서울지역 여고생의 배변 실태와 음료 섭취에 관한 연구

임은태,김영남 대한지역사회영양학회 2003 대한지역사회영양학회지 Vol.8 No.6

The purpose of this study was to study the relationship between the prevalence of constipation and beverage intake. Research data were collected from first and second grade female students at Hyehwa High School in Seoul by means of questionnaires. A total of 190 questionnaires were analyzed using the SPSS/WIN program. The results are summarized as follows: The average body mass index (BMI) was 20.7. Of the students, 38.4% had a BMI of less than 20 (underweight), and 15.8% had a BMI of over 23 (overweight). However, 84.7% of the students wanted to lose weight. To estimate the prevalence of constipation, five factors were used: frequency and regularity of defecation, time spent defecating, defecation difficulty, and feeling of residue after defecation. The percentage of the students who emptied their bowels every day was 22.1 %. About 2/5 of the students (42.1%) had irregular defecation, and 15.2% spent more than 10 minutes in the rest room when defecating. The students who did not have difficulty defecating and those who did not have feelings of residue after defecating were only 24.7% and 28.9%, respectively. The amount of beverage intake per day was 1,062ml: 674ml of water, 128ml of milk, 88ml of soft drinks, and 53ml of fruit juice. The amount of beverage intake before breakfast, during breakfast, before lunch and during lunch was about 100ml, each; before dinner, during dinner, and after dinner it was about 200ml, each. The amount of beverage intake during the weekend was 120ml greater than on weekdays. Students who drank more beverages, especially water, before breakfast, showed a higher defecation frequency, more regular defecation, spent less time defecating, had less difficulty defecating, and had less feeling of residue after defecation, so that they have a better defecation pattern. Based on these results, increasing the amount of beverage consumption, especially of water, and drinking greater quantities of beverage before breakfast are ways to reduce constipation. (Korean J Community Nutrition 8(6): 856~866, 2003)

사상 체질별 대소변 소증에 대한 체계적 고찰 연구

박유경,한상윤,채한,배나영,PARK, Yu-Gyeong,HAN, Sang Yun,CHAE, Han,BAE, Nayoung 사상체질의학회 2018 사상체질의학회지 Vol.30 No.3

Introduction The purpose of this study was to systematically review previous studies on Sasang type-specific pathophysiological symptoms in urination and defecation. Methods Peer-reviewed articles on type-specific pathophysiological symptoms of urination and defecation published until September 2016 were extracted from domestic and international six databases. Clinical characteristics from thirteen extracted articles were categorized into three urination domains of appearance of urine, capacity of bladder and urinary discomfort, and three defecation domains of irritability of bowel movement, functional constipation and discomfort from irregularity. Results As for the urination, Tae-Eum type showed dark color with foam, however So-Eum type had frequent urination and sensitivity to dysuria but no nocturia and residual urine sense. As for the defecation, So-Yang type showed frequent urgency and constipation, however So-Eum type reported loose stool. So-Yang type showed varied level of health status depending on defecation irregularity. There were disparities with rectal tenesmus among Sasang types. Discussion Six domains of urination and defecation related type-specific pathophysiological clinical symptoms were provided in this study. This study would contribute to the standardized clinical measures of Sasang typology in the near future.

출구폐쇄형 배변장애의 성별에 따른 차이점 -배변조영술 1,513예의 분석-

박덕훈,윤서구,윤종섭,이종호,노희정,문민주,김현식,이종균,김광연 대한대장항문학회 2002 Annals of Coloproctolgy Vol.18 No.2

Diagnosis and Treatment of Dyssynergic Defecation

( Satish S C Rao ),( Tanisa Patcharatrakul ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2016 Journal of Neurogastroenterology and Motility (JNM Vol.22 No.3

Dyssynergic defecation is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability to coordinate the abdominal and pelvic floor muscles to evacuate stools. A detailed history, prospective stool diaries, and a careful digital rectal examination will not only identify the nature of bowel dysfunction, but also raise the index of suspicion for this evacuation disorder. Anorectal physiology tests and balloon expulsion test are essential for a diagnosis. Newer techniques such as high-resolution manometry and magnetic resonance defecography can provide mechanistic insights. Recently, randomized controlled trials have shown that biofeedback therapy is more effective than laxatives and other modalities, both in the short term and long term, without side effects. Also, symptom improvements correlated with changes in underlying pathophysiology. Biofeedback therapy has been recommended as the first-line of treatment for dyssynergic defecation. Here, we provide an overview of the burden of illness and pathophysiology of dyssynergic defecation, and how to diagnose and treat this condition with biofeedback therapy. (J Neurogastroenterol Motil 2016;22:423-435)

