3) using the wireless motility capsule (WMC), validate the precise location of the pH fall around the ileo-caecal junction as a landmark for measuring colonic motility; (4) obtain normative data for colonic motility (transit and contractility) and intraluminal pH in a large cohort of healthy volunteers using the WMC, and compare this to patients with STC. Methods: The following methods were used: (1) prolonged pancolonic manometry in healthy volunteers and patients with STC; (2) a dual scintigraphic technique, involving radioactive-labelling of the WMC in healthy volunteers; (3) wireless motility capsule studies of colonic motility in healthy volunteers and in patients with STC. Results: Colonic manometric recording technique (bowel preparation or not, and different catheter types) significantly influences some characteristics of propagating sequence (PS) activity, including frequency, amplitude, polarity, relationship between consecutive PSs, and circadian rhythm. Patients with STC display dysregulated colonic motor function represented by disorganised spatiotemporal patterning and loss of 'regional linkage' among PSs. The fall in pH measured by the WMC was confirmed to be either in the caecum, ascending colon, or as the capsule moved from the caecum to the ascending colon. Using the WMC, the upper limit of normal colonic transit time (CTT) was found to be 51 h; however, CTT is not a continuous variable and exhibits peaks every 24 h. CTT is significantly prolonged in females and affected by the study protocol employed. In patients with STC, colonic contractility (motility index) is increased in comparison with healthy controls, and intraluminal pH is more acidic in the proximal colon, and more alkaline in the distal colon. Conclusions: The method of pancolonic manometry requires standardisation. However, novel metrics derived from prolonged pancolonic recordings have improved our understanding of the physiology of colonic motor function in health, and also pathophysiology in constipation. The WMC provides an alternative, less invasive method to investigate colonic motility; this technique also requires standardisation, but early results in patients with STC complement those from manometry, and also reveal alterations in intraluminal pH that may be of pathophysiological significance.
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Clarke, Melanie C. C. "Chronic childhood constipation : novel approaches to diagnosis and management." Thesis, University of Edinburgh, 2011. http://hdl.handle.net/1842/24461.
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Introduction: This thesis describes the aetiology, pathology, diagnosis and management of children with constipation. In particular, it describes a condition, slow transit constipation, which represents a form of chronic childhood constipation that is not readily responsive to conventional treatment. Hypothesis and aims: Firstly this thesis hypothesises that quality of life is affected by slow transit constipation when subjects are compared to healthy age matched controls. Secondly, it proposes to ascertain whether or not nuclear scintigraphy represents a reliable means of assessing colonic motility. Thirdly, it seeks to determine whether or not transcutaneous electrical stimulation (in the form of interferential therapy) has the ability to alter either the clinical symptoms, quality of life or colonic transit of children with slow transit constipation. Lastly, this thesis aims to look at a subgroup of children with slow transit constipation managed by antegrade continence enemas delivered via an appendix stoma, and determine whether or not colonic activity, measured by a manometric catheter inserted via their appendicostomy, is affected by transcutaneous inferential therapy. Methods: Study 1 - Children (8-18yrs) with symptoms of constipation and proven slow transit constipation on nuclear scintigraphy, with symptoms for > 2years unresponsive to conventional dietary, medical and behavioural therapies, were recruited from gastrointestinal and surgical out-patient clinics. Control subjects were recruited from a local scout jamboree. QoL was assessed using the PedsQL tool that consists of parallel parent and child reported scores. Physical, psychosocial and total quality of life scores were compared using Wilcoxon matched pairs and Mann Whitney tests. Study 2 - Children (8-18yrs) with symptoms of constipation for > 2years unresponsive to conventional dietary, medical and behavioural therapies, who had had 2 nuclear transit studies performed on separate occasions were recruited from gastrointestinal and surgical out-patient clinics. Geometric centres of radioactivity were compared at 6, 24, 30 and 48hrs. The GC at each time point for the initial and repeat studies were compared by parametric statistical analysis (paired t-test). Study 3 - Children (8-18yrs) with symptoms of constipation and proven slow transit constipation on nuclear scintigraphy, with symptoms for > 2years unresponsive to conventional dietary, medical and behavioural therapies, were recruited from gastrointestinal and surgical out-patient clinics. Children were randomised to receive either real or placebo interferential therapy consisting of 12 treatment sessions over a 4 week period. Frequency of defecation, soiling and abdominal pain were assessed before, during and after intervention. Quality of life scores (PedsQL, Holschneider and Templeton) and