The Experts below are selected from a list of 297 Experts worldwide ranked by ideXlab platform
Joseph Lysy - One of the best experts on this subject based on the ideXlab platform.
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tricyclic antidepressants for the treatment of Tenesmus associated with rectal prolapse
Colorectal Disease, 2015Co-Authors: Dan M Livovsky, Samuel N Adler, Tomer Adar, Bargil A Shitrit, Joseph LysyAbstract:Aim Tenesmus in rectal prolapse leads to a vicious circle of straining with deterioration of prolapse. The primary phenomenon triggering this may be rectal hypersensitivity. We aimed to assess whether treatment with tricyclic antidepressants (TCAs) may break the vicious circle and improve Tenesmus. Method A retrospective review was carried out of patients with rectal prolapse and severe Tenesmus who were poor surgical candidates or had refused surgery. They were treated at our tertiary centre with low dose tricyclic antidepressants. Results Twenty-three (18 female) patients were included, with mean age 75.3 (±SD 14.6) years. The mean duration of symptoms was 10.8 (± 8.6) months. Full-thickness rectal prolapse was diagnosed in 16 (70%) patients while seven (30%) had mucosal or incomplete prolapse. Ten (43%), eight (35%) and five (22%) patients were treated with nortriptyline (25 mg daily), amitriptyline (10 mg daily) and desipramine (25 mg daily). After a mean follow-up of 9.05 (± 8.2) months, 14 (61%) patients reported significant improvement in symptoms, five (22%) had a partial response, three (13%) were lost to follow-up and one (4%) failed to respond. The response rates for nortriptyline, desipramine and amitriptyline were 90%, 100% and 62.5%. Conclusion To the best of our knowledge this is the first report to address the symptomatic, conservative treatment of Tenesmus in patients with rectal prolapse. TCAs may be an acceptable option for poor surgical candidates or patients refusing surgery.
Fliss E M Murtagh - One of the best experts on this subject based on the ideXlab platform.
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p 103 a systematic review of the effectiveness of palliative interventions to treat rectal Tenesmus in cancer
BMJ, 2017Co-Authors: Aine Ni Laoire, Lucy Fettes, Fliss E M MurtaghAbstract:Background Rectal Tenesmus is a distressing symptom in patients with advanced cancer and challenging to treat. There is lack of consensus on the appropriate management of rectal Tenesmus in this patient population. Aim To identify and examine the effectiveness of interventions to palliate rectal Tenesmus caused by advanced cancer when surgery, radiotherapy or chemotherapy are no longer treatment options. Design A systematic review of the literature following standard systematic review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. Data sources A comprehensive search of the electronic databases MEDLINE, EMBASE and the Cochrane Library was conducted from the date of inception to April 2016. PubMed “related articles”, grey literature, and hand-searches of the bibliographies of relevant papers and textbooks were also performed. Non-cancer patients were excluded. Any studies involving surgery or radiotherapy to treat Tenesmus were excluded. Studies involving interventions to treat pelvic pain syndromes without specific outcome measures on severity of Tenesmus were excluded. The quality of the studies was assessed using a National Institute for Health and Clinical Excellence recommended quality assessment tool. Results From 861 studies, nine met full criteria and were selected. All were case series investigating the use of pharmacological interventions (diltiazem, nifedipine, methadone, mexiletine hydrochloride, lidocaine, bupivacaine), anaesthetic interventions (lumbar sympathectomy, neurolytic superior hypogastric plexus block), and endoscopic laser interventions. The included studies showed substantial heterogeneity and therefore a meta-analysis was not feasible. Conclusion From this review we identified a significant gap in research into the palliation of rectal Tenesmus. A multimodal approach may be necessary due to the complexity of the pathophysiology of Tenesmus. Future research in this area should focus on randomised controlled trials of drug therapies whose potential effectiveness is suggested by case series’.
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a systematic review of the effectiveness of palliative interventions to treat rectal Tenesmus in cancer
Palliative Medicine, 2017Co-Authors: Aine Ni Laoire, Lucy Fettes, Fliss E M MurtaghAbstract:Background:Rectal Tenesmus is a distressing symptom in patients with advanced cancer and challenging to treat. There is lack of consensus on the appropriate management of Tenesmus in this patient population.Aim:To identify and examine the effectiveness of interventions to palliate rectal Tenesmus caused by advanced cancer when surgery, radiotherapy or chemotherapy are no longer treatment options.Design:A systematic review of the literature following standard systematic review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance.Data sources:A comprehensive search of the electronic databases MEDLINE, EMBASE and the Cochrane Library was conducted from date of inception to April 2016. PubMed ‘related articles’ search, grey literature search and hand-searches of the bibliographies of relevant papers and textbooks were also performed. Non-cancer patients were excluded. Any studies involving surgery or radiotherapy to treat Tenesmus were excluded. Studies involving int...
Lee Dvorkin - One of the best experts on this subject based on the ideXlab platform.
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Abdominopelvic Splenosis—An Unusual Cause of Tenesmus
Journal of Gastrointestinal Surgery, 2014Co-Authors: Kenneth Cheung, Thomas Wagner, Margaret Hall, Lee DvorkinAbstract:Splenosis is a rare condition defined as seeding and autotransplantation of splenic tissue, typically after blunt abdominal trauma (e.g. from road traffic collision). Sites of splenosis ranging from intrathoracic to intrapelvic have been reported, and symptoms vary greatly depending on the site and size of lesions. We present the use of Tc-99m sulphur colloid SPECT/CT in diagnosing a case of multiple abdominopelvic splenosis as the cause of new-onset Tenesmus and constipation, which was initially thought to be due to colorectal malignancy, 47 years following the initial abdominal trauma.
