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Friesen HJ, Thompson P, Schurman JV, Colombo JM, Friesen CA. Overactive bladder syndrome symptoms in youth with abdominal pain-associated disorders of gut-brain interaction. Sci Rep 2023; 13:11042. [PMID: 37422526 PMCID: PMC10329665 DOI: 10.1038/s41598-023-37937-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/29/2023] [Indexed: 07/10/2023] Open
Abstract
The purpose of the current study was to assess the frequency of overactive bladder syndrome (OBS) symptoms and their relationship to gastrointestinal symptoms in youth with abdominal pain-associated disorders of gut-brain interaction (AP-DGBI). This is a retrospective study of 226 youth diagnosed with an AP-DGBI. As part of standard care, all patients completed a symptom questionnaire regarding gastrointestinal and non-gastrointestinal symptoms including increased urinary frequency, nighttime urination, and urinary urgency. Overall, 54% of patients reported at least one OBS symptom. Increased frequency of urination was reported by 19%, urinary urgency by 34%, and nighttime urination by 36%. Increased frequency of urination and urinary urgency were associated with a change in stool form, a change in stool frequency, and in those fulfilling criteria for IBS. Increased frequency of urination was reported more frequently in those reporting predominantly loose stools (33% vs. 12%). Urinary symptoms are common in youth with AP-DGBI. Increased urinary frequency and urinary urgency are specifically associated with IBS, with increased urinary frequency being primarily associated with diarrhea predominant IBS. Further studies are needed to determine the impact of OBS on AP-DGBI severity and quality of life, and whether they impact DGBI treatment.
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Affiliation(s)
- Hunter J Friesen
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Mercy Kansas City, Kansas City, MO, 64108, USA
| | - Pierce Thompson
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Mercy Kansas City, Kansas City, MO, 64108, USA
| | - Jennifer V Schurman
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Mercy Kansas City, Kansas City, MO, 64108, USA
| | - Jennifer M Colombo
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Mercy Kansas City, Kansas City, MO, 64108, USA
| | - Craig A Friesen
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Mercy Kansas City, Kansas City, MO, 64108, USA.
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Algera J, Lövdahl J, Sjölund J, Tornkvist NT, Törnblom H. Managing pain in irritable bowel syndrome: current perspectives and best practice. Expert Rev Gastroenterol Hepatol 2023; 17:871-881. [PMID: 37552616 DOI: 10.1080/17474124.2023.2242775] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/27/2023] [Indexed: 08/10/2023]
Abstract
INTRODUCTION Irritable bowel syndrome (IBS) is characterized by chronic symptoms (>6 months) of abdominal pain in combination with a disturbed bowel habit. There is an association between the intensity of abdominal pain and the need for health care utilization. A bidirectionally disordered gut-brain interaction is central in the pathophysiology of IBS where a number of factors, gastrointestinal and non-gastrointestinal, can contribute to the illness experience. In order to treat abdominal pain in IBS, mapping these factors in a multidimensional clinical profile is helpful. AREAS COVERED This review covers basic epidemiology and pathophysiology of abdominal pain in IBS, the diagnostic approach, and a multidimensional treatment model where the management of abdominal pain is in focus. EXPERT OPINION A personalized treatment of abdominal pain in IBS is possible in patients who understand the diagnosis, the potential of therapies used, and where a good continuity in the patient-doctor relationship is established.
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Affiliation(s)
- Joost Algera
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jenny Lövdahl
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jessica Sjölund
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Navkiran Thind Tornkvist
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hans Törnblom
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Kendler KS, Rosmalen JG, Ohlsson H, Sundquist J, Sundquist K. A distinctive profile of family genetic risk scores in a Swedish national sample of cases of fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome compared to rheumatoid arthritis and major depression. Psychol Med 2023; 53:3879-3886. [PMID: 35354508 PMCID: PMC10317803 DOI: 10.1017/s0033291722000526] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Functional somatic disorders (FSD) feature medical symptoms of unclear etiology. Attempts to clarify their origin have been hampered by a lack of rigorous research designs. We sought to clarify the etiology of the FSD by examining the genetic risk patterns for FSD and other related disorders. METHODS This study was performed in 5 829 186 individuals from Swedish national registers. We quantified familial genetic risk for FSD, internalizing disorders, and somatic disorders in cases of chronic fatigue syndrome (CFS), fibromyalgia (FM), and irritable bowel syndrome (IBS), using a novel method based on aggregate risk in first to fifth degree relatives, adjusting for cohabitation. We compared these profiles with those of a prototypic internalizing psychiatric - major depression (MD) - and a somatic/autoimmune disorder: rheumatoid arthritis (RA). RESULTS Patients with FM carry substantial genetic risks not only for FM, but also for pain syndromes and internalizing, autoimmune and sleep disorders. The genetic risk profiles for IBS and CFS are also widely distributed although with lower average risks. By contrast, genetic risk profiles of MD and RA are much more restricted to related conditions. CONCLUSION Patients with FM have a relatively unique family genetic risk score profile with elevated genetic risk across a range of disorders that differs markedly from the profiles of a classic autoimmune disorder (RA) and internalizing disorder (MD). A similar less marked pattern of genetic risks was seen for IBS and CFS. FSD arise from a distinctive pattern of genetic liability for a diversity of psychiatric, autoimmune, pain, sleep, and functional somatic disorders.
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Affiliation(s)
- Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics and Department of Psychiatry, Virginia Commonwealth University, Box 980126, Richmond, VA 23298-0126, USA
| | - Judith G.M. Rosmalen
- Departments of Psychiatry and Internal Medicine, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, Netherlands
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University Clinical Research Centre (CRC), Box 50332, SE-202 13 Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University Clinical Research Centre (CRC), Box 50332, SE-202 13 Malmö, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University Clinical Research Centre (CRC), Box 50332, SE-202 13 Malmö, Sweden
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54
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Duncanson K, Tikhe D, Williams GM, Talley NJ. Irritable bowel syndrome - controversies in diagnosis and management. Expert Rev Gastroenterol Hepatol 2023; 17:649-663. [PMID: 37317843 DOI: 10.1080/17474124.2023.2223975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/07/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The irritable bowel syndrome (IBS) is the best-recognized disorder of gut brain interactions (DGBI). However, it is controversial if the Rome IV criteria iteration for IBS diagnosis is fit for purpose. AREAS COVERED This review critically evaluates Rome IV criteria for diagnosis of IBS and addresses clinical considerations in IBS treatment and management, including dietary factors, biomarkers, disease mimics, symptom severity, and subtypes. The role of diet in IBS is critically reviewed along with the influence of the microbiota, including small intestinal bacterial overgrowth. EXPERT OPINION Emerging data suggest the Rome IV criteria are more suitable for identifying severe IBS and least useful for sub-diagnostic patients who are still likely to benefit from IBS treatment. Despite convincing evidence that IBS symptoms are diet-driven and often postprandial, a relationship to eating is not a Rome IV diagnostic criterion. Few IBS biomarkers have been identified, suggesting the syndrome is too heterogeneous to be measured by a single marker, and combined biomarker, clinical, dietary, and microbial profiling may be needed for objective characterization. With many organic diseases mimicking and overlapping with IBS, it's important clinicians are knowledgable about this to mitigate the risk of missing comorbid organic intestinal disease and to optimally treat IBS symptoms.
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Affiliation(s)
- Kerith Duncanson
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Centre of Research Excellence in Digestive Health, The University of Newcastle, New Lambton Heights, NSW, Australia
- Immune Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Dhanashree Tikhe
- Centre of Research Excellence in Digestive Health, The University of Newcastle, New Lambton Heights, NSW, Australia
- Department of Gastroenterology, John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW, Australia
| | - Georgina M Williams
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Centre of Research Excellence in Digestive Health, The University of Newcastle, New Lambton Heights, NSW, Australia
- Immune Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Nicholas J Talley
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Centre of Research Excellence in Digestive Health, The University of Newcastle, New Lambton Heights, NSW, Australia
- Immune Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Department of Gastroenterology, John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW, Australia
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Seeling KS, Hehl L, Vell MS, Rendel MD, Creasy KT, Trautwein C, Mehler DMA, Keszthelyi D, Schneider KM, Schneider CV. Comorbidities, biomarkers and cause specific mortality in patients with irritable bowel syndrome: A phenome-wide association study. United European Gastroenterol J 2023; 11:458-470. [PMID: 37151116 PMCID: PMC10256994 DOI: 10.1002/ueg2.12397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/02/2023] [Indexed: 05/09/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is one of the most common functional digestive disorders. Our understanding about its comorbidities, biomarkers, or long-term risks is still incomplete. OBJECTIVE To characterize comorbidities and biomarkers for IBS and establish the effect of IBS on overall- and cause specific mortality. METHODS We analyzed data from the population-based cohort of the UK Biobank (UKB) with 493,974 participants, including self-reported physician-diagnosed (n = 20,603) and ICD-10 diagnosed (n = 7656) IBS patients, with a mean follow-up of 11 years. We performed a phenome-wide association study (PheWAS) and competing risk analysis to characterize common clinical features in IBS patients. RESULTS In PheWAS analyses, 260 PheCodes were significantly overrepresented in self-reported physician-diagnosed IBS patients, 633 in patients with ICD-10 diagnosed IBS (ICD-10-IBS), with 221 (40%) overlapping. In addition to gastrointestinal diseases, psychiatric, musculoskeletal, and endocrine/metabolic disorders represented the most strongly associated PheCodes in IBS patients. Self-reported physician-diagnosed IBS was not associated with increased overall mortality and the risk of death from cancer was decreased (hazard ratio [HR] = 0.78 [95% CI = 0.7-0.9]). Lastly, we evaluated changes in serum metabolites in IBS patients and identified glycoprotein acetyls (GlycA) as a potential biomarker in IBS. One standard deviation increase in GlycA raised the risk of self-reported IBS/ICD-10 coded by 9%-20% (odds ratio [OR] = 1.09 [95% CI = 1.1-1.1]/OR = 1.20 [95% CI = 1.1-1.3]) and the risk of overall mortality in ICD-10-IBS patients by 28% (HR = 1.28 [95% CI = 1.1-1.5]). CONCLUSION Our large-scale association study determined IBS patients having an increased risk of several different comorbidities and that GlycA was increased in IBS patients.
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Affiliation(s)
- Katharina Sophie Seeling
- Medical Clinic IIIGastroenterology, Metabolic Diseases and Intensive CareUniversity Hospital RWTH AachenAachenGermany
| | - Leonida Hehl
- Medical Clinic IIIGastroenterology, Metabolic Diseases and Intensive CareUniversity Hospital RWTH AachenAachenGermany
| | - Mara Sophie Vell
- Medical Clinic IIIGastroenterology, Metabolic Diseases and Intensive CareUniversity Hospital RWTH AachenAachenGermany
| | - Miriam Daphne Rendel
- Medical Clinic IIIGastroenterology, Metabolic Diseases and Intensive CareUniversity Hospital RWTH AachenAachenGermany
| | - Kate Townsend Creasy
- Department of Biobehavioral Health SciencesPerelman School of NursingUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Christian Trautwein
- Medical Clinic IIIGastroenterology, Metabolic Diseases and Intensive CareUniversity Hospital RWTH AachenAachenGermany
| | - David Marc Anton Mehler
- Department of Psychiatry, Psychotherapy and PsychosomaticsUniversity Hospital RWTH AachenAachenGermany
- Institute for Translational PsychiatryUniversity of MünsterMünsterGermany
| | - Daniel Keszthelyi
- Division of Gastroenterology‐HepatologyDepartment of Internal MedicineMaastricht University Medical Center+Maastrichtthe Netherlands
| | - Kai Markus Schneider
- Medical Clinic IIIGastroenterology, Metabolic Diseases and Intensive CareUniversity Hospital RWTH AachenAachenGermany
| | - Carolin Victoria Schneider
- Medical Clinic IIIGastroenterology, Metabolic Diseases and Intensive CareUniversity Hospital RWTH AachenAachenGermany
- The Institute for Translational Medicine and TherapeuticsThe Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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Yamamoto Y, Furukawa S, Miyake T, Watanabe J, Kato A, Kusumoto K, Takeshita E, Ikeda Y, Yamamoto N, Saeki Y, Hiasa Y. Exercise habits that include exercise partners and irritable bowel syndrome in a young Japanese population: a cross-sectional study. Eur J Gastroenterol Hepatol 2023; 35:641-645. [PMID: 37115986 DOI: 10.1097/meg.0000000000002561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
OBJECTIVE Evidence regarding the association between exercise habits and irritable bowel syndrome (IBS) remains scarce in a young population. It is also unknown whether the existence of an exercise partner affects this issue. The purpose of this study was to explore the association between exercise habits that include an exercise partner and IBS in a young Japanese population. METHODS This study enrolled 8923 Japanese university students and examined exercise frequency and intensity, and exercise partners using self-administered questionnaires. IBS and functional dyspepsia were defined according to the Rome III criteria. RESULTS The prevalence of IBS in this survey was 6.5%. Moderate frequency exercise was inversely related with IBS [adjusted odds ratio (aOR): 0.65 (95% confidence interval, CI: 0.51-0.83), P for trend = 0.005]. Moderate and high exercise intensities were independently and inversely related with IBS, respectively [aORs were moderate: 0.76 (95% CI: 0.61-0.95) and high: 0.62 (95% CI: 0.48-0.78), P for trend = 0.001]. Exercising with a group or with friends instead of alone was independently inversely related with IBS [aOR with groups: 0.53 (95% CI: 0.40-0.70) and with friends: aOR 0.71 (95% CI: 0.54-0.93)]. After excluding subjects with overlapping IBS and functional dyspepsia, an inverse association between high intensity of exercise or exercise in a group and IBS remained significant. CONCLUSION The frequency and intensity of exercise may be independently inversely related with IBS in a young Japanese population. Also, exercise with others may be important for preventing IBS.
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Affiliation(s)
| | | | - Teruki Miyake
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon
| | - Junichi Watanabe
- Department of Physical Therapy, Faculty of Health Sciences, Yamagata Prefectural University of Health Sciences, Yamagata
| | - Aki Kato
- Health Services Center, Ehime University, Matsuyama
| | | | - Eiji Takeshita
- Department of Inflammatory Bowel Diseases and Therapeutics, Ehime University Graduate School of Medicine
| | - Yoshio Ikeda
- Endoscopy Center, Ehime University Hospital, Toon
| | - Naofumi Yamamoto
- Faculty of Collaborative Regional Innovation, Ehime University, Matsuyama
| | - Yuka Saeki
- Health Services Center, Ehime University, Matsuyama
- Community Health Systems for Nursing, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Yoichi Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon
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Vichos T, Rezaie A, Vichos P, Cash B, Pimentel M. Irritable Bowel Syndrome Is Not Associated with an Increased Risk of Polyps and Colorectal Cancer: A Systematic Review and Meta-Analysis. Dig Dis Sci 2023; 68:2585-2596. [PMID: 36871131 PMCID: PMC10188394 DOI: 10.1007/s10620-023-07885-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVES Colorectal cancer (CRC) is the third most common malignancy in the US. Several factors are associated with increased/decreased CRC risk and often linked to adenomatous colorectal polyps (CRP). Recent studies suggest a lower risk of neoplastic lesions among irritable bowel syndrome (IBS) patients. We aimed to systematically assess the occurrence of CRC and CRP in IBS patients. METHODS Searches of the Medline, Cochrane, and EMBASE databases were performed, blindly and independently, by two investigators. Studies of CRC or CRP incidence in IBS patients (diagnosed by Rome or other symptom-based criteria) were eligible for inclusion. CRC and CRP effect estimates were pooled in meta-analyses using random models. RESULTS Of 4941 non-duplicate studies, 14 were included, comprising 654,764 IBS patients and 2,277,195 controls in 8 cohort studies, and 26,641 IBS patients and 87,803 controls in 6 cross-sectional studies. Pooled analysis revealed a significantly decreased prevalence of CRP in IBS subjects vs. controls, with a pooled odds ratio (OR) of 0.29 (95% CI (0.15, 0.54)). There was significant heterogeneity between studies (I2 = 96%, p < 0.01). This finding persisted when studies which did not report pre-cancerous polyps separately were excluded (OR 0.23, 95% CI (0.15, 0.35), I2 = 85%, p < 0.01). CRC prevalence was lower in IBS subjects, but this did not reach statistical significance (OR 0.40, 95% CI (0.09, 1.77]). CONCLUSION Our analyses reveal a decreased incidence of colorectal polyps in IBS, although CRC did not reach significance. Mechanistic studies with detailed genotypic analysis and clinical phenotyping are needed to better elucidate the potentially protective effect of IBS on CRC development.
