151
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Liang CM, Hsu CH, Chung CH, Chen CY, Wang LY, Hsu SD, Chang PK, Hong ZJ, Chien WC, Hu JM. Risk for Irritable Bowel Syndrome in Patients with Helicobacter Pylori Infection: A Nationwide Population-Based Study Cohort Study in Taiwan. Int J Environ Res Public Health 2020; 17:ijerph17103737. [PMID: 32466223 PMCID: PMC7277457 DOI: 10.3390/ijerph17103737] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 12/12/2022]
Abstract
Background: The association between Helicobacter pylori (H. pylori) infection and the risk of developing irritable bowel syndrome (IBS) has yet to be investigated; thus, we conducted this nationwide cohort study to examine the association in patients from Taiwan. Methods: A total of approximately 2669 individuals with newly diagnosed H. pylori infection and 10,676 age- and sex-matched patients without a diagnosis of H. pylori infection from 2000 to 2013 were identified from Taiwan’s National Health Insurance Research Database. The Kaplan–Meier method was used to determine the cumulative incidence of H. pylori infection in each cohort. Whether the patient underwent H. pylori eradication therapy was also determined. Results: The cumulative incidence of IBS was higher in the H. pylori-infected cohort than in the comparison cohort (log-rank test, p < 0.001). After adjustment for potential confounders, H. pylori infection was associated with a significantly increased risk of IBS (adjusted hazard ratio (aHR) 3.108, p < 0.001). In addition, the H. pylori-infected cohort who did not receive eradication therapy had a higher risk of IBS than the non-H. pylori-infected cohort (adjusted HR 4.16, p < 0.001). The H. pylori-infected cohort who received eradication therapy had a lower risk of IBS than the comparison cohort (adjusted HR 0.464, p = 0.037). Conclusions: Based on a retrospective follow-up, nationwide study in Taiwan, H. pylori infection was associated with an increased risk of IBS; however, aggressive H. pylori infection eradication therapy can also reduce the risk of IBS. Further underlying biological mechanistic research is needed.
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Affiliation(s)
- Chia-Ming Liang
- Division of General Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-M.L.); (S.-D.H.); (Z.-J.H.)
| | - Chih-Hsiung Hsu
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan; (C.-H.H.); (P.-K.C.)
- Teaching Office, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan;
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei 11490, Taiwan
| | - Chao-Yang Chen
- Division of Colorectal Surgery, Department of surgery, Tri-service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Lin-Yin Wang
- Department of Surgery, Taoyuan Armed Forces General Hospital, Taoyuan 32551, Taiwan;
| | - Sheng-Der Hsu
- Division of General Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-M.L.); (S.-D.H.); (Z.-J.H.)
| | - Pi-Kai Chang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan; (C.-H.H.); (P.-K.C.)
- Division of Colorectal Surgery, Department of surgery, Tri-service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Zhi-Jie Hong
- Division of General Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-M.L.); (S.-D.H.); (Z.-J.H.)
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan;
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence: (W.-C.C.); (J.-M.H.)
| | - Je-Ming Hu
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan; (C.-H.H.); (P.-K.C.)
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Division of Colorectal Surgery, Department of surgery, Tri-service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
- School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence: (W.-C.C.); (J.-M.H.)
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152
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Varjú P, Ystad B, Gede N, Hegyi P, Pécsi D, Czimmer J. The role of small intestinal bacterial overgrowth and false positive diagnosis of lactose intolerance in southwest Hungary-A retrospective observational study. PLoS One 2020; 15:e0230784. [PMID: 32384113 PMCID: PMC7209350 DOI: 10.1371/journal.pone.0230784] [Citation(s) in RCA: 2] [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: 06/10/2019] [Accepted: 03/09/2020] [Indexed: 12/12/2022] Open
Abstract
Background Lactose intolerance is a frequent gastrointestinal disease affecting 47% of the Eastern European population. Small intestinal bacterial overgrowth (SIBO) leads to carbohydrate malabsorption and therefore to false results during lactose breath and tolerance tests. Objectives We aimed to assess the prevalence of lactose maldigestion and intolerance in Hungary and to investigate the role of combined diagnostic method and testing for SIBO in reducing false results. Methods We retrospectively analyzed data from 264 adult symptomatic patients who underwent 50g lactose breath and tolerance tests in parallel over a one-year period at our center. A ≥20 ppm elevation of H2 or less than 1.1 mmol/l rise of blood glucose was diagnostic for lactose maldigestion. Patients with maldigestion who had symptoms during the test were defined as lactose intolerant. Patients with an early (≤90 min) significant (≥20 ppm) rise of H2 during lactose and/or lactulose breath tests were determined to have SIBO. Patients with slow/rapid oro-cecal transit and inappropriate preparation before the test were excluded. Results 49.6% of the 264 patients had lactose maldigestion, and 29.5% had lactose intolerance. The most frequent symptom was bloating (22.7%), while 34.8% of the study population and 60% of the symptomatic patients had SIBO. In 9.1% and 9.8% of the patients, the lactose breath and tolerance test alone gave false positive result compared with the combined method. SIBO was present in 75% of the false positives diagnosed with breath test only. Conclusions The prevalence of lactose intolerance is lower in Hungary compared to the Eastern European value (29.5% vs 47%), so it is worth performing a population-based prospective analysis in this area. A combination of lactose breath and tolerance tests and the careful monitoring of results (with early H2 rise, lactulose breath test, etc.) can decrease the false cases caused by e.g. SIBO.
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Affiliation(s)
- Péter Varjú
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Birgit Ystad
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Noémi Gede
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
- Hungarian Academy of Sciences-University of Szeged, Momentum Gastroenterology Multidisciplinary Research Group, Szeged, Hungary
| | - Dániel Pécsi
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - József Czimmer
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
- * E-mail:
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153
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Ozer M, Bengi G, Colak R, Cengiz O, Akpinar H. Prevalence of irritable bowel syndrome-like symptoms using Rome IV criteria in patients with inactive inflammatory bowel disease and relation with quality of life. Medicine (Baltimore) 2020; 99:e20067. [PMID: 32384473 PMCID: PMC7220554 DOI: 10.1097/md.0000000000020067] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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] [Indexed: 12/19/2022] Open
Abstract
Irritable bowel syndrome (IBS)-like symptoms tend to be common in inflammatory bowel disease (IBD) patients even during the long-standing remission phase, and quality of life (QOL) seem to reduce in IBD patients with such symptoms. Thus, the aim of this study was to define the prevalence of IBS-like symptoms in inactive IBD patients using Rome IV criteria and evaluate the effect of IBS-like symptoms on QOL.Total 137 patients with IBD (56 with ulcerative colitis (UC) and 81 with Crohn disease (CD), who had been in long-standing remission according to the clinical scoring system and 123 control participants were included. These patients completed questionnaires to evaluate IBS-like symptoms according to Rome IV criteria, and the impact of these symptoms on the QOL of inactive IBD patients was compared with and without IBS-like symptoms according to disease-specific inflammatory bowel disease questionnaire (IBDQ).Depending on our research, IBS-like symptoms were found in 32% (18/56) of patients with inactive UC, 35% (29/81) of patients with inactive CD, and 13.8% (17/123) of control participants (P < .001). The QOL seemed to be significantly lower in both inactive UC and CD patients with IBS-like symptoms than in those without such symptoms (P < .001).In conclusion, we defined that the prevalence of IBS-like symptoms in IBD patients in remission is 2 to 3 times higher than that in healthy control participants, and significantly lower IBDQ scores showed QOL was reduced in inactive IBD patients with IBS-like symptoms as compared with patients without IBS-like symptoms.
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Affiliation(s)
- Muhammet Ozer
- Dokuz Eylul University, Department of Internal Medicine, Izmir, Turkey
- Capital Health Regional Medical Center, Department of Internal Medicine, Trenton, NJ, USA
| | - Goksel Bengi
- Dokuz Eylul University, Division of Gastroenterology, Izmir, Turkey
| | - Rumeysa Colak
- Dokuz Eylul University, Department of Internal Medicine, Izmir, Turkey
| | - Ozan Cengiz
- Dokuz Eylul University, Division of Gastroenterology, Izmir, Turkey
| | - Hale Akpinar
- Dokuz Eylul University, Division of Gastroenterology, Izmir, Turkey
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154
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Usai-Satta P, Bassotti G, Bellini M, Oppia F, Lai M, Cabras F. Irritable Bowel Syndrome and Gluten-Related Disorders. Nutrients 2020; 12:nu12041117. [PMID: 32316404 PMCID: PMC7231142 DOI: 10.3390/nu12041117] [Citation(s) in RCA: 12] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 04/04/2020] [Accepted: 04/13/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Irritable bowel syndrome (IBS) is frequently associated with celiac disease (CD) and nonceliac gluten/wheat sensitivity (NCGS/NCWS), but epidemiological and pathophysiological aspects are still unclear. Furthermore, a gluten-free diet (GFD) can positively influence IBS symptoms. Methods: A comprehensive online search for IBS related to CD, NCGS and GFD was made using the Pubmed, Medline and Cochrane databases. Results: Although a systematic screening for CD in IBS is not recommended, CD prevalence can be increased in diarrhea-predominant IBS patients. On the other hand, IBS symptoms can be persistent in treated CD patients, and their prevalence tends to decrease on a GFD. IBS symptoms may overlap and be similar to those associated to nonceliac gluten and/or wheat sensitivity. Increased gut permeability could explain the gluten/wheat effects in IBS patients. Finally, a GFD could improve symptoms in a subgroup of IBS patients. Conclusions: The possible interplay between IBS and gluten-related disorders represents a scientifically and clinically challenging issue. Further studies are needed to confirm these data and better clarify the involved pathophysiological mechanisms.
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Affiliation(s)
- Paolo Usai-Satta
- Gastroenterology Unit, Brotzu Hospital, 09121 Cagliari, Italy; (F.O.); (F.C.)
- Correspondence: ; Tel.: +39-070-539-395
| | - Gabrio Bassotti
- Gastroenterology & Hepatology Section, Department of Medicine, University of Perugia, 06156 Perugia, Italy;
| | - Massimo Bellini
- Gastrointestinal Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56010 Pisa, Italy;
| | - Francesco Oppia
- Gastroenterology Unit, Brotzu Hospital, 09121 Cagliari, Italy; (F.O.); (F.C.)
| | - Mariantonia Lai
- Gastroenterology Unit, University of Cagliari, 09042 Monserrato, Italy;
| | - Francesco Cabras
- Gastroenterology Unit, Brotzu Hospital, 09121 Cagliari, Italy; (F.O.); (F.C.)
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155
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Basilisco G. Patient dissatisfaction with medical therapy for chronic constipation or irritable bowel syndrome with constipation: analysis of N-of-1 prospective trials in 81 patients. Aliment Pharmacol Ther 2020; 51:629-636. [PMID: 32048753 DOI: 10.1111/apt.15657] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 12/27/2019] [Revised: 01/06/2020] [Accepted: 01/21/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Patients with chronic constipation (CC) or with irritable bowel syndrome with constipation are often dissatisfied about their medical therapy, but their condition remains poorly defined. AIM To evaluate the patients' satisfaction rates and which factors predict favourable outcomes through the aggregate analysis of N-of-1 trials. METHODS Eighty-one outpatients with CC or with irritable bowel syndrome with constipation underwent N-of-1 trials with at least a one-month cycle of effective treatment. Three primary endpoints (satisfaction with therapy, improvement after treatment and an extended satisfaction criterion including both endpoints) were adopted to define satisfaction with therapy. Dyssynergia, resting anal pressure, colonic transit time and somatisation were assessed. The Patient Assessment of Constipation-Symptoms (PAC-SYM) questionnaire and its Modified version (M-PAC-SYM) measured constipation severity. Straining at defecation, stool frequency and form were daily recorded. K statistics for agreement and logistic regression were used at statistical analysis. RESULTS Satisfaction with therapy was not achieved by 43% of patients, who had a significantly lower Body Mass Index (BMI) and more severe constipation at baseline. Only the change in constipation severity according to M-PAC-SYM remained significantly associated with satisfaction with therapy (OR = 4.3; P < 0.001) at multivariate analysis. CONCLUSIONS Satisfaction with therapy is often an unmet need for patients with CC or with irritable bowel syndrome with constipation. Lower BMI and more severe constipation are associated with worse outcome. Changes in M-PAC-SYM reflect satisfaction with therapy. ClinicalTrials.gov no. NCT02813616.
