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Shin SP, Choi YM, Kim WH, Hong SP, Park JM, Kim J, Kwon O, Lee EH, Hahm KB. A double blind, placebo-controlled, randomized clinical trial that breast milk derived- Lactobacillus gasseri BNR17 mitigated diarrhea-dominant irritable bowel syndrome. J Clin Biochem Nutr 2018; 62:179-186. [PMID: 29610559 PMCID: PMC5874236 DOI: 10.3164/jcbn.17-73] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 08/27/2017] [Indexed: 12/12/2022] Open
Abstract
The exact pathogenesis of diarrhea-dominant irritable bowel syndrome (IBS) is not known, but the abnormal microbiota of the gastrointestinal tract is considered to be one of the important contributing factors as in other gastrointestinal diseases such as inflammatory bowel disease, antibiotic-associated diarrhea, and colorectal cancer as well as systemic diseases. Though diverse trials of probiotics had been continued in the treatment of diarrhea-IBS, only a few proved by randomized clinical trial. To prove the efficacy of Lactobacillus gasseri BNR17 isolated from breast milk in patients with diarrhea-IBS, prospective, randomized, placebo controlled clinical trial was done including health related-quality of life analysis, colon transit time, and the changes of fecal microbiota. BNR17 significantly improved the symptoms of diarrhea compared to control group. Health related-QOL analysis showed significant improvement of abdominal pain, distension, disturbed daily life, and mean defecation frequency with BNR17. On comparative CTT before and after BNR17, 6 out of 24 subjects showed significant correction of rapid colon transit pattern, while only 2 out of 24 in placebo (p<0.01). Upon fecal microbiota analysis, BNR17 significantly increased B. fecalis, E. rectale, C. aerofaciens, F. prausnitzil and B. steroris. Conclusively, Lactobacillus gasseri BNR17 can be a potential probiotics to ameliorate diarrhea-IBS.
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Affiliation(s)
- Suk Pyo Shin
- Department of Gastroenterology, Hallym University Sacred Hospital, Chooncheon, Korea
| | - Yoon Mi Choi
- Digestive Disease Center, CHA University Bundang Medical Center, 59 Yatap-roBundang-gu, Seongnam 13496, Korea
| | - Won Hee Kim
- Digestive Disease Center, CHA University Bundang Medical Center, 59 Yatap-roBundang-gu, Seongnam 13496, Korea
| | - Sung Pyo Hong
- Digestive Disease Center, CHA University Bundang Medical Center, 59 Yatap-roBundang-gu, Seongnam 13496, Korea
| | - Jong-Min Park
- CHA Bio Complex CHA Cancer Prevention Research Center, Pangyo, 13488, Korea
| | - Joohee Kim
- Department of Nutritional Science and Food management, Ewha Woman University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Oran Kwon
- Department of Nutritional Science and Food management, Ewha Woman University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Eun Hyun Lee
- Graduate School of Public Health, Ajou University, Suwon, 16499, Korea
| | - Ki Baik Hahm
- Digestive Disease Center, CHA University Bundang Medical Center, 59 Yatap-roBundang-gu, Seongnam 13496, Korea.,CHA Bio Complex CHA Cancer Prevention Research Center, Pangyo, 13488, Korea
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Lim YJ, Rosita J, Chieng JY, Hazizi AS. The Prevalence and Symptoms Characteristic of Functional Constipation Using Rome III Diagnostic Criteria among Tertiary Education Students. PLoS One 2016; 11:e0167243. [PMID: 27997551 PMCID: PMC5172545 DOI: 10.1371/journal.pone.0167243] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 11/10/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND AIMS Functional constipation is very common with heterogeneous symptoms that have substantial impact on patient quality of life as well as medical resources which are rarely reported as life-threatening. The aim of this study is to examine the prevalence and symptoms characteristic of functional constipation (FC) by using Rome III diagnostic criteria among tertiary education students with an intention to introduce treatment in the future. METHODS