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Affiliation(s)
- Theodoros Vichos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ali Rezaie
- Medically Associated Science and Technology (MAST) Program, Cedars-Sinai, 770 N. San Vicente Blvd, Suite G271, West Hollywood, CA, USA
- Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai, Los Angeles, CA, USA
| | - Petros Vichos
- Medical School, University of Cyprus, Nicosia, Cyprus
| | - Brooks Cash
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Mark Pimentel
- Medically Associated Science and Technology (MAST) Program, Cedars-Sinai, 770 N. San Vicente Blvd, Suite G271, West Hollywood, CA, USA.
- Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai, Los Angeles, CA, USA.
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高 旭, 刘 娜, 郝 宇, 张 晓, 杨 倩, 蒋 潇, 刘 奕, 蔡 雅, 宋 萍, 纪 泛, 王 进. [Prevalence Survey of Functional Dyspepsia and Irritable Bowel Syndrome in Chinese College Students Based on Rome Ⅳ Diagnostic Criteria]. Sichuan Da Xue Xue Bao Yi Xue Ban 2023; 54:574-578. [PMID: 37248586 PMCID: PMC10475438 DOI: 10.12182/20230560208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Indexed: 05/31/2023]
Abstract
Objective To investigate the prevalence and risk factors of functional dyspepsia (FD) and irritable bowel syndrome (IBS) among college students in China. Methods An online questionnaire survey of college students aged 17-35 from across China was conducted. The online questionnaire survey was supplemented by an offline survey. A total of 2025 valid samples were included for statistical analysis. χ 2 test and logistic regression were performed for statistical analysis. Results The prevalence of FD among college students who met the Rome Ⅳ diagnostic criteria was 5.5% (112/2025), with most of them, or 66.1% (74/112), suffering from postprandial discomfort syndrome (PDS). Smoking (odds ratio [ OR]=2.334, 95% confidence interval [ CI]: 1.187-4.589, P=0.014), depression ( OR=2.447, 95% CI: 1.421-4.214, P=0.001), and insomnia ( OR=1.947, 95% CI: 1.291-2.937, P=0.001) were positively correlated with the prevalence of FD. The prevalence of IBS was 1.9% (38/2025), with IBS-diarrhea dominant (IBS-D) being the most important subtype that accounted for 44.7%. Anxiety ( OR=3.63, 95% CI: 1.34-9.88, P=0.012) and insomnia ( OR=2.35, 95% CI: 1.18-4.68, P=0.015) were positively correlated with the prevalence of IBS. Conclusion Based on Rome Ⅳ criteria, IBS and FD are not uncommon among Chinese university students. Psychological disorders and some related lifestyle factors may be related to the development of the disease. In the future, more series of studies based on different diagnostic criteria, different regions, and multiple factors should be conducted in China.
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Affiliation(s)
- 旭 高
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 娜 刘
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 宇杰 郝
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 晓辉 张
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 倩 杨
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 潇洒 蒋
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 奕辛 刘
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 雅琴 蔡
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 萍 宋
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 泛扑 纪
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 进海 王
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
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Kridin K, Ludwig RJ. Isotretinoin and the risk of inflammatory bowel disease and irritable bowel syndrome: A large-scale global study. J Am Acad Dermatol 2023; 88:824-830. [PMID: 36529376 DOI: 10.1016/j.jaad.2022.12.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Risk of inflammatory bowel disease under isotretinoin is a scope of a long-standing controversy. The burden of isotretinoin-related irritable bowel syndrome has not been investigated. OBJECTIVE To evaluate the risk of Crohn's disease, ulcerative colitis (UC), and irritable bowel syndrome in patients with acne starting isotretinoin vs oral antibiotics treatment. METHODS A global population-based retrospective cohort study assigned 2 groups of patients with acne initiating isotretinoin (n = 77,005) and oral antibiotics (n = 77,005). Comprehensive propensity-score matching was conducted. RESULTS The lifetime risk of Crohn's disease (hazard ratio [HR], 1.05; 95% CI, 0.89-1.24; P = .583) and UC (HR, 1.13; 95% CI, 0.95-1.34; P = .162) was comparable between study groups, whereas the lifetime risk of irritable bowel syndrome was lower in isotretinoin-prescribed patients (HR, 0.82; 95% CI, 0.76-0.89; P < .001). In time-stratified analysis, isotretinoin-related risk of UC was significantly increased during the first 6 months following drug initiation (HR, 1.93; 95% CI, 1.29-2.88; P = .001), but decreased afterward to level the risk of the comparator group. The absolute risk difference within the first 6 months was clinically marginal (5.0 additional UC cases/10,000 patients starting isotretinoin; 95% CI, 2.5-7.7). LIMITATIONS Retrospective data collection. CONCLUSION Isotretinoin does not confer an elevated risk of Crohn's disease, whilst it might be associated with a slight and transient increase in UC risk.
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Affiliation(s)
- Khalaf Kridin
- Lűbeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel; Unit of Dermatology and Skin Research Laboratory, Barch Padeh Medical Center, Poriya, Israel.
| | - Ralf J Ludwig
- Lűbeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany; Department of Dermatology, University of Lübeck, Lübeck, Germany
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Ghoshal UC, Sachdeva S, Pratap N, Karyampudi A, Mustafa U, Abraham P, Bhatt CB, Chakravartty K, Chaudhuri S, Goyal O, Makharia GK, Panigrahi MK, Parida PK, Patwari S, Sainani R, Sadasivan S, Srinivas M, Upadhyay R, Venkataraman J. Indian consensus statements on irritable bowel syndrome in adults: A guideline by the Indian Neurogastroenterology and Motility Association and jointly supported by the Indian Society of Gastroenterology. Indian J Gastroenterol 2023; 42:249-273. [PMID: 36961659 PMCID: PMC10036984 DOI: 10.1007/s12664-022-01333-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 12/20/2022] [Indexed: 03/25/2023]
Abstract
The Indian Neurogastroenterology and Motility Association (INMA), earlier named the Indian Motility and Functional Diseases Association developed this evidence-based practice guidelines for the management of irritable bowel syndrome (IBS). A modified Delphi process was used to develop this consensus containing 28 statements, which were concerning diagnostic criteria, epidemiology, etiopathogenesis and comorbidities, investigations, lifestyle modifications and treatments. Owing to the Coronavirus disease-19 (COVID-19) pandemic, lockdowns and mobility restrictions, web-based meetings and electronic voting were the major tools used to develop this consensus. A statement was regarded as accepted when the sum of "completely accepted" and "accepted with minor reservation" voted responses were 80% or higher. Finally, the consensus was achieved on all 28 statements. The consensus team members are of the view that this work may find use in teaching, patient care, and research on IBS in India and other nations.
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Affiliation(s)
- Uday C Ghoshal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India.
| | - Sanjeev Sachdeva
- Department of Gastroenterology, GB Pant Hospital, New Delhi, 110 002, India
| | - Nitesh Pratap
- Department of Gastroenterology, KIMS Hospital, Secunderabad, 500 003, India
| | - Arun Karyampudi
- Department of Gastroenterology, GSL Medical College and General Hospital, Rajahmundry , 533 296, India
| | - Uzma Mustafa
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India
| | - Philip Abraham
- Department of Gastroenterology, P. D. Hinduja Hospital, Mumbai, 400 016, India
| | - Chetan B Bhatt
- Sir HN Reliance Foundation Hospital, Mumbai, 400 004, India
| | - Karmabir Chakravartty
- Department of Gastroenterology, Woodland Multispeciality Hospital, Kolkata, 700 027, India
| | - Sujit Chaudhuri
- Department of Gastroenterology, AMRI Hospitals, Salt Lake, Kolkata, 700 098, India
| | - Omesh Goyal
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, 141 001, India
| | - Govind K Makharia
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, 110 029, India
| | - Manas Kumar Panigrahi
- Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, 751 019, India
| | - Prasanta Kumar Parida
- Department of Gastroenterology, SCB Medical College and Hospital, Cuttack, 753 001, India
| | | | - Rajesh Sainani
- Department of Gastroenterology, Jaslok Hospital, Mumbai, 400 026, India
| | - Shine Sadasivan
- Department of Gastroenterology, Amrita Institute of Medical Sciences, Kochi, 682 041, India
| | - M Srinivas
- Department of Gastroenterology, Gleneagles Global Health City, Chennai, 600 100, India
| | - Rajesh Upadhyay
- Department of Gastroenterology, Max Superspeciality Hospital, New Delhi, 110 017, India
| | - Jayanthi Venkataraman
- Department of Gastroenterology, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, India
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Wang XJ, Ebbert JO, Loftus CG, Rosedahl JK, Philpot LM. Comorbid extra-intestinal central sensitization conditions worsen irritable bowel syndrome in primary care patients. Neurogastroenterol Motil 2023; 35:e14546. [PMID: 36807964 DOI: 10.1111/nmo.14546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 11/25/2022] [Accepted: 01/24/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is characterized as a central sensitization syndrome (CSS), a group of conditions including fibromyalgia, chronic fatigue, and restless leg syndrome (RLS) among others with frequent comorbidities of anxiety, depression, and chemical sensitivity. The prevalence of comorbid conditions and their impact on IBS symptom severity and quality of life in rural community populations has not been described. METHODS We administered a cross-sectional survey to patients with a documented CSS diagnosis in rural primary care practices to evaluate the relationship between CSS diagnoses, quality of life, symptom severity, and interactions with healthcare providers utilizing validated questionnaires. Subgroup analysis was performed on the IBS cohort. Mayo Clinic IRB approved the study. KEY RESULTS Seven hundred seventy-five individuals out of 5000 completed the survey (15.5% response rate) with 264 (34%) reporting IBS. Only 3% (n = 8) of IBS patients reported IBS alone without comorbid CSS condition. Most respondents reported overlapping migraine (196, 74%), depression (183, 69%), anxiety (171, 64%), and fibromyalgia (139, 52%). IBS patients with more than two comorbid CS condition showed significantly higher symptom severity with linear increase. Quality of life was lower in IBS with comorbid conditions, particularly in patients with IBS and RLS (mean EQ5-D 0.36 vs. 0.8 in IBS only, p < 0.01). Quality of life declined as number of comorbid conditions increased. CONCLUSIONS & INFERENCES Patients with IBS often have multiple CS disorders which increases symptom severity and lowers quality of life. Understanding the impact of multiple CSS diagnoses and treating these as a global condition may improve patient experience.
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Affiliation(s)
- Xiao Jing Wang
- Gastroenterology and Hepatology, Mayo Clinic, Minnesota, Rochester, USA
| | - Jon O Ebbert
- Community Internal Medicine, Mayo Clinic, Minnesota, Rochester, USA
| | - Connor G Loftus
- Gastroenterology and Hepatology, Mayo Clinic, Minnesota, Rochester, USA
| | - Jordan K Rosedahl
- Quantitative Health Sciences, Mayo Clinic, Minnesota, Rochester, USA
| | - Lindsey M Philpot
- Community Internal Medicine, Mayo Clinic, Minnesota, Rochester, USA
- Quantitative Health Sciences, Mayo Clinic, Minnesota, Rochester, USA
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Van Ouytsel P, Piessevaux H, Szalai A, Loi P, Louis H. Irritable bowel syndrome-like symptoms before and after bariatric surgery and association with short-chain fermentable carbohydrates consumption: an observational prospective study. Acta Gastroenterol Belg 2023; 86:288-297. [PMID: 37428161 DOI: 10.51821/86.2.11530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Background and aims Irritable Bowel Syndrome (IBS)-like symptoms are frequent following bariatric surgery. This study aims to evaluate the frequency of IBS symptoms severity before and after bariatric surgery and their association with short-chain fermentable carbohydrates (FODMAPs) consumption. Patients and methods IBS symptoms severity in a cohort of obese patients was evaluated prospectively before, 6 and 12 months after bariatric surgery by validated questionnaires and tools (Irritable Bowel Syndrome Severity Scoring System (IBS SSS), Bristol Stool Scale (BSS), Quality of Life Short- Form-12 (SF-12), Hospital Anxiety and Depression scale (HAD)). FODMAPs consumption and its association with IBS symptom severity was evaluated by using a food frequency questionnaire focused on high-FODMAPs food consumption. Results Fifty-one patients were included (41 female; mean age 41 years (SD: 12)), 84% received a sleeve gastrectomy, and 16% a Roux-en-Y gastric bypass. Symptoms compatible with IBS were observed in 43% of patients before surgery, in 58% of patients at 6 months and 33% at 12 months (NS, p-value=0,197 and 0,414). In a multivariate model, a significant association was found between the IBS SSS score and lactose consumption at 6 months (β = + 58, 1; p = 0.03), and with polyols consumption at 12 months (β = + 112,6; p = 0.01). Conclusions Mild to moderate IBS symptoms are frequent in obese patients before bariatric surgery. A significant association between lactose and polyols consumption and IBS SSS score was observed after bariatric surgery, suggesting a potential link between the severity of IBS symptoms and some specific FODMAPs consumption.
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Affiliation(s)
- Pauline Van Ouytsel
- Department of Dietetics, HUB - CUB Hôpital Erasme (ULB), Brussels, Belgium
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, HUB - CUB Hôpital Erasme (ULB), Brussels, Belgium
| | - H Piessevaux
- Department of Hepato-Gastroenterology, Cliniques universitaires Saint-Luc (UCLouvain), Brussels, Belgium
| | - A Szalai
- Department of Dietetics, HUB - CUB Hôpital Erasme (ULB), Brussels, Belgium
| | - P Loi
- Department of Digestive Surgery, HUB - CUB Hôpital Erasme (ULB), Brussels, Belgium
| | - H Louis
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, HUB - CUB Hôpital Erasme (ULB), Brussels, Belgium
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Rueda-Ruzafa L, Roman P, Cardona D, Requena M, Ropero-Padilla C, Alarcón R. Environmental pesticide exposure and the risk of irritable bowel syndrome: A case-control study. Environ Toxicol Pharmacol 2023; 98:104076. [PMID: 36754128 DOI: 10.1016/j.etap.2023.104076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/27/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
The agricultural model in southern Spain is highly productive, mainly due to the intensive cultivation under plastic. Despite strict pesticide regulation, human exposure to pesticides in the environment has been connected to an increase in diseases such as celiac disease. Certain pesticides have also been associated to the disruption of the intestinal microbiota, which has been tied to the development of irritable bowel syndrome (IBS). A case-control study was conducted in Andalusia, south Spain, to assess the prevalence and risk of IBS related to pesticide exposure. This research found a high prevalence of IBS in Andalusia between 2000 and 2021 in areas with high pesticide exposure using agronomic criteria. Furthermore, the odds ratio for IBS was significantly higher in the population with high pesticide exposure. This study suggests that pesticides may be involved in IBS, whereas more research is needed to determine the role of pesticides in IBS symptomatology.
