El consumo de dos kiwis diarios podría mejorar el hábito intestinal en personas con estreñimiento crónico / Daily consumption of two kiwifruits could improve bowel habits in people with chronic constipation

A partir del caso de una paciente con síndrome de intestino irritable a predominio de estreñimiento cuyos síntomas mejoraron con el consumo regular de kiwi, el médico de familia se planteó la pregunta de si el kiwi podría mejorar los síntomas asociados a constipación crónica en comparación con el tratamiento habitual. Tras realizar una búsqueda de estudios que analizaran los efectos del consumo de kiwi sobre el hábito intestinal, fueron seleccionados tres artículos que permiten concluir que el consumo de esta fruta tiene una eficacia superior al placebo y comparable al psyllium y las pasas de ciruela para mejorar los síntomas de personas con estreñimiento crónico. (AU)

Based on the case of a patient with constipation-predominant irritable bowel syndrome whose symptoms improved with regular consumption of kiwi, the family doctor wondered if kiwi could improve symptoms associated with chronic constipation compared to usual treatment. After conducting a search for studies that analyzed the effects of kiwi consumption on intestinal habit, three articles were selected that allow us to conclude that the consumption of this fruit has an efficacy superior to placebo and comparable to psyllium and plum raisins to improve the symptoms of people with chronic constipation. (AU)

Carboxymethylcellulose and psyllium effects in sand output of horses with asymptomatic sand accumulation / [Efeitos da carboximetilcelulose e do psyllium sobre a eliminação de areia de cavalos com sablose assintomática]

The aim of this study was to evaluate the effects of Psyllium (PSY) and Carboxymethylcellulose (CMC) administration on fecal elimination of sand in horses with asymptomatic sand accumulations. Eight horses were selected from sandy areas and randomly divided into 2 groups of four animals. The subjects were treated either with CMC or PSY. The presence of intestinal sand was confirmed through radiography and glove sedimentation test. The study was performed in two phases, with a 7-day interval. In phase I, all the animals received 8 liters of warm water; in phase II, the CMC group received 8 liters of water + 1g/kg of CMC, whereas the PSY group received 8 liters of water + 1g/kg of PSY. All administrations were performed through nasogastric intubation and fractionated in 2 equal volume administrations with an interval of two hours. General and specific physical examination of the digestive system were performed in conjunction with abdominal ultrasonography before the administrations and after 6, 12, 24, 36 and 48 hours, aiming to evaluate intestinal motility and presence of sand. All the feces eliminated by the animals within the 72 hours following the administrations were quantified, diluted and sedimented in order to calculate the sand output (g/kg of feces). All the animals were also subjected to radiographic examination to quantify sand accumulation prior to phase I and after 72 hours of phases I and II. No adverse effects were observed after the treatments. It was possible to notice higher sand elimination in both groups during the phase I, whereas no difference was observed in sand elimination rates between the groups in phase II. The radiographic scores presented differences between the initial timepoint and 72h in phases I and II for both groups. Based on the sand elimination rates and radiographic score, this study demonstrated that sand output was greater after administration of water alone, compared to CMC and Psyllium, leading to the inference that removal of the sandy environment and prevention of sand re-ingestion are effective measures for the elimination of sand from the colon of horses with asymptomatic sand accumulations.(AU)

O objetivo deste estudo foi avaliar os efeitos da administração do psyllium (PSY) e da carboximetilcelulose (CMC) sobre a eliminação fecal de areia em equinos com sablose assintomática. Oito equinos com confirmação radiográfica de sablose assintomática foram divididos em dois grupos (grupo CMC e grupo PSY). O estudo foi realizado em duas fases, com intervalo de sete dias. Na fase 1, todos os animais receberam 8L de água; na fase 2, o grupo CMC recebeu 8L de água + 1g/kg de CMC e o grupo PSY recebeu 8L de água + 1g/kg de PSY. Antes da administração de cada solução e após seis, 12, 24, 36 e 48 horas, foram realizados exame físico e ultrassonografia abdominal. Todas as fezes eliminadas em 72 horas foram avaliadas para quantificar a eliminação de areia (g/kg de fezes). Antes da fase 1 e após 72 horas das fases 1 e 2, o exame radiográfico foi realizado para quantificar o escore de acúmulo de areia. Houve maior eliminação de areia após a administração de água em comparação com a administração de CMC, e não se observou diferença entre a CMC e o PSY. Uma redução significativa nos escores radiográficos de acúmulo de areia foi observada após a administração de água, bem como a manutenção dos escores após a administração da CMC e do PSY. Com base na produção de areia e no escore radiográfico, este estudo sugere que a remoção do ambiente arenoso, impedindo a reingestão de areia, é uma medida eficaz para a eliminação da areia do cólon de cavalos com acúmulos de areia assintomáticos.(AU)