Demographic, socio-economics characteristics and symptoms of FC using the Rome III criteria were sought using a questionnaire administered to Malaysian students in a tertiary education setting. Other data obtained were the general health status, lifestyle factors and anthropometric measurements. Using a simple random sampling method, a total of 1662 students were recruited in the study with a response rate of 95.0%. Sampled data are presented as frequency and percentage and stratified accordingly into categories for Chi-square analysis. RESULTS The prevalence of functional constipation among the students was 16.2%, with a significantly higher prevalence among women (17.4%) than men (12.5%). Hard or lumpy stool, incomplete evacuation, anorectal obstruction and straining were reported as the commonest symptoms experienced. Type 3 was the most frequent stool consistency experienced among the constipated individuals (35.2%). Only 4.4% of individuals reported having less than three defecations per week. Using univariable analysis, FC was significantly associated with sex (odds ratio: 1.48, 95% CI: 1.06-2.06) and age group (odds ratio: 1.34, 95% CI: 1.01-1.79) with P value < 0.05 significance level. In multivariate logistic regression analysis, only sex was found significantly associated with FC (adjusted odds ratio: 1.53, 95% CI: 1.08-2.17, P < 0.05). CONCLUSIONS Based on the prevalence rate, constipation is a common problem among tertiary education students (16.2%), with significantly more prevalence among the female respondents. Early detection of symptoms and further intervention studies focusing on treatment recommendation in improving the symptoms are essential.
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Affiliation(s)
- Ying Jye Lim
- Department of Nutrition & Dietetics, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor Darul Ehsan, Malaysia
| | - Jamaluddin Rosita
- Department of Nutrition & Dietetics, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor Darul Ehsan, Malaysia
| | - Jin Yu Chieng
- Department of Medicine, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor Darul Ehsan, Malaysia
| | - Abu Saad Hazizi
- Department of Nutrition & Dietetics, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor Darul Ehsan, Malaysia
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Di Ciaula A, Grattagliano I, Portincasa P. Chronic alcoholics retain dyspeptic symptoms, pan-enteric dysmotility, and autonomic neuropathy before and after abstinence. J Dig Dis 2016; 17:735-746. [PMID: 27684550 DOI: 10.1111/1751-2980.12415] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 09/14/2016] [Accepted: 09/26/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To carry out a comprehensive study on gastrointestinal symptoms, motility and autonomic neuropathy in chronic alcoholics before and one year after abstinence. METHODS Dyspeptic symptoms (questionnaires), fasting and postprandial gallbladder and gastric motility (ultrasonography), oro-cecal transit time (lactulose H2 -breath test), stool form score (indirect marker of colonic transit), and autonomic neuropathy (sweat spot test, R-R ratio) were assessed at baseline in 268 subjects (136 chronic alcoholics and 132 healthy controls). A subgroup of 39 patients was re-evaluated after 12 months of abstinence. RESULTS Chronic alcoholics had increased dyspepsia, delayed gastric emptying and oro-cecal transit time but faster gallbladder emptying, with slightly accelerated colonic transit. Sympathetic, but not parasympathetic, autonomic dysfunction was found. Dyspeptic symptoms and functional alterations of gastric emptying and oro-cecal transit tests were still present after 12-month abstinence, whereas gallbladder motility, stool form score and sympathetic function improved. CONCLUSIONS Chronic alcoholics exhibit combined and interdependent presence of dyspeptic symptoms, impaired motility at different levels of the gastrointestinal tract, with sympathetic dysfunction. Only a few of these abnormalities improve after one year of abstinence from alcohol.