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Affiliation(s)
- Guido Basilisco
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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156
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Li J, Yuan B, Li G, Lu X, Guo Y, Yang Y, Liang M, Ding J, Zhou Q. Convergent syndromic atrophy of pain and emotional systems in patients with irritable bowel syndrome and depressive symptoms. Neurosci Lett 2020; 723:134865. [PMID: 32109554 DOI: 10.1016/j.neulet.2020.134865] [Citation(s) in RCA: 6] [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: 10/28/2019] [Revised: 02/22/2020] [Accepted: 02/24/2020] [Indexed: 12/19/2022]
Abstract
Irritable bowel syndrome (IBS) is a brain-gut disorder that is often accompanied by psychiatric comorbidities, particularly depression. However, the neuroanatomical substrates of IBS with depressive symptoms (DEP-IBS) and how depressive symptoms and brain morphology modulate IBS symptoms remain unknown. In this study, structural MRI data were processed using a voxel-based morphometry technique and one-way analysis of covariance (ANCOVA) and post-hoc t-tests were performed to compare gray matter volume (GMV) among 28 patients with DEP-IBS, 21 patients with IBS who lacked depressive symptoms (nDEP-IBS), and 36 healthy controls (HC). Correlation and mediation analyses were performed to evaluate the relationship between differing GMV in DEP-IBS and clinical variables. We found that GMV in the bilateral prefrontal, insular, and dorsal striatal areas, as well as the left temporal pole, were significantly lower in the DEP-IBS group than in the HC group. Moreover, compared with the nDEP-IBS group, the DEP-IBS group exhibited decreased GMV in the bilateral medial, dorsolateral prefrontal, and orbitofrontal cortices, bilateral dorsal striatum, and left insular cortices. Correlation analysis revealed that GMV in these atrophic brain areas of the DEP-IBS group was negatively correlated with depression, gastrointestinal symptoms, and disease duration. Our results further revealed that depressive symptoms served as a mediator between gastrointestinal symptoms and GMV in the left insula, right medial prefrontal cortex, and right middle frontal gyrus, while gastrointestinal symptoms served as a mediator between depression and GMV in these regions. Our results suggest convergent syndromic atrophy in the pain and emotional systems of patients with DEP-IBS.
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Affiliation(s)
- Jie Li
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China; Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Binke Yuan
- Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen, Guangdong, China
| | - Guoxiong Li
- Department of Gastroenterology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Xingqi Lu
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yun Guo
- Department of Gastroenterology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Ying Yang
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Minjie Liang
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Jianping Ding
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China.
| | - Quan Zhou
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China; Department of Radiology, Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou, Guangdong, China.
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157
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Khayyat YM. Functional somatic illnesses in patients with functional bowel disorders. A cross-sectional cohort study in western Saudi Arabia. Saudi Med J 2020. [PMID: 32020157 DOI: 10.15537/smj.2020.2.24901.pmid:] [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: 11/16/2022] Open
Abstract
OBJECTIVES To study the prevalence of functional gastrointestinal disorders (FGID) in Saudi patients with irritable bowel syndrome (IBS). Methods: A cross-sectional study was conducted in patients with IBS treated at a private tertiary medical center in western Saudi Arabia between 2013 and 2017. We used ROME 3 criteria with data from the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Patient Health Questionnaire-9 (PHQ-9) depression scale, and International Classification of Headache Disorders (ICHD) to assess the prevalence of psychosomatic illness. Statistical analysis of frequency and statistical correlation was performed using Chi-square. Results: The final analysis of 307 patients revealed a combined 425 diagnoses of psychosomatic illness, including diagnoses of headache in 104 patients (34%), migraine in 93 patients (30.5%), fibromyalgia in 169 patients (55%), and depression in 59 patients (19%). There was a statistically significant correlation between patients' ages and diagnoses of joint pain and migraines. Conclusion: Fibromyalgia and headache disorders were common in this cohort of Saudi patients with IBS. This coexistence of illness is partly explained by the functional nature of these illnesses. Collective efforts to provide multidisciplinary care is needed for these patients.
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Affiliation(s)
- Yasir M Khayyat
- Department of Medicine, Faculty of Medicine, Makkah, and from the Department of Medicine, International Medical Centre, Jeddah, Kingdom of Saudi Arabia. E-mail.
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158
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Khayyat YM. Functional somatic illnesses in patients with functional bowel disorders. Saudi Med J 2020; 41:203-206. [PMID: 32020157 PMCID: PMC7841642 DOI: 10.15537/smj.2020.2.24901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Yasir M Khayyat
- Department of Medicine, Faculty of Medicine, Makkah, and from the Department of Medicine, International Medical Centre, Jeddah, Kingdom of Saudi Arabia. E-mail.
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159
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Salari-Moghaddam A, Hassanzadeh Keshteli A, Esmaillzadeh A, Adibi P. Water consumption and prevalence of irritable bowel syndrome among adults. PLoS One 2020; 15:e0228205. [PMID: 31978193 PMCID: PMC6980581 DOI: 10.1371/journal.pone.0228205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/17/2019] [Accepted: 01/10/2020] [Indexed: 12/12/2022] Open
Abstract
Background and aim No previous study examined the association between whole-day water intake and odds of irritable bowel syndrome (IBS). We examined the association between whole-day water intake and odds of IBS in a large sample of Iranian adults. Methods This cross-sectional study was conducted among 4763 adults in Isfahan, Iran. Daily water intake was assessed using a pre-tested questionnaire by asking questions about the average number of glasses of water consumed in a day. IBS was assessed and defined using a modified Persian version of Rome III questionnaire. Results After taking potential confounders into account, no significant association between water consumption and odds of IBS was seen (OR: 1.14; 95% CI: 0.74–1.78). We observed that participants who were taking >8 glasses/d of water had greater odds of IBS-M in comparison to those who consumed <2 glasses daily (OR: 2.07; 95% CI: 1.01–4.22). No significant association was observed between water intake and odds of IBS in either gender as well [for men: OR: 1.15; 95% CI: 0.59–2.24 and for women: OR: 1.15; 95% CI: 0.62–2.12]. By BMI status, no significant association was observed between whole day water intake and odds of IBS among normal weight (BMI<25 kg/m2) or overweight and obese people (BMI≥25 kg/m2). Conclusion We found that whole-day water intake was not associated with odds of IBS. A significant association between consumption of >8 glasses of water per day and odds of IBS-M was observed.
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Affiliation(s)
- Asma Salari-Moghaddam
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ammar Hassanzadeh Keshteli
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- * E-mail:
| | - Peyman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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160
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Isakov VA, Morozov SV, Pilipenko VI. [Innovative approaches to study food patterns in functional gastrointestinal disorders]. Vopr Pitan 2020; 89:172-185. [PMID: 32986330 DOI: 10.24411/0042-8833-2020-10051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 07/29/2020] [Indexed: 02/05/2023]
Abstract
Dietary patterns play an important role in pathogenesis and treatment of functional gastrointestinal disorders. The aim - to perform literature review on modern approaches to perform nutritional assessment in functional gastrointestinal disorders and to summarize available data on its role in assessment of clinical manifestations and treatment of these conditions. Material and methods. A search was performed in the PubMed and Google scholar system with the use of keywords: "nutritional pattern", "dietary pattern", in combination with "methodology", "assessment", "functional gastrointestinal disorders", "GERD", "gastroesophageal reflux disease", "irritable bowel syndrome", "IBS", "small intestinal bacterial overgrowth", "treatment". The inclusion criteria were type of the paper (original study); they had to contain data on nutrition of patients with functional gastrointestinal disorders; main digital data should be present (sample size, design, diagnostic criteria, patients' eligibility criteria, control group characteristics, as well as results in quantitative characteristics and measure of dispersion of values). Results and discussion. Based on the data of 81 selected papers structured literature review was performed. We summarized the data on the methods of food patterns assessment, the knowledge on the food patterns in patients with functional gastrointestinal disorders (including gastroesophageal reflux disease and irritable bowel syndrome), clinical utility of the nutritional assessment with the use of food patterns. Assessment of nutritional patterns in patients with functional gastrointestinal disorders provides additional evidence that allows to correct the diet of these patients more effectively, to achieve better results of treatment in shorter time, to reduce the number of medications, and may be of use for the development of new functional foods.
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Affiliation(s)
- V A Isakov
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, 109240, Moscow, Russian Federation
| | - S V Morozov
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, 109240, Moscow, Russian Federation
| | - V I Pilipenko
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, 109240, Moscow, Russian Federation
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161
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Johnsen PH, Hilpüsch F, Valle PC, Goll R. The effect of fecal microbiota transplantation on IBS related quality of life and fatigue in moderate to severe non-constipated irritable bowel: Secondary endpoints of a double blind, randomized, placebo-controlled trial. EBioMedicine 2020; 51:102562. [PMID: 31877418 PMCID: PMC6931102 DOI: 10.1016/j.ebiom.2019.11.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/13/2019] [Accepted: 11/13/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Severity in irritable bowel syndrome (IBS) is associated to impaired quality of life and fatigue. Fecal microbiota transplantation (FMT) induces significant relief in gastro-intestinal related complaints. The objective was to evaluate the effect of FMT on the secondary endpoints: IBS-related quality of life and fatigue in patients with non-constipated IBS. METHOD In this double-blind randomized placebo-controlled, parallel-group, single-center study, we enrolled patients with non-constipated IBS, defined by the ROME 3 criteria. We randomly assigned participants (2:1) in blocks of six to active or placebo FMT. Responder in fatigue and quality of life were defined as a decrease of 20 points in total Fatigue Impact Scale score, and improvement of 14 points in the IBS-quality of life questionnaire, respectively. In a modified-intention-to-treat population, we excluded participants who did not undergo treatment or who were diagnosed with any other disease by pinch biopsies during the treatment procedure. FINDINGS Between Jan1, and Oct 30, 2015, we recruited 90 participants and randomly assigned them to active treatment (n = 60) or placebo (n = 30). Three participants did not undergo FMT and four were excluded after diagnosis of microscopic colitis, leaving 83 for final modified intention-to-treat analysis (55 in the active treatment group and 28 in the placebo group). Significant improvement in QoL (Odds ratio (OR) 3,801; confidence interval (CI) = 1,309-11,042 p = 0.011) and fatigue (OR = 4,398; CI = 1,175-16,468 and p = 0,020) was found at six months. Absence of other self reported functional disorders and presence of depression at baseline is suggested to predict a lasting effect of FMT in QoL and fatigue, respectively. INTERPRETATION FMT induced significant relief in quality of life and fatigue. Results suggest a lasting effect of FMT in subgroups that should be further investigated in future studies. Funding Helse Nord, Norway and the Norwegian Centre of Rural Medicine, University of Tromsø, Norway.
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Affiliation(s)
- Peter Holger Johnsen
- University Hospital of North Norway Harstad, Harstad, Norway; UIT The Arctic University of Norway, Tromsø, Norway.
| | - Frank Hilpüsch
- Sjøkanten Legesenter, Harstad, Norway; Norwegian Centre of Rural Medicine, UIT Arctic University of Norway, Norway
| | | | - Rasmus Goll
- University Hospital of North Norway Tromsø, Tromsø, Norway; UIT The Arctic University of Norway, Tromsø, Norway
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162
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Cakir M, Sag E, Saygin I, Orhan F. Ileocolonic Lymphonodular Hyperplasia in Children Related to Etiologies Ranging from Food Hypersensitivity to Familial Mediterranean Fever. Med Princ Pract 2020; 29:473-479. [PMID: 32000163 PMCID: PMC7511677 DOI: 10.1159/000506257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/10/2019] [Accepted: 01/30/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE We aimed to share our observations on the demographics, clinical characteristics, and outcomes of lymphonodular hyperplasia (LNH) in children. SUBJECTS AND METHODS The study included children on whom colonoscopy was performed between January 2015 and May 2018 (n = 361). Demographics, treatment modalities, and outcomes of the patients with LNH were recorded. RESULTS LNH was found in 66 patients (18.3%; mean age 8.6 ± 5.96 years, 59.1% male). We found that the etiologic factors were food hypersensitivity (FH) in 25 (37.8%), nonspecific colitis in 12 (18.2%), irritable bowel syndrome in 10 (15.2%), familial Mediter-ranean fever in 7 (10.6%), primary immunodeficiency in 4 (6.1%), and intestinal dysmotility, oxyuriasis, Crohn's disease, and giardiasis in 1 (1.5%) patient. Additionally, in the genetic analysis of patients with idiopathic LNH (n = 4), we detected heterozygote MEFV mutations in all. Cow's milk and egg (25%) were the most common allergens in patients with FH. Symptoms of all patients (n = 25) improved after an elimination diet. CONCLUSIONS LNH is a common finding in pediatric colonoscopies with a variety of etiologies ranging from FH and familial Mediterranean fever to immunodeficiency.
