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Beh KH, Chuah KH, Rappek NAM, Mahadeva S. The association of body mass index with functional dyspepsia is independent of psychological morbidity: A cross-sectional study. PLoS One 2021; 16:e0245511. [PMID: 33497382 PMCID: PMC7837482 DOI: 10.1371/journal.pone.0245511] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/30/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND AIM The association between body mass index (BMI) and functional gastrointestinal disorders (FGIDs) has been inconsistent. We aimed to explore the association of BMI with FGIDs in a primary care setting to provide more data in this area. METHODS A cross-sectional study of consecutive Asian adults attending a primary healthcare setting was conducted. This study was conducted in 2 phases: The association between BMI and common FGIDs (functional diarrhea/FD, irritable bowel syndrome/IBS, functional diarrhea and functional constipation/FC) was studied initially. The influence of anxiety and depression on BMI and FGIDs was additionally explored in phase 2. RESULTS A total of 1002 subjects (median age 32 years, 65.4% females, 90.7% Malay ethnicity, 73.2% higher than secondary level education) were recruited between August 2019 to January 2020. The majority of subjects were obese (39.2%), and had central obesity (51.7%), while 6.1% had metabolic syndrome. The prevalence of FD, IBS, functional diarrhea and FC were 7.5% (n = 75), 4.0% (n = 40), 1.2% (n = 12) and 10.5% (n = 105) respectively, based on the Rome III criteria. Among individual FGIDs, FD subjects had more underweight adults (BMI<18.5kg/m2) compared to controls (13.3% vs 3.5%, P = 0.002) and being underweight remained as an independent association with FD [OR = 3.648 (95%CI 1.494-8.905), P = 0.004] at multi-variate analysis. There were no independent associations between BMI and other FGIDs. When psychological morbidity was additionally explored, anxiety (OR 2.032; 95%CI = 1.034-3.991, p = 0.040), but not depression, and a BMI<18.5kg/m2 (OR 3.231; 95%CI = 1.066-9.796, p = 0.038) were found to be independently associated with FD. CONCLUSIONS FD, but not other FGIDs, is associated with being underweight. This association is independent of the presence of anxiety.
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Affiliation(s)
- Keng Hau Beh
- Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kee Huat Chuah
- Gastroenterology and Hepatology Unit, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Sanjiv Mahadeva
- Gastroenterology and Hepatology Unit, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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302
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Li C, Xu J, Yin D, Zhang Y, Shan D, Jiang X, Shang L. Prevalence and trigger factors of functional gastrointestinal disorders among male civil pilots in China. Sci Rep 2021; 11:2021. [PMID: 33479463 PMCID: PMC7820411 DOI: 10.1038/s41598-021-81825-0;] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 01/04/2021] [Indexed: 06/16/2023] Open
Abstract
Functional gastrointestinal disorders (FGIDs) are common among the aircrew due to their arduous working environment. This study investigated the prevalence of FGIDs in Chinese male pilots and assessed the effects of trigger factors on the FGIDs. A cross-sectional study including 212 male pilots was performed in a Chinese large civil airline company. FGIDs were diagnosed according to the Rome IV diagnostic criteria. The psychological performance, dietary pattern, sleep situation, and physical activity of the respondents were assessed. Logistic regression analysis and structural equation modeling were used to explore the association between these trigger factors and FGIDs. FGIDs were observed in 83 (39.22%) respondents, of which 31 (37.35%) had overlap syndromes. Age, flight level, flight time, high-salt food pattern, anxiety, and sleep performance were found to be associated with FGIDs (all P < 0.05). Stepwise logistic regression analysis revealed that the flight level (OR 0.59, 95% CI 0.31-0.080), high-salt food pattern (OR 2.31, 95% CI 1.28-4.16), and sleep performance (OR 2.39, 95% CI 1.11-5.14) were the influencing factors associated with FGIDs. Structural equation modeling confirmed the correlations between FGIDs and the occupational, dietary, and psychological factors with a reasonable fit. The preventive strategies were necessitated according to occupational and psychological characteristics.