Supplementation with psyllium seed husk reduces myocardial damage in a rat model of ischemia/reperfusion

BACKGROUND/OBJECTIVES: Myocardial infarction (MI) is caused by extensive myocardial damage attributed to the occlusion of coronary arteries. Our previous study in a rat model of ischemia/reperfusion (I/R) demonstrated that administration of arabinoxylan (AX), comprising arabinose and xylose, protects against myocardial injury. In this study, we undertook to investigate whether psyllium seed husk (PSH), a safe dietary fiber containing a high level of AX (> 50%), also imparts protection against myocardial injury in the same rat model. MATERIALS/METHODS: Rats were fed diets supplemented with PSH (1, 10, or 100 mg/kg/d) for 3 d. The rats were then subjected to 30 min ischemia through ligation of the left anterior descending coronary artery, followed by 3 h reperfusion through release of the ligation. The hearts were harvested and cut into four slices. To assess infarct size (IS), an index representing heart damage, the slices were stained with 2,3,5-triphenyltetrazolium chloride (TTC). To elucidate underlying mechanisms, Western blotting was performed for the slices. RESULTS: Supplementation with 10 or 100 mg/kg/d of PSH significantly reduces the IS. PSH supplementation (100 mg/kg/d) tends to reduce caspase-3 generation and increase BCL-2/BAX ratio. PSH supplementation also upregulates the expression of nuclear factor erythroid 2-related factor 2 (NRF2), and its target genes including antioxidant enzymes such as glutathione S-transferase mu 2 (GSTM2) and superoxide dismutase 2 (SOD2). PSH supplementation upregulates some sirtuins (NAD+-dependent deacetylases) including SIRT5 (a mitochondrial sirtuin) and SIRT6 and SIRT7 (nuclear sirtuins). Finally, PSH supplementation upregulates the expression of protein kinase A (PKA), and increases phosphorylated cAMP response element-binding protein (CREB) (pCREB), a target protein of PKA. CONCLUSIONS: The results from this study indicate that PSH consumption reduces myocardial I/R injury in rats by inhibiting the apoptotic cascades through modulation of gene expression of several genes located upstream of apoptosis. Therefore, we believe that PSH can be developed as a functional food that would be beneficial in the prevention of MI.

The Effect of Soluble Fiber Supplementation on Metabolic Syndrome Profile among Newly Diagnosed Type 2 Diabetes Patients

Diets with high fiber content improve most metabolic syndrome (MetS) profile in non-diabetic individuals, but there is scarce information about the role of fiber intake in patients with the MetS and diabetes. The objective of this study is to determine whether soluble fiber supplementation improve MetS profile for 8 weeks of intervention in newly diagnosed type 2 diabetes (T2D) adult patients. After one week of dietary stabilization phase, 36 newly diagnosed T2D patients were stratified to different strata according to sex, age, fasting blood sugar (FBS), and waist circumference (WC). Then they were randomly allocated into 2 groups. The psyllium group (n = 18) received 10.5 g of psyllium daily for 8 weeks. The control group (n = 18) maintained their regular diet for 8 weeks. Soluble fiber supplementation showed significant reduction in the majority of MetS profile; FBS (43.55 mg/dL, p < 0.001), triglyceride (37.89 mg/dL, p < 0.001), total cholesterol (20.32 mg/dL, p < 0.001), systolic blood pressure (7.50 mmHg, p < 0.001), diastolic blood pressure (2.78 mmHg, p = 0.013), and WC (2.54 cm, p < 0.001) in the intervention group compared with the control group after 8 weeks of intervention. The high-density lipoprotein cholesterol was reduced in both groups, but this reduction was insignificant. The improvement in the MetS profile was enhanced by combining psyllium to the normal diet. Consumption of foods containing moderate amounts of these fibers may improve MetS profile in newly diagnosed T2D patients. This study was registered in Current Controlled Trials (PHRC/HC/28/15).