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Affiliation(s)
- Murat Cakir
- Department of Pediatric Gastroenterology Hepatology and Nutrition, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey,
| | - Elif Sag
- Department of Pediatric Gastroenterology Hepatology and Nutrition, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
| | - Ismail Saygin
- Department of Pathology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
| | - Fazil Orhan
- Department of Pediatric Allergy and Immunology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
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163
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Zhao Q, Li R, Jin YZ, Sun HY, Zhao SM. Equation Derivation of the Probability Distribution of IBS Score among Full Sibling Pairs. Fa Yi Xue Za Zhi 2019; 35:657-661. [PMID: 31970950 DOI: 10.12116/j.issn.1004-5619.2019.06.003] [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: 11/16/2018] [Indexed: 06/10/2023]
Abstract
Objective To derive the general equation of the probability distribution of identity by state (IBS) score among biological full sibling pairs by calculating STR allele frequency. Methods Based on the Mendelian genetics law and the hypothesis that parents of biological full siblings (FS) were unrelated individuals, the IBS score and corresponding probability of different genotype combinations in the offspring when unrelated individuals of different genotype combinations give birth to two offsprings were derived. Results Given fi (i=1, 2, …, m) as the frequency of the ith allele of a STR locus, the probability of sharing 2 alleles (p2FS), 1 allele (p1FS) or 0 allele (p0FS) with biological full sibling pairs on the locus can be respectively expressed as follows: (see the text). The sum of p2FS, p1FS and p0FS must be 1. As for the multiple genotyping system that contained n STR loci, IBS scores between biological full sibling pairs conform to binomial distribution: IBS~B(2n, π1). The population rate π1, can be given by the formula: (see the text). Conclusion The alternative hypothesis in biological full sibling testing is that two appraised individuals are biological full siblings. The probability of the corresponding alternative hypothesis of any STR locus combination or IBS score can be directly calculated by the equations presented in this study, and the calculation results are the basis for explanations of the evidence.
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Affiliation(s)
- Q Zhao
- Shanghai Cubicise Biotechnology Co. Ltd, Shanghai 201114, China
| | - R Li
- Department of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Y Z Jin
- Shanghai Cubicise Biotechnology Co. Ltd, Shanghai 201114, China
| | - H Y Sun
- Department of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - S M Zhao
- Southeast Academy of Forensic Evidence (JiangSu) Co. Ltd, Nanjing 210042, China
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164
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Ng QX, Foo NX, Loke W, Koh YQ, Seah VJM, Soh AYS, Yeo WS. Is there an association between Helicobacter pylori infection and irritable bowel syndrome? A meta-analysis. World J Gastroenterol 2019; 25:5702-5710. [PMID: 31602169 PMCID: PMC6785524 DOI: 10.3748/wjg.v25.i37.5702] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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] [Received: 05/29/2019] [Revised: 07/30/2019] [Accepted: 09/09/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a prevalent and debilitating gastrointestinal condition. Research has reported persistent, low-grade mucosal inflammation and significant overlaps between patients with IBS and those with dyspepsia, suggesting a possible pathogenic role of Helicobacter pylori (H. pylori) in IBS. This study therefore aimed to provide the first systematic review and meta-analysis on the association between H. pylori infection and IBS. AIM To investigate the association between H. pylori infection and IBS. METHODS Using the keywords "H. pylori OR Helicobacter OR Helicobacter pylori OR infection" AND "irritable bowel syndrome OR IBS", a preliminary search of PubMed, Medline, Embase, Cochrane Database of Systematic Reviews, Web of Science, Google Scholar and WanFang databases yielded 2924 papers published in English between 1 January 1960 and 1 June 2018. Attempts were also made to search grey literature. RESULTS A total of 13 clinical studies were systematically reviewed and nine studies were included in the final meta-analysis. Random-effects meta-analysis found a slight increased likelihood of H. pylori infection in patients with IBS, albeit this was not statistically significant (pooled odds ratio 1.47, 95% confidence interval: 0.90-2.40, P = 0.123). It must also be acknowledged that all of the available studies reported only crude odd ratios. H. pylori eradication therapy also does not appear to improve IBS symptoms. Although publication bias was not observed in the funnel plot, there was a high degree of heterogeneity amongst the studies included in the meta-analysis (I 2 = 87.38%). CONCLUSION Overall, current evidence does not support an association between IBS and H. pylori infection. Further rigorous and detailed studies with larger sample sizes and after H. pylori eradication therapy are warranted.
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Affiliation(s)
- Qin Xiang Ng
- Medicine, MOH Holdings Pte Ltd, Singapore 099253, Singapore
- General and Community Psychiatry, Institute of Mental Health, Singapore 117597, Singapore
| | - Nadine Xinhui Foo
- Medicine, MOH Holdings Pte Ltd, Singapore 099253, Singapore
- Department of General Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
| | - Wayren Loke
- Medicine, MOH Holdings Pte Ltd, Singapore 099253, Singapore
| | - Yun Qing Koh
- Medicine, MOH Holdings Pte Ltd, Singapore 099253, Singapore
- Department of General Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
| | - Vanessa Jing Min Seah
- Medicine, MOH Holdings Pte Ltd, Singapore 099253, Singapore
- Department of General Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
| | - Alex Yu Sen Soh
- Department of Gastroenterology and Hepatology, National University Hospital, National University Health System, Singapore 119074, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Wee Song Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
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165
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Trifan A, Burta O, Tiuca N, Petrisor DC, Lenghel A, Santos J. Efficacy and safety of Gelsectan for diarrhoea-predominant irritable bowel syndrome: A randomised, crossover clinical trial. United European Gastroenterol J 2019; 7:1093-1101. [PMID: 31662866 PMCID: PMC6794699 DOI: 10.1177/2050640619862721] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [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: 03/29/2019] [Accepted: 06/18/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is highly prevalent and presents a clinical challenge. Gelsectan is a medical device containing xyloglucan (XG), pea protein and tannins (PPT) from grape seed extract, and xylo-oligosaccharides (XOS), which act together to protect and reinforce the intestinal barrier. OBJECTIVE The objective of this study is to evaluate the efficacy and safety of XG + PPT + XOS in patients with diarrhoea-predominant IBS (IBS-D). METHODS In this double-blind study, 60 patients were randomly assigned to receive XG + PPT + XOS or placebo for 28 days, then crossed over to the alternative treatment. Patients were followed for 60 days. RESULTS At Day 28, a significantly higher proportion of patients starting treatment with XG + PPT + XOS than placebo (87 vs 0%; p = 0.0019) presented normal stools (Bristol Stool Form Scale type 3-4). At Day 56, a significantly higher proportion of patients who crossed over to XG + PPT + XOS than placebo (93% vs 23%; p = 0.0001) presented normal stools. In the group allocated to receive XG + PPT + XOS after placebo, benefits of XG + PPT + XOS were maintained during follow-up. Subjective assessments of abdominal pain, bloating, quality of life and general health indicated significant improvement with XG + PPT + XOS over placebo. There were no related adverse events. CONCLUSION XG + PPT + XOS effectively controlled diarrhoea and alleviated clinical symptoms in patients with IBS-D, and was well tolerated.
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Affiliation(s)
| | - Ovidiu Burta
- Department of Internal Medicine,
Municipal Hospital Dr. Gavril Curteanu, Oradea, Romania
| | - Nicoleta Tiuca
- Department of Internal Medicine,
University
Emergency Hospital Bucharest, Romania
| | | | | | - Javier Santos
- Digestive System Research Unit,
University Hospital Vall d'Hebron, Spain
- Javier Santos, University Hospital Vall
d'Hebron, Digestive System Research Unit, Laboratory of
Neuro-Immuno-Gastroenterology, Passeig Vall d'Hebron 119–129, Barcelona 08035,
Spain.
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166
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Soltani S, Hassanzadeh Keshteli A, Esmaillzadeh A, Adibi P. Food Item Avoidance of Patients with Irritable Bowel Syndrome Compared with Healthy People. Arch Iran Med 2019; 22:369-375. [PMID: 31679379] [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: 07/31/2018] [Accepted: 04/17/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND To construct a dietary guideline for patients with irritable bowel syndrome (IBS), data about foods these people exclude from their diet to improve their symptoms are necessary. This study was designed to assess the prevalence of food exclusions as well as the reasons for such exclusions in a large group of IBS patients. METHODS In this cross-sectional study, data on 3846 Iranian adults, 828 of whom were patients with IBS, working in 50 different health centers were examined. A 106-item self-administered Dish-based Semi-quantitative Food Frequency Questionnaire (DSFFQ) which was designed and validated specifically for Iranian adults was used for assessing dietary intake. IBS was assessed using a modified Persian version of the Rome III questionnaire. RESULTS The whole prevalence of IBS was 21.5% (n = 828) in the total population (23.9% in women and 18.6% in men). Mean age of patients with IBS was 36.26 ± 7.91 years and for subjects without IBS, it was 36.52 ± 8.12 years. IBS patients had a greater probability to avoid consumption of ketchup (90% vs 33%, P = 0.005), Dough (100% vs 1%, P = 0.003), Gaz (50% vs. 1%, P = 0.035), grapes (33% vs. 7%, P = 0.034), fresh berries (56% vs. 14%, P = 0.036) and butter (100% vs. 60%, P = 0.02) due to gastrointestinal (GI) symptoms compared with healthy individuals. Although, the exclusion of plum (1% vs. 26%, P = 0.006), pickles (39% vs. 67%, P = 0.004), lemon juice (21% vs 35%, P = 0.027), egg (5% vs. 25%, P = 0.011), fresh fig (19% vs. 44%, P = 0.038) and cake (25% vs. 100%, P = 0.028) due to GI symptoms in IBS patients were lower than non-IBS participants. CONCLUSION The present study showed that IBS patients were more likely to avoid consumption of ketchup, Dough, Gaz, grapes, fresh berries and butter due to GI symptoms compared with healthy individuals. Further studies are required to confirm these findings.
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Affiliation(s)
- Sanaz Soltani
- Students' scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ammar Hassanzadeh Keshteli
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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167
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Abstract
Irritable bowel syndrome (IBS) is an umbrella term for a common range of symptoms such as abdominal pain, distension (bloating), diarrhoea and constipation. Nurses will often encounter patients with IBS in their day-to-day practice. As well as patients who present to healthcare services seeking assistance in managing their IBS, nurses may also encounter patients who were initially seeking assistance for other conditions, but were also found to be exhibiting symptoms of IBS. This article outlines the causes of IBS and the range of symptoms that people with IBS may experience. It details the pharmacological therapies available for IBS, and examines the range of management interventions that nurses can use to ameliorate the underlying factors that contribute to IBS.
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Affiliation(s)
- Alison Coutts
- School of Health Sciences, Division of Nursing, City, University of London, London, England
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168
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Mawani M, Azeem A, Gheewala S, Butt N, Abid S. Understanding Constipation: A Cross-sectional Study from a Developing Country Setting. J Coll Physicians Surg Pak 2019; 29:284-286. [PMID: 30823961 DOI: 10.29271/jcpsp.2019.03.284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 10/24/2018] [Indexed: 06/09/2023]
Abstract
A cross-sectional study was conducted in the Gastroenterology Clinics of The Aga Khan Hospital and Jinnah Postgraduate Medical Centre in Karachi. All patients complaining of constipation were included. Patients with alarm features were excluded. Interviews were conducted by trained doctors using a structured Rome III based pre-tested questionnaire and Bristol Stool Form Scale. Out of 396 participants, 186 (47.0%) had FC and 209 (52.7%) had IBS-C. Based upon Bristol Stool Form Scale, only 214 (54%) reported to have slow transit constipation (BSS <2). A higher proportion of women reported severe form of constipation as compared to men (81.5%, n=150 vs. 65.1%, n=138 p<0.001). However, a higher percentage of men reported using medications to treat their symptoms (71.2%, n=151 vs. 57.1%, n=105 p=0.003). Proper understanding of patient's symptoms is essential for optimizing individual patient management.
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Affiliation(s)
- Minaz Mawani
- Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan
| | - Abdul Azeem
- Medical Student, The Aga Khan University Hospital, Karachi, Pakistan
| | - Sakina Gheewala
- Medical Student, The Aga Khan University Hospital, Karachi, Pakistan
| | - Nazish Butt
- Department of Gastrology, The Aga Khan University Hospital, Karachi, Pakistan
| | - Shahab Abid
- Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan
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169
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Van den Houte K, Carbone F, Pannemans J, Corsetti M, Fischler B, Piessevaux H, Tack J. Prevalence and impact of self-reported irritable bowel symptoms in the general population. United European Gastroenterol J 2019; 7:307-315. [PMID: 31080615 PMCID: PMC6498809 DOI: 10.1177/2050640618821804] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [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: 09/27/2018] [Accepted: 11/20/2018] [Indexed: 12/12/2022] Open
Abstract
Background and aims The symptom-based diagnostic criteria for irritable bowel syndrome (IBS) have recently been revised in the Rome IV consensus. On the other hand, with rising public awareness of IBS, self-diagnosis and self-management is also increasing. We compared the prevalence and impact of Rome IV-based IBS vs self-diagnosed IBS in the general population. Methods An internet panel filled out an online survey on bowel symptoms and their impact on health care utilization and daily activities. Results A representative internet panel of 1012 individuals completed the online survey. Bowel symptoms were present in 68.6% of the population. Of these, 21% consulted a physician for these symptoms in the last year and 42% earlier. Rome IV IBS criteria were fulfilled by 5.5%, and these were younger and more likely to be female. In this subset, 37% had consulted a physician for IBS symptoms in the preceding year and 29% had done so earlier. A colonoscopy had been performed in 22%. Based on a brief description, 17.6% of the population self-identified as suffering from IBS (p < 0.001 compared to Rome IV IBS prevalence), and these were more likely to be female. Concordance with the Rome IV criteria was only 25%, but except for a lower reporting of pain, the symptom pattern, severity, impact on daily life, inability to work and health care utilization were similar to the Rome IV group. A total of 134 days of absence from work were attributed to bowel symptoms in those self-reporting with IBS. Conclusion In the general population, bowel symptoms are highly prevalent, and the self-reported "IBS" is three times more prevalent than according to Rome IV criteria. Self-reported IBS is associated with a similar impact on health care utilization and quality of life but a higher impact on absence from work.