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Affiliation(s)
- Chen Li
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Junrong Xu
- Department of Gastroenterology, The Affiliated Hospital of Northwest University Xi'an No.3 Hospital, No.10 Eastern Section of the Third Fengcheng Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Daiwen Yin
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Yuhai Zhang
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Dezhi Shan
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Xun Jiang
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University, No 1 Xinsi Road, Xi'an, 710032, Shaanxi, People's Republic of China.
| | - Lei Shang
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, 710032, Shaanxi, People's Republic of China.
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303
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Li C, Xu J, Yin D, Zhang Y, Shan D, Jiang X, Shang L. Prevalence and trigger factors of functional gastrointestinal disorders among male civil pilots in China. Sci Rep 2021; 11:2021. [PMID: 33479463 PMCID: PMC7820411 DOI: 10.1038/s41598-021-81825-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 01/04/2021] [Indexed: 12/19/2022] Open
Abstract
Functional gastrointestinal disorders (FGIDs) are common among the aircrew due to their arduous working environment. This study investigated the prevalence of FGIDs in Chinese male pilots and assessed the effects of trigger factors on the FGIDs. A cross-sectional study including 212 male pilots was performed in a Chinese large civil airline company. FGIDs were diagnosed according to the Rome IV diagnostic criteria. The psychological performance, dietary pattern, sleep situation, and physical activity of the respondents were assessed. Logistic regression analysis and structural equation modeling were used to explore the association between these trigger factors and FGIDs. FGIDs were observed in 83 (39.22%) respondents, of which 31 (37.35%) had overlap syndromes. Age, flight level, flight time, high-salt food pattern, anxiety, and sleep performance were found to be associated with FGIDs (all P < 0.05). Stepwise logistic regression analysis revealed that the flight level (OR 0.59, 95% CI 0.31–0.080), high-salt food pattern (OR 2.31, 95% CI 1.28–4.16), and sleep performance (OR 2.39, 95% CI 1.11–5.14) were the influencing factors associated with FGIDs. Structural equation modeling confirmed the correlations between FGIDs and the occupational, dietary, and psychological factors with a reasonable fit. The preventive strategies were necessitated according to occupational and psychological characteristics.
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Affiliation(s)
- Chen Li
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Junrong Xu
- Department of Gastroenterology, The Affiliated Hospital of Northwest University Xi'an No.3 Hospital, No.10 Eastern Section of the Third Fengcheng Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Daiwen Yin
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Yuhai Zhang
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Dezhi Shan
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Xun Jiang
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University, No 1 Xinsi Road, Xi'an, 710032, Shaanxi, People's Republic of China.
| | - Lei Shang
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, No.169 Changlexilu Road, Xi'an, 710032, Shaanxi, People's Republic of China.
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304
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Bachani P, Kumar L, Kumar N, Fatima M, Naz S, Memon MK, Memon S, Rizwan A. Prevalence of Irritable Bowel Syndrome and Frequency of Symptoms in the General Population of Pakistan. Cureus 2021; 13:e12541. [PMID: 33564537 PMCID: PMC7863025 DOI: 10.7759/cureus.12541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Irritable bowel syndrome (IBS) is a chronic and debilitating functional gastrointestinal disorder. Risk factors include infective enteritis, female sex, antibiotic exposure, anxiety, and depression. The aim of this study is to find out the prevalence of IBS in healthy population and determine the characteristics of symptoms. MATERIAL AND METHODS A cross-section study was conducted in the internal medicine unit of a tertiary care hospital in multiple cities of Pakistan. Eight hundred (800) healthy peoples were selected for study from June 2019 to August 2019. Diagnosis of IBS was made by using Rome III criteria. RESULTS The prevalence of irritable bowel syndrome (IBS) in general population in our study was 33.2%. IBS was more common in females compared to males (57.7% vs. 42.2%; p value = 0.009). IBS was more common in age group between 20 and 29 years (45.5%). Among patient diagnosed with IBS in this study, the most common was bloating (74.7%) followed by increased stool frequency (54.4%). CONCLUSION IBS is very prevalent in Pakistan, yet there is very little data and awareness related to it. Any change in stool frequency or consistency in young adults, especially women, shall be evaluated for IBS after ruling out other diseases. Early diagnosis and treatment of IBS will assist in improving the patient's quality of life.