Rice Cakes Containing Dietary Fiber Supplemented with or without Artemisia Annua and Gynura Procumbens Merr. Alleviated the Risk Factors of Metabolic Syndrome

We investigated whether the consumption of Korean rice cakes enriched with dietary fiber with or without polyphenol rich plants might decrease the risk factors of metabolic syndrome (MetS). Rice cakes were manufactured using fructooligosaccharides, resistant starch, and psyllium as sources of dietary fibers with and without polyphenol rich Artemisia annua and Gynura procumbens Merr. (RC+FP and RC+F, respectively), and prepared in three forms (songpyeon, seolgidduk, and chaldduk). Ninety subjects with at least one MetS risk factor were recruited for 6 weeks of dietary intervention. Sixty subjects were finally included for the analysis. Compared to the initial values, RC+FP group had decreased levels of fasting blood glucose (FBG), HOMA-IR and blood pressure after 6 weeks, whereas RC+F group didn't have significant changes in them. Regarding the improvement of individual MetS risk factors, RC+FP group showed significant reduction in FBG and blood pressures but RC+F group only had reduction in systolic blood pressure. After the intervention, a reduction in the number of MetS risk factors was greatert in the RC+FP group than in the RC+F group. In conclusion, Dietary fiber enriched rice cakes with or without polyphenols decreased the number and/or the levels of MetS risk factors. Polyphenol rich plant components may provide additional health benefits in controlling FBG and blood pressure.

Conventional Laxatives / 대한내과학회지

Based on published guidelines on the management of chronic constipation, secondary causes should be excluded and then patients should be told to increase their dietary fiber intake to 20-25 g per day. If these measures do not improve the symptoms, conventional laxatives are generally the next choice. Although there is limited evidence for the efficacy of these older laxatives due to a lack of well-designed clinical trials, most clinicians agree that they are effective at relieving the symptoms of constipation. Conventional laxatives include bulk-forming, osmotic, and stimulant laxatives. Bulking laxatives consist of fiber such as psyllium, cellulose, and bran. Osmotic laxatives are classified into sugar-based laxatives and polyethylene glycol. Bisacodyl and sodium picosulfate are stimulant laxatives. Understanding their mechanisms of action, efficacy, and side effects might improve the quality of life of patients suffering from chronic constipation.

Physicochemical characterization and evaluation of suspending properties of arabinoxylan from Ispaghula [Plantago ovata] husk

The purpose of this study is to evaluate the use of arabinoxylan as potential suspending agent, an effective alternative to commercially used excipients for the preparation of pharmaceutical suspensions. Alkali extraction was done to separate arabinoxylan from ispaghula [Plantago ovata] seed husk by alkali extraction its physicochemical characterization was done and the suspending properties of arabinoxylan isolated were evaluated comparatively with those of bentonite at different concentration ranges of 0.125,0.25,0.5 and 1% in Zinc oxide suspension. The parameters employed for evaluation were sedimentation volume, degree of flocculation, flow rate, density, pH, redispersibility, microbiological evaluation and particle size analysis. Physicochemical characterization of arabinoxylan indicates its suitability as excipient as it has fair flow properties, low moisture content and almost neutral pH. Arabinoxylan at low conc. 0.125% showed sedimentation volume comparable to commercially used suspending agents such as bentonite 1% while suspensions containing higher concentrations such as 0.25% [sedimentation volume 92%], 0.5% [sedimentation volume 94%] and 1% conc. [sedimentation volume 98%] of arabinoxylan remained almost completely suspended during study period of 7 days. Formulations containing 0.125% and 0.25% arabinoxylan as suspending agents are easily redispersible as compared to bentonite containing formulation while formulation containing 0.5% arabinoxylan are moderately redispersible while formulation containing 1% suspending agent gel upon storage and was not redispersible. Furthermore arabinoxylan produces stable, highly flocculated suspension, which fulfilled microbiological, and particle size specifications, however the formulations containing higher arabinoxylan 1% concentration gel upon storage. So it is concluded that arabinoxylan could be used as effective suspending agent at low concentrations in Zinc oxide suspension

