Prevalence and predictors of functional evacuation disorder in patients with chronic constipation

Background: Functional evacuation disorder (FED) is the second most common cause of functional constipation (FC) after constipation-predominant irritable bowel syndrome. However, the data on FED is relatively scanty in our region. Hence, the present study was performed to evaluate the demographics of FED and to find out the predictors of FED in patients with chronic constipation. Methods: A total of 134 patients with chronic constipation diagnosed according to the Rome IV criteria who were referred for high-resolution anorectal manometry (HRAM) were retrospectively enrolled in the present study. All FC patients who underwent HRAM were asked to fill a questionnaire and underwent anorectal manometry and were submitted to the balloon expulsion test (BET). Results: The mean age of patients was 43.09 ± 9.32 years old, with a total of 76 (54%) males. The most common symptom was straining during defecation (87%) followed by incomplete evacuation (86%). The prevalence of FED, diagnosed by HRAM and by the BET was 39%. Patients with FED had a significantly higher percentage of straining and sensation of anorectal blockade compared with those without FED (96 versus 82%; p < 0.01; 81 versus 44%; p < 0.001, respectively). On the multivariate regression analysis, straining > 30 minutes (odds ratio [OR] = 3.63; p = 0.03), maximum squeeze pressure (OR = 1.05; p < 0.001), and balloon volume at maximal sensation (OR = 1.06; p < 0.001) were found to be significant independent predictors of FED. Conclusion: Prolonged straining and sensation of anorectal blockade were significant indicators of FED in patients with chronic constipation. (AU)

Epidemiology of Pancreatitis in the State of Odisha

Backgroundand Aims: Background and Aim of the Study: Acute pancreatitis is a surgical condition which may impact other organsresulting in damage to multiple organs or death. Chronic pancreatitis (CP) has deadly long-term consequences such as diabetes mellitusand pancreatic cancer. Although there have been several studies evaluating the epidemiology of pancreatitis in India, due to the diversityof the country, more evidence is required from different regions of the country. Therefore, this study evaluates the epidemiology of acuteand CP in the state of Odisha.Methodology: This study was a prospective study carried out in a single hospital, Institute of Medical Sciences and Sum Hospital,Bhubaneswar, during 2016–2017.Results: Results showed that there were more acute cases of pancreatitis (n=65, 73.9%) and overall pancreatitis was more prevalent inmen (n = 70; 79%). Unfortunately, an overwhelming majority of the patients do not know what aggravates (n = 71; 81.8%) or alleviates(n = 79; 89.8%) their condition. There was no significant difference in the type of pancreatitis (acute, chronic, acute, or chronic) bygender, smoking, educational status, diet, alcohol intake, socioeconomic status, and religion (P > 0.05).Conclusion: Men were more likely to develop acute and CP than women. Future studies should explore the genetic interactionsmodifying disease development, especially in India