gastrointestinal transit time (nuclear scintigraphy) were also evaluated before and after treatment. Data were analysed using independent sample and paired t tests. Where the data were not normally distributed, either Mann Whitney or Wilcoxon matched pairs testing was performed. Study 4 - Children (8-18yrs) with symptoms of constipation and proven slow transit constipation on nuclear scintigraphy, with symptoms for > 2years unresponsive to conventional dietary, medical and behavioural therapies, with pre-existing appendix stomas were recruited from gastrointestinal and surgical out-patient clinics. Subjects received the same intervention as described in study 3 with all participants receiving real interferential therapy. Colonic activity was assessed pre- and post-intervention by colonic manometry - the catheter having been inserted in an antegrade fashion via the appendicostomy. Data were analysed using paired t tests. Results: Study 1 - Subjects with slow transit constipation (n=51) described significantly poorer quality of life than age matched controls (n=79). This was so for total child reported (p = < 0.0001) and parent reported (p < 0.0001) scores. Reported scores for subjects with slow transit constipation were comparable to other chronic disease states. Study 2-7 children were recruited in whom 2 nuclear transit studies had been performed. There was no statistical difference between the 2 studies when comparing mean geometric centre of radioactivity at 6hrs (p = 0.161), 24hrs (p = 0.780), 30hrs (p = 0.947) and 48hrs (p = 0.615). Study 3-35 children were recruited, 18 of whom were randomised to receive real interferential therapy. There were no statistical differences between the 2 groups. There was no change in frequency of defecation or soiling. There was a small improvement in episodes of abdominal pain in the group that received real treatment (p = 0.05). There appeared to be a decrease in colonic transit time as measured by nuclear scintigraphy after intervention with real interferential therapy. There was a significant difference in the post-intervention GC between the 2 treatment arms at 24 (p = 0.004), 30 (p = 0.02) and 48 (p = 0.002) hours. Comparing the 2 treatment groups before and after intervention there was no change in quality of life scores. When looking at each individual treatment arm, children described a significant improvement in their quality of life (PedsQL scores) after real interferential therapy (p = 0.005). Study 4-5 children underwent colonic manometry before and after treatment with inferential therapy. There was a small increase in antegrade colonic activity following intervention p = 0.03. No other measured parameters were affected (amplitude, duration, velocity and regional linkage). There was no statistical difference in their frequency of episodes of defecation, soiling or abdominal pain. Conclusion This thesis concludes that quality of life is adversely affected by slow transit constipation and that evaluation of quality of life should be part of routine assessment of children with constipation. It also proposes that nuclear scintigraphy represents a reliable means of assessing colonic transit in states of colonic inertia such as slow transit constipation. Lastly, having demonstrated varied subjective and objective responses to its application, it proposes that further evaluation is required to evaluate the potential use of interferential therapy in children with slow transit constipation.
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Bodnar, G. B. "Specifics of elemental status in children with chronic constipation." Thesis, БДМУ, 2022. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/19762.
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Bhave, Sukhada. "THE ROLE OF ENTERIC GLIA IN OPIOID-INDUCED CONSTIPATION." VCU Scholars Compass, 2016. http://scholarscompass.vcu.edu/etd/4658.
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Morphine is one of the most widely used drugs for the treatment of pain but its clinical efficacy is limited by adverse effects including persistent constipation and colonic inflammation. Morphine-induced colonic inflammation is facilitated by microbial dysbiosis and bacterial translocation. In this study, we demonstrate that secondary inflammation and persistent constipation are modulated by enteric glia. In chronic morphine treated mice (75 mg morphine pellet/5 days), ATP-induced currents were significantly enhanced in enteric glia isolated from the mouse colon myenteric plexus. Chronic morphine resulted in significant disruption of the colonic epithelium and increased Il-1β in the myenteric plexus. The increase in ATP-induced currents, IL-1β expression and ATP release were also observed in isolated glia treated with lipopolysaccharide (LPS) consistent with bacterial translocation as a potential mediator of chronic morphine-induced inflammation. These effects of LPS were reversed by carbenoxolone, a connexin43 hemichannel blocker. In-vivo treatment with carbenoxolone (25 mg/kg) prevented 1) ATP-induced currents in enteric glia, 2)the decrease in neuronal density, and 3) colonic inflammation in chronic morphine treated mice. Inhibition of connexin43 in enteric glia also reversed morphine mediated decrease in gastrointestinal transit. These findings indicate that bacterial translocation-induced enteric glial activation and inflammation is a significant modulator of morphine-related constipation.