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Affiliation(s)
- Lola Rueda-Ruzafa
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento S/N, La Cañada, 04120 Almeria, Spain.
| | - Pablo Roman
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento S/N, La Cañada, 04120 Almeria, Spain; Health Research Center, University of Almeria, Carretera Sacramento S/N, La Cañada 04120, Spain.
| | - Diana Cardona
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento S/N, La Cañada, 04120 Almeria, Spain; Health Research Center, University of Almeria, Carretera Sacramento S/N, La Cañada 04120, Spain.
| | - Mar Requena
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento S/N, La Cañada, 04120 Almeria, Spain; Health Research Center, University of Almeria, Carretera Sacramento S/N, La Cañada 04120, Spain.
| | - Carmen Ropero-Padilla
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento S/N, La Cañada, 04120 Almeria, Spain.
| | - Raquel Alarcón
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento S/N, La Cañada, 04120 Almeria, Spain; Health Research Center, University of Almeria, Carretera Sacramento S/N, La Cañada 04120, Spain.
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Alzahrani MA, Alamri HA, Alshehri MA, Ayyashi MM, Alqarni SA, Alshehri SH, Alshehri MS, Alqahtani MM, Alasmari NH, Alsabban AM, Alshahrani AS. Assessing the relationship between burnout syndrome and irritable bowel syndrome among medical health providers and medical students in Saudi Arabia. J Med Life 2023; 16:277-283. [PMID: 36937468 PMCID: PMC10015567 DOI: 10.25122/jml-2022-0242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 01/29/2023] [Indexed: 03/21/2023] Open
Abstract
Burnout syndrome, characterized by chronic unmanageable workplace stress, has been linked to lower gastrointestinal disorders, including irritable bowel syndrome. However, the relationship between burnout syndrome and irritable bowel syndrome among medical health providers and medical students in Saudi Arabia has not been fully explored. This cross-sectional correlational study was conducted in Southern Saudi Arabia from 2021 to 2022 and involved 931 medical health providers and medical students who completed an electronic questionnaire. The study assessed the presence and severity of burnout and irritable bowel syndrome and examined their relationship. Burnout syndrome was evaluated using the Maslach Burnout Inventory-Student Survey (MBI-SS), while irritable bowel syndrome criteria and severity were assessed using validated tools. The study found that 85% of medical health providers and medical students experienced high levels of burnout and irritable bowel syndrome severity, with physicians and nurses mainly affected. Occupational exhaustion was high in 44.4% of participants, while depersonalization was high in 53% of participants. Personal accomplishment was low in 73.5% of participants. Mild, moderate, and severe irritable bowel syndrome was reported in 25.6%, 23.8%, and 12% of participants, respectively. The study highlights a significant association between burnout syndrome and irritable bowel syndrome severity among medical health providers and medical students in Saudi Arabia. These findings underscore the importance of developing effective interventions to prevent and manage burnout syndrome and related health issues among healthcare professionals and medical students in the region.
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Affiliation(s)
- Mohammed Attieh Alzahrani
- Internal Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
- Gastroenterology Department, Assir Central Hospital, Abha, Saudi Arabia
| | | | | | | | - Saeed Ali Alqarni
- Department of Medicine, College of Medicine, King Khalid University, Abha, Saudi, Arabia
| | - Salem Hassan Alshehri
- Department of Medicine, College of Medicine, King Khalid University, Abha, Saudi, Arabia
| | | | - Majed Musfer Alqahtani
- Department of Medicine, College of Medicine, King Khalid University, Abha, Saudi, Arabia
| | - Nader Hasan Alasmari
- Department of Medicine, College of Medicine, King Khalid University, Abha, Saudi, Arabia
| | | | - Abdulaziz Saad Alshahrani
- Internal Medicine, College of Medicine, Najran University, Saudi Arabia
- Department of Medicine, King Khalid Hospital, Najran, Saudi Arabia
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Aja-Cadena MG, Amieva-Balmori M, Taboada-Liceaga HA, Cobos-Quevedo OJ, Hernández-Ramírez GA, Reyes-Huerta J, Roesch-Dietlen F, Meixuerio-Daza A, Remes-Troche JM. Prevalence of methanogens and associated factors in patients with irritable bowel syndrome and healthy controls in a Southeastern Mexican population. Rev Gastroenterol Mex (Engl Ed) 2023; 88:50-56. [PMID: 34863643 DOI: 10.1016/j.rgmxen.2021.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/30/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Methane (CH4) is an inert gas produced by colonic anaerobes and has been associated with different intestinal diseases, including irritable bowel syndrome (IBS). According to geographic region, the prevalence of methanogens varies, being higher in Africa (80%) and lower in the United States (35-40%). In Mexico, the prevalence of methanogens is unknown. AIM To evaluate the prevalence of CH4 producers and associated factors in a group of patients with IBS and controls in a Mexican population. MATERIALS AND METHODS A baseline fasting measurement of alveolar H2 and CH4 gas was carried out, by gas chromatography (stationary phase), in consecutive patients diagnosed with IBS and a control group. Subjects with baseline levels of H2 of 0 ppm and CH4 ≥ 5 ppm were classified as methanogenic. RESULTS A total of 132 controls (53.8% women) and 67 patients with IBS (76% women) were included. The overall prevalence (n = 199) of methanogenic subjects was 38% (n = 76) (95% CI: 0.31-0.45) and they had a greater prevalence of overweight/obesity (56.5 vs 39.8%, P = .028). The prevalence of methanogens in the healthy controls was 41.6% (95% CI: 0.33-0.49), whereas, in the patients with IBS, it was 31.4% (n = 21, 71% IBS-C and 29% IBS-M). CONCLUSIONS The prevalence of methanogens in our study on a Mexican population was comparable to that reported in other populations and was associated with overweight/obesity. One-third of the patients with IBS presented with methanogens. Said microorganisms were particularlyassociated with the constipation-predominant IBS subtype.
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Affiliation(s)
- M G Aja-Cadena
- Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Médico Biológicas, Universidad Veracruzana, Veracruz, Veracruz, Veracruz, Mexico
| | - M Amieva-Balmori
- Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Médico Biológicas, Universidad Veracruzana, Veracruz, Veracruz, Veracruz, Mexico
| | - H A Taboada-Liceaga
- Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Médico Biológicas, Universidad Veracruzana, Veracruz, Veracruz, Veracruz, Mexico
| | - O J Cobos-Quevedo
- Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Médico Biológicas, Universidad Veracruzana, Veracruz, Veracruz, Veracruz, Mexico
| | - G A Hernández-Ramírez
- Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Médico Biológicas, Universidad Veracruzana, Veracruz, Veracruz, Veracruz, Mexico
| | - J Reyes-Huerta
- Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Médico Biológicas, Universidad Veracruzana, Veracruz, Veracruz, Veracruz, Mexico
| | - F Roesch-Dietlen
- Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Médico Biológicas, Universidad Veracruzana, Veracruz, Veracruz, Veracruz, Mexico
| | - A Meixuerio-Daza
- Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Médico Biológicas, Universidad Veracruzana, Veracruz, Veracruz, Veracruz, Mexico
| | - J M Remes-Troche
- Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Médico Biológicas, Universidad Veracruzana, Veracruz, Veracruz, Veracruz, Mexico.
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Gravina AG, Pellegrino R, Romeo M, Palladino G, Cipullo M, Iadanza G, Olivieri S, Zagaria G, Mazzarella C, Durante T, Federico A. The Burden of Irritable Bowel Syndrome in Medical and Nurse Italian University Student Population: The VANVITELLI-IBS Survey. Rev Recent Clin Trials 2023; 18:206-213. [PMID: 37157215 DOI: 10.2174/1574887118666230508154027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND The increased prevalence of irritable bowel syndrome (IBS) among medical and nursing students is a global challenge. Unfortunately, data on the Italian medical and nurse student population are scarce. Therefore, this study was designed to assess the prevalence of IBS in this setting and to evaluate the demographic, university, Mediterranean diet adherence, and anxiety factors associated with its increased presence. OBJECTIVE To assess the prevalence of IBS, anxiety levels, and adherence to the Mediterranean diet in medical and nursing university students. METHODS An anonymous online questionnaire was sent to participants. Several demographic and educational variables were assayed, and the presence of symptoms associated with the definition of IBS (according to Rome IV criteria). In addition, anxiety levels and adherence to the Mediterranean diet were also assessed. RESULTS Of 161 students, 21.11% met the Rome IV criteria for IBS. Some subgroups, the out-ofcourse students or no scholarship recipients, were found to have a higher percentage of IBS (p < 0.05). Being out-of-course was shown to be associated with an increased and unreported risk of presenting IBS (OR: 8.403, p < 0.001). Levels of anxiety and adherence to the Mediterranean diet were significantly worse in the IBS group (p < 0.01). Adherence to the Mediterranean diet was associated with a reduced risk of presenting IBS in our setting (OR 0.258, p = 0.002). CONCLUSION Our sample of Italian medical and nursing students recorded a non-negligible percentage of IBS. Therefore, screening and awareness campaigns could be suggested.
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Affiliation(s)
- Antonietta Gerarda Gravina
- Hepatogastroenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via L. de Crecchio, Naples, 80138, Italy
| | - Raffaele Pellegrino
- Hepatogastroenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via L. de Crecchio, Naples, 80138, Italy
| | - Mario Romeo
- Hepatogastroenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via L. de Crecchio, Naples, 80138, Italy
| | - Giovanna Palladino
- Hepatogastroenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via L. de Crecchio, Naples, 80138, Italy
| | - Marina Cipullo
- Hepatogastroenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via L. de Crecchio, Naples, 80138, Italy
| | - Giorgia Iadanza
- Hepatogastroenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via L. de Crecchio, Naples, 80138, Italy
| | - Simone Olivieri
- Hepatogastroenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via L. de Crecchio, Naples, 80138, Italy
| | - Giuseppe Zagaria
- Hepatogastroenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via L. de Crecchio, Naples, 80138, Italy
| | - Chiara Mazzarella
- Hepatogastroenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via L. de Crecchio, Naples, 80138, Italy
| | - Tommaso Durante
- Mental Health Department, S. Pio Hospital, via dell'Angelo, Benevento, 82100, Italy
| | - Alessandro Federico
- Hepatogastroenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via L. de Crecchio, Naples, 80138, Italy
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Abusageah F, Hakami A, Zogel B, Zaalah S, Alfaifi S, Shubayli S, Hakami K, Qadah E, Aldharman S, Hakami F, Alqasemi M, Mobarki M, Alhazmi AH. A Cross-Sectional Study about Knowledge, Attitude, and Practices among Primary Health Care Physicians in Jazan Province, Saudi Arabia, Regarding Rome IV Criteria for Diagnosis of Irritable Bowel Syndrome. Medicina (Kaunas) 2022; 58:medicina58121811. [PMID: 36557013 PMCID: PMC9785885 DOI: 10.3390/medicina58121811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022]
Abstract
Background and objectives: Most individuals with irritable bowel syndrome (IBS) are diagnosed by primary health care (PHC) physicians. However, a significant percentage of patients remain undiagnosed or misdiagnosed owing to the lack of knowledge or a systematic strategy regarding the use of ROME IV criteria for the diagnosis of IBS. Thus, in this study, we aimed to assess the knowledge, attitude, and practices among primary health care physicians in Jazan Province, Saudi Arabia, regarding ROME IV criteria for the diagnosis of IBS. Methods: A cross-sectional study was conducted using a pretested self-administered questionnaire that determines participants' sociodemographic data and measures knowledge about ROME IV criteria, targeting PHC physicians in Jazan Province, Saudi Arabia. Data were analyzed using the Statistical Package for Social Sciences (SPSS) v.23. Results: We included 200 participants, and the majority of participants in our study (approximately 78%) were aware of the ROME IV diagnostic criteria for IBS; this awareness was associated with age, nationality, specialty, and classification. The participants' mean level of knowledge was 4.30 (out of 6). However, knowledge was higher among Saudi and family medicine doctors in this study, as compared to non-Saudi and doctors of other specialties. More than two-thirds of participants who were aware of ROME IV criteria thought that they are sufficient to diagnose IBS; however, only 47.5% of physicians reported using ROME IV frequently in their daily practice. Conclusions: Most of the participants of this study are aware of ROME IV criteria, and better knowledge was noted among Saudi and family medicine physicians. About 70% thought that ROME IV criteria are effective enough to diagnose IBS, and only about half of the participants use ROME IV criteria in their practice. Therefore, due to its high prevalence in the region, further efforts are required to disseminate basic knowledge and improve attitudes and practices related to ROME IV criteria among PHC physicians of all specialties.
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Affiliation(s)
- Faisal Abusageah
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Alwaleed Hakami
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Basem Zogel
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Shaden Zaalah
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Samar Alfaifi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Sahar Shubayli
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Khalid Hakami
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Entsar Qadah
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Sarah Aldharman
- Faculty of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia
| | - Faisal Hakami
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Maram Alqasemi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Mousa Mobarki
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Abdulaziz H. Alhazmi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
- Correspondence: ; Tel.: +966-7329-5000
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Ganji L, Shirazi MH, Ebrahimi-Daryani N, Eslami P, Rahbar M, Zali MR, Alebouyeh M. Carriage of CdtB Encoding Campylobacter spp., Salmonella enterica, and Yersinia entercolitica in Patients with Gastroenteritis and Irritable Bowel Syndrome. Dig Dis Sci 2022; 67:5522-5528. [PMID: 35357609 DOI: 10.1007/s10620-022-07468-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 03/01/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Cytolethal distending toxin (Cdt) is one of the bacterial toxins that present in a variety of gram-negative human pathogens, such as E. coli, Salmonella spp., and Campylobacter spp. CDT is composed of three subunits encoded by three adjacent genes, including cdtA, cdtB, and cdtC. cdtB has been shown to have toxic activity and cause DNA damage in host cells. Despite its presence in different bacterial species, the role of CdtB in acute and chronic infections, such as gastroenteritis and irritable bowel syndrome (IBS), is unclear. To analyze this correlation, we studied the prevalence of cdtB among different enteropathogenic bacteria in patients with gastroenteritis and IBS compared with healthy people. MATERIALS AND METHODS In this cross-sectional descriptive study, 230 stool samples were collected from patients with gastroenteritis, IBS, and healthy people. The presence of CdtB encoding bacteria, including Escherichia coli, Campylobacter spp., Yersinia entercolitica, Providencia alkalifacience, and Salmonella enterica, was examined by polymerase chain reaction using genus-specific primers. RESULTS Out of 230 stool samples, CdtB encoding Campylobacter spp. were found in 34.6% (52/150), 6.25% (5/80), and 4% (2/50) of the patients with gastroenteritis, IBS, and the control group, respectively. Carriage of CdtB encoding Salmonella enterica was characterized among 5.3% (8/150) of the patients with gastroenteritis and 17.5% (14/80) of the IBS patients. Although none of the patients carried CdtB encoding E. coli and Providencia spp., cdtB of Y. enterocolitica was detected in one of the patients with gastroenteritis (0.6%). Statistical analysis showed significant correlation between infection with CdtB encoding Campylobacter spp. and IBS-D subtype. No significant correlation was found between infection with CdtB encoding bacteria and other clinical and demographic data. CONCLUSION Our results confirmed a relatively higher frequency of CdtB encoding bacteria in the intestine of patients with gastroenteritis and those with IBS compared with healthy individuals. Regarding the frequency of CdtB encoding Salmonella and Campylobacter bacteria, it was proposed that infection with these enteropathogens could be considered a risk factor for the development or progression of IBS among Iranian patients. Further studies are needed to establish this involvement.
