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Guo Z, Long T, Yao J, Li Y, Xiao L, Chen M. Potential antidepressant effects of Traditional Chinese botanical drug formula Chaihu-Shugan-San and its active ingredients. Front Pharmacol 2024; 15:1337876. [PMID: 38628641 PMCID: PMC11019007 DOI: 10.3389/fphar.2024.1337876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/13/2024] [Indexed: 04/19/2024] Open
Abstract
Background: Depression is a severe mental disorder that poses a significant threat to both the physical and mental wellbeing of individuals. Currently, there are various methods for treating depression, including traditional Chinese herbal formulations like Chaihu-Shugan-San (CSS), which have shown effective antidepressant effects in both clinical and animal research. Objective: This review aims to provide a comprehensive synthesis of evidence related to CSS, considering both preclinical and clinical studies, to uncover its potential multi-level, multi-pathway, and multi-target mechanisms for treating depression and identify its active ingredients. Methods: A thorough search was conducted in electronic databases, including PubMed, MEDLINE, Web of Science, Google Scholar, CNKI, and Wanfang, using keywords such as "Chaihu Shugan" and "depression" to retrieve relevant literature on CSS and its active ingredients. The review process adhered to the PRISMA guidelines. Results: This review consolidates the mechanisms underlying antidepressant effects of CSS and its active ingredients. It emphasizes its involvement in the regulation of monoaminergic neurotransmitter systems, synaptic plasticity, and the hypothalamic-pituitary-adrenal axis, among other aspects. Conclusion: CSS exerts a pivotal role in treating depression through various pathways, including the monoaminergic neurotransmitter system, the hypothalamic-pituitary-adrenal axis, synaptic plasticity, inflammation, brain-derived neurotrophic factor levels, and the brain-gut axis. This review facilitates a comprehensive understanding of the current state of CSS research, fostering an in-depth exploration of the etiological mechanisms of depression and the potential discovery of novel antidepressant drugs.
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Affiliation(s)
- Ziyi Guo
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, Macao SAR, China
| | - Tianjian Long
- Henan University of Chinese Medicine, Zhengzhou, China
| | - Jianping Yao
- Henan University of Chinese Medicine, Zhengzhou, China
| | - Yamin Li
- Henan University of Chinese Medicine, Zhengzhou, China
| | - Lu Xiao
- Zunyi Medical University, Zhuhai, China
| | - Min Chen
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, Macao SAR, China
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Sundas A, Sampath H, Lamtha SC, Soohinda G, Dutta S. Psychosocial quality-of-life correlates in functional gastrointestinal disorders. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2024; 89:11-18. [PMID: 35810093 DOI: 10.1016/j.rgmxen.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 04/22/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION AND AIM Functional gastrointestinal disorders (FGIDs) are complex illnesses characterized by gastrointestinal symptoms, with no underlying organic pathology. They are common, chronic, recurrent, and disabling disorders that significantly impair quality of life (QoL). The aim of the present cross-sectional analytical study was to assess QoL and its correlates in adult patients with FGIDs. MATERIALS AND METHODS A cross-sectional, observational, hospital-based study was conducted at the gastroenterology outpatient department of a tertiary care teaching hospital. The ROME IV diagnostic criteria were used to identify the FGIDs. Anxiety, depression, coping strategies, social support, and QoL were assessed by the hospital anxiety and depression scale, the coping strategies inventory, the multidimensional scale of perceived social support, and the functional digestive disorders quality-of-life questionnaire, respectively. RESULTS Of the 52 consecutive patients diagnosed with FGIDs, functional dyspepsia (51.92%) and irritable bowel syndrome (40.38%) were the most common. There were no significant associations between sociodemographic variables (age, sex, marital status, socioeconomic status, educational level, employment, occupation, dietary pattern) and QoL scores (all p values >0.05). Duration and social support were not significantly associated with QoL (all p values >0.05). In contrast, psychological variables, such as disengagement coping (r=-0.344, p=0.012), depression (r=-0.600, p=0.000), and anxiety (r=-0.590, p=0.000), were significantly correlated with QoL. CONCLUSIONS Despite advances in neurogastroenterology, patients continue to be disabled by FGIDs. Psychological factors, especially depression, significantly contribute to poor QoL in those patients and should be addressed in a holistic, multidisciplinary way. The biopsychosocial framework, as it applies to FGIDs, should lead to the inclusion of psychosocial assessments in the clinical management and research of those disorders.
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Affiliation(s)
- A Sundas
- Instituto Central de Psiquiatría, Ranchi, India
| | - H Sampath
- Departamento de Psiquiatría, Hospital Central de Referencias, Instituto de Ciencias Médicas de Sikkim Manipal, Universidad de Sikkim Manipal, Gangtok, Sikkim, India.
| | - S C Lamtha
- Departamento de Gastroenterología, Nuevo Hospital de Gobierno STNM, Gangtok, Sikkim, India
| | - G Soohinda
- Departamento de Psiquiatría, Hospital Central de Referencias, Instituto de Ciencias Médicas de Sikkim Manipal, Universidad de Sikkim Manipal, Gangtok, Sikkim, India
| | - S Dutta
- Departamento de Psiquiatría, Hospital Central de Referencias, Instituto de Ciencias Médicas de Sikkim Manipal, Universidad de Sikkim Manipal, Gangtok, Sikkim, India
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Tran TTT, Luu MN, Tran LL, Nguyen D, Quach DT, Hiyama T. Association of mental health conditions and functional gastrointestinal disorders among Vietnamese new-entry medical students. PLoS One 2023; 18:e0289123. [PMID: 37490495 PMCID: PMC10368230 DOI: 10.1371/journal.pone.0289123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/12/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Functional gastrointestinal disorders (FGIDs), also known as disorders of gut-brain interaction, occur not only in the elderly but also in young adults. This study aimed to evaluate the association between mental health conditions and FGIDs among Vietnamese new-entry medical students. METHODS This cross-sectional study was conducted in February 2022 among new-entry medical students in Ho Chi Minh City, Vietnam. A printed questionnaire was distributed to all students on the day of freshmen health screening. Their urine samples were collected to screen for Helicobacter pylori infection using rapid urinary test. FGIDs were diagnosed using ROME IV criteria. Gastroesophageal reflux disease (GERD) was defined as the presence of typical reflux symptoms at least twice a week. Mental health conditions, including generalized anxiety disorder (GAD) and major depressive disorder (MDD), were identified using Generalized Anxiety Disorder Assessment-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scales, respectively. RESULTS Among 400 new-entry medical students who participated in the study, the overall prevalence of FGIDs was 10.3% (functional dyspepsia 6.5%, irritable bowel disease 5.5%). The overlap syndrome (OS) of GERD-FGIDs or different FGIDs was present in 3.0% of participants. The prevalences of GAD and MDD were 6.8% and 10.2%, respectively. The urinary test was positive in 180 (45.0%) participants. In the multivariable logistic regression analysis, MDD was significantly associated with not only the risk of FGIDs (OR = 5.599, 95%CI: 2.173-14.430, p<0.001) but also the risk of OS (OR = 10.076, 95CI%: 2.243-45.266, p = 0.003). CONCLUSIONS MDD is associated with FGIDs and OS among new-entry medical students.
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Affiliation(s)
- Tam Thao Tuyet Tran
- Department of Family Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Mai Ngoc Luu
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Linh Le Tran
- Department of Family Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Duy Nguyen
- Department of General Surgery, Central Highlands Regional General Hospital, Buon Ma Thuot City, Daklak, Vietnam
| | - Duc Trong Quach
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Toru Hiyama
- Health Service Center, Hiroshima University, Higashihiroshima, Japan
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4
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Fairlie T, Shah A, Talley NJ, Chey WD, Koloski N, Yeh Lee Y, Gwee KA, Jones MP, Holtmann G. Overlap of disorders of gut-brain interaction: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2023:S2468-1253(23)00102-4. [PMID: 37211024 DOI: 10.1016/s2468-1253(23)00102-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/29/2023] [Accepted: 03/29/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Rome criteria differentiate distinct types of disorders of gut-brain interaction (DGBI); also known as functional gastrointestinal disorders. Overlap of symptom categories frequently occurs. This systematic review and meta-analysis aimed to define the prevalence of DGBI overlap and compare overlap in population-based, primary care or tertiary care health settings. Furthermore, we aimed to compare symptom severity of psychological comorbidities in DGBI with and without overlap. METHODS For this systematic review and meta-analysis we searched MEDLINE (PubMed) and Embase electronic databases from inception until March 1, 2022, for original articles and conference abstracts of observational cross-sectional, case-controlled, or cohort design studies that reported the prevalence of DGBI overlap in adult participants (aged ≥18 years). We included only those studies where the diagnosis of DGBI was based on clinical assessment, questionnaire data, or specific symptom-based criteria. Studies were excluded if reporting on mixed populations of DGBI and organic diseases. Aggregate patient data were extracted from eligible published studies. The prevalence of DGBI overlap in all studies was pooled using the DerSimonian and Laird random effects model, and further analysis stratified by subgroups (care setting, diagnostic criteria, geographic region, and gross domestic product per capita). We also assessed the relationship between DGBI overlap with anxiety, depression, and quality of life symptom scores. This study was registered with PROSPERO (CRD42022311101). FINDINGS 46 of 1268 screened studies, reporting on 75 682 adult DGBI participants, were eligible for inclusion in this systematic review and meta-analysis. Overall, 24 424 (pooled prevalence 36·5% [95% CI 30·7 to 42·6]) participants had a DGBI overlap, with considerable between-study heterogeneity (I2=99·51, p=0·0001). In the tertiary health-care setting, overlap among participants with DGBI was more prevalent (8373 of 22 617, pooled prevalence 47·3% [95% CI 33·2 to 61·7]) compared with population-based cohorts (11 332 of 39 749, pooled prevalence 26·5% [95% CI 20·5 to 33·4]; odds ratio 2·50 [95% CI 1·28 to 4·87]; p=0·0084). Quality of life physical component scores were significantly lower in participants with DGBI overlap compared with participants without overlap (standardised mean difference -0·47 [95% CI -0·80 to -0·14]; p=0·025). Participants with DGBI overlap had both increased symptom scores for anxiety (0·39 [95% CI 0·24 to 0·54]; p=0·0001) and depression (0·41 [0·30 to 0·51]; p=0·0001). INTERPRETATION Overlap of DGBI subtypes is frequent, and is more prevalent in tertiary care settings and associated with more severe symptom manifestations or psychological comorbidities. Despite the large sample size, the comparative analyses revealed substantial heterogeneity, and the results should be interpreted with caution. FUNDING National Health and Medical Research Council and Centre for Research Excellence.
