Clinical practice guidelines from the French National Society of Coloproctology in treating chronic constipation

(Véronique), Vitton; Damon, Henri; Benezech, Alban; Bouchard, D.; Brardjanian, S.; Brochard, Charlène; Coffin, Benoït; Fathallah, Nadia; Higuero, Thierry; Jouët, Pauline; Am, Leroi; Luciano, Laure; Meurette, G.; Piche, Thierry; Ropert, Alain; Jm, Sabaté; Siproudhis, L.

doi:10.1097/meg.0000000000001080

Cited by 20 publications

(34 citation statements)

References 79 publications

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“…The remaining two TCM CPGs and one IM CPG were generated as CB guidelines[34,41,42]. One CPG focused only on treatment[43], and the remaining FC CPGs were comprehensive guidelines. Four guidelines pertained to both diseases, while one CPG only discussed the symptom of constipation, namely, IBS-constipation (IBS-C), and FC[45].…”

Section: Resultsmentioning

confidence: 99%

“…The 2016 Korean FC guideline provided a symptomatic definition of chronic constipation, including infrequent bowel movements, hard stool, sensation of incomplete evacuation, straining while defecating, sensation of anorectal blockage during defecation, and assistance of digital maneuvers[40]. In the 2018 French FC guideline, diagnostic information was not included[43]. Because the ROME criteria were updated over time, the diagnostic criteria given by the CPGs also continued to evolve.…”

Section: Resultsmentioning

confidence: 99%

“…Among the nine CPGs that mentioned physical exercise, six gave weak recommendation[38,40-42,44,48], and three considered there to be insufficient evidence[37,43,45]. In addition, of the nine guidelines that referred to increased fluid intake, five provided weak recommendation[35,38,41,42,44], and the other four reported insufficient evidence[37,43,45,48]. With regard to increasing dietary fiber, two guidelines recommended that consuming food with a high soluble fiber content could benefit mild constipation[43,48].…”

Section: Resultsmentioning

confidence: 99%

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Irritable bowel syndrome and functional constipation management with integrative medicine: A systematic review

Dai¹,

Zhong²,

Ji³

2019

WJCC

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BACKGROUNDIrritable bowel syndrome (IBS) and functional constipation (FC) are two commonly encountered functional gastrointestinal disorders in clinical practice and are usually managed with Western medicines in cooperation with traditional Chinese medicine (TCM) interventions. Although clinical practice guidelines (CPGs) have been developed to assist clinicians with their decisions, there are still gaps in management with regard to integrative medicine (IM) recommendations.AIMTo comprehensively review the currently available CPGs and to provide a reference for addressing the gaps in IBS and FC management.METHODSWe searched mainstream English and Chinese databases and collected data from January 1990 to January 2019. The search was additionally enriched by manual searches and the use of publicly available resources. Based on the development method, the guidelines were classified into evidence-based (EB) guidelines, consensus-based (CB) guidelines, and consensus-based guidelines with no comprehensive consideration of the EB (CB-EB) guidelines. With regard to the recommendations, the strength of the interventions was uniformly converted to a 4-point grading scale.RESULTSThirty CPGs met the inclusion criteria and were captured as data extraction sources. Most Western medicine (WM) CPGs were developed as EB guidelines. All TCM CPGs and most IM CPGs were identified as CB guidelines. Only the 2011 IBS and IM CPG was a CB-EB set of guidelines. Antispasmodics and peppermint oil for pain, loperamide for diarrhea, and linaclotide for constipation were relatively common in the treatment of IBS. Psyllium bulking agents, polyethylene glycol and lactulose as osmotic laxatives, bisacodyl and sodium picosulfate as stimulant laxatives, lubiprostone and linaclotide as prosecretory agents, and prucalopride were strongly recommended or recommended in FC. TCM interventions were suggested based on pattern differentiation, while the recommendation level was considered to be weak or insufficient.CONCLUSIONWM CPGs generally provide a comprehensive management algorithm, although there are still some gaps that could be addressed with TCM. Specific high-quality trials are needed to enrich the evidence.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Irritable bowel syndrome and functional constipation management with integrative medicine: A systematic review

