Interactions between symptoms and motor and visceral sensory responses of irritable bowel syndrome patients to spasmolytics (antispasmodics).

Aim: to evaluate and correlate the symptomatic, motor and sensory responses to two widely used categories of spasmolytic agents in irritable bowel syndrome (IBS).

Methods: 118 patients with IBS, diagnosed by Rome II criteria and 45 healthy individuals were studied. In the IBS subjects, pain severity, as well as the sensory response to rectal balloon distention and rectal and sigmoid motility, were studied at baseline and after two weeks therapy with either oral buscopan (20 mg three times a day, n=37), a buscopan suppository (30 mg once daily, n=21), oral drotaverine (80 mg three times a day, n=30), calcium gluconate tablets (one three times a day, n=16) as a control for oral agents, or calendula suppository (once daily, n=14) as a control for those who received a suppository.

[Proctectomy with external sphincter elements' preservation in surgery of low-ampullary rectal cancer].

Operational technique for the rectum tumors, localized at the level of dentate line, developed in the State center of coloproctology, allows preservation of external anal sphincter elements and thus, partial preservation of defecation control. Technique is described and proved, preliminary treatment results of 42 patients are analysed. The operation is oncologically effective (local recurrence rate 4,8%).

[Long-term results of excision of anal fissure in combination with lateral subcutaneous sphincterotomy].

One hundred and seventeen patients with anal fissure underwent fissure excision in combination with lateral subcutaneous sphincterotomy. The mean follow-up after treatment was 4.3 years.

[Nerve-preserving operations in surgery of rectal cancer].

Forty-eight patients underwent surgery for rectal cancer. In all the patients total mesorectumectomy was combined with one of the types of nerves-preserving surgeries. Three groups were divided depending on types of this surgery: 1-- complete preservation of elements of autonomic nervous system (n=31), 2 -- partial preservation (n=16), 3 -- complete ablation (n=1).

[Long-term results of formation of smooth muscle sphincter in the perineal colostomy area in patients after rectal extirpation].

The authors discuss an original method for formation of a smooth-muscle cuff from the wall of a pulled-through colon in the region of a perineal colostoma. It was applied in 89 patients who had undergone extirpation of the rectum for malignant neoplasms. The smooth-muscle sphincter was formed during removal of the rectum in 72 patients and no earlier than 2 years after the extirpation in 17 patients.

[Comparative evaluation of the anal sphincter function after sphincter-sparing operations in diffuse polyposis].

Experience in treating 76 patients who were subjected to various sphincter-preserving operations is analysed. It is shown that after subtotal resection of the large intestine with ++abdomino-anal resection of the rectum and pull-through of the right parts of the colon into the anal canal as well as after pull-through of the segment of the transverse colon into the anal canal, the neuro-reflex activity of the musculus sphincter ani internus is destroyed in 55% and reduces in 25% of patients while the reflex activity of the musculus sphincter ani externus is disturbed in 45% of patients and is not restored later. The results bear evidence that the condition of the rectal obturation apparatus does not depend on the segment of the colon subjected to the pull-through operation (cecum, ascending colon, transverse colon).

[Functional state of the distal part of the large intestine in Crohn disease].

State of the locking apparatus has been studied in 22 patients with Crohn's disease free of the anorectal complications. Even prior to the development of these complications caused by metabolic abnormalities and inflammatory changes in the intestinal wall the locking apparatus undergoes certain functional changes.

[Treatment of anal sphincter insufficiency due to injury of the rectum and perineum].

Insufficiency of the anal sphincter due to injuries of the rectum and perineum in our series comes up to 75.7% of all degrees of anal insufficiency. The treatment--conservative or by surgery--depends on the kind and degree of insufficiency.