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Affiliation(s)
- Thomas Fairlie
- Faculty of Medicine and Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Ayesha Shah
- Faculty of Medicine and Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Nicholas J Talley
- School of Medicine and Public Health, and Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - William D Chey
- Division of Gastroenterology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Natasha Koloski
- Faculty of Medicine and Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia; School of Medicine and Public Health, and Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Kok-Ann Gwee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael P Jones
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - Gerald Holtmann
- Faculty of Medicine and Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia.
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5
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Dong X, Zhao D. Ferulic acid as a therapeutic agent in depression: Evidence from preclinical studies. CNS Neurosci Ther 2023. [PMID: 37183361 PMCID: PMC10401106 DOI: 10.1111/cns.14265] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/17/2023] [Accepted: 05/03/2023] [Indexed: 05/16/2023] Open
Abstract
Depression is a common but severe mood disorder with a very high prevalence across the general population. Depression is of global concern and poses a threat to human physical and mental health. Ferulic acid (FA) is a natural active ingredient that has antioxidative, anti-inflammatory, and free radical scavenging properties. Furthermore, studies have shown that FA can exert antidepressant effects through a variety of mechanisms. The aim of the review was to comprehensively elucidate the mechanisms in FA that alleviate depression using animal models. The in vivo (animal) studies on the mechanism of FA treatment of depression were searched in PubMed, Chinese National Knowledge Infrastructure, Baidu academic, and Wan fang databases. Thereafter, the literature conclusions were summarized accordingly. Ferulic acid was found to significantly improve the depressive-like behaviors of animal models, suggesting that FA is a potential natural product in the treatment of depression. The mechanisms are achieved by enhancing monoamine oxidase A (MOA) activity, inhibiting microglia activation and inflammatory factor release, anti-oxidative stress, promoting hippocampal nerve regeneration, increasing brain-derived neurotrophic factor secretion, regulating gut microbiome, and activating protein kinase B/collapsin response mediator protein 2 (AKT/CRMP2) signaling pathway. Ferulic acid produces significant antidepressant effects in animal depression models through various mechanisms, suggesting its potential value as a treatment of depression. However, clinical research trials involving FA are required further to provide a solid foundation for its clinical application.
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Affiliation(s)
- Xiaoyu Dong
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Dongxue Zhao
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
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Sebaratnam G, Karulkar N, Calder S, Woodhead JS, Keane C, Carson DA, Varghese C, Du P, Waite SJ, Tack J, Andrews CN, Broadbent E, Gharibans AA, O’Grady G. Standardized system and App for continuous patient symptom logging in gastroduodenal disorders: Design, implementation, and validation. Neurogastroenterol Motil 2022; 34:e14331. [PMID: 35156270 PMCID: PMC9541247 DOI: 10.1111/nmo.14331] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/09/2022] [Accepted: 01/22/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Functional gastroduodenal disorders include functional dyspepsia, chronic nausea and vomiting syndromes, and gastroparesis. These disorders are common, but their overlapping symptomatology poses challenges to diagnosis, research, and therapy. This study aimed to introduce and validate a standardized patient symptom-logging system and App to aid in the accurate reporting of gastroduodenal symptoms for clinical and research applications. METHODS The system was implemented in an iOS App including pictographic symptom illustrations, and two validation studies were conducted. To assess convergent and concurrent validity, a diverse cohort with chronic gastroduodenal symptoms undertook App-based symptom logging for 4 h after a test meal. Individual and total post-prandial symptom scores were averaged and correlated against two previously validated instruments: PAGI-SYM (for convergent validity) and PAGI-QOL (for concurrent validity). To assess face and content validity, semi-structured qualitative interviews were conducted with patients. KEY RESULTS App-based symptom reporting demonstrated robust convergent validity with PAGI-SYM measures of nausea (rS =0.68), early satiation (rS =0.55), bloating (rS =0.48), heartburn (rS =0.47), upper gut pain (rS =0.40), and excessive fullness (rS =0.40); all p < 0.001 (n = 79). The total App-reported Gastric Symptom Burden Score correlated positively with PAGI-SYM (rS =0.56; convergent validity; p < 0.001), and negatively with PAGI-QOL (rS = -0.34; concurrent validity; p = 0.002). Interviews demonstrated that the pictograms had adequate face and content validity. CONCLUSIONS AND INFERENCES The continuous patient symptom-logging App demonstrated robust convergent, concurrent, face, and content validity when used within a 4-h post-prandial test protocol. The App will enable standardized symptom reporting and is anticipated to provide utility in both research and clinical practice.
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Affiliation(s)
| | | | - Stefan Calder
- The University of AucklandAucklandNew Zealand,Alimetry LtdAucklandNew Zealand
| | - Jonathan S.T. Woodhead
- Alimetry LtdAucklandNew Zealand,Maurice Wilkins Centre for Molecular BiodiscoveryAucklandNew Zealand
| | - Celia Keane
- The University of AucklandAucklandNew Zealand,Alimetry LtdAucklandNew Zealand
| | | | | | - Peng Du
- The University of AucklandAucklandNew Zealand,Alimetry LtdAucklandNew Zealand
| | | | - Jan Tack
- Department of GastroenterologyUniversity HospitalsLeuvenBelgium
| | - Christopher N. Andrews
- Alimetry LtdAucklandNew Zealand,Division of GastroenterologyCumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | | | - Armen A. Gharibans
- The University of AucklandAucklandNew Zealand,Alimetry LtdAucklandNew Zealand
| | - Greg O’Grady
- The University of AucklandAucklandNew Zealand,Alimetry LtdAucklandNew Zealand
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7
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Goyal O, Goyal P, Kishore H, Kaur J, Kumar P, Sood A. Quality of life in Indian patients with functional dyspepsia: Translation and validation of the Hindi version of Short-Form Nepean Dyspepsia Index. Indian J Gastroenterol 2022; 41:378-388. [PMID: 35188623 DOI: 10.1007/s12664-021-01233-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 12/02/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND/PURPOSE Patients with functional dyspepsia (FD) have poor health-related quality of life (HRQOL), but Indian data are lacking. Also, there is non-availability of validated disease-specific questionnaire to assess HRQOL in Hindi-speaking patients with dyspepsia. We aimed to develop and validate a reliable translation of Short-Form Nepean Dyspepsia Index (SF-NDI) in Hindi, and assess the impact of FD on HRQOL in Indian patients. METHODS Cross-cultural adaptation of English version of SF-NDI, translation to Hindi, and adaptation of Hindi version were performed using standard procedures. English and Hindi versions were assessed against Short Form-36 (SF-36), examining for internal consistency, test-retest reliability, and validity. RESULTS Total 211 FD patients (144 Hindi speaking, 67 English speaking) were enrolled (mean age 40.8 ± 11.7 years; male:female = 115:96). Median total SF-NDI scores for both languages were 38.75 and 40.0, respectively. Test-retest reliability intraclass correlation coefficients were 0.85 (Hindi) and 0.89 (English). Internal consistency evaluation revealed Cronbach's α coefficient of 0.79-0.86 (Hindi) and 0.78-0.89 (English). SF-NDI sub-scales showed moderate to good correlation with various domains of SF-36 (content validity). There was significant (p < 0.001) decline of HRQOL in patients with severe dyspepsia relative to those with mild dyspepsia (construct validity). On multivariate analysis, factors independently associated with HRQOL were duration of symptoms and dyspepsia severity. CONCLUSION Both English and Hindi versions of SF-NDI are reliable and valid for HRQOL assessment in Indian FD patients, and will be useful in future epidemiological and clinical studies. Indian FD patients have poor HRQOL, being worse in those with severe dyspepsia and longer duration of symptoms.
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Affiliation(s)
- Omesh Goyal
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana 141 001, India.
| | - Prerna Goyal
- Department of Medicine, Baba Jaswant Singh Dental College Hospital and Research Institute, Ludhiana, 141 010, India
| | - Harsh Kishore
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana 141 001, India
| | - Jaskirat Kaur
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana 141 001, India
| | - Paraag Kumar
- Department of Gastroenterology, MM Institute of Medical Sciences and Research, Mullana 133 203, India
| | - Ajit Sood
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana 141 001, India
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Lee JY, Kim N, Park JH, Yu JE, Song YJ, Yoon JW, Lee DH. Sex and Gender Differences in Overlap Syndrome of Functional Gastrointestinal Disorder and Effect of Genetic Polymorphisms in South Korea: A Long-term Follow-up Study. J Neurogastroenterol Motil 2022; 28:145-158. [PMID: 34980697 PMCID: PMC8748849 DOI: 10.5056/jnm21047;] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 10/02/2021] [Accepted: 10/11/2021] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND/AIMS Overlap functional gastrointestinal disorder (FGID) is associated with more severe gastrointestinal symptoms and lower quality of life. The aim of this study is to evaluate clinical features of non-erosive reflux disease (NERD), functional dyspepsia, irritable bowel syndrome, their overlap in terms of sex and gender, and to assess the risk factors, including genetic polymorphisms. METHODS A total of 494 FGIDs and 239 controls were prospectively enrolled between 2004 and 2020. FGIDs were diagnosed based on the Rome III criteria and symptoms were evaluated using a questionnaire. Follow-up questionnaires were conducted to determine the change of symptoms during the 75.8-month mean observation period. Risk factors including genetic polymorphisms in neurotransmitter receptor (SLC6A4 5-HTTLPR, GNB3, ADRA2A, CCKAR, and TRPV1) and cytokine (TNFA and IL10) genes. RESULTS NERD was more prevalent in men, and functional dyspepsia in women. Overlap FGIDs (n = 239) were more prevalent than nonoverlap FGIDs (n = 255) in women (P = 0.019). Anxiety and depression scores were higher in the overlaps (P = 0.012 and P < 0.001, respectively). Symptoms were more frequent and severe in the overlap FGIDs than in the non-overlaps (P < 0.001). During followup, symptoms progressed more frequently in the overlap FGIDs, especially in patients with the L/S genotype of SLC6A4 5-HTTLPR and anxiety/depression. CONCLUSIONS Overlap FGID patients need attention given their association with anxiety/depression and more severe symptoms, especially in women. Genetic polymorphisms also may be associated with certain symptoms of overlap FGIDs.
