Defecation

Diagnosis and alleviation of the cause, if possible, is of primary importance. Often, however, this is not possible and therapy is used to alleviate the inconvenience and pain of diarrhea. These compounds usually only mask the underlying factors producing the problem. Diarrhea may cause significant dehydration and loss of electrolytes and is a particularly serious problem in infants. Antidiarrheals do not usually prevent the loss of fluids and electrolytes into the large bowel and, although these may prevent frequent defecation, often the serious imbalance of body electrolytes and fluids is not significantly affected. 

Klare, /. clearness clarifier clear (clarified) liquid coal dust boneash. klkren, v.t. clear, clarify, purify, defecate. — v.r. clear, clear up. 

Kot, m. feces, excrement mud sludge dirt. Kot-. fecal, -abgang, m. defecation, kot-artig, a. fecal, feculent, excremental. -aus- fUhrend, -ausleerend, p.a. purgative, cathartic, aperient. 

Lauter-ofen, m. refining furnace (or kiln), -pfanne, f. clearing pan, clarifier defecator, -trommel, /. washing drum. 

Scheide-ofen, m. parting furnace, almond furnace. -pfanne, /. (Sugar) defecating pan, clarifier, -punkt, m. separation point. 

Prevention Follow measures to control the spread of infection. Wash hands immediately before eating or preparing food and after defecation. 

A laxative is most often prescribed for the short-term relief or prevention of constipation. Certain stimulant, emollient, and saline laxatives are used to evacuate the colon for rectal and bowel examinations. Fecal softeners or mineral oil are used prophylactically in patients who should not strain during defecation, such as after anorectal surgery or a myocardial infarction. Psyllium may be used in patients with irritable bowel syndrome and diverticular disease. Fblycarbophil may be prescribed for constipation or diarrhea associated with irritable bowel syndrome and diverticulosis. Mineral oil is... 

Only a small fraction of faecal contaminants contributed to the enviromnent through human and animal faeces reach new hosts to infect them. Many of the defecated microorganisms never reach the soil and/or water bodies, since faecal wastes are submitted to purification (water) and hygienization (solids) processes, which remove a fraction of the pathogens and indicators. An important fraction of those that reach either the soil or water are removed (adsorption to soil particles and suspended solids, followed by sedimentation) and/or inactivated by natural stressors (physical, chemical and biological) in soil and water bodies. 

Male rats exposed to 264 mg/m of methyl parathion by inhalation had 59% (range 53-61%) inhibition of blood (a combination of erythrocyte and plasma) cholinesterase 1 hour after exposure (EPA 1978e). These animals had typical cholinergic signs of toxicity salivation, exophthalmos, laerimation, spontaneous defecation and urination, and muscle fasciculation. Values for controls were not provided. Death was not correlated to the degree of eholinesterase inhibition in whole blood. 

III pruritus flush Urticaria angioedema (not mandatory) vomiting defecation diarrhea laryngeal edema bronchospasm cyanosis shock... 

The belt-and-braces sequence of sound + chemical => tactile response is explained by the necessity of perineal stimulation. In its absence defecation cannot begin, with lethal consequences. By 12 days, the pup s UHF response discriminates male and female adults calls are given only after removal of anaesthetised females, but not on male removal anosmia abolishes the discrimination unless an active female is present... 

Constipation can be due to primary and secondary causes (Table 18-1). Primary or idiopathic constipation is typified by normal-transit constipation, slow-transit constipation, and dyssynergic defecation. In the normal-transit type, colonic motility is unchanged and patients tend to experience hard stools despite normal movements. In the slow-transit type, motility is decreased leading to infrequent harder, drier stools. In dyssynergic defecation (also known as pelvic floor dysfunction), patients have lost the ability to relax the anal sphincter while coordinating muscle contractions of the pelvic floor. Some causes of secondary constipation are listed in Table 18-1. 

Psychogenic (postponing the urge to defecate, psychiatric conditions)... 

A complete history should be obtained so that the patient s symptoms can be evaluated and the diagnosis of constipation confirmed. The diagnosis of constipation is suggested by fewer than three bowel movements per week, consistency of hard lumpy stool, excessive straining, prolonged defecation time, or need to support the perineum or digitally manipulate the anorectum. 

Functional constipation (constipation occurring in the absence of a demonstrated pathologic condition) involves the presence of at least two of the following symptoms straining, lumpy or hard stools, sensation of incomplete evacuation, sensation of anorectal obstruction or blockage, need for manual maneuvers to facilitate defecation and/or, infrequent (fewer than three) bowel movements per week. 

Other complaints may include painful or difficult defecation, bloating, and absence of loose stools. 

Ask the patient about the absence or improvement in symptoms to determine whether laxative therapy is effective. Patients should have an increase in stool frequency to more than three well-formed stools per week. Patients should report the absence of prolonged defecation time or the absence of the need for excessive straining. 

Patients report a history of abdominal pain or discomfort that is relieved with defecation. Symptom onset is associated with change in frequency or appearance of stool. Some persons experience hard, dry stools whereas others experience loose or watery stools. Some stools may be small and pellet-like in appearance while others may be narrow and pencil-like. 

Lactulose is the foundation of pharmacologic therapy to prevent and treat hepatic encephalopathy. It is a non-digestible synthetic disaccharide laxative that is hydrolyzed in the gut to an osmotically-active compound that draws water into the colon and stimulates defecation. Lactulose also lowers colonic pH, which favors the conversion of ammonia (NH3) to ammonium (NHf).48 Ammonium is ionic and cannot cross back into systemic circulation it is eliminated in the feces. Lactulose is usually initiated at 15 to 30 mL two to three times per day and titrated to a therapeutic goal of two to four soft bowel movements daily.20 49 50... 

Although many factors contribute to the etiology of diaper rash, it is most likely the result of prolonged contact of the skin with urine and feces in the diaper. If a diaper is not changed soon after urination or defecation, the protective layer of the... 

The effect of orlistat in adolescent patients has been evaluated recently. In a group of 12- to 16-year-old individuals, orlistat (120 mg three times daily) in combination with diet, exercise, and behavior modification exhibited minimal weight increase after 1 year (0.53 kg) compared with placebo-treated patients (3.14 kg). Common adverse reactions observed were fatty or oily stools, oily spotting, oily evacuation, or abdominal pain and/or flatulence with bowel movements. Soft stools, nausea, increased defecation, and fecal incontinence also were noted. Orlistat may be better suited for prevention of weight gain in tolerant adolescents, but more studies are warranted before providing a solid recommendation.36... 

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