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Affiliation(s)
| | - Ignazio Grattagliano
- Italian College of General Practitioners, Florence, Italy
- Clinica Medica 'A. Murri', Department of Biomedical Sciences and Human Oncology, 'Aldo Moro' University Medical School, Bari, Italy
| | - Piero Portincasa
- Clinica Medica 'A. Murri', Department of Biomedical Sciences and Human Oncology, 'Aldo Moro' University Medical School, Bari, Italy
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Wang FW, Chuang HY, Tu MS, King TM, Wang JH, Hsu CW, Hsu PI, Chen WC. Prevalence and risk factors of asymptomatic colorectal diverticulosis in Taiwan. BMC Gastroenterol 2015; 15:40. [PMID: 25888375 PMCID: PMC4383068 DOI: 10.1186/s12876-015-0267-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 03/11/2015] [Indexed: 12/21/2022] Open
Abstract
Background To investigate the prevalence and risk factors of asymptomatic colorectal diverticulosis in Taiwanese general population. Methods From January 2009 to December 2011, consecutive asymptomatic subjects undergoing a health check-up were evaluated by colonoscopy. The colorectal diverticulosis was assessed, and a medical history and demographic data were obtained from each subject. Logistic regression analysis was conducted to search the risk factors of colorectal diverticulosis. Results Of the 1899 asymptomatic subjects, the prevalence of colorectal diverticulosis was 13.5%. On univariate logistic regression analysis, age over 60 years old, male, adenomatous polyp, current smoking and heavy alcohol consumption were significantly associated with diverticulosis. Multivariate logistic regression analysis revealed that age over 60 years old (relative risk [RR], 2.57; 95% confidence interval [CI], 1.64-6.47), adenomatous polyps (RR, 2.18; 95% CI, 1.18-4.61) and heavy alcohol consumption (RR, 1.82; 95% CI, 1.04-3.08) were independent predictors for colorectal diverticulosis. Conclusions The prevalence of asymptomatic colorectal diverticulosis was 13.5% in Taiwan. Age over 60 years old, adenomatous polyp and heavy alcohol consumption may affect the risk of development of the disease.
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Affiliation(s)
- Fu-Wei Wang
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, 81362, Taiwan. .,Department of Public Health, Kaohsiung Medical University, Kaohsiung City, 803, Taiwan.
| | - Hung-Yi Chuang
- Department of Public Health, Kaohsiung Medical University, Kaohsiung City, 803, Taiwan.
| | - Ming-Shium Tu
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, 81362, Taiwan.
| | - Tai-Ming King
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung City, 81362, Taiwan.
| | - Jui-Ho Wang
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung City, 81362, Taiwan.
| | - Chao-Wen Hsu
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung City, 81362, Taiwan.
| | - Ping-I Hsu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1 st Road, Kaohsiung City, 80424, Taiwan. .,School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Wen-Chi Chen
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1 st Road, Kaohsiung City, 80424, Taiwan. .,School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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5
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Kato I, Startup J, Ram JL. Fecal Biomarkers for Research on Dietary and Lifestyle Risk Factors in Colorectal Cancer Etiology. CURRENT COLORECTAL CANCER REPORTS 2013. [DOI: 10.1007/s11888-013-0195-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Abstract
BACKGROUND AND AIM The exact factors predisposing to colonic diverticulosis other than age are unknown. METHODS Cross-sectional study of asymptomatic subjects undergoing screening colonoscopy. A detailed dietary and social questionnaire was completed on all participants. A worldwide review of the literature was performed to further investigate any association between identified risk factors and diverticulosis. RESULTS Seven hundred forty-six consecutive individuals were enrolled (mean age, 61.1±8.3 y; female: male=0.98). Overall, the prevalence of diverticulosis was 32.8% (95% CI, 29.5-36.2). Diverticula were left-sided, right-sided, or both in 71.5%, 5.8%, and 22.7% of affected subjects, respectively. On univariate analysis, age, sex, adenomatous polyps, advanced neoplasia (adenoma≥1 cm, villous histology, or cancer), aspirin, and alcohol use were significantly associated with diverticulosis. Diet, body mass index, physical activity, and bowel habits were not associated with the disease. On multivariate analysis, increasing age (P<0.001), advanced neoplasia (P=0.021), and alcohol consumption (P<0.001) were significantly associated with diverticulosis. The adjusted odds ratio for diverticulosis in alcohol users was 1.91 (1.36 to 2.69), with increasing prevalence with higher alcohol consumption (P-value for trend=0.001). When the prevalence of diverticulosis reported from 18 countries was analyzed against alcohol use, there was a strong correlation with national per-capita alcohol consumption rates (Pearson correlation coefficient r=0.68; P=0.002). CONCLUSIONS Alcohol use is a significant risk factor for colonic diverticulosis and may offer a partial explanation for the existing East-West paradox in disease prevalence and phenotype. Further studies are needed to investigate this association and its putative pathophysiological mechanisms.