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Affiliation(s)
- Ju Yup Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Hyun Park
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong Eun Yu
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea
| | - Yun Jeong Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea
| | - Jung Won Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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9
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Lee JY, Kim N, Park JH, Yu JE, Song YJ, Yoon JW, Lee DH. Sex and Gender Differences in Overlap Syndrome of Functional Gastrointestinal Disorder and Effect of Genetic Polymorphisms in South Korea: A Long-term Follow-up Study. J Neurogastroenterol Motil 2022; 28:145-158. [PMID: 34980697 PMCID: PMC8748849 DOI: 10.5056/jnm21047] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 10/02/2021] [Accepted: 10/11/2021] [Indexed: 12/13/2022] Open
Abstract
Background/Aims Overlap functional gastrointestinal disorder (FGID) is associated with more severe gastrointestinal symptoms and lower quality of life. The aim of this study is to evaluate clinical features of non-erosive reflux disease (NERD), functional dyspepsia, irritable bowel syndrome, their overlap in terms of sex and gender, and to assess the risk factors, including genetic polymorphisms. Methods A total of 494 FGIDs and 239 controls were prospectively enrolled between 2004 and 2020. FGIDs were diagnosed based on the Rome III criteria and symptoms were evaluated using a questionnaire. Follow-up questionnaires were conducted to determine the change of symptoms during the 75.8-month mean observation period. Risk factors including genetic polymorphisms in neurotransmitter receptor (SLC6A4 5-HTTLPR, GNB3, ADRA2A, CCKAR, and TRPV1) and cytokine (TNFA and IL10) genes. Results NERD was more prevalent in men, and functional dyspepsia in women. Overlap FGIDs (n = 239) were more prevalent than non-overlap FGIDs (n = 255) in women (P = 0.019). Anxiety and depression scores were higher in the overlaps (P = 0.012 and P < 0.001, respectively). Symptoms were more frequent and severe in the overlap FGIDs than in the non-overlaps (P < 0.001). During follow-up, symptoms progressed more frequently in the overlap FGIDs, especially in patients with the L/S genotype of SLC6A4 5-HTTLPR and anxiety/depression. Conclusions Overlap FGID patients need attention given their association with anxiety/depression and more severe symptoms, especially in women. Genetic polymorphisms also may be associated with certain symptoms of overlap FGIDs.
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Affiliation(s)
- Ju Yup Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea.,Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea.,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Hyun Park
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong Eun Yu
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea
| | - Yun Jeong Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea
| | - Jung Won Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea.,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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10
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Klaassen T, Smeets FGM, Vork L, Tack J, Talley NJ, Simrén M, Aziz Q, Ford AC, Kruimel JW, Conchillo JM, Leue C, Masclee AAM, Keszthelyi D. Psychometric evaluation of an experience sampling method-based patient-reported outcome measure in functional dyspepsia. Neurogastroenterol Motil 2021; 33:e14136. [PMID: 33934444 PMCID: PMC8519073 DOI: 10.1111/nmo.14136] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/16/2021] [Accepted: 03/09/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Due to important biases, conventional end-of-day and end-of-week assessment methods of gastrointestinal symptoms in functional dyspepsia (FD) are considered suboptimal. Real-time symptom assessment based on the experience sampling method (ESM) could be a more accurate measurement method. This study aimed to evaluate validity and reliability of an ESM-based patient-reported outcome measure (PROM) for symptom assessment in FD. METHODS Thirty-five patients with FD (25 female, mean age 44.7 years) completed the ESM-based PROM (a maximum of 10 random moments per day) and an end-of-day symptom diary for 7 consecutive days. On day 7, end-of-week questionnaires were completed including the Nepean Dyspepsia Index (NDI) and Patient Assessment of Gastrointestinal Symptom Severity Index (PAGI-SYM). KEY RESULTS Experience sampling method and corresponding end-of-day scores for gastrointestinal symptoms were significantly associated (ICCs range 0.770-0.917). However, end-of-day scores were significantly higher (Δ0.329-1.031) than mean ESM scores (p < 0.05). Comparing ESM with NDI and PAGI-SYM scores, correlations were weaker (Pearson's r range 0.467-0.846). Cronbach's α coefficient was good for upper gastrointestinal symptoms (α = 0.842). First half-week and second half-week scores showed very good consistency (ICCs range 0.913-0.975). CONCLUSION AND INFERENCES Good validity and reliability of a novel ESM-based PROM for assessing gastrointestinal symptoms in FD patients was demonstrated. Moreover, this novel PROM allows to evaluate individual symptom patterns and can evaluate interactions between symptoms and environmental/contextual factors. ESM has the potential to increase patients' disease insight, provide tools for self-management, and improve shared decision making. Hence, this novel tool may aid in the transition toward personalized health care for FD patients.
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Affiliation(s)
- Tim Klaassen
- Division of Gastroenterology‐HepatologyDepartment of Internal MedicineSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht University Medical Centre+MaastrichtThe Netherlands
| | - Fabienne G. M. Smeets
- Division of Gastroenterology‐HepatologyDepartment of Internal MedicineSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht University Medical Centre+MaastrichtThe Netherlands
| | - Lisa Vork
- Division of Gastroenterology‐HepatologyDepartment of Internal MedicineSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht University Medical Centre+MaastrichtThe Netherlands
| | - Jan Tack
- Department of Clinical and Experimental MedicineTranslational Research Centre for Gastrointestinal Disorders (TARGID)University of LeuvenLeuvenBelgium
| | - Nicholas J. Talley
- Faculty of Health and MedicineUniversity of NewcastleCallaghanNSWAustralia
| | - Magnus Simrén
- Department of Molecular and Clinical MedicineInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Qasim Aziz
- Centre for Neuroscience and TraumaWingate Institute of NeurogastroenterologyBlizard Institute, Barts and the London School of Medicine & DentistryQueen Mary University of LondonLondonUK
| | - Alexander C. Ford
- Leeds Gastroenterology InstituteLeeds Teaching Hospitals NHS TrustLeedsUK,Leeds Institute of Medical Research at St. James'sUniversity of LeedsLeedsUK,Leeds Institute of Biomedical and Clinical SciencesUniversity of LeedsLeedsUK
| | - Joanna W. Kruimel
- Division of Gastroenterology‐HepatologyDepartment of Internal MedicineSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht University Medical Centre+MaastrichtThe Netherlands
| | - José M. Conchillo
- Division of Gastroenterology‐HepatologyDepartment of Internal MedicineSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht University Medical Centre+MaastrichtThe Netherlands
| | - Carsten Leue
- Department of Psychiatry and PsychologyMaastricht University Medical CentreMaastrichtThe Netherlands
| | - Adrian A. M. Masclee
- Division of Gastroenterology‐HepatologyDepartment of Internal MedicineSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht University Medical Centre+MaastrichtThe Netherlands
| | - Daniel Keszthelyi
- Division of Gastroenterology‐HepatologyDepartment of Internal MedicineSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht University Medical Centre+MaastrichtThe Netherlands
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11
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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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12
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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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13
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Yao X, Yang Y, Zhang S, Shi Y, Zhang Q, Wang Y. The impact of overlapping functional dyspepsia, belching disorders and functional heartburn on anxiety, depression and quality of life of Chinese patients with irritable bowel syndrome. BMC Gastroenterol 2020; 20:209. [PMID: 32631285 PMCID: PMC7336672 DOI: 10.1186/s12876-020-01357-1;] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 06/23/2020] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Functional dyspepsia (FD), belching disorders (BD) and functional heartburn (FH) are the three most common upper functional gastrointestinal disorders (FGID) in IBS patients. FD is known to exert deleterious effects on health-related quality of life (HRQoL) and the psychological status of IBS patients; however, the impact of overlapping BD and FH on anxiety, depression and HRQoL of IBS patients remains unknown. This cross-sectional study was conducted to investigate the impact of overlapping FD, BD and FH on anxiety, depression and HRQoL in patients with IBS. METHODS This study enrolled 319 consecutive outpatients with IBS from 2 tertiary hospitals in Beijing and Shijiazhuang of China. IBS, FD, BD and FH were diagnosed using the Rome III Criteria. Hospital Anxiety and Depression Scale and a 36-item Short-Form Health Survey (SF-36) were used to assess the psychological distress and HRQoL of patients respectively. RESULTS Among the 319 patients with IBS, the IBS subtypes were diarrhoea (67%), constipation (16%), unsubtyped (12%) and mixed (5%). These IBS patients were further classified into IBS + FD, IBS + BD/FH (BD and/or FH), IBS + FD + BD/FH, or IBS only according to the patients' overlapping upper GI symptoms. IBS+FD patients reported higher levels of anxiety than IBS+BD/FH and elevated depression scores than IBS only patients (P< 0.05). The latter observation remained consistent after confounder-adjustment. The IBS + FD and IBS + FD + BD/FH groups exhibited statistically significant impairment in most of SF-36 scales, while the IBS + BD/FH group only showed lower HRQoL results in general health, when compared to the IBS only group. Multiple linear regression analysis demonstrated IBS + FD + BD/FH was linked to worse mental, physical and global HRQoL. Furthermore, IBS + FD was a strong predictor of poorer physical and global HRQoL compared to IBS only. CONCLUSIONS Among the diarrhoea-prevalent IBS patients, those with concomitant FD experienced more psychological distress and demonstrated poorer physical HRQoL. Overlapping FD + BD/FH is a significant predictor of worse mental and physical HRQoL for IBS patients. The impact of concomitant BD and FH on the psychological status and HRQoL of IBS patients was limited. These findings implied that the overlapping upper FGIDs in IBS might be treated distinctively when developing comprehensive management strategies for IBS treatment.