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Affiliation(s)
- K Van den Houte
- Department of Chronic Diseases, Metabolism and
Ageing, University of Leuven, Translational Research Center for Gastrointestinal
Disorders (TARGID), Leuven, Belgium
| | - F Carbone
- Department of Chronic Diseases, Metabolism and
Ageing, University of Leuven, Translational Research Center for Gastrointestinal
Disorders (TARGID), Leuven, Belgium
| | - J Pannemans
- Department of Chronic Diseases, Metabolism and
Ageing, University of Leuven, Translational Research Center for Gastrointestinal
Disorders (TARGID), Leuven, Belgium
| | - M Corsetti
- Department of Chronic Diseases, Metabolism and
Ageing, University of Leuven, Translational Research Center for Gastrointestinal
Disorders (TARGID), Leuven, Belgium
| | - B Fischler
- Department of Chronic Diseases, Metabolism and
Ageing, University of Leuven, Translational Research Center for Gastrointestinal
Disorders (TARGID), Leuven, Belgium
| | - H Piessevaux
- Department of Chronic Diseases, Metabolism and
Ageing, University of Leuven, Translational Research Center for Gastrointestinal
Disorders (TARGID), Leuven, Belgium
| | - J Tack
- Department of Chronic Diseases, Metabolism and
Ageing, University of Leuven, Translational Research Center for Gastrointestinal
Disorders (TARGID), Leuven, Belgium
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170
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von Wulffen M, Talley NJ, Hammer J, McMaster J, Rich G, Shah A, Koloski N, Kendall BJ, Jones M, Holtmann G. Overlap of Irritable Bowel Syndrome and Functional Dyspepsia in the Clinical Setting: Prevalence and Risk Factors. Dig Dis Sci 2019; 64:480-486. [PMID: 30368683 DOI: 10.1007/s10620-018-5343-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [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: 03/18/2018] [Accepted: 10/17/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND According to Rome IV criteria, functional dyspepsia (FD) and irritable bowel syndrome (IBS) are distinct functional gastrointestinal disorders (FGID); however, overlap of these conditions is common in population-based studies, but clinical data are lacking. AIMS To determine the overlap of FD and IBS in the clinical setting and define risk factors for the overlap of FD/IBS. METHODS A total of 1127 consecutive gastroenterology outpatients of a tertiary center were recruited and symptoms assessed with a standardized validated questionnaire. Patients without evidence for structural or biochemical abnormalities as a cause of symptoms were then categorized based upon the symptom pattern as having FD, IBS or FD/IBS overlap. Additionally, this categorization was compared with the clinical diagnosis documented in the integrated electronic medical records system. RESULTS A total of 120 patients had a clinical diagnosis of a FGID. Based upon standardized assessment with a questionnaire, 64% of patients had FD/IBS overlap as compared to 23% based upon the routine clinical documentation. In patients with severe IBS or FD symptoms (defined as symptoms affecting quality of life), the likelihood of FD/IBS overlap was substantially increased (OR = 3.1; 95%CI 1.9-5.0) and (OR = 9.0; 95%CI 3.5-22.7), respectively. Thus, symptom severity for IBS- or FD symptoms were significantly higher for patients with FD/IBS overlap as compared to patients with FD or IBS alone (p all < 0.01). Age, gender and IBS-subtype were not associated with overlap. CONCLUSION In the clinical setting, overlap of FD and IBS is the norm rather than the exception. FD/IBS overlap is associated with a more severe manifestation of a FGID.
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Affiliation(s)
- Moritz von Wulffen
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, 199 Ipswich Rd, Woolloongabba, Brisbane, QLD, 4102, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Translational Research Institute, Brisbane, QLD, Australia
| | - Nicholas J Talley
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Johann Hammer
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Translational Research Institute, Brisbane, QLD, Australia
- Medical University of Vienna, Vienna, Austria
| | - Jessica McMaster
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, 199 Ipswich Rd, Woolloongabba, Brisbane, QLD, 4102, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Translational Research Institute, Brisbane, QLD, Australia
| | - Graeme Rich
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, 199 Ipswich Rd, Woolloongabba, Brisbane, QLD, 4102, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Translational Research Institute, Brisbane, QLD, Australia
| | - Ayesha Shah
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, 199 Ipswich Rd, Woolloongabba, Brisbane, QLD, 4102, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Translational Research Institute, Brisbane, QLD, Australia
| | - Natasha Koloski
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, 199 Ipswich Rd, Woolloongabba, Brisbane, QLD, 4102, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Bradley J Kendall
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, 199 Ipswich Rd, Woolloongabba, Brisbane, QLD, 4102, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Translational Research Institute, Brisbane, QLD, Australia
| | - Mike Jones
- Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Gerald Holtmann
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, 199 Ipswich Rd, Woolloongabba, Brisbane, QLD, 4102, Australia.
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
- Translational Research Institute, Brisbane, QLD, Australia.
- Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia.
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171
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Fond G. [Syndrome de l'intestin irritable : de la comorbidité anxiodépressive au microbiote]. Rev Prat 2019; 69:219-220. [PMID: 30983231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Guillaume Fond
- Université Aix- Marseille, faculté de médecine, secteur La Timone, EA 3279 : CEReSS (Centre d'étude et de recherche sur les services de santé et la qualité de vie), Marseille, France
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Dunbar KB. Gastroenterology for the Internist. Med Clin North Am 2019; 103:xvii-xviii. [PMID: 30466680 DOI: 10.1016/j.mcna.2018.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Kerry B Dunbar
- VA Gastroenterology Section, Dallas VA Medical Center-VA North Texas Healthcare System, Internal Medicine, University of Texas, Southwestern Medical Center, GI Lab, CA 111-B1, 4500 South Lancaster Road, Dallas, TX 75216, USA.
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Abstract
Irritable Bowel Syndrome (IBS) is the most prevalent functional gastrointestinal disorder. Psychosocial stress is one of the pathogenic factors involved in the pathogenesis of IBS. The Pressure Management Indicator (PMI) is a validated questionnaire to analyze all aspects of occupational stress-a model involving sources of pressure, the mechanisms of coping, the personality, and the resulting effects of the interaction between these 3 elements. The purpose of this study was to analyze the association between socio-professional stress effects in IBS, and the relationship of IL-6 levels and salivary cortisol with occupational stress.We conducted a prospective cross-sectional study on 76 patients (39 patients with IBS, diagnosed according to the Rome III criteria and 37 healthy controls) who were investigated using a validated self-administered questionnaire: PMI. The biologic markers of chronic stress were analyzed using salivary cortisol and the immune response with serum interleukin 6 (IL-6).The IBS patients corresponded to the following subtypes: diarrhea-predominant: 22, constipation-predominant: 14 and mixed: 3. All the socio-professional pressure effects variables and scales were statistically significant, in an inversely proportional relation with IBS. Lower scores (poor effects) were found in IBS subjects. The adjusted odds ratios of having IBS versus healthy subjects for the socio-professional pressure effects scales were: 0.81 (95% confidence interval (CI) 0.72-0.88), for satisfaction, 0.85 (95% CI 0.78-0.91) for organization, 0.85 (95% CI 0.79-0.91) for mental wellbeing and 0.8 (95% CI 0.71-0.87) for physical wellbeing (P <.001). Also, the serum IL-6 levels were significantly higher in IBS than in controls (p < 0.001). There was no statistical difference between the salivary levels of cortisol between IBS patients and controls (P = .898).The level of occupational stress was higher in IBS patients compared to healthy subjects (socio-professional stress effects were lower in IBS patients) and correlated with IL-6 levels. Salivary cortisol was not associated with occupational pressure management.
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Affiliation(s)
| | - Daniel Corneliu Leucuta
- Department of Medical Informatics and Biostatistics, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
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174
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Cong X, Perry M, Bernier KM, Young EE, Starkweather A. Effects of Self-Management Interventions in Patients With Irritable Bowel Syndrome: Systematic Review. West J Nurs Res 2018; 40:1698-1720. [PMID: 28854852 PMCID: PMC5794643 DOI: 10.1177/0193945917727705] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Irritable bowel syndrome (IBS) is a prevalent and costly condition, with expenditures exceeding US$21 billion annually. As there is no known cure for IBS, treatment is focused on symptom self-management strategies. The purpose of this systematic review was to investigate the efficacy and overall effect of self-management interventions for patients with IBS. Of the 64 publications that were identified, 20 were included in the systematic review. Self-management interventions were found in diverse formats, including web-based, self-training booklets, individual and/or group interventions with health care providers, and cognitive-behavioral therapy or exercise-based interventions. Different symptom measures were used across the studies, whereas measurement of quality of life was more standardized. Overall, there is robust evidence supporting self-management interventions for improving short-term symptom management and improving quality of life, whereas longer term outcomes are variable. Further studies are needed to use standardized symptom measures and tailor interventions for pediatric populations, and tracking longer term outcomes.
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Affiliation(s)
- Xiaomei Cong
- 1 University of Connecticut, Storrs, CT, USA
- 2 University of Connecticut, Farmington, CT, USA
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175
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Sadeghian M, Sadeghi O, Hassanzadeh Keshteli A, Daghaghzadeh H, Esmaillzadeh A, Adibi P. Physical activity in relation to irritable bowel syndrome among Iranian adults. PLoS One 2018; 13:e0205806. [PMID: 30335859 PMCID: PMC6193664 DOI: 10.1371/journal.pone.0205806] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 12/26/2017] [Accepted: 10/02/2018] [Indexed: 12/12/2022] Open
Abstract
Background Irritable bowel syndrome (IBS) is the most prevalent functional gastrointestinal disorder worldwide. Physical activity in relation to IBS has been investigated in few studies and data in this regard are conflicting. Aim To investigate the association between physical activity and IBS in a large sample of Iranian adults. Methods This cross-sectional study was done on 4763 Iranian adults in the framework of SEPAHAN (The Study on the Epidemiology of Psycho-Alimentary Health and Nutrition) project. The physical activity of study participants was assessed using the General Practice Physical Activity Questionnaire (GPPAQ). Using a validated self-administered modified Rome III questionnaire, functional gastrointestinal disorders including irritable bowel syndrome was assessed. Results The mean age of study participants was 36.5 years. Irritable bowel syndrome was prevalent among 21.5% of participants. Compared with physically active individuals (≥ 1 hour/wk), those with sedentary physical activity (<1 hour/wk) had 1.27 times greater probability of suffering from IBS (OR: 1.27, 95% CI: 1.08–1.49). However, this association was attenuated after adjusting for age, sex, cigarette smoking and medical history of colitis and diabetes. When the analysis was additionally adjusted for diet-related practices and body mass index (BMI), a non-significant association was found between sedentary physical activity and IBS (OR: 1.18, 95% CI: 0.98–1.41). Gender-stratified analysis revealed similar findings in women either before (OR: 1.29, 95% CI: 1.04–1.61) or after controlling for covariates (OR: 1.27, 95% CI: 0.99–1.62). In BMI-stratified analysis, a significant positive association was seen between sedentary physical activity and IBS among individuals with normal BMI (OR: 1.38, 95% CI: 1.07–1.79). Conclusion We found a significant positive association between sedentary physical activity and IBS, particularly among women and individuals of normal weight.
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Affiliation(s)
- Mehdi Sadeghian
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Sadeghi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hamed Daghaghzadeh
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail:
| | - Peyman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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176
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Peter J, Fournier C, Durdevic M, Knoblich L, Keip B, Dejaco C, Trauner M, Moser G. A Microbial Signature of Psychological Distress in Irritable Bowel Syndrome. Psychosom Med 2018; 80:698-709. [PMID: 30095672 PMCID: PMC6250280 DOI: 10.1097/psy.0000000000000630] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [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: 10/13/2017] [Revised: 07/10/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Irritable bowel syndrome (IBS) is associated with alterations along the brain-gut-microbiota axis. Previous studies have suggested a parallel segregation of microbial features and psychological burden in IBS. This study aimed at exploring the microbial correlates of psychological distress in patients with IBS. METHODS Forty-eight patients with IBS (Rome III criteria, M (SD) age = 42 (15) years, 35 female, 25 diarrhea-dominant, 5 constipation-dominant, and 18 alternating-type IBS) were assessed for psychological and clinical variables with validated questionnaires, fecal samples underwent microbial 16S rRNA analyses (regions V1-2). Microbial analyses comprised examination of alpha and beta diversity, correlational analyses of bacterial abundance and comparisons among subgroups defined by thresholds of psychological and IBS symptom variables, and machine learning to identify bacterial patterns corresponding with psychological distress. RESULTS Thirty-one patients (65%) showed elevated psychological distress, 22 (31%) anxiety, and 10 depression (21%). Microbial beta diversity was significantly associated with distress and depression (q = .036 each, q values are p values false discovery rate-corrected for multiple testing). Depression was negatively associated with Lachnospiraceae abundance (Spearman's ρ = -0.58, q = .018). Patients exceeding thresholds of distress, anxiety, depression, and stress perception showed significantly higher abundances of Proteobacteria (q = .020-.036). Patients with anxiety were characterized by elevated Bacteroidaceae (q = .036). A signature of 148 unclassified species accounting for 3.9% of total bacterial abundance co-varied systematically with the presence of psychological distress. CONCLUSIONS Psychological variables significantly segregated gut microbial features, underscoring the role of brain-gut-microbiota interaction in IBS. A microbial signature corresponding with psychological distress was identified. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02536131, retrospectively registered.