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abdominopelvic splenosis an unusual cause of Tenesmus
Journal of Gastrointestinal Surgery, 2014Co-Authors: King Kenneth Cheung, Thomas Wagner, Margaret Hall, Lee DvorkinAbstract:Splenosis is a rare condition defined as seeding and autotransplantation of splenic tissue, typically after blunt abdominal trauma (e.g. from road traffic collision). Sites of splenosis ranging from intrathoracic to intrapelvic have been reported, and symptoms vary greatly depending on the site and size of lesions. We present the use of Tc-99m sulphur colloid SPECT/CT in diagnosing a case of multiple abdominopelvic splenosis as the cause of new-onset Tenesmus and constipation, which was initially thought to be due to colorectal malignancy, 47 years following the initial abdominal trauma.
Dan M Livovsky - One of the best experts on this subject based on the ideXlab platform.
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tricyclic antidepressants for the treatment of Tenesmus associated with rectal prolapse
Colorectal Disease, 2015Co-Authors: Dan M Livovsky, Samuel N Adler, Tomer Adar, Bargil A Shitrit, Joseph LysyAbstract:Aim Tenesmus in rectal prolapse leads to a vicious circle of straining with deterioration of prolapse. The primary phenomenon triggering this may be rectal hypersensitivity. We aimed to assess whether treatment with tricyclic antidepressants (TCAs) may break the vicious circle and improve Tenesmus. Method A retrospective review was carried out of patients with rectal prolapse and severe Tenesmus who were poor surgical candidates or had refused surgery. They were treated at our tertiary centre with low dose tricyclic antidepressants. Results Twenty-three (18 female) patients were included, with mean age 75.3 (±SD 14.6) years. The mean duration of symptoms was 10.8 (± 8.6) months. Full-thickness rectal prolapse was diagnosed in 16 (70%) patients while seven (30%) had mucosal or incomplete prolapse. Ten (43%), eight (35%) and five (22%) patients were treated with nortriptyline (25 mg daily), amitriptyline (10 mg daily) and desipramine (25 mg daily). After a mean follow-up of 9.05 (± 8.2) months, 14 (61%) patients reported significant improvement in symptoms, five (22%) had a partial response, three (13%) were lost to follow-up and one (4%) failed to respond. The response rates for nortriptyline, desipramine and amitriptyline were 90%, 100% and 62.5%. Conclusion To the best of our knowledge this is the first report to address the symptomatic, conservative treatment of Tenesmus in patients with rectal prolapse. TCAs may be an acceptable option for poor surgical candidates or patients refusing surgery.
Aine Ni Laoire - One of the best experts on this subject based on the ideXlab platform.
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p 103 a systematic review of the effectiveness of palliative interventions to treat rectal Tenesmus in cancer
BMJ, 2017Co-Authors: Aine Ni Laoire, Lucy Fettes, Fliss E M MurtaghAbstract:Background Rectal Tenesmus is a distressing symptom in patients with advanced cancer and challenging to treat. There is lack of consensus on the appropriate management of rectal Tenesmus in this patient population. Aim To identify and examine the effectiveness of interventions to palliate rectal Tenesmus caused by advanced cancer when surgery, radiotherapy or chemotherapy are no longer treatment options. Design A systematic review of the literature following standard systematic review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. Data sources A comprehensive search of the electronic databases MEDLINE, EMBASE and the Cochrane Library was conducted from the date of inception to April 2016. PubMed “related articles”, grey literature, and hand-searches of the bibliographies of relevant papers and textbooks were also performed. Non-cancer patients were excluded. Any studies involving surgery or radiotherapy to treat Tenesmus were excluded. Studies involving interventions to treat pelvic pain syndromes without specific outcome measures on severity of Tenesmus were excluded. The quality of the studies was assessed using a National Institute for Health and Clinical Excellence recommended quality assessment tool. Results From 861 studies, nine met full criteria and were selected. All were case series investigating the use of pharmacological interventions (diltiazem, nifedipine, methadone, mexiletine hydrochloride, lidocaine, bupivacaine), anaesthetic interventions (lumbar sympathectomy, neurolytic superior hypogastric plexus block), and endoscopic laser interventions. The included studies showed substantial heterogeneity and therefore a meta-analysis was not feasible. Conclusion From this review we identified a significant gap in research into the palliation of rectal Tenesmus. A multimodal approach may be necessary due to the complexity of the pathophysiology of Tenesmus. Future research in this area should focus on randomised controlled trials of drug therapies whose potential effectiveness is suggested by case series’.
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a systematic review of the effectiveness of palliative interventions to treat rectal Tenesmus in cancer
Palliative Medicine, 2017Co-Authors: Aine Ni Laoire, Lucy Fettes, Fliss E M MurtaghAbstract:Background:Rectal Tenesmus is a distressing symptom in patients with advanced cancer and challenging to treat. There is lack of consensus on the appropriate management of Tenesmus in this patient population.Aim:To identify and examine the effectiveness of interventions to palliate rectal Tenesmus caused by advanced cancer when surgery, radiotherapy or chemotherapy are no longer treatment options.Design:A systematic review of the literature following standard systematic review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance.Data sources:A comprehensive search of the electronic databases MEDLINE, EMBASE and the Cochrane Library was conducted from date of inception to April 2016. PubMed ‘related articles’ search, grey literature search and hand-searches of the bibliographies of relevant papers and textbooks were also performed. Non-cancer patients were excluded. Any studies involving surgery or radiotherapy to treat Tenesmus were excluded. Studies involving int...
