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Dent E, Davinson N, Wilkie S. The impact of gastrointestinal conditions on psychosocial factors associated with the biopsychosocial model of health: A scoping review. Appl Psychol Health Well Being 2021; 14:626-644. [PMID: 34866337 DOI: 10.1111/aphw.12323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/04/2021] [Indexed: 11/28/2022]
Abstract
The increase in the prevalence of gastrointestinal (GI) conditions is an emerging global health concern. Studies of the impact on the lives of individuals living with GI conditions such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) typically focus on biological elements, such as symptomology and treatment efficacy. Comparatively fewer studies have explored the psychological and social aspects of GI conditions, which could provide key information needed to better understand the impact of GI conditions on people and their lived experiences. In this review, existing literature concerning the psychosocial factors and well-being outcomes associated with GI conditions was reviewed using a scoping methodology. Sixty-eight studies were selected for inclusion. Of these studies, the well-being outcomes most frequently addressed, for both IBS and IBD, were quality of life and health-related quality of life, and the most frequently addressed psychosocial factors were social support and coping. These outcomes are largely consistent with those identified for other medical conditions explored using the biopsychosocial model of health, with some exploration of the lived experiences of those with a GI condition.
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Affiliation(s)
- Elizabeth Dent
- School of Psychology, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Nicola Davinson
- School of Psychology, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Stephanie Wilkie
- School of Psychology, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
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Jones MP, Shah A, Ben-Jacob R, Talley NJ, Hansen T, Walker MM, Gray M, Koloski NA, Holtmann G. Routine assessment of gastrointestinal symptom using a validated questionnaire in the clinical setting to assess the probability of organic or functional gastrointestinal diseases. Neurogastroenterol Motil 2021; 33:e14091. [PMID: 33512740 DOI: 10.1111/nmo.14091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/07/2021] [Accepted: 01/12/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Patients presenting with gastrointestinal symptoms can be challenging in terms of determining etiology and management strategies. Identifying likely organic pathology is important since it can be treated and may result in further, long-term harm to the patient if not treated. Currently, organic pathology is often identified via invasive procedures such as endoscopy or referral to a medical imaging service. We report on an approach that offers a first step at identifying patients with an organic gastrointestinal disease based on the SAGIS, a validated symptom questionnaire. METHODS 8,922 patients referred to a tertiary care hospital were classified as having either functional gastrointestinal disease or an organic gastrointestinal disease. A model was developed to distinguish organic from functional symptoms on one random split half of the sample and validated on the other half. The incremental benefit of including psychological conditions and extra-gastrointestinal conditions was also evaluated. KEY RESULTS Functional gastrointestinal patients scored higher on average than organic patients on all dimensions of the SAGIS and reported higher rates of psychological and extra-gastrointestinal conditions. All five dimensions of the SAGIS provided statistically independent discrimination of organic from functional diagnoses with good overall discrimination (AUC = 0.75). However, there was no noticeable incremental benefit of adding either psychological or extra-gastrointestinal conditions. Model performance was highly reproducible. CONCLUSIONS AND INFERENCES The proposed algorithm for identifying likely organic gastrointestinal disease applied to symptoms as recorded in the SAGIS questionnaire provides a useful tool for the clinician in deciding what or if further diagnostic testing is required.