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Affiliation(s)
- Leila Ganji
- Health Reference Laboratory Research Center, Reference Health Laboratory, Ministry of Health and Medical Education, Tehran, Iran
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Shirazi
- Department of Pathobiology, School of Public Health, University of Medical Sciences, Tehran, Iran
| | - Nasser Ebrahimi-Daryani
- Department of Gastroenterology and Hepatology, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Eslami
- Department of Microbiology, Central Laboratory, Milad Hospital, Tehran, Iran
| | - Mohammad Rahbar
- Health Reference Laboratory Research Center, Reference Health Laboratory, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Alebouyeh
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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69
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Wongtrakul W, Charoenngam N, Ungprasert P. The association between irritable bowel syndrome and ischemic colitis: a systematic review and meta-analysis. Minerva Gastroenterol (Torino) 2022; 68:470-474. [PMID: 34547858 DOI: 10.23736/s2724-5985.21.02957-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Studies have suggested an association between ischemic colitis and irritable bowel syndrome (IBS) although the results were inconsistent. This systematic review and meta-analysis were performed to comprehensively examine the association between IBS and ischemic colitis by identifying all available cohort and case-control studies and combining their effect estimates together. EVIDENCE ACQUISITION EMBASE, MEDLINE and Google Scholar databases were systematically reviewed up to June 2020. Eligible study had to be either cohort or case-control studies that evaluated whether patients with IBS have a higher risk of ischemic colitis than individuals without IBS. Point estimates and standard errors from each eligible study were combined together using the generic inverse variance method of DerSimonian and Laird. EVIDENCE SYNTHESIS The systematic review identified three cohort and eight case-control studies. The pooled analysis found a significantly higher risk of ischemic colitis among patient with IBS with the pooled odds ratio of 2.50 (95% CI, 2.00-3.14; I2 57%). Funnel plot was relatively symmetric and was not suggestive of presence of publication bias. CONCLUSIONS A significantly increased risk of ischemic colitis among patients with IBS was observed in this systematic review and meta-analysis.
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Affiliation(s)
- Wasit Wongtrakul
- Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand -
| | - Nipith Charoenngam
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Patompong Ungprasert
- Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, OH, USA
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70
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Olmos JI, Piskorz MM, Litwin N, Schaab S, Tevez A, Bravo-Velez G, Uehara T, Hashimoto H, Rey E, Sorda JA, Olmos JA. Exocrine Pancreatic Insufficiency is Undiagnosed in Some Patients with Diarrhea-Predominant Irritable Bowel Syndrome Using the Rome IV Criteria. Dig Dis Sci 2022; 67:5666-5675. [PMID: 35704255 DOI: 10.1007/s10620-022-07568-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/21/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND AIMS Irritable bowel syndrome (IBS) is one of the most frequent disorders in clinical practice, with a mean 7.6-10.8% worldwide prevalence. A study showed that 6.1% of patients with diarrhea-predominant IBS (IBS-D) had severe exocrine pancreatic insufficiency (EPI). We aimed to identify the prevalence of EPI based on fecal elastase stool testing (Fel-1) in IBS-D and the clinical characteristics that may predict the diagnosis of EPI. METHODS Patients aged > 18 years presenting to tertiary hospital outpatient clinics with IBS-D completed validated questionnaires and gave a stool sample where Fel-1 concentration was measured. Patients with Fel-1 < 100 µg/g represented EPI and > 100 to < 200 µg/g underwent testing for pancreatic pathology with laboratory and endoscopic ultrasound (EUS) evaluation. RESULTS One hundred forty patients (mean age 60 years, females 75.7%) were studied. EPI was found in 5% (95% CI 2.2-10.4), and pancreatic steatosis was the main EUS finding (71%). Dyspepsia was an independent factor associated with EPI (OR 34.7; 95% CI 4.95-366.37, p = 0.0007). After pancreatic enzyme replacement therapy (PERT), patients showed a significant improvement in the Bristol stool scale (p < 0.0001), bowel movements per day (p < 0.005), distension score (0.0009), pain score (0.0277) and IBS severity (0.0034). CONCLUSION EPI is present in 5% of patients who fulfill Rome IV criteria for D-IBS, and dyspepsia was an independent symptom strongly associated with EPI. Pancreatic steatosis was the main endoscopic ultrasound finding. After PERT therapy, patients had significantly improved stool frequency, stool consistency, abdominal pain, distension and IBS severity score.
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Affiliation(s)
- Juan I Olmos
- Department of Gastroenterology, Hospital de Clínicas "General José de San Martín" Universidad de Buenos Aires, Av. Córdoba 2351, C1120, Buenos Aires, Argentina.
| | - María M Piskorz
- Department of Gastroenterology, Hospital de Clínicas "General José de San Martín" Universidad de Buenos Aires, Av. Córdoba 2351, C1120, Buenos Aires, Argentina
| | - Nestor Litwin
- Gastroenterology Biochemical Laboratory (Litwin-Laboratorio Bioquímico en Gastroenterología), Buenos Aires, Argentina
| | - Sara Schaab
- Department of Gastroenterology, Hospital de Clínicas "General José de San Martín" Universidad de Buenos Aires, Av. Córdoba 2351, C1120, Buenos Aires, Argentina
| | - Adriana Tevez
- Department of Gastroenterology, Hospital de Clínicas "General José de San Martín" Universidad de Buenos Aires, Av. Córdoba 2351, C1120, Buenos Aires, Argentina
| | - Gladys Bravo-Velez
- Department of Gastroenterology, Hospital de Clínicas "General José de San Martín" Universidad de Buenos Aires, Av. Córdoba 2351, C1120, Buenos Aires, Argentina
| | - Tatiana Uehara
- Department of Gastroenterology, Hospital de Clínicas "General José de San Martín" Universidad de Buenos Aires, Av. Córdoba 2351, C1120, Buenos Aires, Argentina
| | - Harumi Hashimoto
- Department of Gastroenterology, Hospital de Clínicas "General José de San Martín" Universidad de Buenos Aires, Av. Córdoba 2351, C1120, Buenos Aires, Argentina
| | - Enzo Rey
- Department of Gastroenterology, Hospital de Clínicas "General José de San Martín" Universidad de Buenos Aires, Av. Córdoba 2351, C1120, Buenos Aires, Argentina
| | - Juan A Sorda
- Department of Gastroenterology, Hospital de Clínicas "General José de San Martín" Universidad de Buenos Aires, Av. Córdoba 2351, C1120, Buenos Aires, Argentina
| | - Jorge A Olmos
- Department of Gastroenterology, Hospital de Clínicas "General José de San Martín" Universidad de Buenos Aires, Av. Córdoba 2351, C1120, Buenos Aires, Argentina
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Schovsbo SU, Møllehave LT, Petersen MW, Ahrendt Bjerregaard A, Eliasen M, Pedersen SB, Eplov LF, Kårhus LL, Fink P, Linneberg A, Dantoft TM, Jørgensen T, Benros ME. Association between infections and functional somatic disorders: a cross-sectional population-based cohort study. BMJ Open 2022; 12:e066037. [PMID: 36323461 PMCID: PMC9639106 DOI: 10.1136/bmjopen-2022-066037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES It has been suggested that infections can trigger functional somatic disorders (FSD). However, current evidence is limited by inconsistent findings in smaller studies conducted in clinical settings within selected populations and short follow-up times. We aimed to test the hypothesis that former infections are associated with FSD using data from nationwide registries and a large population-based cohort study, the Danish Study of Functional Disorders study. DESIGN FSD cases were identified in a cross-sectional population-based cohort and linked retrospectively to former hospital contacts with infections identified in the Danish National Patient Registry. The associations between FSD and former infections within 17 years were analysed using logistic regressions to calculate ORs and 95% CIs adjusted for age, sex and subjective social status. SETTING A population-based cohort in Denmark examined between 2011 and 2015. PARTICIPANTS A total of 9656 men and women aged 18-76 years. MAIN OUTCOME MEASURES FSD measured by various delimitations, including bodily distress syndrome (BDS), irritable bowel (IB), chronic fatigue (CF), chronic widespread pain (CWP), and multiple chemical sensitivity (MCS). RESULTS Overall, infections were associated with increased risk of all delimitations of FSD. The associations were more pronounced for multisystemic FSD. The number of prior infections increased the risk in a dose-response manner (p<0.0001). Bacterial but not viral infections were significantly associated with BDS (OR 1.69 (95% CI 1.46 to 1.96)), IB (OR 1.41 (95% CI 1.06 to 1.88)), CWP (OR 1.47 (95% CI 1.13 to 1.90)) and CF (OR 1.62 (95% CI 1.34 to 1.96)), but not MCS. CONCLUSION Former infections leading to hospital contacts were associated with a higher risk of having FSD. These associations were more pronounced for bacterial than viral infections, and more infections increased the risk in a dose-response manner. These results tend to support the idea that severe infections could play a role in FSD.
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Affiliation(s)
- Signe Ulfbeck Schovsbo
- Centre for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Line Tang Møllehave
- Centre for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Marie Weinreich Petersen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Anne Ahrendt Bjerregaard
- Centre for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Marie Eliasen
- Centre for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Susanne Brix Pedersen
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Lene Falgaard Eplov
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Line Lund Kårhus
- Centre for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Per Fink
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- Institute of Clinical Medicine, University of Aarhus, Aarhus, Denmark
| | - Allan Linneberg
- Centre for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Meinertz Dantoft
- Centre for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Torben Jørgensen
- Centre for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen C, Denmark
| | - Michael Eriksen Benros
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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72
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Yang YY, Jun S. The Effects of Cognitive Behavioral Therapy for Insomnia among College Students with Irritable Bowel Syndrome: A Randomized Controlled Trial. Int J Environ Res Public Health 2022; 19:14174. [PMID: 36361052 PMCID: PMC9658882 DOI: 10.3390/ijerph192114174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
The aim of the study was to develop and evaluate cognitive behavioral therapy for insomnia (CBT-I) among college students with irritable bowel syndrome (IBS). We randomly assigned 60 college students with IBS comorbid insomnia to the experimental group who received CBT-I for 90 min once a week for 4 weeks and the control (non-CBT-I) group. Participants completed self-report measures of insomnia severity, pre-sleep arousal, sleep-related dysfunctional cognitions, maladaptive sleep habits, IBS symptom severity and IBS quality of life (QOL) at baseline, after intervention, and at 3-month follow-up. Sleep pattern, GI symptoms during sleep and Interleukin-6 (IL-6) and C-Reaction Protein (CRP) were measured at baseline and after intervention. The experimental group showed significant decreases in insomnia severity, sleep onset latency, total time in bed, pre-sleep arousal, GI symptoms during sleep, sleep-related dysfunctional cognitions, maladaptive sleep habits, and IBS symptom severity, compared with the control group. This group also showed significant increases in sleep efficiency and IBS QOL compared with the control group. No significant differences were observed between the levels of IL-6 and CRP of both groups. CBT-I for college students with comorbid IBS and insomnia was effective in reducing insomnia, IBS symptom severity, and IBS QOL.
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Affiliation(s)
- Yun-Yi Yang
- Department of Nursing, Healthcare Science & Human Ecology, Dong-Eui University, Busan 47340, Korea
| | - Sangeun Jun
- College of Nursing, Keimyung University, Daegu 42601, Korea
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73
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Andreev DN, Bordin DS, Vyuchnova ES, Lebedeva EG, Dicheva DT, Umyarova RM, Maev IV. [Prevalence of combination of functional dyspepsia and irritable bowel syndrome: a meta-analysis of studies using the Rome III-IV Criteria]. TERAPEVT ARKH 2022; 94:1099-1108. [PMID: 36286762 DOI: 10.26442/00403660.2022.09.201849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 10/23/2022] [Indexed: 06/16/2023]
Abstract
AIM To systematize data on the prevalence of the combination of functional dyspepsia (FD) and irritable bowel syndrome (IBS) using the Rome IIIIV Criteria. MATERIALS AND METHODS A search in electronic databases MEDLINE/PubMed, EMBASE, and Cochrane was conducted. The depth of search was 17 years (from January 2006 to May 2022). Original publications from peer-reviewed periodicals that applied the Rome IIIIV Criteria for diagnosis of FD and IBS in an adult patient population with detailed descriptive statistics to allow the resulting data to be included in the meta-analysis were selected for final analysis. RESULTS The final analysis included 38 studies involving 17,993 patients with FD and 15,883 patients with IBS. In the overall pool of studies using the Rome IIIIV Criteria, the pooled prevalence of FD in patients with IBS was 34.625% (95% confidence interval [CI] 28.15941.390), and the pooled prevalence of IBS in patients with FD was 37.549% (95% [CI] 31.51143.787). A random-effects model was used in the analyses since significant heterogeneity between results was found (p0.0001; I298%). Using the Rome III Criteria, the pooled prevalence of FD in patients with IBS was 31.993% (95% CI 26.13538.150; I2=98.17%), while the prevalence of IBS in patients with FD was 34.694% (95% [CI] 29.31940.273; I2=97,89%). An analysis of papers using the Rome IV Criteria demonstrated that the pooled prevalence of FD in patients with IBS was 42.614% (95% CI 18.58868.675; I2=98.97%), and the prevalence of IBS in patients with FD was 50.444% (95% CI 37.95662.904; I2=94,39%). CONCLUSION This meta-analysis demonstrated that the prevalence of the combination of FD and IBS identified using the Rome IIIIV Criteria is high and is reported in approximately 1 in 3 patients with the functional gastrointestinal disorders concerned. The prevalence of a combination of FD and IBS identified using the Rome IV Criteria is at least 10% higher than that using the Rome III Criteria.
