Journal of Physiology & Pathology in Korean Medicine
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v.37
no.1
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pp.19-24
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2023
Postoperative adhesive small bowel obstruction (ASBO) is an intractable disorder which sometimes leads to adhesiolysis or small bowel resection. These therapeutic reoperations, however, also have many limitations including complications. An 80-year-old female, who had undergone 4-abdominal surgeries, visited the hospital with continuous vomiting. Based on her clinical symptoms and history, multiple air-fluid levels and distention of the small bowel in an abdominal X-ray, we diagnosed her with postoperative incomplete ASBO. We conducted acupuncture and an herbal medicine enema to stimulate bowel movement and relieve pain. The patient came in complaining of abdominal pain and vomited more than 10 times on hospital day 0 stopping on hospital day 4. Comparing hospital day 0 with hospital day 4, the abdominal pain decreased from a numerical rating scale (NRS) 10 to 4. There were no side effects such as redness or burns during the treatment process. This study presented an acupuncture-based treatment will be helpful for clinicians managing cases of ASBO with poor performance in elderly individuals.
Objectives The purpose of this study is to report the case of fecal impaction in a child without any abdominal symptoms treated by taking herbal medicine. Methods We examined a 7-year-old girl who had normal bowel movement and defecation per day, and had no particular abdominal symptoms. Abdominal radiography was taken, and unexpected severe fecal impaction was observed throughout the abdominal cavity, filled with intestinal gas and feces. According to the subject's parents, she had no generalized symptoms, such as abdominal pain or distension, and had on a regular diet and normal bowel movement daily. She was treated with herbal medicine (Daeseunggi-tang) for 23 days. While she was on the therapy, numbers, doses, bowel movements, and radiography were checked and recorded. Results During the treatment, her stool was softened, and fecal impaction was relieved as showed by abdominal radiography. Conclusions We have identified that there are cases where subjects have no symptoms of abdominal pain, despite presence of severe fecal impaction. In addition, it was found that Daeseunggi-tang is effective in fecal impaction in childhood.
Urticaria is acute febrile dermatopathy. Patients suffer from Urticaria, because It causes wheals, flare, itching and so on. It occurs usually. $15%{\sim}20%$ of all people experience it in one's whole life. This case is about one patient who suffered from urticaria. He was controled by western medicine, but he was not treated. We diagnosed his case as Soyangin(少陽人) Yangdokbalban(陽毒發斑), We observed his bowel movement condition, he had constipation. Our objective was that his bowel movement rendition would be normal. So we and used Soyangin(少陽人) Yangdokbaekho-tang(陽毒白虎湯). As a result of this treatment, his symptom vanished.
Objectives : In Oriental Medicine, the improvement of constipation is very important for patients at the acute stage of cerebrovascular accident. For constipation, oral medicine has usually been used but is not available to stroke patients with dysphagia and mental disorder, and may bring about side effects on the gastrointestinal tract. In such cases, general enema has been used for assistant therapy, We needed to develop a more effective enema technique on constipation of stroke patients. Methods : Sixty-three patients were researched. We treated 29 patients with Bo-Ryu enema and 34 patients with general enema. To compare the effect of the Bo-Ryu enema group with that of the general enema group, we analyzed general characteristics, bowel movement, abdominal examination and related symptoms. Results : Sixty-three patients comprised the Bo-Ryu (n=29) and general (n=34) enema groups. Between the Bo-Ryu and general enema groups, the Bo-Ryu enema was more effective than the general enema in the number of bowel movements, total and corrected amount of stool, tonus of rectus abdominis muscle and abdominal discomfort. However, there were not significant differences in the power of abdominal muscle, digestion and physical power. Among the subgroups, Bo-Ryu enema group was most effective in the number of bowel movements, total amount of stool and tonus of rectus abdominis muscle, and Bo-Ryu enema group was best in the corrected amount of stool and abdominal discomfort. Conclusions : Bo-Ryu enema should be considered as an effective and safe treatment for patients with constipation during the acute stage of cerebrovascular accident.