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Affiliation(s)
- Michael P Jones
- Psychology Department, Macquarie University, North Ryde, NSW, Australia
| | - Ayesha Shah
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital and Translational Research Institute (TRI, Woolloongabba, QLD, Australia.,Faculty of medicine, University of Queensland, Brisbane, QLD, Australia
| | - Ronen Ben-Jacob
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital and Translational Research Institute (TRI, Woolloongabba, QLD, Australia
| | - Nicholas J Talley
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Teressa Hansen
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital and Translational Research Institute (TRI, Woolloongabba, QLD, Australia
| | - Marjorie M Walker
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Marcus Gray
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital and Translational Research Institute (TRI, Woolloongabba, QLD, Australia.,Faculty of medicine, University of Queensland, Brisbane, QLD, Australia
| | - Natasha A Koloski
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital and Translational Research Institute (TRI, Woolloongabba, QLD, Australia.,Faculty of medicine, University of Queensland, Brisbane, QLD, Australia.,Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Gerald Holtmann
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital and Translational Research Institute (TRI, Woolloongabba, QLD, Australia.,Faculty of medicine, University of Queensland, Brisbane, QLD, Australia
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García Romero R, López Ubeda M, Cardiel Valiente L, Ros Arnal I. The importance of calprotectin for differentiating organic inflammatory disease and avoiding unnecessary procedures in paediatrics. Med Clin (Barc) 2018; 151:231-235. [PMID: 29292106 DOI: 10.1016/j.medcli.2017.11.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 11/14/2017] [Accepted: 11/16/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVE The objective of the study was to determine the ability of faecal calprotectin to differentiate functional and organic intestinal diseases in paediatric patients, and to evaluate the correlation between inflammatory parameters and levels of faecal calprotectin. PATIENTS AND METHODS This retrospective study involved clinical data from 129 paediatric patients with symptoms of intestinal pathology. Faecal calprotectin was determined by quantitative immunoassay. Patients were classified into three groups: functional (32.8% of patients); organic non-inflammatory bowel disease (IBD, 53.9%); and organic IBD (13.3%). RESULTS Calprotectin levels were significantly different among the three groups; between patients with IBD and the others, and also between patients with non-organic IBD and functional. Positive associations were found between high levels of calprotectin and higher erythrocyte sedimentation rate (rho=0.497), C-reactive protein (rho=0.460), and platelet count (rho=0.232). Nevertheless, an inverse correlation was found between high levels of calprotectin and transferrin saturation (rho=-0.310), albumin (rho=-0.412), and haemoglobin levels (rho=-0.309). DISCUSSION Determination of faecal calprotectin is a complementary tool in clinical practice for discriminating between functional and organic IBD, avoiding, according to the levels of calprotectin, unnecessary invasive procedures in paediatric patients.
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Affiliation(s)
- Ruth García Romero
- Department of Paediatric Gastroenterology, Miguel Servet University Hospital, Paseo Isabel La Católica, 1-3, 50009, Zaragoza, Spain.
| | - Marta López Ubeda
- Department of Paediatric Gastroenterology, Miguel Servet University Hospital, Paseo Isabel La Católica, 1-3, 50009, Zaragoza, Spain
| | - Lidia Cardiel Valiente
- Department of Paediatric Gastroenterology, Miguel Servet University Hospital, Paseo Isabel La Católica, 1-3, 50009, Zaragoza, Spain
| | - Ignacio Ros Arnal
- Department of Paediatric Gastroenterology, Miguel Servet University Hospital, Paseo Isabel La Católica, 1-3, 50009, Zaragoza, Spain
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Del'arco APWT, Magalhães P, Quilici FA. SIM BRASIL STUDY - WOMEN'S GASTROINTESTINAL HEALTH: GASTROINTESTINAL SYMPTOMS AND IMPACT ON THE BRAZILIAN WOMEN QUALITY OF LIFE. ARQUIVOS DE GASTROENTEROLOGIA 2017; 54:115-122. [PMID: 28273276 DOI: 10.1590/s0004-2803.201700000-09] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 01/10/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Gastrointestinal symptoms seem to affect more women, due to hormonal and emotional issues, impacting the quality of life. The emotional state can affect the bowel functioning through a bidirectional communication system between the gut and the brain involving the neuroendocrine system. Altered bowel functioning and gastrointestinal symptoms can alter quality of life. OBJECTIVE The SIM study aimed to describe, characterize and quantify gastrointestinal symptoms reported by Brazilian women, their causes, feelings and impact. METHODS A structured electronic questionnaire was developed following qualitative phase for semantic formatting, and was administered to volunteer women in ten Brazilian cities. Descriptive and Bayesian statistics analyses were used. RESULTS From the 3029 respondent, 66% reported gastrointestinal symptoms. The most prevalent symptoms were gases (46%), abdominal distention and constipation (43%). The main causes were lifestyle and eating habits. Gastrointestinal symptoms affected quality of life in most women (62%), especially constipation (mood (89%), concentration (88%) and sexual life (79%)). Most common solutions were drinking water, teas, eating foods rich in fiber and probiotics. CONCLUSION Gastrointestinal symptoms are highly prevalent in Brazilian women and negatively impact different aspects of quality of life (mood, concentration and sexuality). The bowel is an important emotional catalyst that can modulate the psychologic behavior. Better understanding of the interaction between the gut and the brain should help in the management of gastrointestinal symptoms to improve women's quality of life.
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Abstract
Non-specific abdominal complaints are a considerable problem worldwide. Many patients are affected and many differential diagnoses have to be considered. Among these, carbohydrate malabsorption seems to play an important role. However, so far, only incomplete absorption of lactose is broadly accepted, while the malabsorption of fructose and sorbitol is still underestimated, although in many parts of the world it is much more frequent. Despite the success of dietary interventions in many patients, there are still a lot of unanswered questions that make further investigations necessary.
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