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Papachrysostomou, Maria. "Studies in anorectal disorders : faecal incontinence and intractable constipation." Thesis, University of Edinburgh, 1992. http://hdl.handle.net/1842/20085.
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The thesis discusses disorders of anorectal and pelvic floor function, i.e. faecal incontinence and intractable constipation. Relevant anatomy, physiology and methodology are first described. Newer forms of apparatus were applied such as a surface anal plug electrode for non-invasive integrated electromyography, a pudendo-anal reflex electrical stimulator for activating the external anal sphincter and a form of EMG biofeedback for relaxation of the pelvic floor musculature. An essential part of the study is anorectal manometry. Various systems for the measurement of pressure are contrasted using both analogue and digital recorders. The digital system was the more sensitive, but the analogue system using a microballoon was free of orientational changes. Over 200 patients with idiopathic faecal incontinence were examined by manometric and somatosensory testing, the majority of whom had pudendal neuropathy. Four subgroups were characterised, two with impairment of either the external or internal anal sphincters, another with both sphincters affected and a fourth with no apparent sphincter deficit but presenting an abnormal rectal compliance. The effect of stimulating the sacral outflow from the spinal cord, via the pudendal nerve to the sphincter mechanism, was therefore assessed and revealed significant improvement in tests of anorectal function.
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Mian, Sarah W. "Constipation : individual perceptions and the effect of diet and stress." Thesis, London South Bank University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.323892.
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Thomas, Gregory. "Optimising the outcome of neuromodulation for faecal incontinence and constipation." Thesis, Imperial College London, 2014. http://hdl.handle.net/10044/1/24930.
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This thesis begins with a summary of the general management of faecal incontinence and constipation. This is followed by a review of the literature to support the use of neuromodulation for these conditions. The first study reports the effect of alteration of pulse width and frequency on sacral nerve stimulation for constipation. The next study investigates the outcome of transcutaneous stimulation of the sacrum for faecal incontinence. The outcome of pudendal nerve stimulation is reported for those who have failed to improve with sacral nerve stimulation. Lastly the effect of unilateral transcutaneous posterior tibial nerve stimulation is studied and applied to bilateral stimulation.
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Rahman, Zia, Fereshteh Gerayli, and Nakia J. Woodward. "Clinical Inquiries. What Treatments Work Best for Constipation in Children?" Digital Commons @ East Tennessee State University, 2009. https://dc.etsu.edu/etsu-works/8812.
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Osmotic laxatives produce the best results. Fiber and behavior modification may have a role. Increased fiber and behavior modification are the most often recommended first steps in managing chronic functional constipation (CFC) in children, but only limited evidence supports this approach. For pharmacologic management, the best evidence supports osmotic laxatives.
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DELONGA, OLIVIER. "Interet de l'electromyographie colique dans la constipation par inertie colique." Clermont-Ferrand 1, 1993. http://www.theses.fr/1993CLF1MS09.
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Dubois, Delphine. "Les conseils du pharmacien d'officine dans le traitement de la constipation." Paris 5, 1998. http://www.theses.fr/1998PA05P027.
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JEAN, CHRISTOPHE. "Bilan diagnostique des constipations severes de l'enfant." Reims, 1989. http://www.theses.fr/1989REIMM054.
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Benetti, Thais Helena. "Variação da pressão anal de repouso induzida pela apneia pos-esforço expiratorio em portadores de constipação secundaria a discinesia do assoalho pelvico." [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308753.