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Affiliation(s)
- D N Andreev
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - D S Bordin
- Yevdokimov Moscow State University of Medicine and Dentistry
- Loginov Moscow Clinical Scientific Center
- Tver State Medical University
| | - E S Vyuchnova
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - E G Lebedeva
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - D T Dicheva
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - R M Umyarova
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - I V Maev
- Yevdokimov Moscow State University of Medicine and Dentistry
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74
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Chan WW, Grover M. The COVID-19 Pandemic and Post-Infection Irritable Bowel Syndrome: What Lies Ahead for Gastroenterologists. Clin Gastroenterol Hepatol 2022; 20:2195-2197. [PMID: 35944588 PMCID: PMC9356717 DOI: 10.1016/j.cgh.2022.05.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 05/24/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Walter W Chan
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Madhusudan Grover
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
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75
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Robbertz AS, Cohen LL, Armistead LP, Reed B. Pandemic-Related Social Disruption and Well-Being in Pediatric Gastrointestinal Diseases. J Pediatr Psychol 2022; 47:981-990. [PMID: 35730966 PMCID: PMC9384296 DOI: 10.1093/jpepsy/jsac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has impacted everyone, but there are few data regarding how the pandemic has influenced the lives of children with gastrointestinal (GI) conditions. This cross-sectional study assessed pandemic-related social disruption (PRSD) in children with inflammatory bowel disease (IBD), celiac disease (CD), and irritable bowel syndrome (IBS), and the potential buffering effect of the parent-child relationship. METHODS A survey completed between September and December 2020 asked 146 children (ages 8-17) diagnosed with IBD (n = 44), CD (n = 81), or IBS (n = 51) and 185 parents how the pandemic has contributed to social disruption (i.e., financial stability, COVID-19 exposure, school changes, GI needs, and isolation) and their social-emotional well-being. Structural equation modeling was used to examine the role of social disruption on well-being, and the moderating effect of the parent-child relationship. RESULTS Increased social disruption predicted worse parent, β = 0.24, p = .02, and child well-being, β = 0.38, p < .01. The parent-child relationship moderated the relationship between parent and child well-being, β = 0.21, p = .03. Strong parent-child relationships predicted a positive association between parent and child well-being, β = 0.23, p = .003, whereas medium, β = 0.09, p = .14, and poor, β = -0.06, p = .52, relationships did not. CONCLUSIONS PRSD negatively impacted the well-being of children with GI conditions, and the parent-child relationship moderated this relationship. These findings are relevant to pediatric psychologists treating the physical and mental health needs of children with GI conditions and their parents.
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Affiliation(s)
| | | | | | - Bonney Reed
- Division of Gastroenterology, Hepatology, & Nutrition, Emory University School of Medicine, USA
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76
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Jadallah KA, Khatatbeh MM, Sarsak EW, Sweidan AN, Alzubi BF. Irritable bowel syndrome and its associated factors among Jordanian medical students: A cross-sectional study. Medicine (Baltimore) 2022; 101:e30134. [PMID: 35984126 PMCID: PMC9387975 DOI: 10.1097/md.0000000000030134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Very scarce studies investigated the prevalence of irritable bowel syndrome (IBS) and its correlates in the Middle East, particularly in college students. We aimed to investigate the prevalence of IBS and its associated factors among Jordanian medical students. We conducted a cross-sectional study at 2 medical facilities in northern Jordan. We recruited 1135 medical students. Participants completed an anonymous questionnaire addressing sociodemographic, lifestyle, and clinical characteristics. An interview questionnaire was used to diagnose IBS according to the Rome III criteria. Comorbid anxiety and depression were diagnosed by using the Hospital Anxiety and Depression Scale. Of the 1135 completed questionnaires, 1094 (94%) had complete data. The prevalence of IBS in our sample was 30.9%. Binary logistic regression analysis of factors associated with IBS indicated having a family history of IBS as a strong predictor of the disease (odds ratio [OR]: 8.09; 95% confidence interval [CI]: 5.84-11.19). Students in the second and third years of their study had ORs of approximately 4 (95% CI: 2.20-6.54) and 3 (95% CI: 1.70-5.30) for suffering from IBS, respectively, compared with those in the first year (P = .001). Increased anxiety score (OR: 1.88; 95% CI: 1.30-2.71), poor sleep quality (OR: 1.76; 95% CI: 1.13-2.76), female sex (OR: 1.59; 95% CI: 1.14-2.20), and living in a school dormitory (OR: 1.35; 95% CI: 1.00-1.84) were significantly associated with IBS (P < .05). IBS is a highly prevalent disorder among Jordanian medical students, with several factors associated with its occurrence.
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Affiliation(s)
- Khaled A. Jadallah
- Department of Internal Medicine, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- *Correspondence: Khaled A. Jadallah, Department of Internal Medicine, King Abdullah University Hospital, Jordan University of Science and Technology, 7th Floor, Wing C, Room 52, Irbid 22110, Jordan (e-mail: )
| | - Moawiah M. Khatatbeh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Enas W. Sarsak
- Department of Internal Medicine, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Aroob N. Sweidan
- Department of Internal Medicine, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Bara F. Alzubi
- Department of Internal Medicine, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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77
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Wang Z, Liu Y, Peng Y, Peng L. Helicobacter pylori Infection—A Risk Factor for Irritable Bowel Syndrome? An Updated Systematic Review and Meta-Analysis. Medicina (B Aires) 2022; 58:medicina58081035. [PMID: 36013502 PMCID: PMC9413972 DOI: 10.3390/medicina58081035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/25/2022] [Accepted: 08/01/2022] [Indexed: 11/25/2022] Open
Abstract
Nowadays, the relationship between Helicobacter pylori infection (HPI) and irritable bowel syndrome (IBS) remains controversial. Objective: The aim of this study is to investigate the relationship between HPI and IBS through a systematic review and meta-analysis based on the current evidence. Methods: We performed a systematic literature search in electronic databases (PubMed, EMBASE, and the Cochrane library) by computer to identify all reports published before 8 August 2021. The odds ratio (OR) and confidence interval (CI) were calculated to evaluate the association between HPI and IBS. Subgroup analyses were conducted for further assessment and exploration of heterogeneity sources. In addition, we assessed publication bias through funnel plots, Egger’s test, and Begg’s test. Finally, we conducted a sensitivity analysis to evaluate the robustness of the results. Results: Thirteen studies with 13,173 participants were included in the meta-analysis. The pooled OR of the association between HPI and IBS was 1.03 (95% CI [0.80,1.31]; p = 0.84). The adjusted OR of the association between HPI and IBS after excluding the studies with confounding factors defined by our team was 1.29 (95% CI [1.03,1.62]; p = 0.03). We found a positive association between HPI and IBS-D (diarrhea subtype) (OR: 1.54; 95% CI [1.22,1.95]; p = 0.0003). The OR of the relationship between cytotoxin-associated gene A (Cag A) positive HPI and IBS was 4.3 (95% CI [0.51,36.17]; p = 0.18). Conclusions: The likelihood of HPI in IBS patients is relatively higher than that of non-IBS participants but not statistically significant, implying that HPI is not significantly associated with IBS, albeit we may underestimate this association. Moreover, we found a positive association between HPI and IBS-D. We also observed an increased likelihood of Cag-A positive HPI in IBS patients than that of non-IBS participants but not statistically significant.
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Affiliation(s)
- Ziyan Wang
- Department of Gastroenterology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China; (Z.W.); (Y.L.)
- The First Clinical School, Guangzhou Medical University, Guangzhou 510120, China
| | - Yuhua Liu
- Department of Gastroenterology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China; (Z.W.); (Y.L.)
- The First Clinical School, Guangzhou Medical University, Guangzhou 510120, China
| | - Yinglong Peng
- School of Medicine, South China University of Technology, Guangzhou 510006, China;
| | - Liang Peng
- Department of Gastroenterology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China; (Z.W.); (Y.L.)
- Correspondence:
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Fan K, Eslick GD, Nair PM, Burns GL, Walker MM, Hoedt EC, Keely S, Talley NJ. Human intestinal spirochetosis, irritable bowel syndrome, and colonic polyps: A systematic review and meta-analysis. J Gastroenterol Hepatol 2022; 37:1222-1234. [PMID: 35385602 PMCID: PMC9545717 DOI: 10.1111/jgh.15851] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/24/2022] [Indexed: 12/09/2022]
Abstract
Human colonic spirochetosis (CS) is usually due toBrachyspira pilosicolior Brachyspira aalborgiinfection. While traditionally considered to be commensal bacteria, there are scattered case reports and case series of gastrointestinal (GI) symptoms in CS and reports of colonic polyps with adherent spirochetes. We performed a systematic review and meta-analysis investigating the association between CS and GI symptoms and conditions including the irritable bowel syndrome (IBS) and colonic polyps. Following PRISMA 2020 guidelines, a systematic search of Medline, CINAHL, EMBASE, and Web of Science was performed using specific keywords for CS and GI disease. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Of 75 studies identified in the search, 8 case-control studies met the inclusion criteria for meta-analysis and 67 case series studies met the inclusion criteria for pooled prevalence analysis. CS was significantly associated with diarrhea (n = 141/127, cases/controls, OR: 4.19, 95% CI: 1.72-10.21, P = 0.002) and abdominal pain (n = 64/65, OR: 3.66, 95% CI: 1.43-9.35, P = 0.007). CS cases were significantly more likely to have Rome III-diagnosed IBS (n = 79/48, OR: 3.84, 95% CI: 1.44-10.20, P = 0.007), but not colonic polyps (n = 127/843, OR: 8.78, 95% CI: 0.75-103.36, P = 0.084). In conclusion, we found evidence of associations between CS and both diarrhea and IBS, but not colonic polyps. CS is likely underestimated due to suboptimal diagnostic methods and may be an overlooked risk factor for a subset of IBS patients with diarrhea.
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Affiliation(s)
- Kening Fan
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
| | - Guy D Eslick
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Prema M Nair
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
| | - Grace L Burns
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
| | - Marjorie M Walker
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Emily C Hoedt
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
| | - Simon Keely
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
| | - Nicholas J Talley
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
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Wang N, Liu X, Ye W, Shi Z, Bai T. Impact of shift work on irritable bowel syndrome and functional dyspepsia: A meta-analysis. Medicine (Baltimore) 2022; 101:e29211. [PMID: 35758349 PMCID: PMC9276432 DOI: 10.1097/md.0000000000029211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 03/17/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The possible association between shift work with irritable bowel syndrome (IBS) and functional dyspepsia (FD) remains controversial. The purpose of the study is to conduct a meta-analysis to explore the potential association between shift work with IBS/FD. METHODS We searched relevant observational studies on Medline (PubMed) and Embase until June 30, 2021. Two different investigators extracted data and assessed the quality of each study independently. The meta-analysis was used to evaluate the pooled odds risk (OR) between shift work and IBS/FD. RESULTS Eight studies were included ultimately. Shift workers were more likely to suffer from IBS. The OR of shift work was 1.81 (95% confidence interval 1.42; 2.32) with low heterogeneity (P < .05, I2 = 0%) for IBS. However, no evidence of the association was observed between shift work and the risk of FD. The OR of shift work was 0.87 (95% confidence interval 0.62; 1.23) (P > .05) for FD. CONCLUSIONS There was a positive association between shift work and IBS. The prevalence of IBS was 81% higher among shift workers than among non-shift workers. Shift work was probably a risk factor for IBS. The low heterogeneity supports the reliability of the results. However, there was no significant association between shift work and FD. The strength of the evidence was limited and further prospective cohort studies were needed.
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Affiliation(s)
- Nian Wang
- Division of Gastroenterology, Wuhan No. 1 Hospital, 215 Zhongshan Road, Wuhan, China
| | - Xinghuang Liu
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, China
| | - Weixiang Ye
- Division of Gastroenterology, Wuhan No. 1 Hospital, 215 Zhongshan Road, Wuhan, China
| | - Zhaohong Shi
- Division of Gastroenterology, Wuhan No. 1 Hospital, 215 Zhongshan Road, Wuhan, China
| | - Tao Bai
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, China
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Abid S, Rehman H, Awan S, Artani A, Siddiqui I. Epidemiology of functional gastrointestinal disorders using ROME III adult questionnaire, a population based cross sectional study in Karachi-Pakistan. PLoS One 2022; 17:e0268403. [PMID: 35696397 PMCID: PMC9191742 DOI: 10.1371/journal.pone.0268403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 04/28/2022] [Indexed: 12/13/2022] Open
Abstract
Objective Functional Gastrointestinal Disorder (FGIDs) are a heterogenous group of disorders, with Irritable Bowel Syndrome (IBS) and Functional Dyspepsia (FD) being the most common disorders worldwide. The purpose of this study was to identify the spectra of FGIDs classified according to the ROME III criteria amongst an adult Pakistani population. It also aimed to correlate the psychosocial alarm symptoms with the prevalence of FGIDs and report the overlap of all FGID. Design This was a community based cross-sectional study. Multi-stage cluster sampling technique was applied, and 1062 households were initially randomly chosen using systematic sampling technique. Only one person from each household was enrolled in the study. After eligibility screening, 860 participating individuals were requested to fill out a structured ROME III interview questionnaire, administered to them by a trained interviewer. Results FGIDs were diagnosed in 468 individuals (54.4%), out of 860 participants. FD was found to be the most prevalent (70.2%), followed by Functional Heartburn (58.9%) and Functional bloating (56.6%). Amongst a total of 468 participants diagnosed with FGIDs, 347 (74.1%) had overlapping disorders. There was also a higher incidence of psychosocial alarm symptoms including higher pain severity (62.6% vs 46.4%) and being victimized at some point in their lives (26.1% vs 6.6%) amongst FGID patients. Conclusion There is a high disease burden of FGIDs in this study population, with approximately half of the population suffering from at least one type of FGID. Overlapping disorders are also common in this part of the world.
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Affiliation(s)
- Shahab Abid
- Department of Medicine, Section of Gastroenterology, Aga Khan University, Karachi, Pakistan
- * E-mail:
| | - Hareem Rehman
- Department of Medicine, Section of Gastroenterology, Aga Khan University, Karachi, Pakistan
| | - Safia Awan
- Department of Medicine, Section of Gastroenterology, Aga Khan University, Karachi, Pakistan
| | - Azmina Artani
- Department of Medicine, Section of Gastroenterology, Aga Khan University, Karachi, Pakistan
| | - Imran Siddiqui
- Department of Pathology and Lab Medicine, Aga Khan University, Karachi, Pakistan
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Emre E, Tazegul G, Akın M. Rome IV Criteria-Defined Irritable Bowel Syndrome in Atopic Patients and the Effect of Anxiety and Depression: A Case-Control Study. Turk J Gastroenterol 2022; 33:397-405. [PMID: 35678797 DOI: 10.5152/tjg.2022.21311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Numerous studies report an increased prevalence of irritable bowel syndrome in patients with atopic diseases such as allergic rhinitis, allergic asthma, and chronic urticaria. Both disease groups have a higher incidence of psychological disorders. In this study, we aimed to examine the relationship of irritable bowel syndrome with the presence and severity of allergic diseases and accom- panying anxiety and depression. METHODS One hundred sixty-two patients (56 with AR, 34 with AA, and 72 with CU) and 43 healthy volunteers were included in the study. Demographic and clinical data, along with disease duration and severity, was analyzed. Irritable bowel syndrome was diagnosed using Rome IV criteria. Hospital Anxiety and Depression Scale was used to evaluate anxiety and depression. All statistical analyses were performed using Statistic Program for Social Sciences 23.0. RESULTS Irritable bowel syndrome prevalence in the control group was 9.3% and 56% in atopic patients (P < .0001). Hospital Anxiety and Depression Scale anxiety scores of 11 and above increased the odds of IBS approximately 14 times, and independently, the presence of allergic disease increased the odds 10 times. In the allergic patient subgroup, Hospital Anxiety and Depression Scale anxiety scores of 11 and above increased the risk of irritable bowel syndrome approximately 18 times. CONCLUSION In this first study using Rome IV criteria to examine the relationship of irritable bowel syndrome, allergic diseases, and anxiety and depression, irritable bowel syndrome was more frequent in allergic patients, especially in patients with anxiety. Awareness of a disease cluster where these 3 disease groups intersect will guide clinicians from different disciplines involved in patients' treatment and follow-up.