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Affiliation(s)
- Johannes Peter
- From the Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Austria (Peter, Fournier, Knoblich, Keip, Dejaco, Trauner, Moser); and Center for Medical Research, Medical University of Graz, Austria (Durdevic)
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177
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Quigley BM, Sova CC, Brenner DM, Keefer LA, Sitrin MD, Radziwon CD, Krasner SS, Lackner JM. (Can't Get No) Patient Satisfaction: The Predictive Power of Demographic, GI, and Psychological Factors in IBS Patients. J Clin Gastroenterol 2018; 52:614-621. [PMID: 28787357 PMCID: PMC5797525 DOI: 10.1097/mcg.0000000000000906] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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] [Indexed: 12/10/2022]
Abstract
GOALS The goal of this study is to assess: (1) the relative contribution of patient factors to satisfaction ratings in irritable bowel syndrome (IBS) patients and (2) the relationship between patient satisfaction (PS) and the number of diagnostic tests patients underwent prior to receiving IBS diagnosis. BACKGROUND Although PS is regarded as an important indicator of quality of care, little is known about its determinants. STUDY A total of 448 Rome III-diagnosed patients (M age=41 y; 79% F), whose GI symptoms were at least moderate in severity completed patient-reported outcome measures as part of pretreatment evaluation of an NIH-funded clinical trial. PS was measured with the 11-point Hospital Consumer Assessment of Healthcare Providers and Systems global rating scale modified to assess for IBS treatments. A series of multiple regression analyses were conducted for demographic, IBS-specific, general physical health, and psychological predictors before running a final model of significant predictors from each domain. RESULTS The final regression model was significant, F6,419=6.34, P<0.001, R=0.08, with race, insurance, number of diagnostic tests, and lower neuroticism predicting PS. Medical tests were rendered nonsignificant when history of seeking care from a gastroenterologist was introduced into the equation. CONCLUSIONS Contrary to hypotheses, neither the IBS symptom severity nor quality of life impairment predicted PS. Patient factors such as a neurotic personality style and sociodemographic profile had a significant but modest impact on PS. Pattern of regression analyses suggests that patients may turn to their gastroenterologist for testing for reassurance, which may in the long-term fuel demand for more testing.
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Affiliation(s)
- Brian M. Quigley
- Department of Medicine, University at Buffalo School of Medicine, SUNY, Buffalo, NY, USA
- Research Institute on Addictions, University at Buffalo, SUNY Buffalo, NY, USA
| | - Christopher C. Sova
- Department of Medicine, University at Buffalo School of Medicine, SUNY, Buffalo, NY, USA
| | - Darren M. Brenner
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Laurie A. Keefer
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michael D. Sitrin
- Department of Medicine, University at Buffalo School of Medicine, SUNY, Buffalo, NY, USA
| | | | - Susan S. Krasner
- Department of Medicine, University at Buffalo School of Medicine, SUNY, Buffalo, NY, USA
| | - Jeffrey M. Lackner
- Department of Medicine, University at Buffalo School of Medicine, SUNY, Buffalo, NY, USA
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178
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Ono M, Kato M, Miyamoto S, Tsuda M, Mizushima T, Ono S, Nakagawa M, Mabe K, Nakagawa S, Muto S, Shimizu Y, Kudo M, Katsuki S, Meguro T, Sakamoto N. Multicenter observational study on functional bowel disorders diagnosed using Rome III diagnostic criteria in Japan. J Gastroenterol 2018; 53:916-923. [PMID: 29305648 DOI: 10.1007/s00535-017-1428-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 05/14/2017] [Accepted: 12/27/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Rome III diagnostic criteria had been used to diagnose functional gastrointestinal disorders (FGIDs) world wide, and functional bowel disorders (FBDs) including irritable bowel syndrome (IBS) have recently attracted the attention of Japanese physicians. However, there have been few reports on the prevalence of FBDs diagnosed by the Rome III diagnostic criteria. AIMS The aim of this study was to determine the prevalence of FBDs diagnosed according to the diagnostic criteria of Rome III in Japan. PATIENTS AND METHODS All patients who were booked for colonoscopy were enrolled from eight institutions in Japan. This study was a prospective observational study in the period from April 2013 to December 2013. Patients filled out FGID questionnaires of Rome III when they were waiting for colonoscopy. RESULTS Data for 1200 patients who underwent colonoscopy were analyzed. A total of 547 patients (45.6%) were diagnosed with FBDs. Out of those patients, 9.1% had IBS. According to the Rome III diagnostic criteria, 134 patients (11.2%) had functional bloating (FB), 73 (6.1%) had functional constipation (FC), 40 (3.3%) had functional diarrhea (FD), and 191 (15.9%) had unspecified functional bowel disorder (UFBD). Patients with FBDs had significantly higher rates of almost all symptoms (abdominal pain, hard or lumpy stools, loose or watery stools, and bloating) than those in the controls. CONCLUSIONS In Japan, the prevalence of FBDs and IBS is high, similar to that in the US. Many patients with FBDs have multiple symptoms.
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Affiliation(s)
- Masayoshi Ono
- Department of Gastroenterology, Hakodate Municipal Hospital, 1-10-1 Minato-cho, Hakodate, Hokkaido, 041-8680, Japan.
| | - Mototsugu Kato
- Department of Gastroenterology, National Hospital Organization Hakodate Hospital, Hakodate, Japan
| | - Shuichi Miyamoto
- Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Momoko Tsuda
- Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takeshi Mizushima
- Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shouko Ono
- Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan
| | - Manabu Nakagawa
- Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan
| | - Katsuhiro Mabe
- Department of Gastroenterology, National Hospital Organization Hakodate Hospital, Hakodate, Japan
| | - Soichi Nakagawa
- Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan
| | - Shuichi Muto
- Department of Gastroenterology, National Hospital Organization, Hokkaido Medical Center, Sapporo, Japan
| | - Yuichi Shimizu
- Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan
| | - Mineo Kudo
- Department of Gastroenterology, Touei Hospital, Sapporo, Japan
| | - Shinichi Katsuki
- Center of Gastroenterology, Otaru Ekisaikai Hospital, Otaru, Japan
| | - Takashi Meguro
- Department of Gastroenterology, Hokkaido Gastroenterology Hospital, Sapporo, Japan
| | - Naoya Sakamoto
- Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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179
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Yeh HW, Chien WC, Chung CH, Hu JM, Tzeng NS. Risk of psychiatric disorders in irritable bowel syndrome-A nationwide, population-based, cohort study. Int J Clin Pract 2018; 72:e13212. [PMID: 29920876 DOI: 10.1111/ijcp.13212] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 02/09/2018] [Accepted: 04/30/2018] [Indexed: 02/06/2023] Open
Abstract
AIMS This cohort study aimed to investigate the association between irritable bowel syndrome (IBS) and the risk of developing psychiatric disorders. METHODS Utilizing the National Health Insurance Research Database (NHIRD) of Taiwan, IBS patients were identified and compared with age, sex, and index year-matched controls (1:3). RESULTS Of the IBS subjects, 3934 in 22 356 (17.60%, or 1533.68 per 100 000 person-years) developed psychiatric disorders when compared with 6127 in 67 068 (9.14%, or 802 per 100 000 person-years) in the non-IBS control group. Fine and Gray's survival analysis revealed that the study subjects were more likely to develop psychiatric disorders. The crude hazard ratio (HR) is 3.767 (95% CI: 3.614-3.925, P < .001), and the adjusted HR is 3.598 (95% CI: 3.452-3.752, P < .001) in the risk of developing psychiatric disorders after being adjusted for age, sex, comorbidities, geographical area of residence, urbanisation level of residence, and monthly insurance premiums. The cohort study revealed that IBS subjects were associated with an increased risk of anxiety, depression, bipolar, and sleep disorders. CONCLUSIONS This cohort study, using NHIRD, shows evidence support that patients with IBS have a 3.6-fold risk of developing psychiatric disorders. Other large or national datasets should be done to explore to underlying mechanisms.
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Affiliation(s)
- Hui-Wen Yeh
- Institute of Bioinformatics and System Biology, National Chiao-Tung University, Hsin-Chu, Taiwan
- Department of Nursing, Kang-Ning University (Taipei Campus), Taipei, Taiwan
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Department of Nursing, Tri-Service General Hospital and School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Je-Ming Hu
- Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Department of Emergency Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
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180
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Devanarayana NM, Rajindrajith S. Irritable bowel syndrome in children: Current knowledge, challenges and opportunities. World J Gastroenterol 2018; 24:2211-2235. [PMID: 29881232 PMCID: PMC5989237 DOI: 10.3748/wjg.v24.i21.2211] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [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] [Received: 03/26/2018] [Revised: 04/26/2018] [Accepted: 05/11/2018] [Indexed: 02/06/2023] Open
Abstract
Irritable bowel syndrome (IBS) is a common and troublesome disorder in children with an increasing prevalence noted during the past two decades. It has a significant effect on the lives of affected children and their families and poses a significant burden on healthcare systems. Standard symptom-based criteria for diagnosis of pediatric IBS have changed several times during the past two decades and there are some differences in interpreting symptoms between different cultures. This has posed a problem when using them to diagnose IBS in clinical practice. A number of potential patho-physiological mechanisms have been described, but so far the exact underlying etiology of IBS is unclear. A few potential therapeutic modalities have been tested in children and only a small number of them have shown some benefit. In addition, most of the described patho-physiological mechanisms and treatment options are based on adult studies. These have surfaced as challenges when dealing with pediatric IBS and they need to be overcome for effective management of children with IBS. Recently suggested top-down and bottom-up models help integrating reported patho-physiological mechanisms and will provide an opportunity for better understanding of the diseases process. Treatment trials targeting single treatment modalities are unlikely to have clinically meaningful therapeutic effects on IBS with multiple integrating patho-physiologies. Trials focusing on multiple combined pharmacological and non-pharmacological therapies are likely to yield more benefit. In addition to treatment, in the future, attention should be paid for possible prevention strategies for IBS.
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Affiliation(s)
| | - Shaman Rajindrajith
- Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Ragama 11010, Sri Lanka
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181
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Schmulson MJ, Frati-Munari AC. Bowel symptoms in patients that receive proton pump inhibitors. Results of a multicenter survey in Mexico. Rev Gastroenterol Mex 2018; 84:44-51. [PMID: 29678362 DOI: 10.1016/j.rgmx.2018.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 12/17/2017] [Revised: 02/20/2018] [Accepted: 02/23/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Proton pump inhibitors (PPIs) have been associated with small intestinal bacterial overgrowth (SIBO), which increases with prolonged PPI use, and SIBO has been associated with irritable bowel syndrome (IBS). OBJECTIVE The aim of the present study was to study the prevalence of bowel symptoms in patients treated with PPIs in Mexico. METHODS Gastroenterologists in 36 cities surveyed patients treated with PPIs, utilizing an ad hoc questionnaire to determine the presence of bowel symptoms and IBS. RESULTS Two hundred and fifteen physicians interviewed 1,851 patients. PPI indications were gastritis (48.8%), gastroesophageal reflux (38.5%), peptic ulcer (6.2%), and others (6.5%). A total of 77.5% of the patients received treatment for ≤6 months and 11.9% for ≥1 year. Symptoms were reported in 92.3% of the patients: abnormal bowel habits (90%), bloating (82%), abdominal pain (63%), flatulence (58%), and abdominal discomfort (53%). A total of 67.5% of the patients fit the Rome III criteria for IBS. Symptoms presented in 55.9% of the patients before PPI intake and in 44.1% of the patients after PPI use (P<.005). Constipation (63.8%) predominated in the former, and diarrhea (56.5%) in the latter (P<.0001). The treatments prescribed for managing those symptoms were antispasmodics, antibiotics, prokinetics, and antiflatulents, but patients stated greater satisfaction with antibiotics (mainly rifaximin) (P<.0001). CONCLUSION The association of PPIs with bowel symptoms and IBS is frequent in Mexico. Diarrhea and bloating predominate, and antibiotics produce the greatest treatment satisfaction, suggesting that SIBO or dysbiosis is the cause of the PPI-related bowel symptoms. However, that remains to be confirmed.