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Orientador: Claudio Saddy Rodrigues CoyDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: A constipação intestinal é um sintoma comum na população, sendo mais frequente em mulheres, podendo ser secundária a erro alimentar, distúrbios orgânicos ou funcionais. Dentre estes, destaca-se a discinesia do assoalho pélvico, caracterizada basicamente por ausência de relaxamento ou contração paradoxal da musculatura pélvica e do canal anal no momento da evacuação. O objetivo deste estudo foi analisar através de dados manométricos a variação da pressão anal de repouso durante o esforço de evacuação com a manobra de Valsalva e com apnéia pós-expiração forçada em portadores de constipação secundária à discinesia do assoalho pélvico. Foram estudados 21 pacientes, com idade média de 47,5 (23-72) anos, sendo 19 (90,4%) do sexo feminino. O diagnóstico foi realizado através de manometria anorretal com cateter de oito canais dispostos no eixo axial, realizando-se as medidas na porção proximal (1) e distal (2) do canal anal. Para o diagnóstico de discinesia do assoalho pélvico considerou-se a elevação dos valores pressóricos em relação ao repouso com esforço de evacuação. Para a avaliação clínica da constipação empregou-se o escore de Agachan. As variáveis estudadas foram: pressão anal média do canal anal por vinte segundos em repouso (R), ao esforço de evacuação com manobra de Valsalva (V) e ao esforço de evacuação em apnéia após expiração forçada (A), assim como a área sob a curva do traçado manométrico nos momentos V e A. A análise dos valores médios da variação da pressão anal de repouso evidenciou diferença entre os canais proximais e distais (p= 0,007), independente do momento, e tendência à diferença nos momentos V e A (p= 0,06). A média dos valores da área sob a curva do traçado manométrico demonstrou diferença entre os momentos V e A (p= 0,0008), tanto na porção proximal como na porção distal do canal anal. Pode-se concluir que o esforço de evacuação associado à apnéia pós-expiração quando comparada ao esforço de evacuação associado à manobra de Valsalva, proporciona menor contração do canal anal pela análise do parâmetro área sob a curva
Abstract: Intestinal constipation - a common symptom in the general population -, is more frequent in women. It may be secondary to improper diet or organic or functional disturbances, such as dyskinesia of the pelvic floor. This is basically characterized by the absence of relaxation or paradoxical contraction of the pelvic floor and the anal sphincter during evacuation. The aim of this study was to analyze, by manometric data, the anal pressure variation at rest, during evacuation effort by using the Valsalva maneuver and forced postexpiratory apnea in subjects with secondary constipation due to dyskinesia of the pelvic floor. Twenty-one patients (19 females - 90.4%) with mean age of 47.5 years old (23-72) were studied. The diagnosis was performed using anorectal manometry, with a catheter containing eight channels disposed at the axial axis, measuring the proximal (1) and distal (2) portions of the anal orifice. In order to diagnose dyskinesia of the pelvic floor, it was considered the elevation of the pressure values in relation to the resting with the evacuation effort. The Agachan score was used for clinical evaluation of the constipation. The variables studied were: mean anal pressure of the anal orifice for twenty seconds at rest (R) to the effort of evacuation using Valsalva (V) maneuver and to the evacuation effort during apnea after forced expiration (A), as well as the area under the curve of the manometric tracing at the moments V and A. The analysis of the mean values of the anal pressure variation at rest evidenced difference between proximal and distal channels (p= 0.007), independent of the moment and tendency to difference at the moments V and A (p= 0.06). The mean of values of the area under the manometric tracing curve showed difference between the moments V and A (p= 0.0008), either at the proximal portion or at the distal portion of the anal orifice. The conclusion is that the evacuation effort associated with postexpiratory apnea, when compared with the evacuation effort associated with the Valsalva maneuver, provides lower elevation of the anal pressure at rest by the parameter area under curve
Mestrado
Pesquisa Experimental
Mestre em Cirurgia
34
Yamamoto, Lucy Junka. "Caracterização dos achados de manometria anorretal em portadores de constipação com e sem elevação dos valores de pressão ao esforço de evacuação." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308751.