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Affiliation(s)
- Emre Emre
- Allergology, and Immunology Specialist, Hatay State Hospital, Hatay, Turkey
| | - Gokhan Tazegul
- Internal Medicine Specialist, Ankara Polatlı Duatepe State Hospital, Ankara, Turkey
| | - Mete Akın
- Department of Internal Medicine, Gastroenterology Division, Akdeniz University Faculty of Medicine, Antalya, Turkey
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Hunskar GS, Rortveit G, Litleskare S, Eide GE, Hanevik K, Langeland N, Wensaas KA. Prevalence of fibromyalgia 10 years after infection with Giardia lamblia: a controlled prospective cohort study. Scand J Pain 2022; 22:348-355. [PMID: 34679267 DOI: 10.1515/sjpain-2021-0122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/21/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To investigate whether acute infection with Giardia lamblia is associated with fibromyalgia 10 years after infection and whether fibromyalgia is associated with irritable bowel syndrome (IBS) and chronic fatigue (CF) in this setting. METHODS A cohort study was established after an outbreak of G. lamblia in Bergen, Norway, 2004. Laboratory-confirmed cases and a matched control group were followed for 10 years. The main outcome was fibromyalgia 10 years after giardiasis, defined by the 2016 revisions of the fibromyalgia diagnostic criteria using the Fibromyalgia Survey Questionnaire (FSQ). RESULTS The prevalence of fibromyalgia was 8.6% (49/572) among Giardia exposed compared to 3.1% (21/673) in controls (p<0.001). Unadjusted odds for having fibromyalgia was higher for Giardia exposed compared to controls (odds ratio (OR): 2.91, 95% confidence interval (CI): 1.72, 4.91), but adjusted for IBS and CF it was not (OR: 1.05, 95% CI: 0.57, 1.95). Among participants without CF the odds for fibromyalgia was 6.27 times higher for participants with IBS than those without (95% CI: 3.31, 11.91) regardless of exposure. Among participants without IBS the odds for fibromyalgia was 4.80 times higher for those with CF than those without (95% CI: 2.75, 8.37). CONCLUSIONS We found a higher prevalence of fibromyalgia among Giardia exposed compared to controls 10 years after the acute infection. Fibromyalgia was strongly associated with IBS and CF, and the difference between the exposed and controls can be attributed to the high prevalence of IBS and CF among the Giardia exposed. Notably, this study was not designed to establish causality between Giardia exposure and the outcomes.
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Affiliation(s)
- Gunnhild S Hunskar
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Dermatology, Haukeland University Hospital, Bergen, Norway
- Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway
| | - Guri Rortveit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway
| | - Sverre Litleskare
- Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway
| | - Geir Egil Eide
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Kurt Hanevik
- Norwegian National Advisory Unit for Tropical Infectious Diseases, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Nina Langeland
- Norwegian National Advisory Unit for Tropical Infectious Diseases, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Knut-Arne Wensaas
- Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway
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Yang W, Yang X, Cai X, Zhou Z, Yao H, Song X, Zhao T, Xiong P. The Prevalence of Irritable Bowel Syndrome Among Chinese University Students: A Systematic Review and Meta-Analysis. Front Public Health 2022; 10:864721. [PMID: 35493361 PMCID: PMC9051230 DOI: 10.3389/fpubh.2022.864721] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/14/2022] [Indexed: 11/26/2022] Open
Abstract
Background Irritable bowel syndrome (IBS) has become a common public health issue among university students, impairing their physical and mental health. This meta-analysis aimed to examine the pooled prevalence of IBS and its associated factors among Chinese university students. Methods Databases of PubMed, EMBASE, MEDLINE (via EBSCO), CINAHL (via EBSCO), Wan Fang, CNKI and Weipu (via VIP) were systematically searched from inception date to May 31, 2021. Meta-analysis was performed using random-effects models. Meta-regression and subgroup analysis were used to detect the potential source of heterogeneity. Key Results A total of 22 cross-sectional studies (14 were in Chinese and 8 were in English) with 33,166 Chinese university students were included. The pooled prevalence of IBS was estimated as 11.89% (95% CI = 8.06%, 16.35%). The prevalence was 10.50% (95% CI = 6.80%, 15.87%) in Rome II criteria, 12.00% (95% CI = 8.23%, 17.17%) in Rome III criteria, and 3.66% (95% CI = 2.01%, 6.60%) in Rome IV criteria. The highest prevalence of IBS was 17.66% (95% CI = 7.37%, 36.64%) in North China, and the lowest was 3.18% (95% CI = 1.28%, 7.68%) in South China. Subgroup analyses indicated that gender, major, anxiety and depression symptoms, drinking and smoking behaviors were significantly associated with the prevalence of IBS. Meta-regression analyses suggested that region influenced prevalence estimates for IBS. Conclusions and Inferences This meta-analysis illustrated that IBS is very common in Chinese university students. Regular screening, effective prevention, and appropriate treatments should be implemented to reduce the risk of IBS in this population. More future studies should be conducted in Northeastern and Southwestern parts of China.
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Affiliation(s)
- Weixin Yang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xiao Yang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xianghao Cai
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Zhuoren Zhou
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Huan Yao
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xingrong Song
- Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Tianyun Zhao
- Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- *Correspondence: Tianyun Zhao
| | - Peng Xiong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- Peng Xiong ;
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Khan EH, Ahamed F, Karim MR, Roy P, Ahammed SU, Moniruzzaman M, Podder BR. Psychiatric Morbidity in Irritable Bowel Syndrome. Mymensingh Med J 2022; 31:458-465. [PMID: 35383767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Psychiatric morbidity is frequent among outpatients with Irritable Bowel Syndrome (IBS) attending gastroenterology clinics. The lifetime prevalence of major depressive and anxiety disorders in IBS patients are up to 76% and 54% respectively. The point prevalence of Major depressive disorder and Anxiety disorders in IBS patients are ranged 9.6 to 54% and from 11.1 to 52.4% respectively. IBS is not usually life-threatening but it has a significant impact on quality of life. So, screening for psychiatric disorders in IBS patients attending Gastroenterology clinics is worthwhile. The objective of this study was to evaluate psychiatric morbidity among the patients with IBS. This cross sectional comparative study was conducted in the Department of Psychiatry, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh during the period from January 2012 to June 2012. Inclusion criteria were patients of irritable bowel syndrome fulfilling the Rome-III criteria, age between 18 to 60 years irrespective of sex. Patients with any red flag sign, serious cognitive impairment such as dementia, schizophrenia, mania, delusional disorder, prior history of abdominal surgery and other chronic diseases were excluded. One hundred and ten patients with IBS were selected according to inclusion and exclusion criteria and categorized as IBS group. Another 110 age and sex matched subjects were selected as control group. The mean±SD age of the patients was 34.3±12.2 years which was almost identical to control group (p=0.820). Most of the patients (66.4%) were below the age of 40 years. There were 64 (58.2%) male and 46 (41.8%) female which was similar to control group (p=0.643). Psychiatric co-morbidity was most frequent in IBS patients (56.4%) as compared to control group (16.4%) p value <0.001. The most common psychiatric disorders were Anxiety disorders (22.7%), followed by major depressive disorder (19.1%) and somatization disorder (14.5%). The results of this study suggest that a significant number of patients with IBS suffer from psychiatric disorders than control, which are similar to the IBS group in age and gender.
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Affiliation(s)
- E H Khan
- Dr Md Enamul Hoque Khan, Associate Professor, Department of Psychiatry, Sheikh Hasina Medical College, Tangail, Bangladesh; E-mail:
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Velasco-Benítez CA, Collazos-Saa LI, García-Perdomo HA. A SYSTEMATIC REVIEW AND META-ANALYSIS IN SCHOOLCHILDREN AND ADOLESCENTS WITH FUNCTIONAL GASTROINTESTINAL DISORDERS ACCORDING TO ROME IV CRITERIA. Arq Gastroenterol 2022; 59:304-313. [PMID: 35830045 DOI: 10.1590/s0004-2803.202202000-53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/25/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To determine the prevalence of functional gastrointestinal disorders (FGIDs) in children according to Rome IV criteria. METHODS We included cohorts and observational descriptive studies, including information for the prevalence of FGIDs according to Rome IV criteria in children 4 to 18 years old. We searched the MEDLINE (Ovid), EMBASE, LILACS, and CENTRAL databases from May 2016 to nowadays. Gray literature and other databases were also consulted. The risk of bias was assessed using the STROBE Statement. The results were reported in forest plots of the estimated effects of the included studies with a 95% confidence interval (95%CI). RESULTS We included 14 studies involving a total of 17427 participants. Three studies were conducted in Europe, two in North America, and nine in Latin America. Most studies were school-based (n=14670, 84.18%), participants were mostly female (55.49%), white (51.73%), 8 to 18 years old (77.64%), and assisted to a public school (81.53%). Thirteen studies used the Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS-RIV) to assess FGIDs. We found a global prevalence for FGIDs of 23% (95%CI 21-25%, I2 99%). Main disorders were functional constipation (FC) with 12% (95%CI 11-15%) followed by functional dyspepsia (FD) (5%, 95%CI 11-15%) and irritable bowel syndrome (IBS) (3%, 95%CI 2-4%). The prevalence of FGIDs was higher in the Americas, representing 23.67% (95%CI 21.2-26.2%, I2 91.3%). CONCLUSION FGIDs are present in one of four children and adolescents, representing a common condition in this age group the central disorders were FC, FD, and IBS.
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Kindt S, Louis H, De Schepper H, Arts J, Caenepeel P, De Looze D, Gerkens A, Holvoet T, Latour P, Mahler T, Mokaddem F, Nullens S, Piessevaux H, Poortmans P, Rasschaert G, Surmont M, Vafa H, Van Malderen K, Vanuytsel T, Wuestenberghs F, Tack J. Belgian consensus on irritable bowel syndrome. Acta Gastroenterol Belg 2022; 85:360-382. [PMID: 35709780 DOI: 10.51821/85.2.10100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is characterised by recurrent abdominal pain related to defaecation or associated with altered stool frequency or consistency. Despite its prevalence, major uncertainties in the diagnostic and therapeutic management persist in clinical practice. METHODS A Delphi consensus was conducted by 20 experts from Belgium, and consisted of literature review and voting process on 78 statements. Grading of recommendations, assessment, development and evaluation criteria were applied to evaluate the quality of evidence. Consensus was defined as > 80 % agreement. RESULTS Consensus was reached for 50 statements. The Belgian consensus agreed as to the multifactorial aetiology of IBS. According to the consensus abdominal discomfort also represents a cardinal symptom, while bloating and abdominal distension often coexist. IBS needs subtyping based on stool pattern. The importance of a positive diagnosis, relying on history and clinical examination is underlined, while additional testing should remain limited, except when alarm features are present. Explanation of IBS represents a crucial part of patient management. Lifestyle modification, spasmolytics and water-solube fibres are considered first-line agents. The low FODMAP diet, selected probiotics, cognitive behavioural therapy and specific treatments targeting diarrhoea and constipation are considered appropriate. There is a consensus to restrict faecal microbiota transplantation and gluten-free diet, while other treatments are strongly discouraged. CONCLUSIONS A panel of Belgian gastroenterologists summarised the current evidence on the aetiology, symptoms, diagnosis and treatment of IBS with attention for the specificities of the Belgian healthcare system.
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Affiliation(s)
- S Kindt
- Department of gastroenterology and Hepatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussel, Belgium
| | - H Louis
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme University Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - H De Schepper
- Department of Gastroenterology and Hepatology, University Hospital Antwerp, Antwerp, Belgium
| | - J Arts
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
- Department of Gastroenterology, AZ Sint-Lucas, Brugge, Belgium
| | - P Caenepeel
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
- Department of Gastroenterology, Ziekenhuis Oost-Limburg, Campus Sint-Jan, Genk, Belgium
- UHasselt, Hasselt, Belgium
| | - D De Looze
- Department of Gastroenterology and Hepatology, University Hospital Ghent, Gent, Belgium
| | - A Gerkens
- Boitsfort Medical Center, Brussels, Belgium
| | - T Holvoet
- Department of Gastroenterology and Hepatology, University Hospital Ghent, Gent, Belgium
- Department of Gastroenterology, AZ Nikolaas, Sint Niklaas, Belgium
| | - P Latour
- Department of Gastroenterology, Hepatology and Digestive Oncology, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - T Mahler
- Department of Pediatrics, Universitair Ziekenuis Brussel, Brussel, Belgium
| | - F Mokaddem
- Department of Gastroenterology and Hepatology, Vivalia-Centre Sud Luxembourg, Arlon, Belgium
| | - S Nullens
- Department of Gastroenterology and Hepatology, University Hospital Antwerp, Antwerp, Belgium
| | - H Piessevaux
- Department of Hepato-gastroenterology, Cliniques universitaires St-Luc, Université catholique de Louvain, Brussels, Belgium
| | - P Poortmans
- Department of gastroenterology and Hepatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussel, Belgium
| | - G Rasschaert
- Department of gastroenterology and Hepatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussel, Belgium
| | - M Surmont
- Department of gastroenterology and Hepatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussel, Belgium
| | - H Vafa
- Department of Gastroenterology and Hepatology, Chirec-Site Delta, Brussels, Belgium
| | - K Van Malderen
- Department of Gastroenterology and Hepatology, University Hospital Antwerp, Antwerp, Belgium
| | - T Vanuytsel
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - F Wuestenberghs
- Department of Gastroenterology and Hepatology, CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium
| | - J Tack
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
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87
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Nikolova VL, Pelton L, Moulton CD, Zorzato D, Cleare AJ, Young AH, Stone JM. The Prevalence and Incidence of Irritable Bowel Syndrome and Inflammatory Bowel Disease in Depression and Bipolar Disorder: A Systematic Review and Meta-Analysis. Psychosom Med 2022; 84:313-324. [PMID: 35067654 DOI: 10.1097/psy.0000000000001046] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The increased prevalence and incidence of affective disorders among patients with gastrointestinal disease have been well established. However, few studies have investigated the inverse relationship. We aimed to identify all pieces of evidence of the prevalence and incidence of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) in people with depression and bipolar disorder. METHODS We conducted a systematic review of studies reporting the association between affective disorders (exposure) and IBS or IBD (outcome) in adults. Evidence was evaluated for quality using Joanna Briggs Institute Critical Appraisal tools. Where suitable data were available, meta-analyses were performed. RESULTS We identified 18 studies that met the selection criteria, of which 11 provided data on IBS, 5 on IBD, and 2 on both. Overall, people with depression were significantly more likely to have comorbid IBS (risk ratio = 2.42, 95% confidence interval = 1.98-2.96) and to develop new-onset IBS (risk ratio = 1.90, 95% confidence interval = 1.41-2.56) compared with people without depression. They were also more likely to have and develop IBD, and among patients with IBD, significantly increased rates of depression were observed as early as 5 years before diagnosis. Bipolar disorder was not consistently associated with risk of either condition. CONCLUSIONS People with depression are at an increased risk of both having and developing lower gastrointestinal disorders. These findings have important implications for how we understand, manage, and prevent this comorbidity in clinical practice. Further studies are needed to improve our understanding of the relationship between bipolar disorder and bowel disease as well as the role of psychotropic medication, particularly selective serotonin reuptake inhibitors.