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Abstract
Human defecation involves integrated and coordinated sensorimotor functions, orchestrated by central, spinal, peripheral (somatic and visceral), and enteric neural activities, acting on a morphologically intact gastrointestinal tract (including the final common path, the pelvic floor, and anal sphincters). The multiple factors that ultimately result in defecation are best appreciated by describing four temporally and physiologically fairly distinct phases. This article details our current understanding of normal defecation, including recent advances, but importantly identifies those areas where knowledge or consensus is still lacking. Appreciation of normal physiology is central to directed treatment of constipation and also of fecal incontinence, which are prevalent in the general population and cause significant morbidity.
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Affiliation(s)
- Somnath Palit
- Academic Surgical Unit (GI Physiology Unit), Barts and the London School of Medicine and Dentistry, Blizard Institute, Queen Mary University, London, UK.
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Ono S, Komada Y, Kamiya T, Shirakawa S. A Pilot Study of the Relationship between Bowel Habits and Sleep Health by Actigraphy Measurement and Fecal Flora Analysis. J Physiol Anthropol 2008; 27:145-51. [DOI: 10.2114/jpa2.27.145] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Delvaux M, Gay G. [Management of a patient with functional diarrhea]. GASTROENTEROLOGIE CLINIQUE ET BIOLOGIQUE 2006; 30:415-20. [PMID: 16633307 DOI: 10.1016/s0399-8320(06)73196-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Affiliation(s)
- Michel Delvaux
- Unité de Médecine Interne à Orientation Digestive, Hôpitaux de Brabois Adultes, CHU de Nancy, Vandoeuvre Les Nancy
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Abstract
Both acute and chronic alcohol consumption have severe effects on the structure and function of the entire gastrointestinal tract (GIT) which result in a vicious cycle. The healthy person who begins to drink heavily, first experiences the toxic effects of high concentrations of ethanol. Mucosal damage compromises the basic functions of the GIT. Suppression of the gastrointestinal immune system and increased transport of toxins across the mucosa result in increased susceptibility to infections. Inhibition of digestion, absorption and secretion cause diarrhea and reduce the transfer of nutrients to the rest of the body. As the individual becomes more dependent on alcohol, the functional reserve and regenerative capacity of the GIT are overwhelmed and malnutrition increases. The rate of progression of this cycle depends on several factors including nutritional intake. Whilst the clinical effects of alcohol are well recognized, more research is required to fully elucidate the underlying mechanisms.
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Affiliation(s)
- Rajkumar Rajendram
- Nutritional Sciences Research Division, School of Biomedical and Health Sciences, King's College London, London, UK.
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11
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Abstract
Colonic motility disorders are common conditions. However, our understanding of normal, and, consequently, pathological motor function of the colon remains limited, mainly due to the relative inaccessibility of this organ for study. Investigation of colonic motility may encompass one or more of the four separate components (myoelectric activity, phasic and tonic contractile activity and movement of intraluminal content) using electrophysiological, manometric or transit studies. Although transit studies provide the best 'functional' appreciation of colonic motor activity, and are the only techniques used in contemporary clinical practice, manometric methods are becoming increasingly popular, as they allow a direct study of colonic contractile activity over prolonged periods. To date, the majority of studies have been limited to the pelvic colon by a retrograde (per rectal) approach; however, recent technological advances have facilitated 'pan-colonic' investigation. This review concentrates on manometry of the human colon proximal to the sigmoid, and includes evaluation of both phasic and tonic motor activity, by utilization of perfused-tube and solid-state manometric catheters, and also the electronic barostat. Methodological techniques, experimental protocols and the analysis and interpretation of recorded data are critically explored, and a contemporary classification of colonic contractile activities is presented.
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Affiliation(s)
- S M Scott
- Academic Department of Surgery, GI Physiology Unit, Barts and the London, Queen Mary School of Medicine & Dentistry, The Royal London Hospital, Whitechapel, London, UK.