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Orientador: Claudio Saddy Rodrigues CoyDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Constipação é um sintoma com conceito amplo. Pode ser primária, em que a causa definida não é encontrada, ou ainda, ser secundária, quando causas específicas são reconhecidas. A constipação primária é um termo coletivo que envolve diferentes desordens funcionais. Dentre estas, a discinesia do assoalho pélvico é caracterizada pela inabilidade de esvaziar o reto durante o esforço de evacuação na ausência de obstrução mecânica. Para melhor diagnóstico, investigação mais específica, principalmente às relacionadas à fisiologia anorretal são necessárias, como a manometria anorretal. O objetivo deste estudo foi a caracterização manométrica de portadores de constipação com e sem elevação dos valores de pressão ao esforço de evacuação. Trinta pacientes com queixa de constipação, com escore de Agachan mínimo 10, foram submetidos à manometria norretal com cateter de oito canais dispostos no eixo axial. Do total, 28 eram do sexo feminino (90%) com média de idade de 51,5 anos (dp = 12,4). Os pacientes foram divididos em dois grupos, sendo incluídos no G1 os que apresentaram manutenção da elevação da pressão anal ao esforço de evacuação e no G2 os que evidenciaram diminuição destes valores. Para o diagnóstico de discinesia do assoalho pélvico considerou-se a elevação da pressão durante o esforço de evacuação. As variáveis estudadas foram pressão anal em repouso, de contração voluntária e ao esforço de evacuação. A análise dos dados deste estudo, possibilitou identificar com intervalo de confiança de 95% que a diferença de pressão maior que 16,5 mmHg entre as pressões médias de repouso e de evacuação, e a diferença percentual maior que 79,2% na pressão média, e diferença de pressão maior que 16,2 mmHg na pressão máxima, entre o repouso e esforço de evacuação, e a diferença percentual maior que 57,4% na pressão máxima podem identificar portadores de constipação secundária à discinesia do assoalho pélvico
Abstract: Constipation is a symptom with many causes. It can be classified as primary when its cause is unknown or secondary when a specific cause can be pointed out. Primary constipation is a collective term that adds together different disorders. From those, the pelvic floor dyssynergia is characterized by the inability to empty the rectum after straining in the absence of mechanic obstruction. To provide a better diagnosis, specific exams, including anorectal physiology tests are necessary. Anorectal manometry can be taken as an example of those exams. The aim of this study was to describe manometric parameters found in patients with constipation with or without increase in anal pressures during straining. Thirty patients with constipation and Agachan score of at least 10 were evaluated using anorectal manometry (a probe with eight axially oriented channels was employed). They were 28 females (90%), with a mean age of 51,5 (+ 12,4) years. Patients were divided accorded with manometric findings into: Group 1 (G1) which included those that showed sustained increase in anal pressures during straining and Group 2 (G2) which included the patients who presented a decrease in those values. Diagnosis of pelvic floor dyssynergia was made when a increase in anal pressures during straining was found. Resting pressure, maximum squeeze pressure and maximal evacuation effort pressure were evaluated. Data analysis shows with confidence interval of 95% that a difference larger than 16,5 mmHg between median resting and evacuation effort pressure or a percentual difference higher than 79,2% in median pressures and the difference larger than 16,2 mmHg in maximal pressures between rest and straining and the percentual difference higher than 57,4% can identify patients with pelvic floor dyssynergia constipation
Mestrado
Cirurgia
Mestre em Cirurgia
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BUISSON, THIERRY. "Peut-on prevenir la constipation des rectopexies ? etude preliminaire a propos de 15 cas de rectopexies avec conservation des ailerons." Reims, 1993. http://www.theses.fr/1993REIMM066.
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Carette, Denis. "Intérêt de la manométrie colique chez le malade constipé chronique : étude portant sur 49 malades et 14 témoins." Lyon 1, 1985. http://www.theses.fr/1985LYO1S007.
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Robert, Anne. "Prise en charge de la constipation fonctionnelle de l'enfant : etude prospective de 74 observations." Lille 2, 1992. http://www.theses.fr/1992LIL2M289.
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Sutcliffe, Jonathan Richard. "Interstitial cell of Cajal Abnormalities in children with Slow Transit Constipation." Thesis, University of Leeds, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.536116.
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Vasudevan, Subash Parakkil. "Rectal hyposensitivity : clinical and physiological impact on patients with chronic constipation." Thesis, Queen Mary, University of London, 2014. http://qmro.qmul.ac.uk/xmlui/handle/123456789/8842.