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Affiliation(s)
- Parkash Bachani
- Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Love Kumar
- Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Naresh Kumar
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Maham Fatima
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Sidra Naz
- Internal Medicine, University of Health Sciences, Lahore, PAK
| | - Muhammad Khizar Memon
- Internal Medicine, Liaquat University of Medical and Health Sciences, Hyderabad, PAK
| | - Sidra Memon
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Amber Rizwan
- Family Medicine, Jinnah Post Graduate Medical Center, Karachi, PAK
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305
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Tseng PH, Chiu HM, Tu CH, Wu MS, Ho HN, Chen MJ. Obesity Exacerbates Irritable Bowel Syndrome-Related Sleep and Psychiatric Disorders in Women With Polycystic Ovary Syndrome. Front Endocrinol (Lausanne) 2021; 12:779456. [PMID: 34867827 PMCID: PMC8635163 DOI: 10.3389/fendo.2021.779456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND/OBJECTIVES Polycystic ovary syndrome (PCOS) and irritable bowel syndrome (IBS) share similar clinical and psychosocial features. We aimed to investigate the clinical characteristics of IBS in women with PCOS, and its relationship with obesity, metabolic and hormonal profiles, as well as sleep and psychiatric disorders. SUBJECTS/METHODS This is a cross-sectional case-control study of 431 untreated women with PCOS and 259 healthy volunteers. All participants were assessed with a comprehensive clinical evaluation and two questionnaires: the Athens Insomnia Scale (AIS) and the Brief Symptom Rating Scale (BSRS-5). IBS was diagnosed using the Rome III criteria. Obesity was defined as a BMI ≥30 kg/m2. Anthropometric measurements, metabolic, hormonal profiles, and psychosocial morbidities were compared. RESULTS Women with PCOS were more likely to have IBS (10.7% vs 5.8%, p=0.029) and obesity (29% vs 4%, p<0.001) than healthy volunteers. Mixed-type IBS (IBS-M) was the most common subtype (74%) among patients with PCOS and IBS. There was a higher prevalence of psychiatric morbidities (total BSRS-5 score ≥10) in women with PCOS than in healthy women (11.4% vs 3.5%, p<0.001). Women with PCOS and IBS were more likely to have sleep difficulties (67.4% vs 30.9%, p<0.001) and psychiatric morbidities (21.7% vs 10.1%, p=0.019) than those without IBS. Anthropometrics, metabolic and hormonal profiles were similar between PCOS women with and without IBS. Among women with PCOS, those with both IBS and obesity had the highest risk of developing sleep difficulties (odds ratio: 5.91; 95% confidence interval: 1.77-19.77) and psychiatric distress (odds ratio: 4.39; 95% confidence interval: 1.26-15.29) than those without. CONCLUSION Women with PCOS have increased IBS, obesity, sleep and psychiatric disturbances. The presence of IBS in PCOS women is associated with sleep and psychiatric disorders. The coexistence of obesity and IBS exacerbates sleep difficulties and psychiatric distress. Screening and management of IBS and obesity might be warranted to improve sleep and psychiatric disturbances in women with PCOS.
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Affiliation(s)
- Ping-Huei Tseng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Han-Mo Chiu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Hung Tu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hong-Nerng Ho
- College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
- Research Center for Cell Therapy and Regeneration Medicine, and College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Mei-Jou Chen
- College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
- Livia Shang Yu Wan Chair Professor of Obstetrics and Gynecology, National Taiwan University, Taipei, Taiwan
- *Correspondence: Mei-Jou Chen,
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306
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So SY, Savidge TC. Sex-Bias in Irritable Bowel Syndrome: Linking Steroids to the Gut-Brain Axis. Front Endocrinol (Lausanne) 2021; 12:684096. [PMID: 34093447 PMCID: PMC8170482 DOI: 10.3389/fendo.2021.684096] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/03/2021] [Indexed: 12/12/2022] Open
Abstract
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is more common in females. Despite its high global incidence, the disease mechanism is still unclear and therapeutic options remain limited. The sexual dimorphism in IBS incidence suggests that sex steroids play a role in disease onset and symptoms severity. This review considers sex steroids and their involvement in IBS symptoms and the underlying disease mechanisms. Estrogens and androgens play important regulatory roles in IBS symptomology, including visceral sensitivity, gut motility and psychological conditions, possibly through modulating the gut-brain axis. Steroids are regulators of hypothalamic-pituitary-adrenal activity and autonomic nervous system function. They also modulate gut microbiota and enteric nervous systems, impacting serotonin and mast cell signaling. Sex steroids also facilitate bidirectional cross-talk between the microbiota and host following bacterial transformation and recycling of steroids by the intestine. The sex-specific interplay between sex steroids and the host provides neuroendocrinology insight into the pathophysiology, epigenetics and treatment of IBS patients.
