• The Journal of Internal Korean Medicine
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• v.33 no.2
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• pp.209-221
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• 2012

Objectives : The aim of this study was to investigate the relationship between the autonomic nervous system and the cold-heat pattern in patients with chronic constipation. Methods : Subjects with chronic constipation (n=30) and without chronic constipation (n=20) were recruited, interviewed and measured for heart rate variability (HRV). Chronic constipation was defined as functional constipation and Irritable Bowel Syndrome (IBS) with constipation based on Rome III criteria. We surveyed patients' general characteristics, categorized by cold-heat pattern, and took measurement of HRV for 5 minutes. Analysis was conducted among these three indices. Results : Women accounted for most of the subjects with chronic constipation (96.7%). In groups with or without constipation, the number of cold patterns was more than of heat patterns. The mean heart rate of subjects without chronic constipation was significantly higher than that of subjects with chronic constipation. No other statistical significance was noted among indices of HRV and cold-heat pattern. Conclusions : Through this study, there were few relationships between autonomic nervous system measured by HRV and cold-heat pattern in chronic constipation.

• Clinical and Experimental Pediatrics
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• v.48 no.4
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• pp.355-362
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• 2005

Constipation is very common phenomenon during childhood that accounts approximately 3% of general pediatric outpatient visits and up to 25% of visit to the pediatric gastroenterologist. The diagnosis of functional constipation is based on the historical features and absence of physical abnormalities. Most infants and children with chronic constipation require no diagnostic tests. Constipation and subsequent fecal retention behavior often begins soon after experience of painful defecation. The effective management of childhood chronic constipation consist of education, prolonged support by physicians and parents, medications, and long term follow up.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.sup1
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• pp.44-54
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• 2008

Chronic functional constipation is a common problem in childhood, with soiling a significant issue. It presents a management problem for pediatrician, and parental concern is high. About 5% of pediatric patients is known to have constipation and/or encopresis which is the second most referred disease in pediatric gastroenterology clinic, accounting for up to 25% of all visits. The etiology of constipation was based on initiation factors including vicious cycle concept, genetic factors, psychological factors, dietary influences and histologic abnormalities of colon. Emphasis is placed on the evaluation and management options that are available to the treating pediatrician. Careful history taking is most important to diagnose functional constipation. In addition, diagnostic tests such as plain abdominal radiograph, colonic transit study, anorectal manometry, barium enema were helpful to diagnose the constipation. Childhood constipation can be very delicate to treat. It often requires prolonged supports by physicians and parents, demystification, medical treatment and especially with the child and parent's cooperation.

• The Journal of Korean Obstetrics and Gynecology
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• v.36 no.3
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• pp.46-61
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• 2023

Objectives: The purpose of this systemic review is to overview and evaluate the efficacy of acupuncture in female patients with chronic constipation. Methods: We conducted a comprehensive search of the literature to identify randomized controlled trials that investigated the effects of acupuncture on female patients with chronic constipation. Key words searched included "Female Constipation", "Women Constipation", "Acupuncture" in database KISS, DBPIA, RISS, Cochrane Central, Scopus, Pubmed, CNKI. Results: Nine randomized controlled trials met our inclusion criteria and were included in this systematic review. Our analysis found that acupuncture was associated with significant improvements in spontaneous bowel movements, complete spontaneous bowel movements, stool consistency, and quality of life in female patients with chronic constipation. Acupuncture was generally well-tolerated, with few adverse effects reported. Conclusions: Our findings suggest that acupuncture treatment would be effective way to treat chronic constipation of female patients.

• Journal of Acupuncture Research
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• v.25 no.5
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• pp.127-137
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• 2008

Objectives : These days, herbal acupuncture therapy is widely applied to many diseases and symptoms by Korean medical doctors in Korea. The aim of this study was to demonstrate the effect of Carthami-Semen herbal acupuncture(CSHA) on chronic constipation. Methods : This single-blind placebo-controlled randomized parellel study enrolled 24 adults with chronic constipation. After one week's run-in period, they were randomly assigned to receive CSHA therapy, or placebo therapy for 4 weeks by 2 times per week. After completing 4 week's therapy, 2 week's follow-up period was continued. During study, defecation frequency, consistency and ease of evacuation were checked before study, every week and follow-up periods. Also, the VAS of constipation, quality of life(QoL) and heart rate variability(HRV : low frequency, high frequency) were checked 3 times totally. Finally, 21 subjects completed the protocol and 20 subjects were analyzed.(1 subject is excluded for analysis because of not following the protocol.) Results : In CSHA group, defecation frequency(continued after 1 week), consistency and ease of evacuation(at 1 week after and follow-up) were increased significantly. The VAS of constipation in CSHA group was significantly decreased. There was no significant change at QoL and HRV. Conclusions : CSHA therapy was effective in treating adults with chronic constipation. Study that have larger case number and longer follow up will be needed in the future.