Chang Soon Bok;Kim Young Ran;Yoon Mi Hee;Shim Joung Un;Ko Eun Hui;Kim Min Ok
Journal of Korean Academy of Nursing
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v.34
no.7
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pp.1164-1171
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2004
Purpose: The purpose of this study was to compare differences in the time when bowel sounds were heard and gas was passed in women who had an abdominal hysterectomy and were treated for 5 minutes (experimental group A) or 10 minutes (experimental group B) with San-Yin-Jiao (SP-6) acupressure. Method: The design of this study was a nonequivalent control group non-synchronized post test only design. The participants included 142 women, 39 in experimental group A, 30 in experimental group B, and 73 in the control group. Data was collected using a structured questionnaire which included items on general characteristics and a self report of time when gas was passed. Differences for the three groups as to time when bowel sounds were heard and gas was passed were analyzed using ANOVA. Result: The time when bowel sounds were heard was statistically significantly shorter in both experimental groups compared to the control group(F=10.29, p=.000). The time when gas was passed was statistically significantly shorter in experimental group B(10 min) compared to the control group(F=4.68, p=.011). Conclusion: It could be concluded that SP-6 acupressure of 10 minutes was effective in shortening the time until bowel sounds were heard and gas was passed for women who had had an abdominal hysterectomy. Replication of the study with a larger number of participants is necessary in order to be able to generalize the results.
Objectives : This study was aimed to describe a case of a patient with FOLFIRI-induced diarrhea, which was improved by treatment with Korean herbal medicine, modified Wiryeong-tang. Methods : The patient with metastatic rectal cancer recieved FOLFIRI plus bevacizumab as a palliative chemotherapy and showed repetitive diarrhea despite administration of loperamide, which was treated with modified Wiryeong-tang. To evaluate the effect of the treatment, the Bristol Stool Form Scale and bowel movement frequency were checked. Results : During the treatment, the stool form using Bristol Stool Form Scale was improved from diarrhea to normal stool, and the bowel movement frequency was decreased. Conclusions : The result suggest that modified Wiryeong-tang may be an effective treatment for FOLFIRI-induced diarrhea.
Kim, HyoJin;Jeon, YeongKyung;Yoon, SoYoung;Lee, GeumMoon
Journal of Korean Academy of Nursing
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v.51
no.6
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pp.732-745
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2021
Purpose: This study aimed to assess combined effects of early oral feeding after Cesarean section (C/S) under regional anesthesia on bowel function, gastrointestinal complications and surgical recovery. Methods: A systematic literature search was conducted using KISS, RISS, PubMed, CINAHL, EMBASE, CENTRAL and Google Scholar to identify randomized clinical trials comparing early oral feeding (EOF) with delayed oral feeding (DOF) after C/S. Outcome variables were bowel function and gastrointestinal complications and surgical recovery. Effect size was calculated using weighted mean differences (WMDs) and relative risks (RRs), with 95% confidence intervals (CIs). Results: Seven studies involving 1,911 patients from 568 studies, 7 studies were included in meta-analysis. EOF was significantly associated with shorter time to recover bowel movement compared with DOF (WMD, - 2.50; CI, - 3.50~- 1.50). EOF was not associated with nausea (RR, 1.15; CI, 0.87~1.53) and vomiting (RR, 0.96; CI, 0.65~1.42), but lower incidence of abdominal distension (RR, 0.70; CI, 0.50~0.98). EOF was significantly associated with shorter time to discontinuation of intravenous fluids (WMD, - 8.88; 95% CI, - 16.65~- 1.11) and removal of urinary catheter (WMD, - 15.23; CI, - 25.62~- 4.85). Conclusion: This meta-analysis provides evidence that EOF after C/S under regional anesthesia not only accelerates return of bowel function and surgical recovery but also reduces gastrointestinal complications. These results suggest that EOF should be offered to women who have undergone C/S to improve the recovery experience and reduce overall medical costs.