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Intact rectal sensation is integral to normal anorectal function. Rectal hyposensitivity (RH) implies diminished rectal sensory perception and is currently diagnosed using standard anorectal physiology tests. There is currently a lack of understanding regarding the nature and severity of symptoms, and pathophysiological mechasnisms by which RH leads to symptoms of constipation. Symptom severity and physiological abnormalities (potential pathophysiological mechanisms) were studied in patients with RH referred to a tertiary centre for evaluation of their symptom of intractable constipation. A pilot study using a novel technique to study recto-anal and recto-rectal reflexes in health and in patients with RH is also presented. RH was not associated with more severe symptoms as assessed using a standard constipation severity questionnaire. RH is more commonly associated with rectal evacuatory dysfunction (functional type). RH is also associated with a specific pattern of transit delay, where there is more hold up of the isotope in the left colon and this is independent of rectal evacuatory dysfunction. Afferent dysfunction in the majority of patients with rectal hyposensitivity relates purely to visceral pathways. However, a combined viscero-somatic pelvic sensory neuropathy is present in a proportion of patients. Similarly, a combined sensori-motor dysfunction was also seen in a subgroup of patients. Patients with RH have abnormal sampling and rectal contractile response to distension and this may play an important role in the pathophysiology of symptoms. The level of interruption of afferent pathway is likely to be heterogenous in patients with RH and constipation. Patients with RH display distinct physiological abnormalities that may be important to identify to tailor management. Whether, this leads to improved clinical outcomes needs to be further evaluated.
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Khan, Usman. "The efficacy of sacral nerve stimulation in patients with neuropathic constipation." Thesis, Durham University, 2012. http://etheses.dur.ac.uk/6371/.
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Constipation is a common complaint in people with neurological diseases causing significant physical and psychological distress. Poor response to therapy is due to a number of factors: severe disruption to normal physiology (gut denervation); use of constipating drugs in the presence of immobility; and co-existence of faecal incontinence and constipation precluding treatment with standard oral laxatives. Sacral nerve stimulation (SNS) has been shown to have a beneficial effect in patients with functional constipation. It is a treatment with established efficacy for faecal incontinence, including that due to neurological disease. However, there are no studies on the efficacy of SNS in neuropathic constipation. Pilot work in this patient group was positive, thus a formal trial was indicated. This thesis reports a proof-of-concept trial examining the effectiveness of temporary SNS in neurological constipation. The study assessed efficacy over a three-week period of temporary SNS using an off-on-off design. Methods and principal evaluation criteria: The trial aimed to recruit 30 patients with constipation of neurological origin from the specialist clinic at the University Hospital North Durham, over a two-year period. For each patient, the trial lasted twelve weeks, including: a pre-SNS period of six weeks of baseline assessment, a three week period of stimulation and a three week period of post-treatment assessment. The measurement schedule of symptoms and quality-of-life during the trial assessed symptom stability and the temporal effects of treatment. Physiological data was collected before and during treatment, in the form of transit studies and laser Doppler flow cytometry of rectal mucosal blood supply. The primary outcome measure was a global assessment of severity of constipation. Self-administered questionnaires including patient assessment of symptoms (PAC-SYM) and patient assessment of quality of life (PAC-QOL), transit study, and laser Doppler flowcytometry (LDFC) constituted the secondary outcome measures. Patients responding to temporary SNS were offered implanted permanent SNS and long term response was evaluated. Results and possible implications: Twenty-two patients were recruited, including 8 men and 14 women with an average age of 51.5 years (Range 38-69 yrs.). Four patients dropped out and were lost to follow-up; 18 patients completed the trial. Twelve patients (67%) had a successful response after three weeks of bilateral temporary stimulation and underwent permanent implant. The Global Assessment Score for constipation, PAC-SYM and PAC-QOL scores for these patients improved during treatment with temporary SNS (p<0.05). There was also an improvement in toileting time (p=0.04) and decrease in overall laxative use (p=0.03). Physiological parameters did not change. The overall response rate during long-term follow-up (mean 20 mths) was 6/12 (50%, 95%CI: 21% to 79%). Interpretation: Short term treatment with SNS helped two thirds of patients with neuropathic constipation in the short term. There was good symptom stability before treatment and rapid return to baseline after treatment. However, there were no improvements in the physiological measures used, so that a placebo response may have brought about the improvement in some patients. Temporary SNS only identified 50% of long-term responders.
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Erichsén, Eva. "Constipation in palliative care : Prevalence, definitions, symptom distress and risk-factors." Licentiate thesis, Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-117188.