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Affiliation(s)
- M J Schmulson
- Laboratorio de Hígado, Páncreas y Motilidad (HIPAM)-Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Hospital General de México, Ciudad de México, México; Gastroenterología y Motilidad Gastrointestinal, Clínica Lomas Altas SC, Ciudad de México, México; Gastroenterología y Endoscopía en Práctica Médica-Centro Médico ABC, Ciudad de México, México.
| | - A C Frati-Munari
- Alfa Wassermann S.A. de C.V., Ciudad de México, México; Medicina interna, Hospital Médica Sur, Ciudad de México, México
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182
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Velasco-Benítez CA, Chanís R, Játiva E, Zablah R, Mejía M, Rodriguez Reynosa L, Leyva Jimenez SA. [Irritable bowel syndrome subtypes and characteristics in children from Panama, Ecuador,El Salvador, Nicaragua and Mexico]. Rev Gastroenterol Peru 2018; 38:131-137. [PMID: 30118458] [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: 06/08/2023]
Abstract
INTRODUCTION Few pediatric studies classify the irritable bowel syndrome (IBS) subtypes. OBJECTIVE To describe the characteristics and subtypes of IBS in children from Panama, Ecuador, El Salvador, Nicaragua and Mexico. MATERIAL AND METHODS Prevalence study performed in children between 8 and 18 years of age with a diagnosis of IBS. The children answered the Questionnaire for Pediatric Gastrointestinal Symptoms Roma III for Schoolchildren and Adolescents (QPGS-III) to identify functional gastrointestinal disorders. Variables such as age and sex were taken into account. The subtypes of IBS were classified in IBS with constipation (IBS-c), with diarrhea (IBS-d), mixed (IBS-m) and without subtype (IBS-ss). Statistical analysis included measures of central tendency, two-tailed student t-test, chi-square test, and Fisher's exact test, with a significant p<0.05. RESULTS We included 79 children (54.4% female, 12.1±2.1 years) presenting IBS-ss in 55.7%, IBS-c in 15.2%, IBS-m in 15.2% and SII-d in 13.9%. Severe pain predominated most of the day and with mucous stools; possible associations for IBS-d school and sex. CONCLUSION After IBS-ss, the IBS-e, IBS-d and IBS-m are similar, being the possible risk factors for IBS-d, the public school and the female gender.
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Affiliation(s)
| | | | - Edgar Játiva
- Universidad Central del Ecuador. Quito, Ecuador; Universidad de la Frontera. Temuco, Chile
| | - Roberto Zablah
- Departamento de Gastroenterología y Endoscopía, Hospital Nacional de Niños Benjamín Bloom. San Salvador, El Salvador
| | - Milton Mejía
- Hospital Nacional de Niños de Nicaragua. Managua, Nicaragua
| | - Laura Rodriguez Reynosa
- Instituto Mexicano del Seguro Social. Monterrey, México; Hospital de Especialidades Clínica No. 25 IMSS. Monterrey, México
| | - Sofia Araceli Leyva Jimenez
- Servicios de Gastroenterología, Hospital del Niño y del Adolescente Morelense en Cuernavaca. Morelos, México
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Abstract
BACKGROUND The most common functional gastrointestinal disorders (FGID) are functional dyspepsia (FD) and irritable bowel syndrome (IBS), with a prevalence in the general population of 15-20% (FD) and 10% (IBS), respectively. The complexity of pathophysiologic mechanisms and limitations in therapeutic options make the management of FD and IBS patients a challenge in routine clinical practice. SUMMARY Syndromes classified as FGID frequently overlap, and coexist with gastroesophageal reflux disease (GERD). Patients with overlapping symptoms are more likely to seek medical care. The challenge for routine clinical practice is to find the best approach for treatment of multiple symptoms. STW 5, a combination of 9 herbal extracts, was shown to have multi-target effects: it normalizes the disturbed gastrointestinal motility, alleviates hypersensitivity, inhibits inflammation, suppresses gastric hypersecretion, and modulates the microbiota. Controlled randomized studies proved STW 5 to be efficacious both in FD and IBS, with control over the full spectrum of upper and lower gastrointestinal symptoms. STW 5 reduced concomitant heartburn in FD patients. STW 5 was well tolerated in the examined populations, independent of concomitant diseases and concomitant medication. Key Messages: The clinical use of the herbal preparation STW 5 in FD and IBS is evidence-based. STW 5 is an example for the concept of multi-target therapy. It offers treatment opportunities in routine clinical practice with high prevalence of overlap of FGID and concomitant GERD. Considering that FD and IBS are typically chronic and recurrent conditions, the clinically observed good tolerability and safety of STW 5 is an advantage.
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184
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Abstract
BACKGROUND The correct diagnosis of functional gastrointestinal disorders (FGIDs) is quite a challenge. The overlaps between syndromes can complicate the interpretation of clinical data. SUMMARY The incidence of functional digestive disorders and irritable bowel syndrome are still underestimated with the currently applied diagnostic tools, and the management of the seemingly elusive disease is not satisfactory. For this reason, the "Rome" criteria were created to provide a better understanding and classification of FGIDs. Key Messages: Rome diagnostic criteria and recommendations should be used in the design and performance of clinical studies in the field of functional dyspepsia and irritable bowel syndrome.
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185
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Mishima T, Fukae J, Fujioka S, Inoue K, Tsuboi Y. The Prevalence of Constipation and Irritable Bowel Syndrome in Parkinson's Disease Patients According to Rome III Diagnostic Criteria. J Parkinsons Dis 2018; 7:353-357. [PMID: 28157108 PMCID: PMC5438471 DOI: 10.3233/jpd-160982] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Gastrointestinal symptoms are one of the most common non-motor features of Parkinson’s disease (PD). Recently, a report from Taiwan revealed that irritable bowel syndrome (IBS) may be associated with an increased risk of developing PD; however, the prevalence of IBS in PD patients has not been fully evaluated. Rome III criteria are widely assessed with a questionnaire to determine functional gastrointestinal disorders. Objective: We assessed the prevalence of constipation and IBS in PD patients in our cohort using Rome III criteria. Methods: Between October 2014 and April 2015, 118 patients with PD were treated at Fukuoka University Hospital and were enrolled in this study. Rome III criteria were used to diagnose constipation and IBS. Results: Constipation and IBS were detected in 32 (27.1%) and 20 patients (17.0%), respectively. The most common symptom related to constipation was straining during defecation (77.1%). Among constipation symptoms, patients’ self-awareness of constipation was mostly related to straining during defecation (odds ratio 5.27, 95% confidence interval 1.475–18.811). The number of constipation symptoms was correlated with the severity of the Hoehn-Yahr Stage (p < 0.05) and total levodopa equivalent dose (p < 0.05). Conclusions: This is the first report to investigate the prevalence of IBS in PD patients with Rome III criteria. We found a higher prevalence of IBS compared with the general population. The prevalence of constipation based on Rome III criteria was much lower than that reported in previous studies. Further studies are warranted to evaluate gastrointestinal symptoms in PD patients using comparable questionnaires.
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Affiliation(s)
| | | | | | | | - Yoshio Tsuboi
- Correspondence to: Yoshio Tsuboi, MD., Department of Neurology, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan. Tel.: +81 92 801 1011/ Ext. 3525; Fax: +81 92 865 7900 (direct); E-mail:
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186
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Saha M, Parveen I, Uddoula MS, Alam MJ, Afsar NS, Debnath BC, Ali SE. Irritable Bowel Syndrome: Prevalence and Dietary Factors in the Sylhet District of Bangladesh. Mymensingh Med J 2018; 27:82-88. [PMID: 29459596] [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: 06/08/2023]
Abstract
Irritable bowel syndrome (IBS) is a common functional bowel disorder. Along with other factors diet plays an important role in the causation of IBS. This population-based study was done to find out the prevalence of IBS and to find out the dietary factors associated with IBS from August 2011 to December 2011 in Sylhet district of Bangladesh. Nineteen hundred apparently healthy subjects selected by cluster sampling methods were interviewed by a validated bowel disease questionnaire. Dietary history of the subjects was also taken. Irritable bowel syndrome was diagnosed according to Rome III criteria. The prevalence of IBS was found 14.2% (n=269, M=15%, F=13.4%, p=0.365). Mean age of the IBS patients were higher than the study population (41.35 years vs. 34.74 years, p=0.000). Irritable bowel syndrome was found more in low education group (16.3%) with lower socioeconomic status (16.5%) and in single person (16.7%). IBSD was the most prevalent subtype (48.7%), IBSM was the next common subtype. Abdominal pain relieved by defecation (81%) and abdominal pain associated with loose stools (81%) were the two commonest symptoms. Age (OR 1.023, p=0.000), less intake of meat (OR 2.281, p=0.000) and pulses (OR 1.648, p=0.001) and more intake of tea (OR 1.524, p=0.009) and spices (OR 0.452, p=0.000) were found as independent predictor of IBS. Irritable bowel syndrome is a common disorder in our community. IBSD is the most prevalent subtype. Less intake of meat, pulses and more intakes of tea and spices are important associated factors for IBS.
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Affiliation(s)
- M Saha
- Professor Madhusudan Saha, Professor, Department of Gastroenterology, North East Medical College, Sylhet, Bangladesh
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187
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Bychkov MA, Ferents IM. [Features of the course of irritable bowel syndrome in patients with excess body weight]. Wiad Lek 2018; 71:688-690. [PMID: 29783248] [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] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Introduction: Currently, the diagnosis of irritable bowel syndrome (IBS) is only based on clinical symptoms without clear interpretation and can be interpreted differently, complicating the diagnosis. Therefore, to study features of the prevalence and the course of IBS in patients with excessive body weight / obesity is of particular significance nowadays. The aim of the research is to evaluate the prevalence and the course of IBS in patients with obesity. PATIENTS AND METHODS Materials and methods: Observation results for 120 obese persons who underwent in-patient treatment at various hospital departments in Western Ukraine have been analyzed to evaluate the prevalence of IBS. A thorough collection of complaints, anamnesis of the disease and lifestyle were conducted due to the survey; objective survey data were analyzed. The diagnosis of IBS was made according to Rome IV diagnostic criteria (2016). RESULTS Results: Patients of all groups were gender and age-matched participants. The average body mass index was 33.9 ± 0.83 kg / m². Excessive body weight was revealed in 6 patients (5.0%). Degrees of obesity: (stage I) was diagnosed in 74 patients (61.6%), stage II was determined in 29 patients (24.2%), and stage III - in 11 patients (9,2%). The vast majority of patients (82.5%) complained of fullness or discomfort in the abdomen. Every second obese patient (52.5%) noted periodic bloating. Periodic nausea was recorded in every third patient with obesity (32.5%). Recurrent abdominal pain was determined in 62 (51.7%) of patients during the last 3 months: in females - 38 (61.3%), in males - 24 (38.7%) respectively. The prevalence of diarrhea with IBS compared to IBS with constipation was also noted: 36 (58.1%) versus 26 (41.9%) of cases. CONCLUSION Conclusions: Irritable bowel syndrome was revealed in 51.7% of obese patients. Significant prevalence of combined pathology was noted in females. The prevalence of irritable bowel syndrome with diarrhea was determined.
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Affiliation(s)
| | - Iryna M Ferents
- Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
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188
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Rukunuzzaman M, Karim AB, Nurullah M, Mazumder MW, Sultana K, Hussain F, Sultana F. Irritable Bowel Syndrome: Is it Rare in Children? Mymensingh Med J 2018; 27:216-221. [PMID: 29459618] [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: 06/08/2023]
Abstract
Irritable bowel syndrome (IBS) is one of the most common and best studied disorders among the group of functional gastrointestinal disorders. It is a functional bowel disorder in which abdominal pain or discomfort is associated with defecation or a change in bowel habit. Visceral hypersensitivity and increased GIT motility are the main patho-physiological mechanism for developing IBS. IBS present with diarrhea and constipation or both. Investigation is least needed for diagnosis of IBS rather done to exclude differential diagnosis. Diagnosis is done on the basis of Rome-III criteria. Proper counseling, dietary management, anti-spasmotic and antidepressant are the mainstay of treatment.