Dai¹,

Zhong²,

Ji³

2019

WJCC

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“…A major paper recently published is the French consensus on therapy of chronic constipation, written by the National Coloproctology Society of France [24]. This working group arrived to a consensus stating that anorectal biofeedback should represent the gold standard for the therapy of anorectal dyssynergia, but only if no response to medical treatment can be observed.…”

Section: The Experience Of Other Centers On Anorectal Biofeedbackmentioning

confidence: 99%

Factors Predicting Failure in Anorectal Biofeedback

David¹,

Farcău²,

Dumitraşcu³

et al. 2018

Biofeedback

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Anorectal biofeedback is a method used by specialists in gastrointestinal motility to treat disorders of defecation. In the case of the anorectal biofeedback, unlike in biofeedback applications in other medical fields, the signal is represented by the pressure in the anorectal canal. The pressure is assessed by anorectal manometry. Patients are trained to become aware of this signal in an attempt to reeducate them for a correct defecation. Following the variation of the signals, patients can learn how to modulate the anal sphincter pressure and to improve their defecation disorders. Anorectal biofeedback is therefore used for fecal incontinence and for chronic terminal constipation. Despite its potential, the method is not intensively used and many patients ignore it. The specialists' evaluation of the method is controversial: from enthusiastic to deceiving results, different data are available. The aim of this presentation is to analyze factors of success and of failure in the use of anorectal biofeedback in a single center specialized in anorectal manometry and to compare our data with results described by other authors.

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“…Chronic constipation is a common disease and is usually divided into primary and secondary constipation, with a prevalence rate of 10-15% [1] . It can signi cantly affect the quality of life of patients.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional ultrasonography study of female defecation disorder caused by changes of the puborectalis muscle

Zhang

Liu

Wang³

et al. 2019

Preprint

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Objective To investigate the correlation between pelvic floor dyssynergia-type constipation and the puborectalis muscle using three-dimensional ultrasonography. Methods Eighty-seven patients with pelvic floor dyssynergia-type constipation (observation group) and 87 healthy volunteers (control group) were enrolled in this study. Three-dimensional ultrasonography of the pelvic floor was performed on patients and healthy volunteers in a lithotomy position at rest and during straining and squeezing. The three-dimensional reconstructed sonogram was analysed to determine the puborectalis angle and puborectalis thickness at the 6 o’clock position (patients in a lithotomy position). Results (1) The puborectalis angles of the observation and control groups were not significantly different at rest [(85.664 ± 1.926)°, (85.813 ± 1.500)°] and during squeezing [(87.478 ± 2.125)°, (86.960 ± 1.751)°] (P > 0.05) but were significantly different when straining [(80.389 ± 2.268)°, (94.382 ± 1.540)°] (P < 0.05). The difference in the puborectalis angles of the two groups between rest and straining [(5.275 ± 1.236)°, (-8.569 ± 1.209)°] was statistically significant (P < 0.05). (2) The puborectalis thickness of the observation and control groups was not significantly different at rest ([3.994 ± 0.128) mm, (3.983 ± 0.091) mm] and during anal squeezing [(4.082 ± 0.154) mm, (4.126 ± 0.113) mm] (P > 0.05) but was significantly different when straining [(4.630 ± 0.199) mm, (4.296 ± 0.121) mm] (P < 0.05). The differences in the puborectalis thickness at rest and during straining in the observation and control groups were (-0.636 ± 0.217) mm and (-0.316 ± 0.089) mm, respectively, resulting in a statistically significant difference between the two groups (P < 0.05). Conclusion The puborectalis angle in patients with pelvic floor dyssynergia-type constipation was smaller than that in healthy volunteers during straining. The puborectalis thickness at the 6 o’clock position with the patient in a lithotomy position in patients with pelvic floor dyssynergia-type constipation was larger than that in healthy volunteers. Moreover, larger differences between rest and straining are associated with a more severe degree of constipation. Project funding Natural Science Foundation of Shandong (ZR2012HM086)

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Clinical practice guidelines from the French National Society of Coloproctology in treating chronic constipation

Cited by 20 publications

References 79 publications

Irritable bowel syndrome and functional constipation management with integrative medicine: A systematic review

Irritable bowel syndrome and functional constipation management with integrative medicine: A systematic review

Factors Predicting Failure in Anorectal Biofeedback

Three-dimensional ultrasonography study of female defecation disorder caused by changes of the puborectalis muscle

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