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Background and aims: Constipation for patients in palliative care is common and described with variations in prevalence. Side -effects from opioid- treatment, is considered to be one of the main factors leading to constipation. The overall aim of the thesis was to study constipation among patients admitted to specialized palliative care- settings in Sweden. The specific aims of the thesis were 1) To describe and explore the prevalence, definition and symptom distress of constipation by applying different definitions of constipation, in patients admitted to specialized palliative care settings in Sweden. 2) To identify factors related to constipation in patients in specialized palliative care and comparing these factors for patients with different types of constipation to patients without constipation. Methods: A literature- search were conducted where prevalence of- and factors related to constipation was explored and included in a questionnaire, developed for this thesis. Data was collected in a cross- sectional design with a response rate of 50% and analysed with logistic regression. Results: A total of 485 patients from 38 specialized palliative care- units in Sweden participated. Prevalence of constipation for patients in specialized palliative care varied between 7- 43 % depending on definition used. Two different constipation- groups were identified: Medical constipation- group 23% (MCG) and Perceived constipation- group 35% (PCG). Three sub- groups was also identified: patients with i) only ≤ 3 defecations/week, 7%, ii) only perception of being constipated, 19%, and iii) patients with both ≤ 3 defecations/ week and perception of being constipated,16%. Several factors were found to be related to constipation as hospitalisation, absence of laxative- treatment, haemorrhoids, poor appetite, hard stool form and opioids. Conclusions: Prevalence of constipation may differ depending on definitions used. Distress from constipation and other factors related to constipation, than opioids, needs to be incorporated into the clinical constipation- assessment. Validated constipation assessment tool needs to be developed.The series name Linköping University, Studies in Health Sciences, Thesis in the Licentiate thesis is incorrect. The correct name is Linköping Studies in Health Sciences. Thesis.
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Baker, Jason. "Improving Chronic Constipation Health Literacy Proficiency: Animation Versus Traditional Written Pamphlets." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5448.
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The U.S. health care system is evolving from medical centric to patient centered, augmenting the importance for patients to comprehend and process medical information. The Department of Education indicated that 77 million Americans have a basic or below basic health literacy proficiency and 12% register as health literacy proficient. Animation is a time-tested device for improving health by enhancing comprehension. Chronic constipation (CC) complexity entails physiological, anatomical, and environmental mechanisms. Using the cognitive theory of multimedia learning and dual-channel auditory and visual processing, the primary research question addressed whether an animated educational video improved health literacy for CC more than a traditional written educational pamphlet. A secondary dataset of 100 CC subjects from the University of Michigan was collected using a cross-sectional study design with a convenience sampling strategy of CC patients who underwent anorectal functional testing. Dependent variables were CC Pretest Quiz and CC Posttest Quiz scores, and independent variables included CC education intervention, demographics, health literacy proficiency, and environmental learning variables. Descriptive and analytical statistical methods were employed for data summarization and comparison. The animated educational video had minimal impact (p = 0.20) on improving health literacy; however, pretest scores (p -?¤ 0.001), age (p = 0.03) and highest level of education achievement (p = 0.03) influenced the largest variance between quiz scores. Enhancing health literacy influences social change by empowering individuals with CC to improve quality of life metrics, increase work productivity, and decrease health care utilization costs.
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RAMPON, ALAIN. "Cisapride dans la constipation chez le blesse medullaire : etude sur 10 cas." Lyon 1, 1991. http://www.theses.fr/1991LYO1M402.
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Ye, Di. "Diarrhoea and constipation link to faster accumulation of heat pain in women." Thesis, Ye, Di ORCID: 0000-0003-0668-2666 (2019) Diarrhoea and constipation link to faster accumulation of heat pain in women. Honours thesis, Murdoch University, 2019. https://researchrepository.murdoch.edu.au/id/eprint/55037/.