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Affiliation(s)
- M Rukunuzzaman
- Dr Md Rukunuzzaman, Associate Professor, Department of Pediatric Gastroenterology & Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
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189
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Stephen DM, Barnett AG. Using Microsimulation to Estimate the Future Health and Economic Costs of Salmonellosis under Climate Change in Central Queensland, Australia. Environ Health Perspect 2017; 125:127001. [PMID: 29233795 PMCID: PMC5963579 DOI: 10.1289/ehp1370] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 11/08/2017] [Accepted: 11/08/2017] [Indexed: 05/31/2023]
Abstract
BACKGROUND The incidence of salmonellosis, a costly foodborne disease, is rising in Australia. Salmonellosis increases during high temperatures and rainfall, and future incidence is likely to rise under climate change. Allocating funding to preventative strategies would be best informed by accurate estimates of salmonellosis costs under climate change and by knowing which population subgroups will be most affected. OBJECTIVE We used microsimulation models to estimate the health and economic costs of salmonellosis in Central Queensland under climate change between 2016 and 2036 to inform preventative strategies. METHODS We projected the entire population of Central Queensland to 2036 by simulating births, deaths, and migration, and salmonellosis and two resultant conditions, reactive arthritis and postinfectious irritable bowel syndrome. We estimated salmonellosis risks and costs under baseline conditions and under projected climate conditions for Queensland under the A1FI emissions scenario using composite projections from 6 global climate models (warm with reduced rainfall). We estimated the resulting costs based on direct medical expenditures combined with the value of lost quality-adjusted life years (QALYs) based on willingness-to-pay. RESULTS Estimated costs of salmonellosis between 2016 and 2036 increased from 456.0 QALYs (95% CI: 440.3, 473.1) and AUD29,900,000 million (95% CI: AUD28,900,000, AUD31,600,000), assuming no climate change, to 485.9 QALYs (95% CI: 469.6, 503.5) and AUD31,900,000 (95% CI: AUD30,800,000, AUD33,000,000) under the climate change scenario. CONCLUSION We applied a microsimulation approach to estimate the costs of salmonellosis and its sequelae in Queensland during 2016-2036 under baseline conditions and according to climate change projections. This novel application of microsimulation models demonstrates the models' potential utility to researchers for examining complex interactions between weather and disease to estimate future costs. https://doi.org/10.1289/EHP1370.
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Affiliation(s)
- Dimity Maree Stephen
- Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Adrian Gerard Barnett
- Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
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190
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Abstract
Abdominal pain is one of the key symptoms of irritable bowel syndrome (IBS). Studies have indicated an increase in the incidence of IBS in Asia. However, yet the pathophysiology of this disease remains unknown. Women are more likely to develop the condition than men, especially the constipation-predominant type. Essential fatty acid (EFA) malnutrition is one of several theories discussing the mechanism of IBS.The authors hypothesized that significant EFA deficiency may cause abdominal pain in patients with IBS. However, because patterns in the oral intake of EFAs differ between cultures, the authors narrowed this study to examine the nutritional status of Asian female patients with IBSThe authors investigated Asian female patients with IBS and compared them with a group of healthy controls. Thirty patients with IBS and 39 healthy individuals were included in this study. The participants' age, height, weight, and waist size were recorded. The 24-item Hamilton Depression Rating Scale was documented. Both erythrocyte and plasma fatty acid content were analyzed through gas-liquid chromatography.The authors found that patients with IBS exhibited significantly higher scores for depression, higher proportions of plasma saturated fatty acids and monounsaturated fatty acids, and lower proportions of docosahexaenoic acid and total omega-3 polyunsaturated fatty acids in plasma are associated with IBS in Asian female patients. Further study is indicated to confirm the causality of this association.
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Affiliation(s)
- Chian Sem Chua
- Graduate Institute of Biomedical Informatics, Taipei Medical University
- Division of Gastroenterology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Western Medicine Division, Hospital Lam Wah Ee, Penang, Malaysia
| | - Shih-Yi Huang
- School of Nutrition and Health Sciences, Taipei Medical University
| | - Chiao-Wen Cheng
- Department of Transportation and Logistics Management, National Chiao Tung University
| | - Chyi-Huey Bai
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University
- School of Public Health, College of Public Health and Nutrition, Taipei Medical University
| | - Chien-Yeh Hsu
- Department of Information Management, National Taipei University of Nursing and Health Sciences
- Master Program in Global Health and Development, College of Public Health and Nutrition, Taipei Medical University
| | - Hung-Wen Chiu
- Graduate Institute of Biomedical Informatics, Taipei Medical University
| | - Jung-Lung Hsu
- Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang-Gung University, Taoyuan
- Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan
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191
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Vicari E, Salemi M, Sidoti G, Malaguarnera M, Castiglione R. Symptom Severity Following Rifaximin and the Probiotic VSL#3 in Patients with Chronic Pelvic Pain Syndrome (Due to Inflammatory Prostatitis) Plus Irritable Bowel Syndrome. Nutrients 2017; 9:nu9111208. [PMID: 29099760 PMCID: PMC5707680 DOI: 10.3390/nu9111208] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 10/29/2017] [Accepted: 10/30/2017] [Indexed: 12/13/2022] Open
Abstract
This study investigated the effects of long-term treatment with rifaximin and the probiotic VSL#3 on uro-genital and gastrointestinal symptoms in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) plus diarrhoea-predominant irritable bowel syndrome (D-IBS) compared with patients with D-IBS alone. Eighty-five patients with CP/CPPS (45 with subtype IIIa and 40 with IIIb) plus D-IBS according to the Rome III criteria and an aged-matched control-group of patients with D-IBS alone (n = 75) received rifaximin and VSL#3. The primary endpoints were the response rates of IBS and CP/CPPS symptoms, assessed respectively through Irritable Bowel Syndrome Severity Scoring System (IBS-SSS) and The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and performed at the start of therapy (V0) and three months after (V3). In IIIa prostatitis patients, the total NIH-CPSI scores significantly (p < 0.05) decreased from a baseline mean value of 21.2 to 14.5 at V3 , as did all subscales, and in the IIIb the total NIH-CPSI score also significantly decreased (from 17.4 to 15.1). Patients with IBS alone showed no significant differences in NIH-CPSI score. At V3, significantly greater improvement in the IBS-SSS and responder rate were found in IIIa patients. Our results were explained through a better individual response at V3 in IIIa prostatitis of urinary and gastrointestinal symptoms, while mean leukocyte counts on expressed prostate secretion (EPS) after prostate massage significantly lowered only in IIIa cases.
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Affiliation(s)
- Enzo Vicari
- Section of Endocrinology, Andrology and Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Michele Salemi
- IRCCS Oasi Institute for Research on Mental Retardation and Brain Aging, Via Conte Ruggiero 73, 94018 Troina, Italy.
| | - Giuseppe Sidoti
- UOSD Medicina Interna Ambulatorio Andrologia & Endocrinologia ARNAS-Garibaldi, 95123 Catania, Italy.
| | - Mariano Malaguarnera
- Research Center "The Great Senescence", University of Catania, 95100 Catania, Italy.
| | - Roberto Castiglione
- Section of Endocrinology, Andrology and Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
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192
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Szilagyi A, Xue X. Comparison of geographic distributions of Irritable Bowel Syndrome with Inflammatory Bowel Disease fail to support common evolutionary roots: Irritable Bowel Syndrome and Inflammatory Bowel Diseases are not related by evolution. Med Hypotheses 2017; 110:31-37. [PMID: 29317064 DOI: 10.1016/j.mehy.2017.10.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 05/24/2017] [Accepted: 10/22/2017] [Indexed: 02/07/2023]
Abstract
Irritable Bowel Syndrome (IBS) shares overlapping symptoms and some features of pathogenesis with Inflammatory Bowel Diseases (IBD: Crohn's disease [CD], and Ulcerative Colitis [UC]). Geographic markers such as latitude/sunshine and more recently lactase population distributions are found to be correlated with IBD. As a result of clinical and pathogenic similarities between the 2 conditions, some authorities questioned whether a connection exists between them. We compare IBS directly with IBD, and indirectly with geographic markers associated with IBD, in order to evaluate possible evolutionary links between IBS and IBD. Similar correlations may link IBS as a precursor to IBD and possibly other conditions which are geographically connected with IBD. Data from four systematic reviews on IBD incidence and prevalence, IBS prevalence, and lactase distributions were included. Pearson's correlations were used for comparisons, with IBD values log-transformed because of skewed distribution. The articles provided 18-28 complete set of national data. Direct comparison between IBS and IBD showed no significant correlations (r = -0.14, r = -0.06 for CD and UC prevalence, r = -0.10 for CD incidence). Indirect comparisons also failed to show correlations of IBS with lactase distributions (r = -0.17), sunshine (r = -0.2) or latitude (r = 0.097); however, there was significant correlation between lactase distributions and CD incidence (r = -0.84), prevalence (r = -0.55) and UC prevalence (r = -0.59). Both sunshine (r= -0.53) and latitude (r = 0.58) are also significantly related to CD incidence. It is concluded that IBS and IBD do not follow similar global geographic patterns. This suggests a lack of an evolutionary genetic background coincident with emergence of lactase persistence. As well, vitamin D has no obvious impact on development of IBS. Similarities with IBD may result from sub groups (not yet identified) within the current Rome criteria of IBS. Alternatively limited intestinal gut-brain responses to host microbial interactions may result in similar overlap features in both.
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Affiliation(s)
- Andrew Szilagyi
- Department of Internal Medicine, Division of Gastroenterology, Jewish General Hospital, McGill University School of Medicine, Canada.
| | - Xiaoqing Xue
- Department of Emergency Medicine, Biostatistics, Jewish General Hospital, McGill University School of Medicine, Canada
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193
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Zhou Q, Wesselmann U, Walker L, Lee L, Zeltzer L, Verne GN. AAPT Diagnostic Criteria for Chronic Abdominal, Pelvic, and Urogenital Pain: Irritable Bowel Syndrome. J Pain 2017; 19:257-263. [PMID: 29079542 DOI: 10.1016/j.jpain.2017.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/27/2017] [Accepted: 10/02/2017] [Indexed: 02/06/2023]
Abstract
In conjunction with the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks public-private partnership with the U.S. Food and Drug Administration and the American Pain Society, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks-American Pain Society Pain Taxonomy (AAPT) initiative strove to develop the characteristics of a diagnostic system useful for clinical and research purposes across disciplines and types of chronic pain conditions. After the establishment of these characteristics, a working group of clinicians and clinical and basic scientists with expertise in abdominal, pelvic, and urogenital pain began generating core diagnostic criteria and defining the related extraintestinal somatic pain and other symptoms experienced by patients. Systematic diagnostic criteria for several common abdominal, pelvic, and urogenital pain conditions are in development. In this report, we present the proposed AAPT criteria for irritable bowel syndrome (IBS), the most common chronic, noncancer abdominal pain condition. A systematic review and synthesis was conducted to complement the Rome IV Diagnostic Criteria for IBS. Future efforts will subject these proposed AAPT criteria to systematic empirical evaluation of their feasibility, reliability, and validity. The AAPT IBS criteria are part of an evidence-based classification system that provides a consistent vocabulary regarding diagnostic criteria, common features, comorbidities, consequences, and putative mechanisms of the disorder. A similar approach is being applied to other chronic and often debilitating abdominal, pelvic, and urogenital pain conditions. PERSPECTIVE The AAPT's goal is to develop an evidence-based taxonomy for chronic pain on the basis of a consistently applied multidimensional framework, and encourage experts to apply this taxonomy to specific chronic pain conditions. In this report, the taxonomy is applied to IBS, a chronic abdominal pain condition.
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Affiliation(s)
- QiQi Zhou
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana; Department of Veteran Affairs, Malcom Randall VAMC, Gainesville, Florida.
| | - Ursula Wesselmann
- University of Alabama at Birmingham (UAB), Department of Anesthesiology and Perioperative Medicine (Division of Pain Medicine), Neurology and Psychology, Birmingham, Alabama
| | - Lynn Walker
- Department of Pediatrics, Vanderbilt University, School of Medicine, Nashville, Tennessee
| | - Linda Lee
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lonnie Zeltzer
- Pediatric Pain and Palliative Care Program, Division of Pediatric Hematology-Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - G Nicholas Verne
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
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194
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Rahman MM, Mahadeva S, Ghoshal UC. Epidemiological and clinical perspectives on irritable bowel syndrome in India, Bangladesh and Malaysia: A review. World J Gastroenterol 2017; 23:6788-6801. [PMID: 29085223 PMCID: PMC5645613 DOI: 10.3748/wjg.v23.i37.6788] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [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] [Received: 06/23/2017] [Revised: 08/23/2017] [Accepted: 09/13/2017] [Indexed: 02/06/2023] Open
Abstract
Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder, common in clinic and in the community. It has a significant impact on both society and patients' quality of life. The epidemiology, clinical presentation, and management of IBS may vary in different geographical regions due to differences in diet, gastrointestinal infection, socio-cultural and psycho-social factors, religious and illness beliefs, symptom perception and reporting. Although previous reviews and consensus reports on IBS in Asia have been published, Asia is quite diverse socio-demographically. In this context, India, Bangladesh and Malaysia share some similarities, including: (1) large proportion of the population living in rural areas; (2) rapid development and associated lifestyle changes in urban areas; and (3) dietary, cultural and religious practices. The present review explores the clinical and epidemiological data on IBS from these three major nations in South and South-East Asia. In-depth review of the literature revealed important differences between IBS in the East, as revealed by studies from these three countries, and the West; these include a predominantly rural profile, differences in bowel habit and symptom profile, raising concern with regards to diagnostic criteria and subtyping of IBS, higher dietary fiber consumption, frequent lactose malabsorption, parasitosis, and possible overlap between post-infectious IBS and tropical sprue. Moreover, the current perception on difference in prevalence of the disorder in these countries, as compared to the West, might be related to variation in survey methods.