The aim of this study was to investigate the dietary and lifestyle factors related to bowel pattern of female high school and college students in Gyeonggi Province. The total of 202 self-administered questionnaires (high school students 77 ; college students 125) were analyzed. All respondents were devided into four groups based on their self-reported pattern of defecation: 18 subjects ($9.0\%$) comprised the normal group, 73 ($36.1\%$) the constipation group, 73 ($36.1\%$) the constipation/diarrhea group, and 38 ($18.8\%$) the diarrhea group. Regularity of exercise was significantly higher in the college students than high school students, and times spending on a chair were longer in the high school students than college students. Most students ($72.7\%$) reported that they had stress. Fourty point six percent of the subjects reported that they had 3 meals per day, which tended to be higher in the normal and diarrhea group than constipation and constipation/ diarrhea group. Most students (69.7) skipped breakfast which was lower in the normal group than the other groups. The most preferred dietary fiber food was korean cabbage kimchi. Fifty-eight point four percent of the subjects reported that they had irregular bowel movement. Bowel movement was more irregular in the high school students than college students, and in the constipation group than the other groups. Of the subjects, $77.7\%$ had defecation frequency between three per week and three per day. Those who spent within 10 minutes for defecation were $79.6\%$, and those had difficulty in evacuating were $76.0\%$. High school students and those with constipation and constipation/diarrhea had a significantly lower defecation frequency, longer time spent at the toilet, and greater difficulty in evacuating than college students and normal and diarrhea group. The percentage of those who had feelings of residue in the intestine after defecation was $92.5\%$, and it was greater in the constipation or diarrhea group than in the normal group. Most students ($93.5\%$) reported that they had abdominal pain or discomfort. These results suggest that decreasing times spending on a chair, decreasing stress, keeping 3 meal per day at regular hours, and increasing dietary fiber intake are associated with desirable bowel pattern.
This study was conducted to identify the effect of meridian acupressure on defecation of patients with post spinal operation. The nonequivalent control group posttest only design was used. The data were obtained from 77 post spinal operative patients, 34 in the experimental 43 in control group in Y Hospital, Seoul, Korea. The neurosurgical unit A and B ward, assigned by matched sample by the name of operation such as laminectomy and posterior lumbar interbody fusion are performed. Meridian acupressure meant the method that an examiner presses response points distributed in the pass of energy vessel. In this study, meridian acupressure program was performed on as points in order of Hegue (LI-4), Zhigou (TE-6), Zusanli (S-36), Shangjuxu (S-37), Xiajuxu (S-39), Tianshu (S-25), Taichong (L-3) which was known to be related to large intestine. Data were collected from 1, July 2003 to 1, September 2003. Meridian acupressure program was carried out for 20 minutes 4 hours after operation twice daily. In order to evaluate the effect of meridian acupressure intervention, they were asked time of bowel recovery, gas passing, and defecation though questionnaire method. Data were analyzed by the SPSS/ WIN 11.0 program. The results of this study were summarized as follows; 1. Homogeneity tests of general characteristics and operation related characteristics of the experimental group and the control group were performed. General characteristics included age, sex, defecation habit, eating pattern, fluid intake, life style, activity, usage of laxative and etc. 2. Hypotheses were verification as follows; 1) Recovery of bowel sound of the experimental group who received meridian acupressure intervention was faster than that of the control group after spinal operation (t=-6.770,P=.000). 2) Time of gas passing of the experimental group who received meridian acupressure program was faster than that of the control group after spinal operation (t=-8.003, P=.000). 3) Time to defecation of the experimental group who received meridian acupressure program was faster than that of the control group after spinal operation (t=-9.026, P=.000). 4) Abdominal discomfort due to defecation of the experimental group who received meridian acupressure program was lesser than that of the control group after spinal operation (t=-3.431, P=.001). From these results, meridian acupressure intervention was effective for recovery of bowel sound, reduce time to gas passing, time to defecation and lessen abdominal discomfort due to defecation on post spinal operative patients. And therefore this intervention can probably considered on clinical practice.
Abnormal distribution of enteric nerves such as adrenergic, cholinergic and non-adrenergic non-cholinergic nerves (NANC) may cause the failure of relaxation at the involved bowel segment in Hirschsprung's disease (HD). Nitric oxide (NO) is a major inhibitory NANC neurotransmitter in the gastrointestinal tract. NO is synthesized by activation of nNOS (neuronal nitric oxide synthase) in the intramural ganglion cells and regulates bowel movement. To assess the distribution of nNOS in HD, immunohistochemical staining to nNOS was utilized on paraffin embedded specimens. Ten control colon specimens were tested for feasibility of staining. Immunohistochemisrty was done on ganglionic colon as well as aganglionic segment of 15 patients with HD. nNOS immunoreactivity was observed in the neuronal cells, small cells and nerve fibers in the muscle layer and submucosal neuronal cells of control specimens. This finding was also observed in the ganglionic segments of HD. But, there was no nNOS immunoreactivity in aganglionic segments of HD. In conclusion nNOS immunohistochemical staining of paraffin embedded specimen is feasible and reliable. And the results suggest that the relaxation failure of the aganglionic bowel in HD is related to the absence of nNOS containing cells and nerve fibers.
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