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The cause of chronic abdominal pain in irritable bowel syndrome remains unclear. This study linked gut microbiome (GM; a recently proposed cause) with pain modulation (an established cause). GM composition was inferred by stool consistency (measured on the Bristol Stool Scale). Pain modulation was tested using the conditioned pain modulation paradigm, where a “pain-inhibits-pain” phenomenon was examined. Participants were 24 women with or without irritable bowel syndrome. First, women with diarrhoea or constipation (reflecting imbalanced GM composition) and women with normal stools showed no pain inhibition to electrical stimuli after heat conditioning. Lack of pain inhibition in both groups may be due to inappropriate study design (e.g., short delay after preliminary pain sensitivity tests and mildly painful stimuli). Second, women with diarrhoea or constipation had a faster accumulation of pain when their forearm was heated than women with normal stool consistency. This finding suggests a link between imbalanced GM composition and heightened pain facilitation. However, the results must be interpreted cautiously because of confounds, such as stimulus intensity and unpleasantness level. Major implications for future studies are (a) to develop a standardised conditioned pain modulation testing protocol, (b) to measure distress or anxiety levels during the testing, (c) to measure the unpleasantness of painful stimuli together with pain intensity, (d) to use an accurate measure of GM composition, and (e) to replicate the findings in large sample.
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Chen, Haochang. "Zhong yi yao zhi liao gong neng xing bian mi liao xiao wen xian ping gu /." click here to view the abstract and table of contents, 2006. http://net3.hkbu.edu.hk/~libres/cgi-bin/thesisab.pl?pdf=b19986919a.pdf.
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LAMARCHE, PIQUEMAL MARTINE. "Traitement par la methode de delorme du prolapsus rectal non exteriosie a l'origine d'une constipation terminale." Toulouse 3, 1992. http://www.theses.fr/1992TOU31130.
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Grenier, Philippe. "Asynchronisme abdomino-pelvien et biofeed-back : à propos de 70 patients." Saint-Etienne, 1992. http://www.theses.fr/1992STET6210.
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FOCHT, DEAN R. "EFFECTIVENESS OF A COLLABORATIVE TREATMENT PROGRAM BASED ON THE NORTH AMERICAN SOCIETY FOR PEDIATRIC GASTROENTEROLOGY, HEPATOLOGY, AND NUTRITION (NASPGHAN) GUIDELINES FOR THE TREATMENT OF CONSTIPATION." University of Cincinnati / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1115662862.
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Guigou, Anne. "Constipation et incontinence anale chez le spina bifida : a propos de 79 cas." Lyon 1, 1988. http://www.theses.fr/1988LYO1M212.
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Gale, Sue. "Identifying contributory factors leading to the suboptimal management of constipation and the development of a nurse-led clinic to improve constipation management in patients with cancer : an action research study." Thesis, Bucks New University, 2008. http://bucks.collections.crest.ac.uk/9846/.
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Constipation in cancer and palliative care is frequent, poorly managed and has a profound adverse effect on patients' lives. This qualitative study explores factors contributing to the suboptimal management of constipation and identifies strategies to alleviate it. In a three-staged action research study data were collected from 11 patient interviews, 26 health care professionals (HCPs) during six focus group meetings and a Constipation Management Clinic (CMC), comprising a cohort of 29 patients, which was developed as part of this study. The findings from stage one, patient interviews, confirm that the management of constipation in patients with cancer and palliative care is suboptimal partly due to HCPs’ poor knowledge and ambivalent attitudes, inadequate patient education and a lack of a concordant approach to management. Patients described feeling abandoned, their condition trivialised and many suffered considerable distress and embarrassment. In stage two, focus groups of HCPs were questioned on their understanding of the condition, its impact and their strategies for treatment. Findings from the patient interviews were fed back as a means of education and to facilitate discussion. The focus groups confirmed the findings from the patient interviews. It was therefore possible to postulate that constipation management would be improved by redressing the educational needs of HCPs, imparting knowledge to patients and working to develop a partnership approach. To test this a CMC was developed during stage three. Patients with severe and intractable constipation were recruited to a nurse-led clinic that adopted a patient-focused, education-based management strategy which also encompassed a concordant approach to laxative recommendations. Following attendance there was an immediate improvement in bowel function in all patients who became more autonomous and concordant with their treatment regimens. Aims of the study were to improve the research’s skills and knowledge in research methodology in the cancer and palliative care setting, identify factors leading to the suboptimal management of constipation and to explore ways in which to alleviate the condition in patients with cancer. Throughout the project the action research methodology incorporated concurrent dissemination of findings to HCPs allowing them to discuss and assist with the evolution of the research and to modify their own practices to the benefit of patients generally. This research demonstrates the advantages of adopting an action research approach when identifying strategies to reduce the incidence of constipation in patients with cancer and the importance of paying attention to detail when trying to manage this frequent and distressing problem.