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Affiliation(s)
- Xin Yao
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, No. 95 Yongan Road, Beijing, 100050 China
- Department of Gastroenterology, Bethune International Peace Hospital, No. 398 Zhongshanxi Road, Shijiazhuang, 050082 China
- Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853 China
| | - Yunsheng Yang
- Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853 China
| | - Shutian Zhang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, No. 95 Yongan Road, Beijing, 100050 China
| | - Yu Shi
- Clinical Epidemiology and EBM Unit, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050 China
| | - Qian Zhang
- Clinical Epidemiology and EBM Unit, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050 China
| | - Yongjun Wang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, No. 95 Yongan Road, Beijing, 100050 China
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14
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The impact of overlapping functional dyspepsia, belching disorders and functional heartburn on anxiety, depression and quality of life of Chinese patients with irritable bowel syndrome. BMC Gastroenterol 2020; 20:209. [PMID: 32631285 PMCID: PMC7336672 DOI: 10.1186/s12876-020-01357-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 06/23/2020] [Indexed: 02/07/2023] Open
Abstract
Background Functional dyspepsia (FD), belching disorders (BD) and functional heartburn (FH) are the three most common upper functional gastrointestinal disorders (FGID) in IBS patients. FD is known to exert deleterious effects on health-related quality of life (HRQoL) and the psychological status of IBS patients; however, the impact of overlapping BD and FH on anxiety, depression and HRQoL of IBS patients remains unknown. This cross-sectional study was conducted to investigate the impact of overlapping FD, BD and FH on anxiety, depression and HRQoL in patients with IBS. Methods This study enrolled 319 consecutive outpatients with IBS from 2 tertiary hospitals in Beijing and Shijiazhuang of China. IBS, FD, BD and FH were diagnosed using the Rome III Criteria. Hospital Anxiety and Depression Scale and a 36-item Short-Form Health Survey (SF-36) were used to assess the psychological distress and HRQoL of patients respectively. Results Among the 319 patients with IBS, the IBS subtypes were diarrhoea (67%), constipation (16%), unsubtyped (12%) and mixed (5%). These IBS patients were further classified into IBS + FD, IBS + BD/FH (BD and/or FH), IBS + FD + BD/FH, or IBS only according to the patients’ overlapping upper GI symptoms. IBS+FD patients reported higher levels of anxiety than IBS+BD/FH and elevated depression scores than IBS only patients (P< 0.05). The latter observation remained consistent after confounder-adjustment. The IBS + FD and IBS + FD + BD/FH groups exhibited statistically significant impairment in most of SF-36 scales, while the IBS + BD/FH group only showed lower HRQoL results in general health, when compared to the IBS only group. Multiple linear regression analysis demonstrated IBS + FD + BD/FH was linked to worse mental, physical and global HRQoL. Furthermore, IBS + FD was a strong predictor of poorer physical and global HRQoL compared to IBS only. Conclusions Among the diarrhoea-prevalent IBS patients, those with concomitant FD experienced more psychological distress and demonstrated poorer physical HRQoL. Overlapping FD + BD/FH is a significant predictor of worse mental and physical HRQoL for IBS patients. The impact of concomitant BD and FH on the psychological status and HRQoL of IBS patients was limited. These findings implied that the overlapping upper FGIDs in IBS might be treated distinctively when developing comprehensive management strategies for IBS treatment.
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15
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Tavakoli T, Hoseini M, Tabatabaee TSJ, Rostami Z, Mollaei H, Bahrami A, Ayati S, Bijari B. Comparison of dialectical behavior therapy and anti-anxiety medication on anxiety and digestive symptoms in patients with functional dyspepsia. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2020; 25:59. [PMID: 33088296 PMCID: PMC7554546 DOI: 10.4103/jrms.jrms_673_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/30/2019] [Accepted: 03/09/2020] [Indexed: 12/26/2022]
Abstract
Background: Functional dyspepsia is a common chronic digestive disorder. The purpose of this study was to compare the effectiveness of dialectical behavior therapy and anti-anxiety medication in patients with functional dyspepsia. Materials and Methods: The present study was a randomized, controlled clinical trial with sixty patients who were suffering from functional dyspepsia that identified by the ROME III criteria. Patients were divided into three groups by using pre- and posttest design, including Group A (dialectal treatment and pantoprazole), Group B (anxiolytic drug treatment and pantoprazole), and Group C (no intervention, only pantoprazole were used). The Beck Anxiety Inventory and the patient assessment of Gastrointestinal Symptom Severity Index Questionnaire were completed by the patients after receiving the written consent. Finally, the data were analyzed using the Statistical Package for the Social Sciences software version 20. Results: There was a significant improvement in the severity of dyspepsia after intervention in all three groups. The greatest decrease in the severity of functional dyspepsia was observed in the dialectical behavioral therapy group as compared to the other groups (Group A: −15.4 ± 6.61, Group B: −3.85 ± 2.77, and Group C: −7.8 ± 4.02; P = 0.001). Furthermore, the Beck Anxiety Inventory scores were statistically significantly improved in all three groups (Group A: −5.75 ± 2.53, Group B: −7.3 ± 3.19, and Group C: −2.60 ± 1.5; P = 0.001). There was a positive correlation between the change in dyspepsia score and change in anxiety score across different intervention groups (r = 0.55; P < 0.001). Conclusion: Dialectical behavioral therapy can be effective in reducing anxiety and improving the dyspepsia symptoms in patients with functional dyspepsia compared to anti-anxiety medication or conventional therapy. Therefore, communication between the physicians and psychologists and psychiatrists can have positive effects on the treatment of these patients.
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Affiliation(s)
- Tahmine Tavakoli
- Department of Gastroenterology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Masoud Hoseini
- Department of Gastroenterology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Zeinab Rostami
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Homa Mollaei
- Department of Biology, Faculty of Sciences, University of Birjand, Birjand, Iran
| | - Afsane Bahrami
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Sara Ayati
- Department of Gastroenterology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Bita Bijari
- Department of Community Medicine, Cardiovascular Disease Research Center, Birjand University of Medical Sciences, Birjand, Iran
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16
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Luo L, Du L, Shen J, Cen M, Dai N. Benefit of small dose antidepressants for functional dyspepsia: Experience from a tertiary center in eastern China. Medicine (Baltimore) 2019; 98:e17501. [PMID: 31593119 PMCID: PMC6799471 DOI: 10.1097/md.0000000000017501] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [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
BACKGROUND Traditional treatment of functional dyspepsia (FD) is unsatisfactory in a subgroup of patients with FD, and the potential role of antidepressant medications also has not been definitely clarified. To provide more evidence for future optimal practice recommendations, we reviewed a 1-year clinical database of antidepressant agents applied in outpatients with FD. METHODS Clinical presentations, treatment course, and outcomes were determined by chart review of patients referring to the functional gastrointestinal disorders specialist clinic. One hundred thirty patients with FD were included for further analysis. RESULTS Patients were treated with different antidepressant drugs according to individual symptoms. The most commonly used drugs were flupenthixol melitracen and fluoxetine. Improvement and complete remission occurred in 93.8% and 54.6% of patients, respectively. There was a trend toward superior outcome for citalopram compared to sulpiride and mirtazapine in overall analysis. Meanwhile, regimens containing fluoxetine had significant increased remission rate compared to any other antidepressant regimens in postprandial distress syndrome subgroup analysis. Furthermore, older patients were more likely to achieve remission. However, sex and symptom duration were not associated with symptom remission. Finally, 11.5% of patients experienced adverse events. CONCLUSIONS This retrospective cohort study indicated that small dose antidepressant therapy, especially citalopram and fluoxetine, is an effective and well tolerated treatment option for refractory FD.
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Affiliation(s)
- Liang Luo
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou
| | - Lijun Du
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou
| | - Jinhua Shen
- Department of Gastroenterology, Affiliated Hospital of Shaoxing University, Shaoxing, China
| | - Mengsha Cen
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou
| | - Ning Dai
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou
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17
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Batebi S, Masjedi Arani A, Jafari M, Sadeghi A, Saberi Isfeedvajani M, Davazdah Emami MH. Validity and Reliability of the Persian Version of Leeds Dyspepsia Questionnaire. Galen Med J 2019; 8:e1609. [PMID: 34466536 PMCID: PMC8343703 DOI: 10.31661/gmj.v8i0.1609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/19/2019] [Accepted: 10/01/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND It is essential in clinical care services to measure the symptoms of functional dyspepsia both in the primary examination and treatment outcomes. No valid assessment tool is already available for functional dyspepsia in Iran. The present study aimed at evaluating the reliability, validity, and responsiveness of the Leeds dyspepsia questionnaire (LDQ). MATERIALS AND METHODS The LDQ was completed by 67 subjects with no dyspepsia symptoms and 93 subjects with certain functional dyspepsia diagnosed via endoscopy by a gastroenterologist and other clinical assessments. After definite diagnosis of functional dyspepsia, the participants were assessed by the LDQ. The psychometric characteristics of the questionnaire were then documented to investigate its reliability, validity, and responsiveness. RESULTS The internal consistency of the LDQ ranged from 0.80 to 0.89 and its test-retest reproducibility was 0.96. The LDQ was significantly correlated with all domains of dyspepsia symptom severity index (DSSI) and also with some of the domains of gastrointestinal symptom rating scale (GSRS). The LDQ had a sensitivity of 90.3% with a great specificity and a very good predictive validity. Moreover, a significant responsiveness to changes was observed (P<0.05). CONCLUSION The LDQ is a valid, reliable, reproducible, and self-rated instrument responsive to change, which can be used to measure the frequency and severity of functional dyspepsia symptoms in clinical trials.
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Affiliation(s)
- Sepideh Batebi
- Department of Clinical Psychology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Masjedi Arani
- Department of Clinical Psychology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Correspondence to: Abbas Masjedi Arani, Department of Clinical Psychology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Telephone Number: +9823031548 Email Address:
| | - Mahdi Jafari
- Department of Clinical Psychology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Sadeghi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Saberi Isfeedvajani
- Medicine, Quran and Hadith Research Center & Department of Community Medicine, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
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18
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Pohl D, Van Oudenhove L, Törnblom H, Le Nevé B, Tack J, Simrén M. Functional Dyspepsia and Severity of Psychologic Symptoms Associate With Postprandial Symptoms in Patients With Irritable Bowel Syndrome. Clin Gastroenterol Hepatol 2018; 16:1745-1753.e1. [PMID: 29702295 DOI: 10.1016/j.cgh.2018.04.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 03/18/2018] [Accepted: 04/13/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Patients with irritable bowel syndrome (IBS) have an increased response of postprandial symptoms to a combined lactulose nutrient challenge test, compared with healthy volunteers. We investigated the associations among comorbid functional dyspepsia (FD), severity of psychologic symptoms, and breath test results in response to this test. METHODS We performed a prospective study of 205 patients with IBS (Rome III criteria), 94 of whom also had FD (IBS-FD), and 83 healthy volunteers in Sweden from 2008 through 2015. All participants completed a breath hydrogen test after a 400-mL liquid meal with 25 g lactulose. Gastrointestinal (GI) symptom severity was assessed using a graded scale and digestive comfort was recorded before the meal and every 15 minutes until 240 minutes after the meal. GI symptom scores over time were compared between groups using linear mixed models with anxiety, depression, and somatization as covariates. RESULTS Average levels of all GI symptoms varied over time among all groups (P < .0001). Patients with IBS-FD had higher levels of bloating (P = .004), abdominal pain (P = .005), and lower levels of digestive comfort (P < .01) than patients with only IBS. We observed a difference in increase in abdominal pain from baseline between IBS-FD and IBS groups (P = .013). Anxiety levels were associated with levels of all symptoms (all P < .025) except abdominal pain, which was associated with somatization severity (P < .0001). Furthermore, anxiety levels associated with level of exhaled hydrogen (P = .0042). CONCLUSIONS In a prospective study of patients with IBS, we found those with FD to have increased GI symptoms before and after a liquid meal with lactulose. Anxiety and somatization have an independent additional effect. The presence of comorbid FD and levels of psychologic symptoms affect reports of food-related symptoms in patients with IBS. ClinicalTrial.gov no: NCT01252550.
