XXXX . A symptom with multiple etiologies.

@entity1 @entity63 @entity1163 @entity102 @entity299 @entity551
To our knowledge, there is no previous clinical description in the literature of @entity1 with @entity1163 . We evaluated 20 @entity1 with this disorder who were a subgroup of a larger, prospective study of @entity1163 , 13 @entity1 and seven @entity1 , with a mean age of 59 years. Eleven @entity1 had had one episode and nine had experienced multiple episodes. Fourteen @entity1 were recumbent before the urge to defecate, nine of these asleep. The diagnostic evaluation disclosed that two @entity1 had gastrointestinal tract problems, three had @entity299 , and one had transient @entity63 attacks. Three additional @entity1 had marked @entity551 . No identifiable cause for @entity1163 was found in 11 @entity1 , but new medical problems were noted in four of those @entity1 . In follow-up at two years, @entity1163 had recurred in ten @entity1 , but the majority of recurrences were unassociated with defecation. Seven @entity1 died during the follow-up period of underlying @entity102 . We conclude that @entity1163 is not a single distinct clinical entity. Multiple pathologic abnormalities in association with physiologic changes during sleep and defecation may contribute to @entity1163 . @entity1 with @entity1163 undergo a careful evaluation for diagnosis of underlying illness causing @entity1163 .