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Affiliation(s)
- Viktoriya L Nikolova
- From the Centre for Affective Disorders, Department of Psychological Medicine (Nikolova, Moulton, Cleare, Young), Institute of Psychiatry, Psychology and Neuroscience; School of Bioscience Education, Faculty of Life Sciences and Medicine (Pelton), Guy's Campus; GKT School of Medical Education (Zorzato); and Department of Neuroimaging (Stone), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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88
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Goebel-Stengel M, Lohmiller J, Schäffeler N, Zipfel S, Stengel A. [Impact of the COVID pandemic on the anxiety of patients with functional gastrointestinal symptoms]. Z Gastroenterol 2022; 60:575-585. [PMID: 35176808 DOI: 10.1055/a-1749-6469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Functional gastrointestinal disorders such as functional dyspepsia (FD) and irritable bowel syndrome (IBS) are stress-associated. The COVID-19 pandemic, which has been rampant since 2020, has caused anxiety and stress in the population. Distancing measures to combat the pandemic have affected mental health. Our objective was to examine the impact of the 3rd lockdown in Germany in December 2020 and January 2021 on the apprehension of patients with FD and IBS.Patients diagnosed with FD or IBS treated in a tertiary or primary care hospital in the South of Baden-Württemberg in 2020 voluntarily participated in an anonymous online survey. Questions about concomitant diseases, concern about COVID-19 and stress perception were answered.A total of 106 patients (♀=67, ♂=38, 1 diverse) participated in the survey. Of these, 16 had FD (♀=9, ♂=6, diverse=1), 80 had IBS (♀=52, ♂=28), and 10 had both (♀=6, ♂=4). The average age was 43.6 years. Depressive and anxiety disorders were most frequently reported comorbidities in both the FD (25% each) and IBS group (20% each), followed by joint wear and tear (FD: 13%, RDS: 14%). In a direct comparison of participants with FD and IBS, those with IBS showed significantly higher scores for an increase in gastrointestinal (GI) symptoms during the pandemic (p=0.007), more frequent presentation to a physician during the pandemic, and greater social withdrawal due to GI symptoms (p=0.05). In direct comparison, those with IBS showed higher scores for fear that vaccination against COVID-19 would adversely affect GI symptoms compared to FD (p=0.05).In times of the pandemic, interdisciplinary collaboration in the care of patients with FD or IBS seems more necessary than ever to address concerns and provide good patient care.
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Affiliation(s)
- Miriam Goebel-Stengel
- Psychosomatic Medicine, Internal Medicine VI, Universitätsklinikum Tübingen, Tübingen, Germany
- Internal Medicine and Gastroenterology, Helios Klinik Rottweil, Rottweil, Germany
| | - Jacqueline Lohmiller
- Psychosomatic Medicine, Internal Medicine VI, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Norbert Schäffeler
- Psychosomatic Medicine, Internal Medicine VI, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Psychosomatic Medicine, Internal Medicine VI, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Andreas Stengel
- Charité Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Psychosomatic Medicine, Internal Medicine VI, Universitätsklinikum Tübingen, Tübingen, Germany
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89
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Strisciuglio C, Cenni S, Serra MR, Dolce P, Kolacek S, Sila S, Trivic I, Lev MRB, Shamir R, Kostovski A, Papadopoulou A, Roma E, Katsagoni C, Jojkic-Pavkov D, Salvatore S, Pensabene L, Scarpato E, Miele E, Staiano A. Functional Gastrointestinal Disorders in Mediterranean Countries According to Rome IV Criteria. J Pediatr Gastroenterol Nutr 2022; 74:361-367. [PMID: 35226645 DOI: 10.1097/mpg.0000000000003358] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim of this study was to assess the prevalence of functional gastrointestinal disorders (FGIDs) in children of Mediterranean area using Rome IV criteria and to compare the prevalence of FGIDs using Rome IV and Rome III criteria. METHODS This was a cross-sectional study enrolling children and adolescents living in Croatia, Greece, Israel, Italy, Macedonia, and Serbia. Subjects were examined in relation to the presence of FGIDs, using the Rome IV criteria. Data were compared with the results of a previous study using Rome III data. RESULTS We analyzed 1972 children ages 4 to 9 years (group A), and 2450 adolescents 10 to 18 years old (group B). The overall prevalence of FGIDs was 16% in group A and 26% in group B, with statistical differences among countries in both groups (P < 0.001). In group A, the prevalence of FGIDs and of functional constipation (FC) was significantly lower than in the previous study (P < 0.001), whereas in group B no significant difference was found. In both groups of age, the prevalence of abdominal migraine and irritable bowel syndrome decreased significantly (P < 0.001 and P < 0.001, respectively) using Rome IV versus Rome III criteria, conversely functional dyspepsia increased (P < 0.001). CONCLUSIONS FGIDs are common in children and adolescents, their frequency increases with age, and there is a significant variation in the prevalence of some FGIDs among different European countries. The application of the Rome IV criteria resulted in a significantly lower prevalence of FGIDs in children compared with Rome III criteria.
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Affiliation(s)
- Caterina Strisciuglio
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli"
| | - Sabrina Cenni
- Department of Translational Medical Science, Section of Pediatrics
| | | | - Pasquale Dolce
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - Sanja Kolacek
- Referral center for Pediatric Gastroenterology and Nutrition, Children's Hospital, University of Zagreb Medical School, Croatia
| | - Sara Sila
- Referral center for Pediatric Gastroenterology and Nutrition, Children's Hospital, University of Zagreb Medical School, Croatia
| | - Ivana Trivic
- Referral center for Pediatric Gastroenterology and Nutrition, Children's Hospital, University of Zagreb Medical School, Croatia
| | - Michal Rozenfeld Bar Lev
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Raanan Shamir
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Aco Kostovski
- University Children Hospital, Faculty of Medicine, Skopje, Macedonia
| | - Alexandra Papadopoulou
- First Department of Paediatrics, University of Athens, Agia Sophia Children's Hospital, Athens, Greece
| | - Elefthería Roma
- First Department of Paediatrics, University of Athens, Agia Sophia Children's Hospital, Athens, Greece
| | - Christina Katsagoni
- First Department of Paediatrics, University of Athens, Agia Sophia Children's Hospital, Athens, Greece
| | - Danijela Jojkic-Pavkov
- Department of Paediatrics, Institute for Child and Youth Health Care of Vojvodina, Medical Faculty Novi Sad, Novi Sad, Serbia
| | - Silvia Salvatore
- Pediatric Department, "F. Del Ponte" Hospital, University of Insubria, Varese
| | - Licia Pensabene
- Department of Medical and Surgical Sciences, Pediatric Unit, University "Magna Graecia of Catanzaro
| | - Elena Scarpato
- Department of Translational Medical Science, Section of Pediatrics
| | - Erasmo Miele
- Department of Translational Medical Science, Section of Pediatrics
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90
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Choi C, Abougergi M, Peluso H, Weiss SH, Nasir U, Pyrsopoulos N. Cannabis Use is Associated With Reduced 30-Day All-cause Readmission Among Hospitalized Patients With Irritable Bowel Syndrome: A Nationwide Analysis. J Clin Gastroenterol 2022; 56:257-265. [PMID: 33471483 DOI: 10.1097/mcg.0000000000001498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 12/13/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cannabinoid receptors are potential therapeutic targets in a variety of gastrointestinal tract disorders. The authors hypothesize that the use of cannabis use is associated with better control of symptoms associated with irritable bowel syndrome (IBS). This study aimed to examine the utilization of inpatient services by patients with IBS who did and did not report the use of cannabis. METHODS This is a retrospective cohort study that utilized the 2016 Nationwide Readmissions Database. Inclusion criteria included a principal diagnosis of IBS. The primary outcome was 30-day hospital readmission rates for IBS-specific causes. Secondary outcomes included the 30-day hospital readmission rates for all causes, resource utilization, and the 5 most common principal diagnoses and independent risk factors associated with readmission. RESULTS Of the 7163 patients with IBS identified in the National Readmission Database, 357 reported the use of cannabis. The 30-day IBS-specific readmission rates were 1.5% in patients who reported cannabis use and 1.1% in those who did not report cannabis use (P=0.53). Among the cannabis users, none of the variables evaluated served as a significant predictor of IBS-specific readmission; median income was a predictor for readmission among those who did not report cannabis use (odds ratio, 2.77; 95% confidence interval, 1.15-6.67; P=0.02). The 30-day readmission rates for all causes were 8.1% and 12.7% for patients who did and did not report cannabis use, respectively. After adjusting for confounders, the odds of 30-day readmission for all causes were lower among patients who reported cannabis use compared with those who did not (adjusted odds ratio, 0.53; 95% confidence interval, 0.28-0.99; P=0.04). The 5 most frequent diagnoses at readmission among patients who did not report cannabis use were enterocolitis because of Clostridioides difficile, IBS without diarrhea, sepsis, noninfective gastroenteritis and colitis, and acute kidney failure. By contrast, the 5 most frequent readmission diagnoses for cannabis users were cyclical vomiting, IBS with diarrhea, endometriosis, right upper quadrant abdominal pain, and nausea with vomiting. A discharge disposition of "against medical advice" was identified as an independent risk factor for 30-day hospital readmission for all causes among patients who reported cannabis use. By contrast, higher comorbidity scores and discharges with home health care were independent predictors of 30-day hospital readmission for all causes among patients who did not report cannabis use. Private insurance was an independent factor associated with lower rates of readmission for all causes among those who did not report cannabis use. CONCLUSION Our review of the National Readmission Database revealed no statistically significant differences in 30-day readmission rates for IBS-specific causes when comparing patients who reported cannabis use with those who did not. However, the authors found that cannabis use was associated with reduced 30-day hospital readmission rates for all causes.
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Affiliation(s)
| | - Marwan Abougergi
- Division of Gastroenterology, Department of Internal Medicine, University of South Carolina School of Medicine, Columbia
- Catalyst Medical Consulting, Simpsonville
| | - Heather Peluso
- Department of Surgery, Prisma Health Upstate, Greenville, SC
| | | | | | - Nikolaos Pyrsopoulos
- Department of Medicine
- Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ
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91
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Ebeid B, Eid RA, Attia D, Daoud SA, Tawfik MM, Abdel Fattah AM. Prevalence of Microscopic Colitis in Diarrhea-predominant Irittable Bowel Syndrome Patients: Cohort Study From Upper Egypt. J Clin Gastroenterol 2022; 56:e232-e238. [PMID: 34334761 DOI: 10.1097/mcg.0000000000001592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/17/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIM There is controversy about colonoscopy and taking biopsy from the normal colonic mucosa in patients with a clinical diagnosis of diarrhea-predominant irritable bowel syndrome (D-IBS). This study aims to estimate the prevalence of microscopic colitis (MC) in D-IBS patients and to select patients without the well-known alarming features who will benefit from colonoscopy and biopsies from the normal colonic mucosa. PATIENTS AND METHODS We performed a cohort cross-sectional study over 6 months duration in a total of 129 patients with Rome III criteria of D-IBS after excluding cases with features of organic diseases. Cases were subjected to colonoscopy and biopsies from the colonic mucosa that seemed normal. RESULTS Histopathologic examination of biopsies taken from cases with normal colonic mucosa revealed 86 (71.66%) cases with nonspecific colitis, 26 (21.66%) cases with MC and 8 (6.66%) cases with ulcerative colitis. Concomitant immunologic diseases (P=0.00005) and triggering drugs intake (P=0.006) were significantly more common in the MC group. The mean duration of diarrhea in MC patients was significantly longer than that of nonspecific colitis and ulcerative colitis patients (P=0.0006). CONCLUSIONS Prevalence of MC in D-IBS patients from Upper Egypt is relatively high (21.66%). Concomitant immunologic diseases, possible triggering drugs intake, and long duration of diarrhea are significant risk factors for undiagnosed MC in D-IBS patients.
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Affiliation(s)
- Basel Ebeid
- Departments of Gastroenterology, Hepatology and Endemic Medicine
| | - Ragaey A Eid
- Departments of Gastroenterology, Hepatology and Endemic Medicine
| | - Dina Attia
- Departments of Gastroenterology, Hepatology and Endemic Medicine
| | - Sahar A Daoud
- Pathology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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92
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DEMİRBAŞ A, ELMAS ÖF, EKER H, ULUTAŞ DEMİRBAŞ G, DURSUN R, ATASOY M, TÜRSEN Ü, LOTTİ T. The relationship between hidradenitis suppurativa and irritable bowel syndrome: a cross-sectional study. Turk J Med Sci 2022; 52:97-104. [PMID: 36161595 PMCID: PMC10734857 DOI: 10.3906/sag-2107-158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 02/22/2022] [Accepted: 01/09/2022] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder in which one experiences abdominal pain, tension, cramping, bloating, and changes in the form and frequency of defecation, without an underlying organic disease. Many skin diseases have been reported to be more common in people with functional bowel disease. To our knowledge, however, no previous study investigated the potential relationship between hidradenitis suppurativa (HS) and IBS. In this study, we aimed to examine the potential association between IBS and HS. METHODS Patients with HS and healthy subjects were enrolled in this cross-sectional study. All participants were assessed for the presence of IBS. ROME IV criteria were used to identify IBS cases. Hurley staging, modified Sartorius score, and physician's global assessment score were applied to define clinical severity and staging of HS. RESULTS According to the Rome IV diagnostic criteria, 54 (67.50%) of 80 HS patients and 23 (28.75%) of 80 control group were diagnosed with IBS. The frequency of IBS was statistically significantly higher in the patient group than in the control group (P < 0.001). No statistically significant difference was found between the two groups in terms of abnormal stool frequency and family history of IBS (P = 0.28, P = 0.862, respectively). Abnormal stool form, mucus in stool, abdominal distension, feeling of incomplete evacuation were statistically significantly higher in HS patients compared to the controls (P = 0.01, P = 0.02, P < 0.001, P = 0.001, respectively).
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Affiliation(s)
| | - Ömer Faruk ELMAS
- Department of Dermatology, Private Medicana Hospital, İstanbul,
Turkey
| | - Hediye EKER
- Department of Dermatology, Selçuk University, Konya,
Turkey
| | | | - Recep DURSUN
- Department of Dermatology, Necmettin Erbakan University, Konya,
Turkey
| | - Mustafa ATASOY
- Department of Dermatology, Health Science University, Kayseri City Hospital, Kayseri,
Turkey
| | - Ümit TÜRSEN
- Department of Dermatology, Mersin University, Mersin,
Turkey
| | - Torello LOTTİ
- Department of Dermatology, Guglielmo Marconi University, Rome,
Italy
- Department of Dermatology, First Medical State University of Moscow I M Sechenev, Moscow,
Russia
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93
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Mustafa U, Ghoshal UC. The challenges of implementing low fermentable oligo-, di-, mono-saccharides and polyol diet in India: An analysis of available data. Indian J Gastroenterol 2022; 41:104-113. [PMID: 35201601 DOI: 10.1007/s12664-022-01250-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/27/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Low fermentable oligo-, di-, monosaccharides, and polyols (FODMAP) diet is used in irritable bowel syndrome (IBS). However, data on the utility and challenges of implementing such a diet in India are scanty. Since dietary practices in India are different from other Asian and Western countries, the existing Indian data were analyzed. METHODS This study attempted to analyze the existing Indian data on the frequency of vegetarianism, cereal (wheat vs. rice), milk/milk product consumption, and lactose malabsorption (LM). A 5-point scale (quiet easy, easy, moderately easy, not easy, difficult) for implementation of low FODMAP diet for IBS patients was proposed based on regional dietary diversity and LM in India. RESULTS Our analysis showed that vegetarianism is high in India with regional differences in frequency. Similarly, there is regional variation in frequency of LM though it is quite high in most parts of India where data are available. While southern, eastern, and north-eastern [corrected] parts of the country have rice as the staple cereal, wheat is consumed more in other parts. We suggest that implementing a low FODMAP diet in north-eastern India may be most easy compared to northern India, where it may be most difficult. Implementing a low FODMAP diet in southern and eastern India may be easy, moderately easy in western India, and not easy in central India. CONCLUSIONS The variation in the difficulty in implementing a low FODMAP diet in India may stem from the regional food preference and differences in vegetarianism, as well as frequency of LM.