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Affiliation(s)
- Daniel Pohl
- Functional Diagnostics Laboratory, Division of Gastroenterology, University Hospital Zurich, Zurich, Switzerland.
| | - Lukas Van Oudenhove
- Translational Research Center for Gastrointestinal Disorders, University of Leuven, Belgium
| | - Hans Törnblom
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Sweden
| | | | - Jan Tack
- Translational Research Center for Gastrointestinal Disorders, University of Leuven, Belgium
| | - Magnus Simrén
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Sweden; Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina, Chapel Hill, North Carolina
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19
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Hussain Z, Jung DH, Lee YJ, Park H. The Effect of Trimebutine on the Overlap Syndrome Model of Guinea Pigs. J Neurogastroenterol Motil 2018; 24:669-675. [PMID: 30114898 PMCID: PMC6175557 DOI: 10.5056/jnm18049] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 05/11/2018] [Accepted: 06/12/2018] [Indexed: 12/21/2022] Open
Abstract
Background/Aims Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are common gastrointestinal (GI) disorders and these patients frequently overlap. Trimebutine has been known to be effective in controlling FD co-existing diarrhea-dominant IBS, however its effect on overlap syndrome (OS) patients has not been reported. Therefore, we investigated the effect of trimebutine on the model of OS in guinea pigs. Methods Male guinea pigs were used to evaluate the effects of trimebutine in corticotropin-releasing factor (CRF) induced OS model. Different doses (3, 10, and 30 mg/kg) of trimebutine were administered orally and incubated for 1 hour. The next treatment of 10 μg/kg of CRF was intraperitoneally injected and stabilized for 30 minutes. Subsequently, intragastric 3 mL charcoal mix was administered, incubated for 10 minutes and the upper GI transit analyzed. Colonic transits were assessed after the same order and concentrations of trimebutine and CRF treatment by fecal pellet output assay. Results Different concentrations (1, 3, and 10 μg/kg) of rat/human CRF peptides was tested to establish the OS model in guinea pigs. CRF 10 μg/kg was the most effective dose in the experimental OS model of guinea pigs. Trimebutine (3, 10, and 30 mg/kg) treatment significantly reversed the upper and lower GI transit of CRF induced OS model. Trimebutine significantly increased upper GI transit while it reduced fecal pellet output in the CRF induced OS model. Conclusions Trimebutine has been demonstrated to be effective on both upper and lower GI motor function in peripheral CRF induced OS model. Therefore, trimebutine might be an effective drug for the treatment of OS between FD and IBS patients.
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Affiliation(s)
- Zahid Hussain
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Da Hyun Jung
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Ju Lee
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyojin Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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20
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Kani HT, Dural U, Sakalli Kani A, Yanartas O, Kiziltas S, Yilmaz Enc F, Atug O, Deyneli O, Kuscu K, Imeryuz N. Evaluation of depression, anxiety, alexithymia, attachment, social support and somatization in functional dyspepsia. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1480081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- Haluk Tarik Kani
- Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey
| | - Uzay Dural
- Department of Psychology, Istanbul Medipol University, Istanbul, Turkey
| | - Ayse Sakalli Kani
- Department of Psychiatry, Marmara University School of Medicine, Istanbul, Turkey
| | - Omer Yanartas
- Department of Psychiatry, Marmara University School of Medicine, Istanbul, Turkey
| | - Safak Kiziltas
- Department of Gastroenterology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Feruze Yilmaz Enc
- Department of Gastroenterology, Goztepe Education and Research Hospital, Istanbul, Turkey
| | - Ozlen Atug
- Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey
| | - Oguzhan Deyneli
- Department of Endocrinology and Metabolism, Marmara University School of Medicine, Istanbul, Turkey
| | - Kemal Kuscu
- Department of Psychiatry, Marmara University School of Medicine, Istanbul, Turkey
| | - Nese Imeryuz
- Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey
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21
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Hantoro IF, Syam AF, Mudjaddid E, Setiati S, Abdullah M. Factors associated with health-related quality of life in patients with functional dyspepsia. Health Qual Life Outcomes 2018; 16:83. [PMID: 29720190 PMCID: PMC5930843 DOI: 10.1186/s12955-018-0913-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 04/25/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) assessment is important for patients with functional dyspepsia. However, no studies have assessed factors associated with HRQoL reduction in such patients in an Asian population. This study aimed to determine the contribution of clinical, psychosocial, and demographic factors to HRQoL in affected patients in Indonesia. METHODS In a cross-sectional study, we recruited 124 patients in a tertiary hospital with functional dyspepsia according to Rome III criteria. HRQoL was measured using the Medical Outcomes Study Short-Form 36 (SF-36) physical component summary (PCS) and mental component summary (MCS) and compared with 2009 United States population norms. The factors investigated were age, gender, symptom severity, education level, employment status, anxiety, depression, and ethnicity. Factors associated with reduced HRQoL were identified using linear regression analysis. RESULTS All domains of HRQoL except vitality were impaired in patients with functional dyspepsia. The mean PCS was 42.3 (SD = 8.4); and the mean MCS was 47.8 (SD = 10). Increasing age (p = 0.002), female gender (p = 0.006), low-to-mid education level (p = 0.015) and greater symptom severity (p < 0.001) were significantly associated with impaired PCS (R2 = 0.36). Female gender (p = 0.047), greater symptom severity (p = 0.002), anxiety (p = 0.001), and depression (p = 0.002 were all significantly associated with an impaired MCS (R2 = 0.41). There were no significant associations between HRQoL and with ethnic group (Javanese/non-Javanese) or employment status. CONCLUSIONS There was significant HRQoL impairment in these patients with functional dyspepsia in Indonesia. Anxiety, depression, increasing age, female gender, greater symptom severity, and low-to-mid education level were significant factors associated with low HRQoL. TRIAL REGISTRATION: ClinicalTrials.gov NCT03321383 . Registered 18 October 2017 retrospectively registered.
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Affiliation(s)
- Ibnu Fajariyadi Hantoro
- Departement of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta, 10430 Indonesia
| | - Ari Fahrial Syam
- Division of Gastroenterology, Departement of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta, 10430 Indonesia
| | - Endang Mudjaddid
- Division of Psychosomatic, Departement of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta, 10430 Indonesia
| | - Siti Setiati
- Clinical Epidemiology Unit, Departement of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta, 10430 Indonesia
| | - Murdani Abdullah
- Division of Gastroenterology, Departement of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta, 10430 Indonesia
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Hantoro IF, Syam AF, Mudjaddid E, Setiati S, Abdullah M. Factors associated with health-related quality of life in patients with functional dyspepsia. Health Qual Life Outcomes 2018; 16:83. [PMID: 29720190 PMCID: PMC5930843 DOI: 10.1186/s12955-018-0913-z;] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 04/25/2018] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) assessment is important for patients with functional dyspepsia. However, no studies have assessed factors associated with HRQoL reduction in such patients in an Asian population. This study aimed to determine the contribution of clinical, psychosocial, and demographic factors to HRQoL in affected patients in Indonesia. METHODS In a cross-sectional study, we recruited 124 patients in a tertiary hospital with functional dyspepsia according to Rome III criteria. HRQoL was measured using the Medical Outcomes Study Short-Form 36 (SF-36) physical component summary (PCS) and mental component summary (MCS) and compared with 2009 United States population norms. The factors investigated were age, gender, symptom severity, education level, employment status, anxiety, depression, and ethnicity. Factors associated with reduced HRQoL were identified using linear regression analysis. RESULTS All domains of HRQoL except vitality were impaired in patients with functional dyspepsia. The mean PCS was 42.3 (SD = 8.4); and the mean MCS was 47.8 (SD = 10). Increasing age (p = 0.002), female gender (p = 0.006), low-to-mid education level (p = 0.015) and greater symptom severity (p < 0.001) were significantly associated with impaired PCS (R2 = 0.36). Female gender (p = 0.047), greater symptom severity (p = 0.002), anxiety (p = 0.001), and depression (p = 0.002 were all significantly associated with an impaired MCS (R2 = 0.41). There were no significant associations between HRQoL and with ethnic group (Javanese/non-Javanese) or employment status. CONCLUSIONS There was significant HRQoL impairment in these patients with functional dyspepsia in Indonesia. Anxiety, depression, increasing age, female gender, greater symptom severity, and low-to-mid education level were significant factors associated with low HRQoL. TRIAL REGISTRATION: ClinicalTrials.gov NCT03321383 . Registered 18 October 2017 retrospectively registered.