배변 격려 프로그램이 인공 슬관절 전치환술 환자의 배변에 미치는 효과

박정희,천성주,권영희,박현숙,김미나,박미란,최혜진 대한근관절건강학회 2022 근관절건강학회지 Vol.29 No.2

Purpose: The purpose of this study was to evaluate the efficacy of applying a defecation encouragement program forpatients undergoing total knee replacement arthroplasty (TKRA). Methods: This program was based on the nursing bestpractice guideline: prevention of constipation in the older adult population by the National Guideline Clearing House (NGC)in 2011, which included fluid intake, bowel training, and abdominal and pelvic floor exercises. A team of one orthopaedicclinical nurse specialist and six orthopaedic nurses with a 10 years of clinical experience applied and assisted patientswith the program. Formal counsel was provided by one orthopaedic doctor, one gastroenterologist, and one exercisetherapist. Patients who defecated one day prior to or on the day of TKRA surgery were included. Data collected from 72subjects were analyzed using SPSS/WIN 21.0. Results: Time until first defecation after surgery was 2.4±1.1 days inexperimental group, which was significantly shorter than the 3.5±0.9 days in control group (t=4.28, p<.001). Constipationassessment scale showed significantly lower points (t=2.55, p=.013) in experimental group (1.3±1.2) compared to controlgroup (2.6±2.6). The experimental group and control group were 17.3±7.67 and 23.7±14.43, respectively, and theexperimental group used less laxatives (t=2.83, p=.021). Conclusion: A defecation encouragement program was provedto be an appropriate nursing intervention for patients undergoing TKRA. This study confirmed that constipation is a nursingproblem that can be sufficiently prevented if nurses are interested and encourage defecation.

이상의 배변 경험과 ｢烏瞰圖 : 詩第五號｣ 새로운 해석

금동현(Geum, Dong-hyeon) 이상문학회 2020 이상리뷰 Vol.- No.16

이 글은 이상의 연작시 『烏瞰圖』의 ｢詩第五號｣의 새로운 해석 가능성을 제시했다. ｢烏瞰圖: 詩第五號｣에 대한 기왕의 연구는 타이포그래피 조작, 장자 사유, 해석의 통일성 중 한 가지 요소를 결하고 있었기에, 전체 요소를 아우르는 해석은 아직 도출되지 않았다. 이에 이 글에서는 ｢烏瞰圖: 詩第五號｣의 원형에 해당하는 일문 시 ｢二十二年｣의 시제를 실마리로 이상이 스물두 살 당시 창작한 시 ｢LE URINE｣을 ｢烏瞰圖: 詩第五號｣ 해석의 참조 텍스트로 삼고, 배변 과정을 담은 ｢LE URINE｣과 ｢烏瞰圖: 詩第五號｣가 동일한 상황을 배경으로 하고 있다고 결론을 내렸다. 또한 ｢烏瞰圖: 詩第五號｣ 해석의 난점을 일으켜 온 “翼殷不逝 目大不覩”를 타이포그래피 조작을 통해 장자적 사유의 맥락을 더욱 부각시킨 것으로 간주했다. 이러한 바탕 위에서 ｢烏瞰圖: 詩第五號｣를 이상이 배변 경험을 위티즘의 방법으로 변용한 것이며, 시의 마지막 행 “臟腑라는것은浸水된畜舍와區別될수잇슬는가”에서 분명히 드러나듯 인간과 변 사이의 지위를 무화하는 인식에 도달하는 과정을 담은 작품으로 해석하였다. This article suggested the possibility of a new interpretation of “Poem Ogamdo the Fifth”. No interpretation of the whole element has yet been derived, as previous research on “Poem Ogamdo the Fift” lacked one of the elements of typography manipulation, Zhuang Zhou idea, and uniformity of interpretation. In this article, the title of “Twenty Two Years,” which corresponds to the prototype of “Ogamdo The Fifth” is a clue to the interpretation of “The Ogamdo The Fifth”. When Lee Sang was 22 years old, he wrote the poem “LE URINE” which describe the process of defecation. This article used “LE URINE as reference text for “Ogamdo The Fifth” and concluded both ｢LE URINE｣ and “Ogamdo The Fifth”, are are set in the same situation, contain the process of defecation. And also “翼殷不逝 目大不覩”, which has caused difficulties in interpreting “Ogamdo The Fifth”, as more emphasizing the context of the idea of Zhuang Zhou through typography manipulation. On this basis, “Ogamdo The Fifth” was transformed by Lee Sang’s Experience of Defecation into the method of Witism, and as clearly evident in the last line of Poem, it is a work that contains the process of reaching the recognition that negates the position between humans and excreta.

Predictive Capability of Anorectal Physiologic Tests for Unfavorable Outcomes Following Biofeedback Therapy in Dyssynergic Defecation

Shin, Jae Kook,Cheon, Jae Hee,Kim, Eun Sook,Yoon, Jin Young,Lee, Jin Ha,Jeon, Soung Min,Bok, Hyun Jung,Park, Jae Jun,Moon, Chang Mo,Hong, Sung Pil,Lee, Yong Chan,Kim, Won Ho The Korean Academy of Medical Sciences 2010 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.25 No.7