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Affiliation(s)
- M Masudur Rahman
- Department of Gastroenterology, Dhaka Medical College and Hospital, Dhaka 1000, Bangladesh
| | - Sanjiv Mahadeva
- Division of Gastroenterology, Department of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Uday C Ghoshal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
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195
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Buscail C, Sabate JM, Bouchoucha M, Torres MJ, Allès B, Hercberg S, Benamouzig R, Julia C. Association between self-reported vegetarian diet and the irritable bowel syndrome in the French NutriNet cohort. PLoS One 2017; 12:e0183039. [PMID: 28841661 PMCID: PMC5571937 DOI: 10.1371/journal.pone.0183039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 12/08/2016] [Accepted: 07/29/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND There is growing interest in using diet counselling in the management of patients with irritable bowel syndrome (IBS). Among new emerging diets, vegetarian diets (VD) seem to be experiencing an important popularity, partly because of their alleged health benefits. A recent study performed among a rural Indian population showed that predominant VD could be associated with IBS. OBJECTIVE This cross-sectional study aimed at assessing the association between the VD and IBS, among a large French cohort, the NutriNet-santé study. METHODS Subjects participating in the NutriNet-Santé cohort study completed a questionnaire based on Rome III criteria (N = 41,682). Anthropometrics, socio-demographical and lifestyle data, including VD, were collected prior to the completion of Rome III questionnaire via self-administered questionnaires. Association between VD and IBS and its subtypes was investigated through multivariate logistic regression. RESULTS The included subjects were mainly women (78.0%) and the mean age was 49.8±14.3 years. Among these individuals, 2,264 (5.4%) presented an IBS, and 805 (1.9%) reported a VD. Overall, VD was not associated with IBS or subtypes. A stable VD (i.e. self-declared at least three times) was associated with IBS (aOR 2.60 95%CI [1.37-4.91]), IBS mixed (aOR 2.97 95%CI [1.20-7.36]) and IBS diarrhoea (aOR 2.77 95%CI [1.01-7.59]). CONCLUSIONS This study suggests that a long term VD could be associated with IBS. Nevertheless, further studies are needed to confirm these results, and investigate the multiple aspects of the vegetarian diet, possibly related to the IBS.
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Affiliation(s)
- Camille Buscail
- Equipe de Recherche en Epidémiologie Nutritionnelle, Université Paris 13, Centre de Recherche en Epidémiologie et Biostatistiques (CRESS), Inserm 1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
- Département de santé publique, Hôpital Avicenne, Bobigny, France
| | - Jean-Marc Sabate
- Service d’ Hépato-Gastro-Entérologie, Hôpital Avicenne, Bobigny, France
| | - Michel Bouchoucha
- Service d’ Hépato-Gastro-Entérologie, Hôpital Avicenne, Bobigny, France
| | - Marion J. Torres
- Equipe de Recherche en Epidémiologie Nutritionnelle, Université Paris 13, Centre de Recherche en Epidémiologie et Biostatistiques (CRESS), Inserm 1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Benjamin Allès
- Equipe de Recherche en Epidémiologie Nutritionnelle, Université Paris 13, Centre de Recherche en Epidémiologie et Biostatistiques (CRESS), Inserm 1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Serge Hercberg
- Equipe de Recherche en Epidémiologie Nutritionnelle, Université Paris 13, Centre de Recherche en Epidémiologie et Biostatistiques (CRESS), Inserm 1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
- Département de santé publique, Hôpital Avicenne, Bobigny, France
| | - Robert Benamouzig
- Service d’ Hépato-Gastro-Entérologie, Hôpital Avicenne, Bobigny, France
| | - Chantal Julia
- Equipe de Recherche en Epidémiologie Nutritionnelle, Université Paris 13, Centre de Recherche en Epidémiologie et Biostatistiques (CRESS), Inserm 1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
- Département de santé publique, Hôpital Avicenne, Bobigny, France
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AlKhalifah MI, Al-Aql AM, Al-Mutairi MS, Alnuqaydan SA, Al-Wehaibi AS, AlJurayyed AM, Aldhuwyan AS, Al-Harbi KG, Alomar IN, Alayyaf SS, Zafar M. Prevalence of irritable bowel syndrome among Qassim school teachers, and its impact on their performance and life duties. Saudi Med J 2017; 37:817. [PMID: 27381548 PMCID: PMC5018652 DOI: 10.15537/smj.2016.7.15043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Indexed: 11/18/2022] Open
Abstract
Objectives: To determine the prevalence of irritable bowel syndrome (IBS) among school teachers in Qassim region, Kingdom of Saudi Arabia (KSA) and it’s impact on their performance -as teachers- and on life duties. Methods: A cross-sectional study was held in Qassim region, KSA between 2012 and 2013. The study was conducted among 300 school teachers selected by multistage stratified random sample method in 2013. The sample size was calculated according to the formula: n = (Z2 * (p) * (q))/c2. A confidential, anonymous, and a self-administered questionnaire was used to collect personal and sociodemographic data, teacher performance oriented questions were included. Rome III Criteria were used. Teachers with red flag symptoms were excluded. Results: The prevalence of IBS symptoms among teachers in Qassim region of KSA is 40.7% with no significant gender predilection. The IBS symptoms significantly affect the work performance of the teachers (61.6%) with high absenteeism rate (46.6%), especially among 51-60 years and 21-30 years, age groups (p<0.05 in chi-square test). Significant proportion (45.3%) of IBS criteria +ve teachers find IBS symptoms to be hindrance in their life duties. Conclusion: Prevalence of IBS in Qassim school teachers is becoming an important issue with 40.7% of teachers reporting symptoms suggestive of IBS in a random sample. Majority of teachers are having frequent performance problems - as teachers - and in usual life duties associated with their IBS Symptoms. Significantly, IBS criteria +ve teachers are more likely to have discipline problems compared with healthy teachers. We recommend a health care program to tackle the problem among the teachers, to improve their performance and reduce working hours loss. Also, follow up studies need to be conducted to assess the health care of IBS patients in local public health care centers.
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197
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Boronat AC, Ferreira-Maia AP, Matijasevich A, Wang YP. Epidemiology of functional gastrointestinal disorders in children and adolescents: A systematic review. World J Gastroenterol 2017; 23:3915-3927. [PMID: 28638232 PMCID: PMC5467078 DOI: 10.3748/wjg.v23.i21.3915] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 03/20/2017] [Accepted: 04/12/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the prevalence of functional gastrointestinal disorders (FGIDs) in children and adolescents.
METHODS PubMed, EMBASE, and Scopus databases were searched for original articles from inception to September 2016. The literature search was made in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. For inclusion, each study had to report epidemiological data on FGIDs in children between 4 and 18 years old and contain standardized outcome based on Rome II, III or IV criteria. The overall quality of included epidemiological studies was evaluated in accordance with Loney’s proposal for prevalence studies of health literature. Two reviewers assessed each study for data inclusion and extraction. Discrepancies were reconciled through discussion with seniors.
RESULTS A total of 659 articles were identified from the databases and 16 through manual search. A total of 43 articles fulfilled the eligibility criteria for full-text reading, with 26 remaining to be included in the final analysis. All studies were written in English and published between 2005 and 2016. Eight (30.8%) articles were performed in North America, five (19.2%) in Latin America, five (19.2%) in Europe, seven (27%) in Asia, and one (3.8%) in Africa. Sample size varied between 114 and 99416 subjects, totaling 132600 individuals. Fourteen (53.9%) studies recruited their target samples from schools, 11 (42.3%) from healthcare settings and the remaining one (3.8%) from online panel community. The overall FGID prevalence rates for student samples ranged from 9.9% to 29% to as high as 87% in clinical samples. Cyclic vomiting, irritable bowel syndrome and functional constipation were the most researched conditions, with a prevalence ranging from 0.2% to 6.2%, 0% to 45.1% and 0.5% to 86.9%, respectively. The qualitative appraisal revealed that most of the studies showed average or below average generalizability.
CONCLUSION The heterogeneity of the studies on FGIDs must be improved in order to allow comparison. Improvements should include appropriate sampling of representative population, comparable study setting, and consistent data collection.
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198
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Marx P, Antal P, Bolgar B, Bagdy G, Deakin B, Juhasz G. Comorbidities in the diseasome are more apparent than real: What Bayesian filtering reveals about the comorbidities of depression. PLoS Comput Biol 2017; 13:e1005487. [PMID: 28644851 PMCID: PMC5507322 DOI: 10.1371/journal.pcbi.1005487] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [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: 12/01/2016] [Revised: 07/10/2017] [Accepted: 03/29/2017] [Indexed: 02/07/2023] Open
Abstract
Comorbidity patterns have become a major source of information to explore shared mechanisms of pathogenesis between disorders. In hypothesis-free exploration of comorbid conditions, disease-disease networks are usually identified by pairwise methods. However, interpretation of the results is hindered by several confounders. In particular a very large number of pairwise associations can arise indirectly through other comorbidity associations and they increase exponentially with the increasing breadth of the investigated diseases. To investigate and filter this effect, we computed and compared pairwise approaches with a systems-based method, which constructs a sparse Bayesian direct multimorbidity map (BDMM) by systematically eliminating disease-mediated comorbidity relations. Additionally, focusing on depression-related parts of the BDMM, we evaluated correspondence with results from logistic regression, text-mining and molecular-level measures for comorbidities such as genetic overlap and the interactome-based association score. We used a subset of the UK Biobank Resource, a cross-sectional dataset including 247 diseases and 117,392 participants who filled out a detailed questionnaire about mental health. The sparse comorbidity map confirmed that depressed patients frequently suffer from both psychiatric and somatic comorbid disorders. Notably, anxiety and obesity show strong and direct relationships with depression. The BDMM identified further directly co-morbid somatic disorders, e.g. irritable bowel syndrome, fibromyalgia, or migraine. Using the subnetwork of depression and metabolic disorders for functional analysis, the interactome-based system-level score showed the best agreement with the sparse disease network. This indicates that these epidemiologically strong disease-disease relations have improved correspondence with expected molecular-level mechanisms. The substantially fewer number of comorbidity relations in the BDMM compared to pairwise methods implies that biologically meaningful comorbid relations may be less frequent than earlier pairwise methods suggested. The computed interactive comprehensive multimorbidity views over the diseasome are available on the web at Co=MorNet: bioinformatics.mit.bme.hu/UKBNetworks.
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Affiliation(s)
- Peter Marx
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Department of Measurement and Information Systems, Budapest University of Technology and Economics, Budapest, Hungary
| | - Peter Antal
- Department of Measurement and Information Systems, Budapest University of Technology and Economics, Budapest, Hungary
| | - Bence Bolgar
- Department of Measurement and Information Systems, Budapest University of Technology and Economics, Budapest, Hungary
| | - Gyorgy Bagdy
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
- NAP-A-SE New Antidepressant Target Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
| | - Bill Deakin
- Neuroscience and Psychiatry Unit, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Gabriella Juhasz
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
- Neuroscience and Psychiatry Unit, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
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199
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Novoa-Sandoval P, Pérez-Acuña K, Achata-Espinoza M, Toro-Huamanchumo CJ. [Irritable bowel syndrome in medical students from Latin America: an overlooked problem?]. Rev Gastroenterol Peru 2017; 37:190-191. [PMID: 28732004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | | | | | - Carlos J Toro-Huamanchumo
- Facultad de Medicina Humana, Universidad de San Martín de Porres. Chiclayo, Perú; Unidad de Investigación en Enfermedades Emergentes y Cambio Climático, Universidad Peruana Cayetano Heredia. Lima, Perú
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200
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Abstract
Various studies have shown that irritable bowel syndrome (IBS) is highly associated with other pathologies, including fibromyalgia (FM). The objective of this study was to analyze the differences among risk factors associated with IBS following FM in a nationwide prospective cohort study.We propose that a relationship exists between FM and IBS. This article presents evidence obtained from a cohort study in which we used data from the Taiwan National Health Insurance Research Database to clarify the relationship between FM and IBS. The follow-up period ran from the start of FM diagnosis to the date of the IBS event, censoring, or December 31, 2011. We analyzed the risk of IBS using Cox proportional hazard regression models, including sex, age, and comorbidities.During the follow-up period, from 2000 to 2011, the overall incidence of IBS was higher in FM patients than in non-FM patients (7.47 vs 4.42 per 1000 person-years), with a crude hazard ratio = 1.69 (95% confidence interval [CI] 1.59-1.79). After adjustment for age, sex, and comorbidities, FM was associated with a 1.54-fold increased risk for IBS.Mutually risk factors may influence the relationship between FM and IBS. We recommend that physiologists conduct annual examinations of FM patients to reduce the incidence of IBS progression.
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Affiliation(s)
- Tse-Yen Yang
- Molecular and Genomic Epidemiology Center, China Medical University Hospital, China Medical University, Taichung
- Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua
| | - Chih-Sheng Chen
- Division of Chinese Trauma, China Medical University Hospital
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital
- College of Medicine, China Medical University, Taichung
| | - Wei-Ming Lin
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi
- Chang Gung University, Taoyuan
| | | | - Chia-Hung Kao
- Department of Nuclear Medicine and PET Center, China Medical University Hospital
- Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
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