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Affiliation(s)
- Ibnu Fajariyadi Hantoro
- Departement of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta, 10430 Indonesia
| | - Ari Fahrial Syam
- Division of Gastroenterology, Departement of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta, 10430 Indonesia
| | - Endang Mudjaddid
- Division of Psychosomatic, Departement of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta, 10430 Indonesia
| | - Siti Setiati
- Clinical Epidemiology Unit, Departement of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta, 10430 Indonesia
| | - Murdani Abdullah
- Division of Gastroenterology, Departement of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta, 10430 Indonesia
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Kim SY, Choung RS, Lee SK, Choe JW, Jung SW, Hyun JJ, Koo JS, Lee SW, Shin C. Self-reported Sleep Impairment in Functional Dyspepsia and Irritable Bowel Syndrome. J Neurogastroenterol Motil 2018; 24:280-288. [PMID: 29605983 PMCID: PMC5885727 DOI: 10.5056/jnm17098;] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/18/2017] [Accepted: 12/12/2017] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND/AIMS Sleep impairment is a common complaint among patients with irritable bowel syndrome (IBS) and functional dyspepsia (FD). This study aimed to evaluate the prevalence of sleep impairment in FD or IBS patients, and to determine whether IBS-FD overlap induced more sleep disturbance than FD or IBS alone. METHODS A population-based cohort in South Korea including 2251 subjects was asked about gastrointestinal symptoms including IBS and dyspepsia-related symptoms. In addition, sleep disturbance was measured using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale questionnaires. One-way ANOVA and logistic regression were used to assess differences among the 4 groups (healthy subjects, IBS alone, FD alone, and IBS-FD overlap). RESULTS Of 2251 subjects who were surveyed by questionnaire, 2031 responded (92.5% response rate) and were analyzed. The prevalence of IBS, FD, and IBS-FD overlap was 8.0% (95% confidence interval [CI], 6.8-9.2%), 4.8% (95% CI, 3.9-5.8%), and 1.8% (95% CI, 1.2-2.4%), respectively. FD alone, but not IBS alone, was significantly associated with a poorer sleep quality index (OR, 2.68; 95% CI, 1.43-5.01) and more daytime sleepiness (OR, 2.21; 95% CI, 1.14-4.30), compared to healthy subjects. IBS-FD overlap had the greatest likelihood of a poorer sleep quality index (OR, 3.88; 95% CI, 1.83-8.19), daytime sleepiness (OR, 2.47; 95% CI, 1.01-5.67), and insomnia (OR, 2.84; 95% CI, 1.39-5.82), compared to healthy subjects. CONCLUSION A correlation between functional gastrointestinal disorders and sleep disturbance was demonstrated, which was significantly pronounced in the context of IBS-FD overlap.
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Affiliation(s)
- Seung Young Kim
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Rok Seon Choung
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota,
USA
| | - Seung Ku Lee
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan,
Korea
| | - Jung Wan Choe
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Sung Woo Jung
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Jong Jin Hyun
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Ja Seol Koo
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Sang Woo Lee
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Chol Shin
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan,
Korea
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Kim SY, Choung RS, Lee SK, Choe JW, Jung SW, Hyun JJ, Koo JS, Lee SW, Shin C. Self-reported Sleep Impairment in Functional Dyspepsia and Irritable Bowel Syndrome. J Neurogastroenterol Motil 2018; 24:280-288. [PMID: 29605983 PMCID: PMC5885727 DOI: 10.5056/jnm17098] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/18/2017] [Accepted: 12/12/2017] [Indexed: 12/13/2022] Open
Abstract
Background/Aims Sleep impairment is a common complaint among patients with irritable bowel syndrome (IBS) and functional dyspepsia (FD). This study aimed to evaluate the prevalence of sleep impairment in FD or IBS patients, and to determine whether IBS-FD overlap induced more sleep disturbance than FD or IBS alone. Methods A population-based cohort in South Korea including 2251 subjects was asked about gastrointestinal symptoms including IBS and dyspepsia-related symptoms. In addition, sleep disturbance was measured using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale questionnaires. One-way ANOVA and logistic regression were used to assess differences among the 4 groups (healthy subjects, IBS alone, FD alone, and IBS-FD overlap). Results Of 2251 subjects who were surveyed by questionnaire, 2031 responded (92.5% response rate) and were analyzed. The prevalence of IBS, FD, and IBS-FD overlap was 8.0% (95% confidence interval [CI], 6.8–9.2%), 4.8% (95% CI, 3.9–5.8%), and 1.8% (95% CI, 1.2–2.4%), respectively. FD alone, but not IBS alone, was significantly associated with a poorer sleep quality index (OR, 2.68; 95% CI, 1.43–5.01) and more daytime sleepiness (OR, 2.21; 95% CI, 1.14–4.30), compared to healthy subjects. IBS-FD overlap had the greatest likelihood of a poorer sleep quality index (OR, 3.88; 95% CI, 1.83–8.19), daytime sleepiness (OR, 2.47; 95% CI, 1.01–5.67), and insomnia (OR, 2.84; 95% CI, 1.39–5.82), compared to healthy subjects. Conclusion A correlation between functional gastrointestinal disorders and sleep disturbance was demonstrated, which was significantly pronounced in the context of IBS-FD overlap.
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Affiliation(s)
- Seung Young Kim
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Rok Seon Choung
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Seung Ku Lee
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Korea
| | - Jung Wan Choe
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sung Woo Jung
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Jong Jin Hyun
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ja Seol Koo
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sang Woo Lee
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Chol Shin
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Korea
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25
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Park KS, Jee SR, Lee BE, Hong KS, Shin JE, Na SY, Kwon JG, Choi SC, Kim YS, Lee HS, Lee TH, Kim KO, Choi J, Moon HS, Kim YS, Park MI, Park SJ, Park SY, Hong SN. Nationwide Multicenter Study for Overlaps of Common Functional Gastrointestinal Disorders in Korean Patients With Constipation. J Neurogastroenterol Motil 2017; 23:569-577. [PMID: 28992677 PMCID: PMC5628990 DOI: 10.5056/jnm17033] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 05/05/2017] [Accepted: 07/12/2017] [Indexed: 12/15/2022] Open
Abstract
Background/Aims In spite of increased concerns about the overlaps among the various functional gastrointestinal disorders (FGIDs), studies for the overlap between constipation and other common FGIDs are rare. Therefore, we investigated the patterns of overlaps between constipation and other common FGIDs. Methods This study was designed as a prospective nationwide multi-center questionnaire study using Rome III questionnaires for functional dyspepsia (FD), irritable bowel syndrome (IBS), and functional constipation (FC), as well as various questionnaires about patients' information, degree of symptoms, and quality of life. For the evaluation of gastroesophageal reflux disease (GERD), GERD-Q was used. Results From 19 centers, 759 patients with constipation were enrolled. The proportions of FC and IBS subtypes of constipation (IBS-C) were 59.4% and 40.6%, respectively. Among them, 492 (64.8%) showed no overlap. One hundred and thirty-six patients (17.9%) presented overlapping GERD, and 80 patients (10.5%) presented overlapping FD. Fifty one (6.7%) of patients were overlapped by both GERD and FD. Coincidental herniated nucleus pulposus (HNP) (P = 0.026) or pulmonary diseases (P = 0.034), reduced fiber intake (P = 0.013), and laxative use (P < 0.001) independently affected the rate of overlaps. These overlapping conditions negatively affected the constipation-associated quality of life, general quality of life, and degree of constipation. Conclusions The overlap of GERD or FD was common in patients with constipation. Coincidental HNP or pulmonary diseases, reduced fiber intake, and laxatives use were found to be independent associated factors for overlapping common FGIDs in Korean patients with constipation.
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Affiliation(s)
- Kyung Sik Park
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | | | - Bong Eun Lee
- Pusan National University School of Medicine, Busan, Korea
| | | | - Jeong Eun Shin
- Dankook University College of Medicine, Cheonan, Chungnam, Korea
| | - Soo-Young Na
- Jeju National University School of Medicine, Jeju, Korea
| | - Joong Goo Kwon
- Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Suck Chei Choi
- Wonkwang University School of Medicine, Iksan, Jeonbuk, Korea
| | - Yong Sung Kim
- Department of Internal Medicine and Wonkwang Digestive Disease Research Institute, Wonkwang University Sanbon Hospital, Gunpo, Gyeonggi-do, Korea
| | - Hyun Seok Lee
- Kyungpook National University School of Medicine, Daegu, Korea
| | - Tae Hee Lee
- Soonchunhyang University College of Medicine, Seoul, Korea
| | - Kyeong Ok Kim
- Yeungnam University College of Medicine, Daegu, Korea
| | | | - Hee Seok Moon
- Chungnam National University School of Medicine, Daejeon, Korea
| | - Yeon Soo Kim
- Hallym University College of Medicine, Chuncheon, Gangwon-do, Korea
| | - Moo In Park
- Kosin University College of Medicine, Busan, Korea
| | | | | | - Sung Noh Hong
- Sungkyunkwan University School of Medicine, Seoul, Korea
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Hussain Z, Kim HW, Huh CW, Lee YJ, Park H. The Effect of Peripheral CRF Peptide and Water Avoidance Stress on Colonic and Gastric Transit in Guinea Pigs. Yonsei Med J 2017; 58:872-877. [PMID: 28541004 PMCID: PMC5447122 DOI: 10.3349/ymj.2017.58.4.872] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 04/15/2017] [Accepted: 04/18/2017] [Indexed: 12/19/2022] Open
Abstract
Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are common gastrointestinal (GI) diseases; however, there is frequent overlap between FD and IBS patients. Emerging evidence links the activation of corticotropin releasing factor (CRF) receptors with stress-related alterations of gastric and colonic motor function. Therefore, we investigated the effect of peripheral CRF peptide and water avoidance stress (WAS) on upper and lower GI transit in guinea pigs. Dosages 1, 3, and 10 μg/kg of CRF were injected intraperitoneally (IP) in fasted guinea pigs 30 minutes prior to the intragastric administration of charcoal mix to measure upper GI transit. Colonic transits in non-fasted guinea pigs were assessed by fecal pellet output assay after above IP CRF doses. Blockade of CRF receptors by Astressin, and its effect on GI transit was also analyzed. Guinea pigs were subjected to WAS to measure gastrocolonic transit in different sets of experiments. Dose 10 μg/kg of CRF significantly inhibited upper GI transit. In contrast, there was dose dependent acceleration of the colonic transit. Remarkably, pretreatment of astressin significantly reverses the effect of CRF peptide on GI transit. WAS significantly increase colonic transit, but failed to accelerate upper GI transit. Peripheral CRF peptide significantly suppressed upper GI transit and accelerated colon transit, while central CRF involved WAS stimulated only colonic transit. Therefore, peripheral CRF could be utilized to establish the animal model of overlap syndrome.