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Affiliation(s)
- Uzma Mustafa
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India
| | - Uday C Ghoshal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India.
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94
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Saha S, Sehgal K, Singh S, Grover M, Pardi D, Khanna S. Postinfection Irritable Bowel Syndrome Following Clostridioides difficile Infection: A Systematic-review and Meta-analysis. J Clin Gastroenterol 2022; 56:e84-e93. [PMID: 34049374 PMCID: PMC8627535 DOI: 10.1097/mcg.0000000000001536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/19/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Postinfection irritable bowel syndrome (PI-IBS) affects ~14% patients after acute bacterial enterocolitis. AIM The aim of this study was to conduct a systematic review and meta-analysis to find the prevalence of PI-IBS following Clostridioides difficile infection (CDI). METHODS We systematically searched Medline, Embase, and Web of Science from inception through January 20, 2020 for cohort studies assessing PI-IBS following CDI. Primary outcome was pooled prevalence calculated using inverse variance heterogeneity model [MetaXL (v. 5.3)]. A priori subgroup analyses were done [by irritable bowel syndrome (IBS) diagnostic criteria-Rome vs. others, time of IBS diagnosis-<6 or >6 mo, exclusion or inclusion of pre-existing IBS and CDI treatment-antibiotic with fecal microbiota transplantation vs. antibiotic only]. Heterogeneity was considered substantial if I2>50%. RESULTS From 2007 to 2019, 15 studies were included (10 prospective, 5 retrospective; 9 full-text, 6 abstracts). Data from 1218 patients were included in the quantitative analysis. Risk of bias was low in 7, medium in 4 and high in 4 studies. Pooled prevalence of PI-IBS was 21.1% (95% confidence interval, 8.2%-35.7%), I2=96%. Common PI-IBS subtypes were diarrhea-predominant in 46.3% (50) patients, and mixed in 33.3% (36) patients. Subgroup analyses by IBS diagnostic criteria, time of IBS diagnosis or CDI treatment did not significantly change the primary outcome (all P>0.05), nor decrease heterogeneity. Funnel plot analysis revealed publication bias. CONCLUSIONS Over 20% of patients develop PI-IBS after CDI. Factors such as diagnostic criteria for IBS and CDI treatment did not affect prevalence, though small numbers limit the confidence in these conclusions. Larger, well conducted studies are needed to study PI-IBS in CDI.
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Affiliation(s)
- Srishti Saha
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA 55905
| | - Kanika Sehgal
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA 55905
| | - Sumitabh Singh
- Division of Endocrinology, Mayo Clinic, Rochester, Minnesota, USA 55905
| | - Madhusudan Grover
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA 55905
| | - Darrell Pardi
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA 55905
| | - Sahil Khanna
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA 55905
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95
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Ilie OD, Bolos A, Nita IB, Cojocariu RO, Balmus IM, Ciobica A, Trus C, Doroftei B. Preliminary Data on Gastrointestinal Deficiencies Incidence and the Prevalence of Anxiety During the COVID-19 Pandemic Among the Medical Workers. J Nerv Ment Dis 2022; 210:98-103. [PMID: 34739008 DOI: 10.1097/nmd.0000000000001445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious new β-coronavirus that primarily affects the lungs. Because of its unprecedented spread, in a relatively short interval, it is declared a global pandemic. Binding to the angiotensin-converting enzyme 2 receptors, SARS-CoV-2 is easily disseminated through air. Apart from the established clinical panel, individuals exposed to prolonged chronic stress also manifest gastrointestinal (GI) symptoms similar to those exhibited by SARS-CoV-2-infected patients.The present study aims to assess the incidence of GI deficiencies and prevalence of anxiety among healthy medical staff by applying the Visual Analog Scale for Irritable Bowel Syndrome (VAS-IBS) and Hamilton Anxiety Rating Scale (HAM-A) during this global crisis.We found significant differences on several items of the VAS-IBS: regarding the incidence of diarrhea (p = 0.04), bloating/gases (p = 0.02), and nausea/vomiting (p = 0.01) from the physical spectrum. After stratification based on age of the participants and after we applied Kruskal-Wallis test because of heterogeneity between groups, we noted two situations in which the null hypothesis is rejected: nausea/vomiting in women between 20 and 30 years, and between 30 and 40, and between 40 and 50 years, respectively (p = 0.026/0.029). Anxiety was prevalent among young and middle-class people after the centralization of HAM-A data, where 40.4% of the participants had various forms of anxiety: mild (n = 13; 13.82%), severe (n = 13; 13.82%), and moderate (n = 12; 12.76%).This study demonstrates that VAS-IBS is a reliable tool for assessing the incidence of GI deficiencies, as well as HAM-A for anxiety.
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Affiliation(s)
| | - Alexandra Bolos
- Faculty of Medicine, University of Medicine and Pharmacy "Grigore T. Popa"
| | - Ilinca-Bianca Nita
- Faculty of Medicine, University of Medicine and Pharmacy "Grigore T. Popa"
| | | | - Ioana-Miruna Balmus
- Department of Exact and Natural Sciences, Institute of Interdisciplinary Research, "Alexandru Ioan Cuza" University, Iasi
| | | | - Constantin Trus
- Department of Morphological and Functional Sciences, Faculty of Medicine, "Dunarea de Jos" University, Galati
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96
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Kamp KJ, Levy RL, Munson SA, Heitkemper MM. Impact of COVID-19 on Individuals With Irritable Bowel Syndrome and Comorbid Anxiety and/or Depression. J Clin Gastroenterol 2022; 56:e149-e152. [PMID: 33780216 PMCID: PMC8435039 DOI: 10.1097/mcg.0000000000001515] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/23/2021] [Indexed: 02/03/2023]
Abstract
GOALS The goal of this study was to describe the influence of the COVID-19 pandemic on ability to engage in activities and the influence on psychological distress and gastrointestinal symptoms among individuals with irritable bowel syndrome (IBS) and comorbid anxiety and/or depression. BACKGROUND Individuals with IBS and comorbid anxiety and/or depression report increased symptoms and decreased quality of life compared with individuals with IBS alone. The current COVID-19 pandemic has the potential to further influence symptoms among individuals with IBS and comorbid anxiety and/or depression. STUDY Individuals who met the Rome-IV IBS criteria and reported mild to severe anxiety and/or depression were included. Participants completed an online survey with questions about anxiety, depression, impact of COVID on activities and symptoms, and demographics. RESULTS Fifty-five individuals participated in the study. The COVID-19 pandemic most commonly influenced their ability to spend time with friends and family, shop for certain types of food, and access health care. Participants also reported increased stress (92%), anxiety (81%), and depressive symptoms (67%). Finally, around half the sample reported increases in abdominal pain (48%), diarrhea (45%), or constipation (44%). CONCLUSIONS The COVID-19 pandemic is related to self-reported increases in psychological distress and gastrointestinal symptoms among individuals with IBS and comorbid anxiety and/or depression. Additional research is needed to intervene on these symptoms.
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Affiliation(s)
| | | | | | - Margaret M Heitkemper
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA
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97
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Bin Abdulrahman KA, Alenazi NS, Albishri SB, Alshehri FF. Association of Migraine and Irritable Bowel Syndrome in Saudi Arabia: A Nationwide Survey. Biomed Res Int 2022; 2022:8690562. [PMID: 35087910 PMCID: PMC8789428 DOI: 10.1155/2022/8690562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/31/2021] [Accepted: 01/04/2022] [Indexed: 12/12/2022]
Abstract
Migraine is a primary headache disorder with a prevalence of 11.6% globally and 27% in Saudi Arabia. Irritable bowel syndrome (IBS) has a prevalence of 9.2% worldwide. The prevalence of IBS has not been established nationally. However, provincial studies for migraine and IBS have been conducted nationwide. There is a significant link between migraine and IBS globally. Migraineurs had a considerably greater prevalence of IBS than nonmigraineurs (OR = 2.49, 95% CI 2.22-2.78). Patients with IBS have 60% higher odds for migraines. This identifies an association that needs to be investigated in a nationwide manner. The study has two main aims. The first is to measure the prevalence of migraine and irritable bowel syndrome in Saudi Arabia. The second is to observe the association and the relationship between migraine and irritable bowel syndrome in Saudi Arabia. A cross-sectional study was conducted among the general population of Saudi Arabia between March 2021 and June 2021, whose ages are 15 years old or greater. Participants filled an online self-administered survey. The data collection tools included the Migraine Screen Questionnaire (MS-Q) for migraine symptoms, migraine severity (MIGSEV) scale for severity of migraine, and the IBS module of the Rome IV Diagnostic Questionnaire (R4DQ) for IBS symptoms and their subtype. With 2802 participants, the majority of the study samples were males, who constituted 52.5%. Among the study's sample, the prevalence of migraine consisted of 27.4%, and the prevalence of IBS was 16.4%. The odds of having IBS in migraineurs were much higher than in those without migraine (OR 4.127; 95% CI 3.325-5.121), and the association was statistically significant (p < 0.001). In conclusion, there is a strong association between migraine and irritable bowel syndrome in Saudi Arabia.
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Affiliation(s)
| | - Nawaf S. Alenazi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Saad B. Albishri
- College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Faisal F. Alshehri
- College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
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98
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Monden R, Rosmalen JGM, Wardenaar KJ, Creed F. Predictors of new onsets of irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia: the lifelines study. Psychol Med 2022; 52:112-120. [PMID: 32546287 PMCID: PMC8711101 DOI: 10.1017/s0033291720001774] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 05/08/2020] [Accepted: 05/16/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND It has been claimed that functional somatic syndromes share a common etiology. This prospective population-based study assessed whether the same variables predict new onsets of irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS) and fibromyalgia (FM). METHODS The study included 152 180 adults in the Dutch Lifelines study who reported the presence/absence of relevant syndromes at baseline and follow-up. They were screened at baseline for physical and psychological disorders, socio-demographic, psycho-social and behavioral variables. At follow-up (mean 2.4 years) new onsets of each syndrome were identified by self-report. We performed separate analyses for the three syndromes including participants free of the relevant syndrome or its key symptom at baseline. LASSO logistic regressions were applied to identify which of the 102 baseline variables predicted new onsets of each syndrome. RESULTS There were 1595 (1.2%), 296 (0.2%) and 692 (0.5%) new onsets of IBS, CFS, and FM, respectively. LASSO logistic regression selected 26, 7 and 19 predictors for IBS, CFS and FM, respectively. Four predictors were shared by all three syndromes, four predicted IBS and FM and two predicted IBS and CFS but 28 predictors were specific to a single syndrome. CFS was more distinct from IBS and FM, which predicted each other. CONCLUSIONS Syndrome-specific predictors were more common than shared ones and these predictors might form a better starting point to unravel the heterogeneous etiologies of these syndromes than the current approach based on symptom patterns. The close relationship between IBS and FM is striking and requires further research.
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Affiliation(s)
- Rei Monden
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Judith G M Rosmalen
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Francis Creed
- Neuroscience and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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99
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Ismail MH, Abbas SK, Molan AL. Prevalence and subtype diversity of Blastocystis sp. in an Iraqi population with and without irritable bowel syndrome (IBS). Ann Parasitol 2022; 68:275-286. [PMID: 35809577 DOI: 10.17420/ap6802.433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The parasites that belong to the genus Blastocystis are the most common intestinal parasite detected in a wide range of hosts including humans. Although the pathogenicity of these parasites remains controversial, many studies confirmed their pathogenicity and some researchers strongly believe that the pathogenicity may be linked with specific subtypes of these parasites. The current study investigated the Blastocystis sp. subtypes recovered from individuals suffering from the irritable bowel syndrome (IBS) in comparison with those recovered from non-IBS subjects. Fresh stool samples were collected from each participant and processed during the same day of collection. Iodine wet mounts and trichrome stained smears prepared from fresh stool and sediment concentrates were microscopically examined for Blastocystis parasites. In addition, Jones's medium has been used in order to confirm the identification and also to get the genomic DNA from positive samples for PCR and sequencing. The culture was significantly more sensitive (P=0.0035) than the other identification methods, especially in IBS patients. Blastocystis was detected in 60.0% of patients with IBS and in 22.0% of non-IBS individuals and the difference between two groups was statistically significant (P=0.0001). Regarding the impact of age and gender on the prevalence of infection with Blastocystis, no significant differences were observed between IBS patients and non-IBS subjects except for the age group (10-30 years) where the non-IBS subjects were significantly more prone (P=0.0223) to the infection with this parasite than IBS patients. The abdominal pain and bloating were the leading symptoms. DNA sequencing and phylogenetic analysis of Iraqi Blastocystis isolates identified three subtypes (ST1, ST2 and ST3). Among these three subtypes, ST3 was significantly more prevalent (OR=8.5; P=0.0058) among IBS patients (60%) than non-IBS subjects (25%). In contrast, the dominance of ST1 was significantly higher (OR=7.0; P=0.0062) in the non-IBS subjects (70%) than their IBS patients counterparts (15%). As far as we know, this study is the first to deal with the genetic characterization of Blastocystis subtypes in an Iraqi population with and without IBS.
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Affiliation(s)
- Masar Hadi Ismail
- Department of Biology, College of Sciences, Mustansiriyah University, Baghdad, Iraq
- Department of Biotechnology, College of Sciences, Diyala University, Diyala, Iraq
| | | | - Abdul-Lateef Molan
- Department of Biotechnology, College of Sciences, Diyala University, Diyala, Iraq
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100
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El Sharawy SM, Amer IF, Elkadeem MZ. Irritable bowel syndrome in Egyptian medical students, prevalence and associated factors: a cross-sectional study. Pan Afr Med J 2022; 41:311. [PMID: 35865835 PMCID: PMC9269039 DOI: 10.11604/pamj.2022.41.311.28228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/21/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction irritable bowel syndrome is a recurrent chronic gastrointestinal functional disorder. Despite it is not dangerous; it carries a significant feedback on self-confidence and quality of life. Medical students are expected to develop irritable bowel syndrome because they are subjected to stress due to over academic pressure. The objectives were to investigate irritable bowel syndrome prevalence, and to detect the related risk factors in this specific group of Egyptian people. Methods this cross-sectional study performed in two faculties of medicine in Nile Delta, Egypt. It had been built on self-administered questionnaires including Rome III criteria for diagnosis of irritable bowel syndrome, as well as several questions for gathering socio-demographic information and manifestations suggesting irritable bowel syndrome. Results fifty (27.5%) of 182 evaluated medical students achieved criteria of irritable bowel syndrome, 64% of them were mixed type. Irritable bowel syndrome had a significant relationship with coffee, milk products, fewer vegetables, and fruits intake (P=0.034, P=0.044, P<0.001 respectively). Depression, anxiety, and food intolerance were detected to be significantly related to irritable bowel syndrome (p<0.001, p=0.005, p=0.04) respectively. Conclusion it was demonstrated that many Egyptian medical students were suffering from irritable bowel syndrome. Some dietary habits, anxiety, and depression of the students could be risk factors related to development of irritable bowel syndrome.
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Affiliation(s)
- Shimaa Mahmoud El Sharawy
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ibrahim Fathi Amer
- Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafr El Sheikh University, Kafr El Sheikh, Egypt
| | - Mahmoud Zaki Elkadeem
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt
- Corresponding author: Mahmoud Zaki Elkadeem, Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt.
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