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12
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Abstract
Consumption of large quantities of alcoholic beverages leads to disturbances in the intestinal absorption of nutrients including several vitamins. The inhibition of the absorption of sodium and water caused by alcohol contributes to the tendency in alcoholics to develop diarrhoea. Excessive alcohol consumption (even a single episode) can result in duodenal erosions and bleeding and mucosal injury in the upper jejunum. An increased prevalence for bacterial overgrowth in the small intestine may contribute to functional and/or morphological abnormalities of this part of the gut and also to non-specific abdominal complaints in alcoholics. The mucosal damage caused by alcohol increases the permeability of the gut to macromolecules. This facilitates the translocation of endotoxin and other bacterial toxins from the gut lumen to the portal blood, thereby increasing the liver's exposure to these toxins and, consequently, the risk of liver injury. The results of recent experimental studies support the assumption that alcohol significantly modulates the mucosal immune system of the gut.
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Affiliation(s)
- Christiane Bode
- Division of Physiology of Nutrition, Department of Biological Chemistry and Nutrition, Hohenheim University, Garbenstr. 28, D-70599, Stuttgart, Germany.
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Dukas L, Willett WC, Giovannucci EL. Association between physical activity, fiber intake, and other lifestyle variables and constipation in a study of women. Am J Gastroenterol 2003; 98:1790-6. [PMID: 12907334 DOI: 10.1111/j.1572-0241.2003.07591.x] [Citation(s) in RCA: 178] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Because the risk factors for constipation in the general population are poorly defined, we examined the association between age, body mass index, and selected lifestyle and dietary factors with the prevalence of constipation in the Nurses' Health Study.A total of 62,036 women, aged 36-61 yr and free of cancer, responded to mailed questionnaires in 1980 and 1982, which assessed bowel movement frequency, dietary, and lifestyle factors. Constipation was defined as two or fewer bowel movements weekly.A total of 3327 women (5.4%) were classified as having constipation. Age and body mass index were inversely associated with constipation (p for trend < 0.0001). In multivariate analysis, women who reported daily physical activity had a lower prevalence of constipation (prevalence ratio [PR] = 0.56, 95% CI = 0.44-0.70). Women in the highest quintile of dietary fiber intake (median intake 20 g/day) were less likely to experience constipation (PR = 0.64, 95% CI = 0.57-0.73) than women in the lowest quintile (median intake 7 g/day). The PR for constipation for women who both reported daily physical activity and were in the highest quintile of fiber intake was 0.32 (95% CI = 0.20-0.54) compared with those with physical activity less than once weekly and those who were in the lowest quintile of fiber intake. Higher frequency of aspirin intake was associated with an increasing prevalence of constipation (PR = 1.38, 95% CI = 1.17-1.62). Current smoking and alcohol use were inversely associated with constipation. Our data suggest that moderate physical activity and increasing fiber intake are associated with substantial reduction in the prevalence of constipation in women.
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Affiliation(s)
- Laurent Dukas
- Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts 02115, USA
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Abstract
Regardless of the type and dose of beverage involved, alcohol facilitates the development of gastroesophageal reflux disease by reducing the pressure of the lower esophageal sphincter and esophageal motility. Fermented and nondistilled alcoholic beverages increase gastrin levels and acid secretion. Succinic and maleic acid contained in certain alcoholic drinks also stimulate acid secretion. Low alcohol doses accelerate gastric emptying, whereas high doses delay emptying and slow bowel motility. Alcohol facilitates the development of superficial gastritis and chronic atrophic gastritis--though it has not been shown to cause peptic ulcer. Alcoholic beverages, fundamentally wine, have important bactericidal effects upon Helicobacter pylori and enteropathogenic bacteria. The main alcohol-related intestinal alterations are diarrhea and malabsorption, with recovery after restoring a normal diet. Alcohol facilitates the development of oropharyngeal, esophageal, gastric, and colon cancer. Initial research suggests that wine may be comparatively less carcinogenic.