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Affiliation(s)
- Zahid Hussain
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hae Won Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Cheal Wung Huh
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Ju Lee
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyojin Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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27
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Jang SH, Ryu HS, Choi SC, Lee HJ, Lee SY. Psychological factors influence the overlap syndrome in functional gastrointestinal disorders (FGIDs) among middle-aged women in South Korea. Women Health 2017; 58:112-127. [PMID: 28095209 DOI: 10.1080/03630242.2017.1282394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This study investigated the psychological factors related to the overlap syndrome, i.e., multiple gastrointestinal conditions that are part of functional gastrointestinal disorders (FGIDs) in the same individual and potentially related to quality of life (QOL) among women aged 45-60 years (n = 627) in South Korea. The study was undertaken between July 2014 and March 2015. Depressive and anxiety symptoms were ascertained using the Center for Epidemiologic Studies Depression scale (CES-D) and the Beck Anxiety Inventory (BAI), respectively. Negative cognition and the cognitive triad were identified using the Automatic Thoughts Questionnaire-Negative (ATQ-N) and the Cognitive Triad Inventory (CTI), respectively. Resilience and QOL were assessed using the Connor-Davidson Resilience Scale (CD-RISC) and World Health Organization Quality of Life scale abbreviated version (WHOQOL-BREF). Women with the overlap syndrome had the highest CES-D (mean = 16.66 ± 11.79, p < .001), BAI (mean = 17.46 ± 12.67, p < .001), and ATQ-N scores (mean = 53.61 ± 20.88, p < .001), followed by women with gastrointestinal disorders but without the overlap syndrome and healthy controls. Healthy controls had the highest WHOQOL-BREF score (mean = 77.69 ± 12.53, p < .001). After stepwise selection, the final model explained 61.8 percent of the variance in QOL. Thus, depressive symptoms, anxiety, negative cognition, cognitive triad, and resilience were significantly related to QOL in women with the overlap syndrome.
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Affiliation(s)
- Seung-Ho Jang
- a Department of Psychiatry, School of Medicine & Hospital , Wonkwang University , Iksan , Republic of Korea
| | - Han-Seung Ryu
- b Division of Gastroenterology, Department of Internal Medicine, School of Medicine , Wonkwang University , Iksan , Republic of Korea
| | - Suck-Chei Choi
- b Division of Gastroenterology, Department of Internal Medicine, School of Medicine , Wonkwang University , Iksan , Republic of Korea
| | - Hye-Jin Lee
- c Department of Public Health , Wonkwang University Graduate School , Iksan , Republic of Korea
| | - Sang-Yeol Lee
- a Department of Psychiatry, School of Medicine & Hospital , Wonkwang University , Iksan , Republic of Korea
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Adibi P, Keshteli AH, Daghaghzadeh H, Roohafza H, Pournaghshband N, Afshar H. Association of anxiety, depression, and psychological distress in people with and without functional dyspepsia. Adv Biomed Res 2016; 5:195. [PMID: 28217633 PMCID: PMC5220680 DOI: 10.4103/2277-9175.190936] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 10/20/2015] [Indexed: 12/13/2022] Open
Abstract
Background: Current studies have indicated a high ratio of psychological problems in functional dyspepsia (FD) which causes disturbance in its management, so recognition these problems help the process of treatment. Materials and Methods: This was a cross-sectional study with a sample size of 4763 carried out in Isfahan University of Medical Sciences in 2011. Modified ROME III questionnaire was used to evaluate FD symptoms. Hospital anxiety and depression scale and 12-item General Health Questionnaire-12 was used to assess the psychological issue. Logistic regression analysis was used to assess the association of psychological problems and FD. Results: We showed that overly 654 (13.7%), 1338 (28.1%), and 1067 (22.4%) of participants, respectively had anxiety, depression, and of psychological distress. Seven hundred and ten (15.5%) participants were diagnosed with FD. Of all participants Mean scores of anxiety (P < 0.001), depression (P < 0.001), and psychological distress (P < 0.001) in participants with FD were significantly more than those with no FD. Multivariate logistic regression analysis showed that psychological problems, whether in the form of psychological distress odds ratio (OR): 2 (95% confidence interval [CI]: 1.3–3) and OR: 1.3 (95% CI: 1.1–1.7) in males and females, respectively, anxiety OR: 2.4 (95% CI: 1.5–3.9) and OR: 2.3 (95% CI: 1.7–3.2) in males and females, respectively) or depression OR: 2.2 (95% CI: 1.5–3.3) and OR: 1.7 (95% CI: 1.3–2.3) in males and females, respectively) were significantly linked to FD in both genders. Conclusions: The prevalence of FD is less in males than females, but psychological links were stronger in males. Thus, it is essential to consider and detect the psychological distress in these patients.
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Affiliation(s)
- Peyman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ammar Hasanzadeh Keshteli
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Daghaghzadeh
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasim Pournaghshband
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Afshar
- Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Motavasselian M, Saghebi SA, Nademi MR, Tavakkoli-Kakhki M. Depression and Dyspepsia: An Implication of Islamic Resources. JOURNAL OF RELIGION AND HEALTH 2016; 55:1864-1868. [PMID: 26359048 DOI: 10.1007/s10943-015-0115-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Depression is a common mental disorder and the leading cause of disability in the worldwide. Based on Islamic resources, indigestion and dyspepsia can lead to depression. In modern medicine, though many somatic diseases have been named as possible causes of depression, the effect of gastrointestinal disorders on depression is still an enigma. Therefore, the focus of this study is to explore the available scientific literature of modern medicine in order to find the footprint of effect of indigestion on depression. In this study, related articles were retrieved from PubMed, Ovid, Proquest and Magiran databases by using the Medical Subject Heading keywords "depression," "psychology," "dyspepsia" and "gastrointestinal diseases." In the next step, studies, which are exactly confirm the Islamic viewpoint, were selected from the retrieved articles. Only one prospective study in 2012 has stated that people with functional gastrointestinal disorders and without elevated levels of anxiety and depression at baseline had significantly higher levels of anxiety and depression at 12-year follow-up. Based on Islamic viewpoint, indigestion can lead to depression, but this aspect approved by only one 12-year prospective population-based study in our review. It seems that it is necessary to conduct complementary studies investigating this hypothesis.
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Affiliation(s)
- Malihe Motavasselian
- Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Seyyd-Ahamd Saghebi
- Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | | | - Mandana Tavakkoli-Kakhki
- Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Science, Mashhad, Iran.
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Bedell A, Taft TH, Keefer L, Pandolfino J. Development of the Northwestern Esophageal Quality of Life Scale: A Hybrid Measure for Use Across Esophageal Conditions. Am J Gastroenterol 2016; 111:493-9. [PMID: 26881974 PMCID: PMC5247632 DOI: 10.1038/ajg.2016.20] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 12/24/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Measures of health-related quality of life (HRQOL) in chronic esophageal conditions such as gastroesophageal reflux disease, eosinophilic esophagitis, and achalasia are widely used to measure this important patient-reported outcome. We seek to leverage these existing measures to create a hybrid measure of esophageal illness HRQOL (the Northwestern Esophageal Quality of Life-NEQOL), allowing for broad use across diseases while maintaining sensitivity to nuances of a specific condition. METHODS A three-step, mixed-methods process per FDA guidelines for patient-reported outcome (PRO) development was followed: review and consolidation of existing HRQOL measure items into a single questionnaire, reliability and validity analyses (principle components factor analysis, Cronbach alpha, Guttman split-half, inter-item correlation, test-retest correlation, and Pearson's correlation with related constructs) based on responses from a representative sample of esophageal illness patients, and individual structured cognitive interviews with patients for item refinement and reduction. RESULTS An initial 30-item measure was created. Two-hundred twelve patients completed the reliability and validity portion of the study, and 15 completed cognitive interviews. Factor analysis and item-reduction resulted in 11 items being removed from the NEQOL prior to patient interviews. Construct validity was supported by moderate and significant correlations with psychological distress and general HRQOL. Test-retest reliability was excellent. Following patient interviews, an additional 5 items were removed because of floor effects or participant feedback yielding a 14-item, single scale measure of HRQOL. CONCLUSIONS Although more research is warranted, the NEQOL is a reliable and a valid hybrid measure of disease-specific HRQOL across several chronic esophageal conditions.
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Affiliation(s)
- Alyse Bedell
- Division of Gastroenterology & Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Tiffany H. Taft
- Division of Gastroenterology & Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Laurie Keefer
- Division of Gastroenterology & Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - John Pandolfino
- Division of Gastroenterology & Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Jang SH, Ryu HS, Choi SC, Lee SY. Psychological factors influence the overlap syndrome in functional gastrointestinal disorders and their effect on quality of life among firefighters in South Korea. J Dig Dis 2016; 17:236-43. [PMID: 26896638 DOI: 10.1111/1751-2980.12330] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 02/05/2016] [Accepted: 02/17/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the predictor variables that could influence overlap syndrome in functional gastrointestinal disorders (FGID) among firefighters in Korea. METHODS Data collected from 1217 firefighters in Korea were reviewed. FGID were diagnosed according to the Rome III diagnostic criteria. Psychological factors were measured by self-reported questionnaires. The scores for depression, anxiety, quality of life (QOL) and occupational job stress were analyzed. The correlation between psychological factors and QOL was analyzed and a stepwise multiple regression analysis was performed. RESULTS FGID were observed in 461 (37.9%) participants. In those with FGID, functional heartburn (FH) was most common (32.2%), followed by functional dyspepsia (12.2%). Patients with overlap syndrome had the highest depression, anxiety and occupational stress score than those having non-overlap syndrome and healthy controls, respectively (depression: F = 142.29, η(2) = 0.190; anxiety: F = 88.33, η(2) = 0.127; occupational stress: F = 43.68, η(2) = 0.067; all P < 0.001). Healthy controls had the highest QOL score (F = 73.39, P < 0.001, η(2) = 0.108). Pychological factors were significantly correlated with QOL in the overlap syndrome of FGID. After the stepwise selection, the final model explained 45.6% of predictable variance and contained four significant variables: depression, self-esteem, occupational stress and anxiety. CONCLUSIONS Psychological factors are associated with the overlap syndrome of FGID. Acknowledging this common comorbidity may facilitate the recognition and treatment of patients with FGID.
