Conservative Measures for Managing Constipation in Patients Living With a Colostomy

Outpatient treatment for colostomy stenosis; report of 3 cases

INTRODUCTION AND IMPORTANCE

Stenosis of the colostomy occurs in 2-15% of patients and, they are the cause of serious discomfort for the patient due to the difficulty in evacuation, as well as the need for new surgical interventions. The purpose of this work demonstrates an outpatient surgical treatment that can be performed in the office.

CASE PRESENTATION

Three patients with definitive colostomy who suffered progressive stenosis are presented. Under local anesthesia, one or two triangular segments, with their bases on the colostomy, which included the thickened and hardened skin, are removed to expand the diameter of the stoma. The mucosa of the colon is sutured to healthy skin with Vicryl 3/0 simple stitches. This method has been used in three patients older than 60 years with permanent colostomy who presented with progressive stenosis 6-7 months after surgery. The average follow-up at 14.5 months was satisfactory, without restenosis.

DISCUSSION

Stoma stenosis is a complication that occurs in up to 15% of cases and requires reconstruction, most of which are carried out in the operating room. The triangular stenoplasty presented is effective and is performed under local anesthesia in the office.

CONCLUSION

Triangular-section stenoplasty of a stenosed permanent colostomy is an effective outpatient treatment.

Dietary fiber and the microbiota: A narrative review by a group of experts from the Asociación Mexicana de Gastroenterología

Dietary fiber intake is one of the most influential and efficacious strategies for modulating the gut microbiota. Said fiber can be digested by the microbiota itself, producing numerous metabolites, which include the short-chain fatty acids (SCFAs). SCFAs have local and systemic functions that impact the composition and function of the gut microbiota, and consequently, human health. The aim of the present narrative review was to provide a document that serves as a frame of reference for a clear understanding of dietary fiber and its direct and indirect effects on health. The direct benefits of dietary fiber intake can be dependent on or independent of the gut microbiota. The use of dietary fiber by the gut microbiota involves several factors, including the fiber's physiochemical characteristics. Dietary fiber type influences the gut microbiota because not all bacterial species have the same capacity to produce the enzymes needed for its degradation. A low-fiber diet can affect the balance of the SCFAs produced. Dietary fiber indirectly benefits cardiometabolic health, digestive health, certain functional gastrointestinal disorders, and different diseases.

Dietary fiber and the microbiota: A narrative review by a group of experts from the Asociación Mexicana de Gastroenterología

Dietary fiber intake is one of the most influential and efficacious strategies for modulating the gut microbiota. Said fiber can be digested by the microbiota itself, producing numerous metabolites, which include the short-chain fatty acids (SCFAs). SCFAs have local and systemic functions that impact the composition and function of the gut microbiota, and consequently, human health. The aim of the present narrative review was to provide a document that serves as a frame of reference for a clear understanding of dietary fiber and its direct and indirect effects on health. The direct benefits of dietary fiber intake can be dependent on or independent of the gut microbiota. The use of dietary fiber by the gut microbiota involves several factors, including the fiber's physiochemical characteristics. Dietary fiber type influences the gut microbiota because not all bacterial species have the same capacity to produce the enzymes needed for its degradation. A low-fiber diet can affect the balance of the SCFAs produced. Dietary fiber indirectly benefits cardiometabolic health, digestive health, certain functional gastrointestinal disorders, and different diseases.

Effects of a nutraceutical supplement on gastrointestinal health in racing standardbreds

BACKGROUND

Feed additives that accelerate gastrointestinal transit time may help support normal gastrointestinal function in horses at risk for impaction colic. Previous research has demonstrated significant stimulatory effect of a hemp-based nutraceutical product (Gs Formula; GF) on contractility of gastric smooth muscle and gastrin production in vitro.

OBJECTIVES

To quantify effects of GF on indicators of GIT transit time and tight junction proteins.

STUDY DESIGN

Randomized placebo-controlled cross-over study.

METHODS

Eight Standardbreds were administered 200 plastic beads by nasogastric tube before (baseline; BL) and after receiving a diet containing GF (CON: 0 g/day, LO: 160 g/day or HI: 480 g/day) for 28 days. Total manure collection occurred every 2 hours for 72 hours after bead administration. Outcome measures included GIT transit time, faecal dry matter (DM), water intake, and complete biochemistry and haematology screens.

RESULTS

There was no effect of GF on GIT transit time. Faecal output was significantly lower in LO and HI horses than CON horses after 28 days on the supplement. HI horses have significantly lower rouleaux formation and lower faecal DM on Day 28 compared with BL. GF also produced changes in electrolytes associated with pH balance, which may indicate a role for GF as an alkalinizing compound in exercising horses. Clinical pathology results support the safety of GF up to 480 g/day for 28 days with no adverse effects being observed in haematology or biochemistry results.

MAIN LIMITATIONS

Future studies on GF should focus on evaluating effect of GF on gastrointestinal transit in horses with naturally or experimentally delayed gastrointestinal motility, and its effect on exercise performance and onset of fatigue.

CONCLUSIONS

GF may help support normal gastrointestinal function in horses at risk for impaction colic by reducing faecal DM and rouleaux formation.

Dietary management in people with an ileostomy: a scoping review protocol

REVIEW QUESTION/OBJECTIVE

The objective of this scoping review is to identify and map the evidence for oral dietary management of ileostomies.The primary review question is: what oral dietary strategies for managing ileostomies in humans have been reported?The secondary review questions are: i) what types of evidence have considered oral dietary strategies for managing ileostomies; ii) what aspects of ileostomy management (for example, stoma output or flatulence) are the oral dietary strategies considered to affect; and iii) what sources do people with an ileostomy receive dietary advice from?

Butyric acid - a well-known molecule revisited

The properties of butyric acid, and the role it plays in the gastrointestinal tract, have been known for many years. However, the newest research shows that butyric acid still remains a molecule with a potential that has not as yet been fully exploited. The article provides an outline of relevant up-to-date knowledge about butyric acid, and presents the expert position on the clinical benefits of using butyric acid products in the therapy of gastrointestinal diseases.