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PHYSIOTHERAPY IN GASTROENTEROLOGICAL PATHOLOGIES
Functional dyspepsia is a symptoms complex characterised by upper abdominal discomfort or pain, nausea, vom-iting, bloating, early satiety, and anorexia in the absence of organic disease. The aetiology of this disease is poorlyunderstood (1).The main aim of the treatment of functional dyspepsia is to reduce or eliminate the symptoms andthus to improve the conditions of the patient.
Standard pharmacological treatment includes prokinetics, analgesics, H2-receptor antagonists, proton pump in-hibitors, antacids, serotonin receptor antagonists, and antidepressants. This treatment often has low efficacy andmight cause side effects associated with the drugs (2, 3). The patients with functional dyspepsia which is refrac-tory to the drug treatments would require other therapeutic options.
Treatment of these pathological conditions using electrotherapy modalities such as transcutaneous elec-troacupuncture (TEA) showed successful results without any reported adverse reactions (4). It accelerates gastricemptying, inhibits gastrointestinal motility, increases plasma levels of neuropeptide Y, stimulates food intake andreduces the symptom scores.
Figure 1. The ef ect of TEA on dyspeptic symptoms (S. Liu et al. Neurogastroenterology & Motility 2008; 20 (11):
1204-1211)The results indicated a marked statistically significant (p ≤ 0.001) improvement in the total symptom score from16.5±1.9 to 4.2±1.5 following the 2-week TEA treatment.
References1.Timmons S, Liston R, Moriarty KJ. Functional dyspepsia: motor abnormalities, sensory dysfunction, and therapeutic options. Am J Gastroenterol 2004; 2. Mönkemüller K, Malfertheiner P. Drug treatment of functional dyspepsia. World J Gastroenterol 2006; 12(17): 2694-27003. Myers RP, McLaughlin K, Hollomby D. Acute interstitial nephritis due to omeprazole. Am J Gastroenterol 2001; 96(12): 3428-34314. Liu S, Peng S, Hou X, Ke M, Chen JD.Transcutaneous electroacupuncture improves dyspeptic symptoms and increases high frequency heart rate variability in patients with functional dyspepsia. Neurogastroenterol Motil 2008; 20(11): 1204-1211 EL PHYSIOTHERAPY 765c Hawthorn Rd Brighton East 3187 Phone: (03) 9005 9282
Idiopathic fecal incontinence
Fecal incontinence is a disabling pathological condition. Few therapeutic tools are available for treating idiopathicanal incontinence (1).
The use of transcutaneous electrical stimulation (TENS) of posterior tibial nerve showed encouraging results fortreatment of the disease.The patients were treated 20 minutes daily for 4 weeks and the results were estimated ac-cording to the Wexner’s score before and after the treatment period (1).
Figure 1. Incontinence score pre- and post-4 week neurostimulation (M. Queralto et al. International Journal of Col-
orectal Disease 2006; 21: 670-672)Wexner’s scores were improved in eight of the ten patients in 4 weeks. Mean improvement in the score was morethan 60% (statistically significant difference p = 0.0046, Wilcoxon rank test). No adverse event was observed.
References1. Queralto M, Portier G, Cabarrot PH, Bonnaud G, Chotard JP, Nadrigny M, Lazorthes F. Preliminary results of peripheral transcutaneous neuromodulation in the treat- ment of idiopathic fecal incontinence. Int J Colorectal Dis 2006; 21: 670-672 Some other gastrointestinal pathologies effectively treated using physiotherapy techniques
Xiao WB, Liu YL. Digestive Diseases and Sciences 2004; 49 (2): 312-319 Eriksson EM et al. World Journal of Gastroenterology 2007; 13 (23): 3206-3214 Vitton V et al. Inflammatory Bowel Diseases 2009; 15 (3): 402-405 Loudon CP et al. American Journal of Gastroenterology 1999; 94 (3): 697-703 Blaut U et al. European Journal of Gastroenterology & Hepatology 2003; 15 (1): 21-26 Lee SK et al. Gastrointestinal Endoscopy 2001; 53: 211-216 Izadpanah A, Hosseini SV. International Journal of Surgery 2005; 3 (4): 258-262 Schubach G. Diseases of the Colon & Rectum 2004; 47: 1990 For additional information or questions please contact Dr Vladimir Gurevich, Senior Clinical Advisor, on 9005 9282or email [email protected] EL PHYSIOTHERAPY 765c Hawthorn Rd Brighton East 3187 Phone: (03) 9005 9282
Orthognathic Surgery Post Operative Instructions After you have undergone a surgical procedure to reposition your upper jaw, lower jaw, or both, attention must be directed to several aspects of post-operative care to help you make the recovery as quick and easy as possible. Since surgery produces soreness in the muscles and bones of the jaw as well as the lips, nose and other areas of the