[Review of antidiabetic plants in Iranian traditional medicine and their efficacy]

High prevalence of diabetes mellitus and its complications and increasing use of complementary therapies, especially herbal therapies, and the need of developing countries to use their indigenous medical methods, motivated us to introduce some plants used in Iranian traditional medicine for the treatment of this disease. The topic of "ziabetes" [the synonym of diabetes] in some of Iranian traditional medical texts were studied and herbal therapies of this disease were collected. Some edible plant compounds introduced and scientific names of plants in these compounds were identified. Pubmed and Scopus databases were searched for studies regarding hypoglycemic effects of these medicinal herbs on animal or human subjects. Many medicinal herbs and; minerals in single or compound form have been used in Iranian traditional medicine. Plants such as Punica granatum, Rosa damascene, Plantago psyllium, Glycyrrhiza glabra, Coriandrum sativum, Portulaca oleracea and Rumex patientia are the most popular ones. Recent studies on animal or human subjects have shown the hypoglycemic effects of some of these plants. Reassessment of the effects of some antidiabetic plants used in Iranian traditional medicine, proved their efficacy mainly in animals. However, we need more clinical trials to prove safety and; efficacy of these herbs and compounds

Fibras na dieta: tendências atuais e benefícios à saúde na síndrome metabólica e no diabetes melito tipo 2: [revisão] / Dietary fibers: current trends and health benefits in the metabolic syndrome and type 2 diabetes: [review]

As fibras dietéticas parecem contribuir tanto na prevenção quanto no tratamento do diabetes melito tipo 2 (DMT2). Em estudos epidemiológicos a ingestão de fibras insolúveis, e não de fibras solúveis, tem sido inversamente associada à incidência do DMT2. Por outro lado, em estudos pós-prandiais, refeições contendo quantidades suficientes de β-glucano, psyllium, ou goma-guar diminuíram as respostas da insulina e da glicose, tanto em indivíduos saudáveis como em pacientes com DMT2. Dietas enriquecidas com quantidade suficiente de fibras solúveis também parecem melhorar o controle glicêmico de uma forma geral no DMT2. As fibras insolúveis têm pouco efeito sobre as respostas pós-prandiais de insulina e glicose. As fibras da dieta aumentam a saciedade. Em alguns estudos, as fibras solúveis têm se associado com um menor aumento de peso corporal ao longo do tempo. Evidências limitadas, a partir de estudos transversais, sugerem uma associação inversa entre o consumo de fibras dos cereais e de grãos integrais e a prevalência de síndrome metabólica. Apesar da escassez de dados sobre estudos de mais longo prazo que foquem especificamente em fibras dietéticas, seguir a recomendação atual de 25 g de fibras ao dia, a partir de uma dieta rica em grãos integrais, frutas e legumes, provavelmente diminuirá o risco para a obesidade, síndrome metabólica e DMT2.

Dietary fiber may contribute to both the prevention and treatment of type 2 diabetes mellitus (T2DM). In epidemiological studies the intake of insoluble fiber, but not the intake of soluble fiber, has been inversely associated with the incidence of T2DM. In contrast, in postprandial studies, meals containing sufficiently quantities of β-glucan, psyllium, or guar gum have decreased insulin and glucose responses in both healthy individuals and patients with T2DM. Diets enriched sufficiently in soluble fiber may also improve overall glycemic control in T2DM. Insoluble fiber has little effect on postprandial insulin and glucose responses. Fiber increases satiety. In some studies, insoluble fiber has been associated with less weight gain over time. Limited cross-sectional evidence suggests an inverse relationship between intake of cereal fiber and whole-grains and the prevalence of the metabolic syndrome. Although long-term data from trials focusing on specifically dietary fiber are lacking, meeting current recommendations for a minimum fiber intake of 25 g/d based on a diet rich in whole grains, fruits and legumes will probably decrease the risk of obesity, the metabolic syndrome and T2DM.

