{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T08:12:38Z","timestamp":1696407158638},"reference-count":18,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,11,7]],"date-time":"2015-11-07T00:00:00Z","timestamp":1446854400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>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 (<jats:styled-content style=\"fixed-case\">TCA<\/jats:styled-content>s) may break the vicious circle and improve tenesmus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010three (18 female) patients were included, with mean age 75.3 (\u00b1<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> 14.6) years. The mean duration of symptoms was 10.8 (\u00b1\u00a08.6) months. Full\u2010thickness 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\u00a0mg daily), amitriptyline (10\u00a0mg daily) and desipramine (25\u00a0mg daily). After a mean follow\u2010up of 9.05 (\u00b1\u00a08.2) months, 14 (61%) patients reported significant improvement in symptoms, five (22%) had a partial response, three (13%) were lost to follow\u2010up and one (4%) failed to respond. The response rates for nortriptyline, desipramine and amitriptyline were 90%, 100% and 62.5%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>To the best of our knowledge this is the first report to address the symptomatic, conservative treatment of tenesmus in patients with rectal prolapse. <jats:styled-content style=\"fixed-case\">TCA<\/jats:styled-content>s may be an acceptable option for poor surgical candidates or patients refusing surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13040","type":"journal-article","created":{"date-parts":[[2015,6,23]],"date-time":"2015-06-23T05:13:34Z","timestamp":1435036414000},"page":"1094-1099","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tricyclic antidepressants for the treatment of tenesmus associated with rectal prolapse"],"prefix":"10.1111","volume":"17","author":[{"given":"D. M.","family":"Livovsky","sequence":"first","affiliation":[{"name":"Digestive Diseases Institute Shaare Zedek Medical Center Affiliated with the Hebrew University Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. N.","family":"Adler","sequence":"additional","affiliation":[{"name":"Digestive Diseases Institute Shaare Zedek Medical Center Affiliated with the Hebrew University Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Adar","sequence":"additional","affiliation":[{"name":"Digestive Diseases Institute Shaare Zedek Medical Center Affiliated with the Hebrew University Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Bar\u2010Gil Shitrit","sequence":"additional","affiliation":[{"name":"Digestive Diseases Institute Shaare Zedek Medical Center Affiliated with the Hebrew University Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Lysy","sequence":"additional","affiliation":[{"name":"Digestive Diseases Institute Shaare Zedek Medical Center Affiliated with the Hebrew University Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,11,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2013.08.002"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800680804"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2008.06.001"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02587407"},{"key":"e_1_2_7_6_1","first-page":"419","article-title":"Using nifedipine to treat tenesmus","volume":"11","author":"McLoughlin R","year":"1997","journal-title":"Palliat Med"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s005200000207"},{"key":"e_1_2_7_8_1","first-page":"2565","article-title":"[Rectal tenesmus due to tumor invasion into the pelvic cavity responding favorably to antiarrhythmic drug therapy]","volume":"39","author":"Yoshino K","year":"2012","journal-title":"Gan To Kagaku Ryoho"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02252991"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02055169"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2013.08.005"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2004.047423"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2013.09.008"},{"key":"e_1_2_7_14_1","first-page":"553","article-title":"Classic articles in colonic and rectal surgery. Alexis Victor Moschcowitz, 1865\u20131937. The pathogenesis, anatomy, and cure of prolapse of the rectum","volume":"26","year":"1983","journal-title":"Dis Colon Rectum"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1075858"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0850-2"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004649901120"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02052209"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2013.08.012"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.13040","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.13040","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T14:54:22Z","timestamp":1696344862000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.13040"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11,7]]},"references-count":18,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2015,12]]}},"alternative-id":["10.1111\/codi.13040"],"URL":"https:\/\/doi.org\/10.1111\/codi.13040","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,11,7]]},"assertion":[{"value":"2015-02-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-04-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-11-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}