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Affiliation(s)
- L Bujanda
- Department of Gastroenterology, San Eloy Hospital, Baracaldo, Spain
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Abstract
Abstract Alcohol generates a large caloric yield without supplying any essential nutrients; alcoholics may thus maintain body weight while suffering from malnutrition. In addition, diarrhea is a common complaint of both acute and chronic alcoholics. Here, we review the effects of alcohol on gastrointestinal morphology, function, its nervous system and motility. Acute morphological changes such as erosions, inflammatory cell infiltrations and microvascular changes are seen in the stomach and small intestine in acute alcoholics. In addition, atrophic gastritis, reduced villous height and decreased mucosal surface area of the small intestine have been described in chronic alcoholics. Acute administration of alcohol inhibits absorption of nutrients and fluids, and can stimulate secretion of water and electrolytes. Bacterial overgrowth in the proximal small intestine and decreased pancreatic secretions have been also described in chronic alcoholics. The well-known deleterious effects of alcohol on the central nervous system raise the possibility of similar acute and chronic effects of the enteric nervous system. Such effects could alter motility and transit. Indeed, esophageal dysmotility and delayed gastric emptying have been observed with high concentrations of alcohol in experimental studies and in chronic alcoholics. Small bowel motility and transit may be abnormal in both acute and chronic alcoholics, and colonic propulsive motility is increased after acute administration of alcohol. Any, or all, of these changes in gastrointestinal functions may contribute to diarrhea in acute binge drinkers and chronic alcoholics. Unfortunately, there is a lack of systematic studies of the pathophysiology of alcohol abuse, and an integrating concept of the diarrhea of alcoholics is still not possible.
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Affiliation(s)
- T Chiba
- Division of Gastroenterology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
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Abstract
Patients recovering from alcohol and other drug addiction have unique medical and pharmacological needs. Careful selection of medications call decrease the risk of relapse. Angiotensin-converting enzyme inhibitors and calcium channel-blocking medications are excellent choices to treat hypertension. Most gastrointestinal problems resolve with abstinence and can be treated nonpharmacologically. In managing pain, physicians should avoid narcotics and use nonpharmacological treatment whenever possible. Treating recovering patients with HIV can be challenging because of the side effects of many of the antiviral medications. The newer antiviral agents have fewer side effects and contraindications. Commonly used remedies for colds and cough can cause a relapse to drug use. Patients with diabetes mellitus need to be monitored very closely in early recovery to prevent hypoglycemia. Frequently a team approach is helpful in managing the medication needs of patients in recovery.
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Affiliation(s)
- J E Schulz
- Department of Family Medicine, East Carolina University School of Medicine, Greenville, North Carolina 27858-4354, USA
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Bowers JM, Dols CL, Barreuther CJ. Diarrhea in HIV-infected individuals: a review. AIDS Patient Care STDS 1996; 10:25-31. [PMID: 11361655 DOI: 10.1089/apc.1996.10.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Affiliation(s)
- G C Cook
- Hospital for Tropical Diseases, London
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Bouchoucha M, Salles JP, Fallet M, Frileux P, Cugnenc PH, Barbier JP. Effect of pinaverium bromide on jejunal motility and colonic transit time in healthy humans. Biomed Pharmacother 1992; 46:161-5. [PMID: 1421047 DOI: 10.1016/0753-3322(92)90024-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Pinaverium bromide is a specific calcium channel blocker used in the treatment of irritable bowel syndrome (IBS) for its spasmolytic activity. The aim of the present study was to evaluate the effect of orally administered pinaverium bromide on jejunal motility and total and segmental colonic transit time in control subjects. Gastrointestinal studies were performed in 10 healthy volunteers (30 +/- 3 years), before and after a treatment phase of 14 days (150 mg/d). Jejunal motility was measured by prolonged manometry (14 h) and colonic transit time by a multiple ingestion, single marker technique. No significant modification of phase III of the migrating motor complexes was demonstrated. On the contrary, a significant (p < 0.01) but weak decrease of the frequency of contraction was found. Unlike previous studies, no decrease of total or segmental colonic transit time was demonstrated.
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Affiliation(s)
- M Bouchoucha
- Service d'Explorations Fonctionnelles, Hôpital-Laennec, Paris, France
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