<P>The purpose of this study is to evaluate the predictive capability of anorectal physiologic tests for unfavorable outcomes prior to the initiation of biofeedback therapy in patients with dyssynergic defecation. We analyzed a total of 80 consecutive patients who received biofeedback therapy for chronic idiopathic functional constipation with dyssynergic defecation. After classifying the patients into two groups (responders and non-responders), univariate and multivariate analyses were performed to determine the predictors associated with the responsiveness to biofeedback therapy. Of the 80 patients, 63 (78.7%) responded to biofeedback therapy and 17 (21.3%) did not. On univariate analysis, the inability to evacuate an intrarectal balloon (<I>P</I>=0.028), higher rectal volume for first, urgent, and maximal sensation (<I>P</I>=0.023, <I>P</I>=0.008, <I>P</I>=0.007, respectively), and increased anorectal angle during squeeze (<I>P</I>=0.020) were associated with poor outcomes. On multivariate analysis, the inability to evacuate an intrarectal balloon (<I>P</I>=0.018) and increased anorectal angle during squeeze (<I>P</I>=0.029) were both found to be independently associated with a lack of response to biofeedback therapy. Our data show that the two anorectal physiologic test factors are associated with poor response to biofeedback therapy for patients with dyssynergic defecation. These findings may assist physicians in predicting the responsiveness to therapy for this patient population.</P>

Predictive Capability of Anorectal Physiologic Tests for Unfavorable Outcomes Following Biofeedback Therapy in Dyssynergic Defecation

신재국,천재희,김은숙,윤진영,이진하,전성민,복현정,박재준,문창모,홍성필,이용찬,김원호 대한의학회 2010 Journal of Korean medical science Vol.25 No.7

The purpose of this study is to evaluate the predictive capability of anorectal physiologic tests for unfavorable outcomes prior to the initiation of biofeedback therapy in patients with dyssynergic defecation. We analyzed a total of 80 consecutive patients who received biofeedback therapy for chronic idiopathic functional constipation with dyssynergic defecation. After classifying the patients into two groups (responders and non-responders),univariate and multivariate analyses were performed to determine the predictors associated with the responsiveness to biofeedback therapy. Of the 80 patients, 63 (78.7%) responded to biofeedback therapy and 17 (21.3%) did not. On univariate analysis, the inability to evacuate an intrarectal balloon (P=0.028), higher rectal volume for first, urgent, and maximal sensation (P=0.023, P=0.008, P=0.007, respectively), and increased anorectal angle during squeeze (P=0.020) were associated with poor outcomes. On multivariate analysis,the inability to evacuate an intrarectal balloon (P=0.018) and increased anorectal angle during squeeze (P=0.029) were both found to be independently associated with a lack of response to biofeedback therapy. Our data show that the two anorectal physiologic test factors are associated with poor response to biofeedback therapy for patients with dyssynergic defecation. These findings may assist physicians in predicting the responsiveness to therapy for this patient population.

Consistency of Feces Affects Defecatory Function

Daming Sun,Kar Man Lo,Ssu-Chi Chen,Wing Wa Leung,Cherry Wong,Tony Mak,Simon Ng,Kaori Futaba,Hans Gregersen 대한소화기 기능성질환∙운동학회 2024 Journal of Neurogastroenterology and Motility (JNM Vol.30 No.3

Background/AimsIt is a common belief that constipated patients have hard feces that contributes to the difficulties defecating. To the best of our knowledge, no studies had been published on controlled evacuation of simulated feces with different consistencies. MethodsTwelve normal subjects were recruited for studies with the simulated feces device “Fecobionics” of different consistency (silicone shore 0A-40A corresponding to Bristol stool form scale types 2-4). The subjects filled out questionnaires and had the balloon expulsion test and anorectal manometry done for reference. The Fecobionics probes were inserted in rectum in random order with +20 minutes between insertions. The bag was filled to urge-to-defecate and evacuations took place in privacy. Non-parametric statistics with median and quartiles are provided. ResultsOne subject was excluded due to technical issues, and another had abnormal anorectal manometry–balloon expulsion test. The 4 females/6 males subjects were aged 23 (range 20-48) years. Most differences were observed between the 0A and 10A probe (duration, maximum bag pressure, duration x maximum bag pressure, and relaxation of the front pressure and the bend angle during evacuation), eg, the duration was 9 (8-12) seconds at 0A and 18 (12-21) seconds at 10A (P < 0.05), and maximum bag pressure was 107 (96-116) cmH2O at 0A and 140 (117-162) cmH2O at 10A (P < 0.05). The bend angle before evacuation differed between the probes whereas only the 10A differed from 40A during defecation. The 10A was harder to evacuate than the 0A probe. Except for the bend angles, no further significant change was observed from 10A to 40A. ConclusionFecal consistency affects defecatory parameters.

배변조영술

성무경 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.13 No.-

Defecography is a test used to evaluate the functional disorders of the rectoanum that are not evident by direct visualization. Radiologic paste is inserted into the rectum by specially designed caulking gun. Then the patient is instructed to empty the rectum sitting on the commode while a fluoroscopic exam of the pelvis is carried out. By this test pelvic floor muscles and rectum can be evaluated functionally during defecation. Non-relaxing puborectalis, rectoanal intussusception, rectocele and sigmoidocele are usual conditions that this test can reveal.