Randomised study to compare the efficacy and safety of isapgol plus atorvastatin versus atorvastatin alone in subjects with hypercholesterolaemia.

Soluble fibre has been shown to augment the cholesterol-lowering effects of low-fat diets in individuals with mild to moderate hypercholesterolaemia. Combination therapy with a statin poses advantages in certain settings and may allow use of lower doses of multiple drugs rather than maximum doses of a single drug. The primary objective of the study was to compare the efficacy of combination of isapgol and atorvastatin versus atorvastatin alone, in the same dose, in reduction of low-density lipoprotein cholesterol (LDL-C), total-cholesterol levels in hypercholesterolaemic patients after 12 weeks of therapy. In a 12-week study, 100 subjects from both sexes and of > 20 years having hyperlipidaemia, with LDL-C level > 130 mg/dl and total cholesterol > 220 mg/dl were included, and were randomised to receive either a combination of isapgol powder (Naturolax) 5.6 g twice daily and atorvastatin 10 mg once daily or atorvastatin 10 mg once daily alone orally. Serum levels of total cholesterol, LDL-C, high-density lipoprotein cholesterol (HDL-C), and triglyceride were assessed at 8 and 12 weeks. Ninety-seven patients completed the study. At the end of the 8th week, both the groups had a significant reduction in mean LDL-C (20.5% in isapgol + atorvastatin group and 16.0% among atorvastatin alone group) as compared to baseline. But between the groups, however, the difference was not significant. At the end of the 12th week fall in LDL-C at 31.4% for isapgol + atorvastatin was significantly greater than 22.8% among the atorvastatin group (p < 0.05). Serum total cholesterol, HDL-C and triglyceride were significantly lowered within the groups at 8th and 12th weeks but between groups, the difference was not significant. Comparison of adverse events profile in both the groups shows that more number of patients from atorvastatin alone group (n = 14, 28%) had adverse reactions than the number of patients from the combination group (n = 4, 8%; p < 005).

Hemorroidectomia e evacuação fisiológica macrogol 3350 ou psyllium? / Macrogol 3350 or psyllium

Introdução: Nos pacientes submetidos a hemorroidectomia é importante a associação entre defecação e dor que, por vezes, é mais acentuada do que a própria dor do trauma cirúrgico (ferida operatória). Objetivo: Comparar a eficácia e tolerância de dois laxativos, macrogol 3350 e psyllium, avaliando qual produzirá melhor evacuação mais fisiológica e melhor recuperação pós-operatória de pacientes submetidos a hemorroidectomia. Metódos: foram avaliados pacientes portadores de doença hemorroidária mista, de ambos os sexos e com idade variável, submetidos a hemorroidectomia, em estudo clínico, prospoectivo, aberto, randonizado, comparativo entre dois grupos homogêneos: no I foi utilizado macrogol 3350 e no II, o mucilóide de psyllium. Todos os enfermos foram avaliados durante os primeiros sete dias de pós-operatório mediato. Resultados: foram incluídos 80 pacientes. No grupo I (macrogol) foram randomizados 38 enfermos (47,5por cento), dos quais 35 concluíram o estudo. Dois pacientes foram exclídos por não ter sido encontrados para responder aos questionamentos e um por não voltar para o retorno. P.O. Os 35 que completaram o protocolo do estudo em 19 (54,3por cento) do sexo feminino e 16 (45,7por cento) do sexo masculino, com idade variando de 31 a 68 anos (média de 49,5 anos). No grupo II (psyllium) foram inclídos 42 enfermos (52,5por cento), dos quais 38 concluíram o estudo. Os quatro excluídos o foram: dois por deixaremmde responder ao questionário por telefone, um por não voltar para o retorno P.O. e outro por parar de utilizar a medicação no 3º dia de P.O. Os 38 que completaram o protocolo eram 21 (55,2por cento) do sexo feminino e 17 (44,8por cento) do masculino, com idade variando de 29 a 66 anos (média de 47, 5 anos). Conclusão: 1) Os quatro parâmetros que caracterizaram a evacuação como fisiológica foram melhores, estatisticamente, no grupo de pacientes que utilizaram o macrogol, em todos os dias do pós-operatório mediato (exceção ao 1º dia), indicando s...