• Journal of Physiology & Pathology in Korean Medicine
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• v.17 no.1
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• pp.251-257
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• 2003

Background and Purpose : We were to investigate whether simple and electric acupuncture can affect the colonic transit time in both normal persons and chronic constipation patients. Methods: Twenty one volunteers were divided into two groups; first, normal control group(N=12) who had normal defecation habits, second, chronic constipation group(N=13). Before acupuncture, colonic transit time was checked using radio-opaque markers. Then simple acupuncture was done at four acupoints(both ST36, LI4) and maintained for 15 minutes during 4 days. Electric acupuncture was done using same methods except for applying 2Hz electrical stimulation. Result : In the normal group, after simple acupuncture, each transit time in the total, right, left was not changed statistic significance compared to pre-acupuncture(P>0.05), but which of rectosigmoid colon shortened statistic significance(P<0.05). After Electric acupuncture, transit time of right colon was shortened(P<0.05), and extended(P>0.05) in rectosigmoid colon compared to pre-acupuncture and simple acupuncture. In constipation group, after simple acupuncture, only rectosigmoid colonic transit time shortened statistic significance compared to pre-acupuncture(P<0.05). After electric acupuncture, also the transit time of rectosigmoid colon was shortened statistic significance compared to pre-acupuncture(P<0.05), but not to simple acupuncture(P>0.05). Conclusion : In normal persons without constipation, acupuncture affect the colonic transit time differently to the methods of it. In chronic constipation group, simple and electric acupuncture only reduces the rectosigmoid colonic transit time statistically significant(P<0.05).

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.4
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• pp.203-208
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• 2014

Chronic constipation is a very common disease in children. Successful treatment of constipation can be achieved not only with medication but also with lifestyle changes, including a proper diet. Diets including fruits, fluids, and probiotics are good for constipation. Some dietary components are helpful for constipation, and some are harmful. In this study, we present diets related to constipation from the literature, and propose some perspectives regarding diets related to constipation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.1
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• pp.38-43
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• 2016

Purpose: Each ethnic group has a unique life style, including diets. Life style affects bowel movement. The aim of this study is to describe the results of colon transit time (CTT) tests in Korean children who had chronic functional constipation based on highly refined data. Methods: One hundred ninety (86 males) out of 415 children who performed a CTT test under the diagnosis of chronic constipation according to Rome III criteria at Konkuk University Medical Center from January 2006 through March 2015 were enrolled in this study. Two hundreds twenty-five children were excluded on the basis of CTT test result, defecation diary, and clinical setting. Shapiro-Wilk and Mann-Whitney U, and chi-square tests were used for statistical analysis. Results: The median value and interquartile range (IQR) of CTT was 54 (37.5) hours in Encopresis group, and those in non-encopresis group was 40.2 (27.9) hours (p<0.001). The frequency of subtype between non-encopresis group and encopresis was statistically significant (p=0.002). The non-encopresis group (n=154, 81.1%) was divided into normal transit subgroup (n=84, 54.5%; median value and IQR of CTT=26.4 [9.6] hours), outlet obstruction subgroup (n=18, 11.7%; 62.4 [15.6] hours), and slow transit subgroup (n=52, 33.8%; 54.6 [21.0] hours]. The encopresis group (n=36, 18.9%) was divided into normal transit subgroup (n=8, 22.2%; median value and IQR of CTT=32.4 [9.9] hours), outlet obstruction subgroup (n=8, 22.2%; 67.8 [34.8] hours), and slow transit subgroup (n=20, 55.6%; 59.4 [62.7] hours). Conclusion: This study provided the basic pattern and value of the CTT test in Korean children with chronic constipation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.2
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• pp.131-134
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• 2013

Cecal volvulus is uncommon in pediatric patients and there are few reports of cecal volvulus with cerebral palsy. Here, we report the case of a 19-year-old male patient who presented with abdominal distension, a history of cerebral palsy, refractory epilepsy due to lissencephaly, and chronic constipation. An abdominal x-ray and computed tomography without contrast enhancement showed fixed dilated bowel intensity in the right lower abdomen. Despite decompression with gastric and rectal tube insertion, symptoms did not improve. The patient underwent an exploratory laparotomy that revealed cecal volvulus. Cecal volvulus usually occurs following intestinal malrotation or previous surgery. In this patient, however, intestinal distension accompanying mental disability and chronic constipation resulted in the development of cecal volvulus. We suggest that cecal and proximal large bowel volvulus should be considered in patients presenting with progressive abdominal distension combined with a history of neuro-developmental delay and constipation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.2
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• pp.127-133
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• 2023

Purpose: Dyssynergic defecation (DSD) is one of the important causes of chronic constipation in children. We aimed to analyze the clinical features, diagnostic test results, and treatments for DSD in children. Methods: Children diagnosed with DSD using fluoroscopic defecography were enrolled in this study. Clinical data, including the results of colon transit time (CTT) test and biofeedback (BF) therapy, were collected from medical records retrospectively. Results: Nineteen children were enrolled. The median age was 9 years (6-18 years), the median frequency of bowel movement was 1/7 days (1-10 days), the median duration of constipation was 7.0 years (2-18 years), the median age of onset of constipation was 2.5 years (1-11 years). In the CTT test, outlet obstruction type was noted in 10/18 (55.6%), slow transit type in 5/18 (27.8%), and normal transit in 1/18 (5.6%). The median CTT was 52 hours (40-142 hours). Initial medical therapy was performed with the polyethylene glycol 4000, and the response was good in 9/19 (47.4%), fair in 9/19 (47.4%), and poor in 1/19 (5.0%). BF was performed in 8/19, with good results in 6/8 (75.0%) children and failure in 2/8 (25.0%) children. After long-term medical therapy (11/19), 3/5 showed good response with medication alone, 6/8 showed good response with BF and medication combined. Conclusion: DSD should be considered as a cause of chronic constipation in children, especially in those with abnormal CTT test results. BF combined with medical therapy is effective even with age-limited cooperation.