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Affiliation(s)
- Sik Yu So
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, United States
- Texas Children’s Microbiome Center, Department of Pathology, Texas Children’s Hospital, Houston, TX, United States
| | - Tor C. Savidge
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, United States
- Texas Children’s Microbiome Center, Department of Pathology, Texas Children’s Hospital, Houston, TX, United States
- *Correspondence: Tor C. Savidge,
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307
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Shorey S, Demutska A, Chan V, Siah KTH. Adults living with irritable bowel syndrome (IBS): A qualitative systematic review. J Psychosom Res 2021; 140:110289. [PMID: 33227554 DOI: 10.1016/j.jpsychores.2020.110289] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/02/2020] [Accepted: 11/07/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To consolidate existing qualitative studies which examined the experiences and needs of adults living with IBS, and to gather a holistic insight for future directions and avenues to support these adults. METHODS A qualitative systematic review was conducted and six databases were searched for qualitative studies, beginning from each database's inception to July 2020. The qualitative data were meta-synthesised and thematic analysis was adopted. Any discrepancies that arose were discussed between the reviewers until a consensus was reached throughout the process of data screening, selection, critical appraisal and synthesis. RESULTS Seventeen studies with a total of 299 adults diagnosed with IBS were included. Four themes were identified: (1) physical, psychological, and social consequences; (2) impact of IBS on working adults; (3) dealing with IBS; and (4) sources of support and support needs. CONCLUSION Future research across geographically diverse locations are needed to gather a thorough perspective of the experiences and needs of adults living with IBS. The development and evaluation of technology-based, trained peer-led volunteers, and interventions that adopt mindfulness, active coping strategies, cognitive behavioural therapy and acceptance, and commitment therapy are needed. Ultimately, the collaboration between the relevant stakeholders is essential for standardised instruments and materials for accurate testing, diagnosis, assessment, treatment and management of IBS.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11 10 Medical Drive, 117597, Singapore.
| | - Alla Demutska
- James Cook University, 149 Sims Drive, 387380, Singapore
| | - Valerie Chan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11 10 Medical Drive, 117597, Singapore
| | - Kewin Tien Ho Siah
- Division of Gastroenterology & Hepatology, Department of Medicine, National University Hospital, Level 10 Tower Block, 1 E Kent Ridge Road, 119228, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore
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308
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Fairbrass KM, Costantino SJ, Gracie DJ, Ford AC. Prevalence of irritable bowel syndrome-type symptoms in patients with inflammatory bowel disease in remission: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2020; 5:1053-1062. [DOI: 10.1016/s2468-1253(20)30300-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 02/07/2023]
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309
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Prevalence of IBS-type symptoms in IBD. Lancet Gastroenterol Hepatol 2020; 5:1029-1031. [DOI: 10.1016/s2468-1253(20)30291-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/22/2022]
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310
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Vasant DH. Global prevalence of irritable bowel syndrome: time to consider factors beyond diagnostic criteria? Lancet Gastroenterol Hepatol 2020; 5:879-880. [DOI: 10.1016/s2468-1253(20)30211-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 12/19/2022]
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311
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Black CJ, Ford AC. How effective are antibiotics for the treatment of irritable bowel syndrome? Expert Opin Pharmacother 2020; 21:2195-2197. [PMID: 32835541 DOI: 10.1080/14656566.2020.1808623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Christopher J Black
- Leeds Gastroenterology Institute, St. James's University Hospital , Leeds, UK.,Leeds Institute of Medical Research, St. James's, University of Leeds , Leeds, UK
| | - Alexander C Ford
- Leeds Gastroenterology Institute, St. James's University Hospital , Leeds, UK.,Leeds Institute of Medical Research, St. James's, University of Leeds , Leeds, UK
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