Effect of four natural sources of soluble fibres on serum cholesterol level in rats

Work carried out to investigate the effect of diets containing natural sources of soluble-fibre showed significant reduction of serum cholesterol levels in rats. The fibre sources were gum hashab [gum H], gum ta [gum T], psyllium and okra [dry] "Weika". The period of the study in the three experiments was six weeks. Three experiments were carried out on rats that consumed diets containing high fat, high fat and 0.1% cholesterol and parboiled psyllium or okra. In addition these diets contained the four natural soluble fibres under investigation. The results showed interesting variations in percentages of reduction with different fibre sources, the maximum reduction of cholesterol 84% occurring in diets containing high fat, 0.1% cholesterol and 3% psyllium at the fourth week

Effects of Psyllium Husk for the Management of Neurogenic Bowel in Chronic Spinal Cord Injured Persons

OBJECTIVE: The purposes were to determine the baseline colon transit time (CTT) and to assess the effect of dietary fiber (psyllium husk) on neurogenic bowel function in chronic spinal cord injured (SCI) persons. METHOD: Eleven chronic spinal cord injured persons with upper motor neuron type neurogenic bowel were participated. Personal interview were carried out for all studied subjects at pre and post treatment period. The baseline colon transit time (CTT) were measured for the right (rCTT), left (lCTT), rectosigmoid (rsCTT) colons as well as for the entire colon using radio-opaque markers. After 4 weeks treatment of psyllium husk, the subjects were reevaluated for their CTTs and the results were compared to the pretreatment values. RESULTS: The mean age of the subjects was 33.9+/-11.0 years and the level of injury ranged from C3 to T10. The mean duration after SCI was 22.6 months (6~47 months). The rCTT, lCTT, rsCTT and tCTT were not affected after the treatment of psyllium husk. Also their bowel care patterns and satisfaction were unaffected by the treatment. CONCLUSION: The results of this study suggest that the use of psyllium husk in chronic spinal cord injured persons do not show the same effect on bowel function as has been previously reported in general population with idiopathic constipation.

Estudo clínico do Psyllium Husk associado à parafina microencapsulada no tratamento da constipaçäo intestinal essencial / Clinical study of psyllium Husk combined to microencapsulated paraffin in intestinal primary constipation therapy

O autor avaliou, segundo a técnica de randomizaçäo da modalidade duplo-cega, o Psyllium Husk associado com a parafina microencapsulada (medicamento I), comparativamente com um produto convencional à base de Psyllium isoladamente (medicamento II), em pacientes portadores de constipaçäo intestinal essencial. As duas fases de três semanas foram separadas por uma janela terapêutica de três dias. Os resultados demonstraram um aumento estatisticamente significativo no número de evacuaçöes por semana com o medicamento I. A tolerabilidade foi excelente em todos os indivíduos, com aceitaçäo satisfatória pelos pacientes. O autor conclui que o medicamento I em estudo foi eficaz, sem ocorrência de efeitos colaterais, no tratamento da constipaçäo intestinal essencial.(au)

Efficacy, safety and tolerability of psyllium hydrophilic mucillpod in mild to moderate hypercholestrolemia

Coronary heart disease is the leading cause of death. Hypercholesterolemia and specially increased LDL cholesterol is the major risk factor in coronary heart disease. Psyllium hydrophilic mucilloid [PHS] is used for decades as laxative agent for the treatment of constipation. Now its role in reducing cholesterol level is well established. We used PHS as adjunctive to low fat diet and we found it effective, safe and well tolerable in patients with mild to moderate hypercholesterolemia. Psyllium [PHS] 3.4 G three times daily as adjunctive to low fat diet reduced total cholesterol and LDL cholesterol by 12.1% and 20.8% with mild transient gastrointestinal disturbances

Passive Bowel Movement with a New Colostomy Device: An Acute Experiment in Dog

In some clinical situations such as cerebrovascular accident, pelvic bone fracture or any bed ridden states patients do not have self control of their bowel movement. Nursing care around the perianal area is not an easy job. There is no devices which substitude the work because of the chracteristics of the anatomy of the anorectum and the fecal matter made of solid and gel state component. AIM: to evaluate the possibility of passive evacuation of the fecal matter from the rectum with a newly developed silicon device. MATERIAL AND METHODS: A New Colostomy Device (NCD; US Patent No. 5,569,216) for fixing in the stoma or rectum of human body, includes an internal balloon, a ring figured external balloon surrounding the internal balloon, a connecting tube disposed under the both internal and external balloons and supply tube containing a pair of air passages and an enema fluid passages. It is designed to be inserted into the rectum and is held in place by an inflatable external balloon and drains irrigated fecal matter through a thin collapsible connecting tube which exist in the anal canal. Six mongrel dog with 20~25 kg of body weight was used for the acute experiment. Three types (1.5, 2.0, 2.5 cm in luminal diameter of the solid portion) of NCD were applied in 3 consecutive every other days. For softening of the stool, normally harder than that of human, Psyllium dextrose 30 gm was added to the daily food. Average 750 cc of tepid water was administered through the device for bowel irrigation. Anesthesia was not used in each procedures. The amount evacuated fecal matter and remained solid stool in rectum were checked. To evaluate the rectal mucosal injury anoscopic examinations were performed. RESULTS: Stool evacuation was closely correlated with the intemal diameter of the device and stool component. The device with 2.5 cm in luminal diameter passed fecal matter well enough in 5 of 6 dogs however, smaller devices did not. Accidental prolapse of NCD were noted in 4 of 6 cases with 2.5 cm sized and all of 1.5 and 2.0 sized devices eventually until last push. CONCLUSION: The NCD with 2.5 cm of internal diameter could be used in selected clinical situations.

Application of a New Colostomy Device in Incontinent Dog Model

BACKGROUND: Recently developed electrically stimulated gracilis neosphicter or artificial sphincter is quite a promising trial in fecal incontinence However, surgical technique is not simple, the devices are expensive and only specialists can perform the procedures successfully. The aim of this study is to evaluate the efficacy of a newly developed simple silicon device in incontinent dog model. METHODS: A New Colostomy Device (NCD; US Patent No. 5,569,216) for fixing in the stoma or rectum of human body, includes an internal balloon, a ring figured extemal balloon surrounding the internal balloon, a connecting tube disposed under the both infernal and external balloons and supply tube containing a pair of air passages and an enema fluid passage. It is designed to be inserted into the rectum and is held in place by an inflatable external balloon and drains irrigated fecal matter through a thin collapsible connecting tube which exist in the anal canal. Six mongrel dog with 22~26 kg of body weight were prepared. Anal incontinence was made by bilateral severing of the internal and external sphincters and puborectalis muscle under the general anesthesia. Marlex mesh ring was applied to the anal canal as Thiersch wire for the prevention of NCD expulsion in straining. After then, NCD with 2.5 cm of luminal diameter was inserted to the rectum proximal to the Malex mesh ring. Daily irrigation and evacuation was done with 800~1000 cc of tepid water in each dogs. Daily food contained 30 gm of Psyllium dextrose. RESULTS: Initially 6 dogs were observed for 7 days. Daily irrigation made evacuation of fecal matter well in each dogs. There was no prolapse of device through the anal orifice. Anoscopic examination after 7 days showed no rectal and anal mucosal injury. Two dogs were kept for 40 days as same manner. Sometimes spontaneous bowel movement without water irrigation was noted when the stool were loose. Weelky anoscopic examination revealed no evidence of mucosal injuries for 40 days also. There was no septic or other complication. CONCLUSION: NCD evacuated fecal matter well enough to empty the rectum in all incontinence dog model. Adequate sized NCD could be used for clinical trials in selected incontinence patients.