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Affiliation(s)
- Seung-Ho Jang
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Korea
| | - Han-Seung Ryu
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Wonkwang University, Iksan, Korea
| | - Suck-Chei Choi
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Wonkwang University, Iksan, Korea
| | - Sang-Yeol Lee
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Korea
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Bang CS, Kim YS, Han JH, Lee YS, Baik GH, Kim JB, Suk KT, Yoon JH, Kim DJ. Functional Gastrointestinal Disorders in Young Military Men. Gut Liver 2016; 9:509-15. [PMID: 25473077 PMCID: PMC4477995 DOI: 10.5009/gnl14109] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND/AIMS To estimate the prevalence and evaluate the associated psychological factors of functional gastrointestinal disorders (FGIDs) in males in their twenties who are currently enrolled in military service. METHODS A total of 1,073 men in the Korean army were asked to complete questionnaires based on the Rome III criteria and Symptom Checklist-90-revised (SCL-90R). The prevalence of FGIDs was estimated, and the associated psychological factors were evaluated. RESULTS A total of 967 men participated. The total prevalence of FGIDs was 18.5% (age-adjusted prevalence, 18.1%; 95% confidence interval [CI], 15.3% to 20.8%). The total SCL-90R scores were higher in men with FGIDs than men without FGIDs (24 [interquartile range, 13 to 44] vs. 13 [5 to 28], p<0.001) and higher in men with overlapping syndromes than in those with single FGIDs (31 [18 to 57] vs. 14 [5.75 to 29], p<0.001). Somatization (odds ratio [OR], 1.141; 95% CI, 1.09 to 1.20; p<0.001), obsessive-compulsive behaviors (OR, 1.084; 95% CI, 1.03 to 1.14; p=0.002) and depression (OR, 0.943; 95% CI, 0.90 to 0.99; p=0.020) were identified as independent predictive factors for FGIDs. CONCLUSIONS FGIDs are common among men in their twenties who are fulfilling their military duty. Somatization and obsessive-compulsive features from the tense atmosphere are associated with the development or progression of FGIDs. Patients who exhibit overlapping syndromes require greater attention given their more severe psychopathology.
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Affiliation(s)
- Chang Seok Bang
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Yeon Soo Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Jin Hyung Han
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Yong Sub Lee
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Gwang Ho Baik
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Jin Bong Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Ki Tae Suk
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Jai Hoon Yoon
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Dong Joon Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
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Evidence-based clinical practice guidelines for functional dyspepsia. J Gastroenterol 2015; 50:125-39. [PMID: 25586651 DOI: 10.1007/s00535-014-1022-3] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 11/20/2014] [Indexed: 02/06/2023]
Abstract
General interest in functional gastrointestinal disorders is increasing among Japanese doctors as well as patients. This increase can be attributed to a number of factors, including recent increased interest in quality of life and advances in our understanding of the pathophysiology of gastrointestinal disease. Japan recently became the world's first country to list "functional dyspepsia" as a disease name for national insurance billing purposes. However, recognition and understanding of functional dyspepsia (FD) remain poor, and no standard treatment strategy has yet been established. Accordingly, the Japanese Society of Gastroenterology (JSGE) developed an evidence-based clinical practice guideline for FD, consisting of five sections: concept, definition, and epidemiology; pathophysiology; diagnosis; treatment; and prognosis and complications. This article summarizes the Japanese guideline, with particular focus on the treatment section. Once a patient is diagnosed with FD, the doctor should carefully explain the pathophysiology and benign nature of this condition, establish a good doctor-patient relationship, and then provide advice for daily living (diet and lifestyle modifications, explanations, and reassurance). The proposed pharmacological treatment is divided into two steps: initial treatment including an acid inhibitory drug (H2RA or PPI) or prokinetics, (strong recommendation); second-line treatment including anxiolytics, antidepressants, and Japanese traditional medicine (weak recommendation). H. pylori eradication, strongly recommended with a high evidence level, is positioned separately from other treatment flows. Conditions that do not respond to these treatment regimens are regarded as refractory FD. Patients will be further examined for other organic disorders or will be referred to specialists using other approaches such as psychosomatic treatment.
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Yoshida M, Kinoshita Y, Watanabe M, Sugano K, Kato M, Joh T, Suzuki H, Tominaga K, Nakada K, Nagahara A, Futagami S, Manabe N, Inui A, Haruma K, Higuchi K, Yakabi K, Hongo M, Uemura N, Kinoshita Y, Sugano K, Shimosegawa T. JSGE Clinical Practice Guidelines 2014: standards, methods, and process of developing the guidelines. J Gastroenterol 2015; 50:4-10. [PMID: 25448314 DOI: 10.1007/s00535-014-1016-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 10/29/2014] [Indexed: 02/04/2023]
Affiliation(s)
- Masahiro Yoshida
- Guidelines Committee for the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13 Ginza, Chuo, Tokyo, 104-0061, Japan,
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Chung HA, Lee SY, Lee HJ, Kim JH, Sung IK, Shim CS, Jin CJ, Park HS. G protein β3 subunit polymorphism and long-term prognosis of functional dyspepsia. Gut Liver 2014; 8:271-6. [PMID: 24827623 PMCID: PMC4026644 DOI: 10.5009/gnl.2014.8.3.271] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background/Aims A link between G protein β3 (GNB3) polymorphism and functional dyspepsia (FD) has been suggested. The aim of this study was to determine the role of GNB3 polymorphism in the long-term prognosis of FD in Koreans. Methods FD patients and normal healthy controls were recruited from patients who visited our center between December 2006 and June 2007. All of the subjects completed Rome III questionnaires before undergoing upper gastrointestinal endoscopy and colonoscopy. Genomic DNA was extracted for GNB3 genotyping. After 5 years, the subjects were reevaluated using the same questionnaires. Results GNB3 825T carrier status was significantly related to FD in Koreans (p=0.04). After 5 years, 61.0% of the initial FD patients and 12.2% of the initial normal subjects were diagnosed with FD (odds ratio [OR], 11.7; 95% confidence interval [CI], 4.3 to 31.1; p<0.001). Regardless of the GNB3 genotype (p=0.798), female sex was strongly correlated with FD after 5 years (OR, 3.3; 95% CI, 1.2 to 9.1; p=0.017). Conclusions The T allele of GNB3 is linked to FD in Koreans but does not predict long-term prognosis. Female sex is related to a higher prevalence of FD after 5 years.
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Affiliation(s)
- Hyun Ah Chung
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Sun Young Lee
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Heon Jeong Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
| | - Jeong Hwan Kim
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - In Kyung Sung
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Chan Sup Shim
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Choon Jo Jin
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Hyung Seok Park
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
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Fujiwara Y, Arakawa T. Overlap in patients with dyspepsia/functional dyspepsia. J Neurogastroenterol Motil 2014; 20:447-57. [PMID: 25257470 PMCID: PMC4204405 DOI: 10.5056/jnm14080] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 08/25/2014] [Accepted: 09/10/2014] [Indexed: 12/13/2022] Open
Abstract
Patients with dyspepsia/functional dyspepsia (FD) show frequent overlapping of other gastrointestinal (GI) diseases, such as irri-table bowel syndrome, and non-GI diseases, in addition to internal subgroup overlapping. These overlap patients have more frequent or more severe symptoms, poorer health-related quality of life and higher somatization scores, and they are more like-ly to experience anxiety, depression or insomnia compared to non-overlap patients. The higher prevalence of overlap in patients with dyspepsia/FD is not by chance, indicating common pathogeneses, including visceral hypersensitivity, altered GI motility, in-fection, and stressful early life events. There are few clinical trials targeting overlap in patients with dyspepsia/FD, and no ther-apeutic strategy has been established. Further studies in this research area are needed. In this review, we describe the epidemi-ology, pathogenesis and treatment of overlap in patients with dyspepsia/FD.(J Neurogastroenterol Motil 2014;20:447-457).
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Affiliation(s)
- Yasuhiro Fujiwara
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Tetsuo Arakawa
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
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Jones MP, Oudenhove LV, Koloski N, Tack J, Talley NJ. Early life factors initiate a 'vicious circle' of affective and gastrointestinal symptoms: A longitudinal study. United European Gastroenterol J 2014; 1:394-402. [PMID: 24917988 DOI: 10.1177/2050640613498383] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 06/25/2013] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Functional gastrointestinal disorders (FGID) have been shown to be associated with both comorbid mood disorders and traumatic events such as abuse earlier in life. In a longitudinal study, we tested a model that hypothesized: (i) childhood abuse was associated with subsequent mood disorder and pain or interference in life by bowel symptoms both directly and indirectly via neurotic personality; and (ii) an ongoing cycle of mood disorder impacts on bowel symptoms. DESIGN Subjects from the general population classified as irritable bowel syndrome and/or functional dyspepsia (IBS/FD, n = 207) or free of FGID (n = 100) were prospectively studied every 6 months over 18 months. In addition to bowel symptom interference and abdominal pain, measures of personality (neuroticism), childhood abuse history, depression, and anxiety were obtained. The hypothesized model was tested via Path Modelling. RESULTS Childhood abuse was found to be directly associated with neuroticism but only indirectly associated with baseline interference and mood disorders (via neuroticism). The data further supported an ongoing cycle of elevations in mood disorders and pain/interference by bowel symptoms. The data supported direct effects of interference at one time point on interference at the subsequent time point in addition to indirect effects of prior anxiety and depression. Repeating the model with pain frequency as the outcome yielded almost identical findings which suggests the findings are generalized across domains of symptoms and quality-of-life. CONCLUSION Our data provide support for a model characterized by a 'vicious circle' between mood disorders and FGID symptoms in adulthood, with initial input from early life factors.
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Affiliation(s)
| | | | | | - Jan Tack
- University of Leuven, Leuven, Belgium
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Prevalence of irritable bowel syndrome and functional dyspepsia, overlapping symptoms, and associated factors in a general population of Bangladesh. Indian J Gastroenterol 2014; 33:265-73. [PMID: 24664445 DOI: 10.1007/s12664-014-0447-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 02/12/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND This community-based survey aimed to find out the prevalence of irritable bowel syndrome (IBS), functional dyspepsia (FD), overlapping symptoms, and associated factors for overlap. METHOD By cluster sampling method, 3,000 (1,523 male) randomly selected adult subjects in the Sylhet district of Bangladesh were interviewed by a questionnaire based on ROME III criteria. Multivariate logistic regression analyses were done to find out the factors for overlap with significance level set at ≤0.05. RESULTS The mean age of the study population was 33.9 ± 16.4 years. Prevalence of IBS and FD and IBS-FD were 12.9 % (n = 387), 8.3 % (n = 249), and 3.5 % (n = 105), respectively. Approximately 27.1 % of IBS patients and 42.1 % of FD patients had overlapping IBS-FD. The odds ratio for IBS-FD overlap was 6.3 (95 % CI, 4.8-8.4). Mean age (p = 0.011) and epigastric pain (p = 0.002) were more in overlap patients than FD alone, whereas epigastric pain syndrome subtype (p < 0.009) was more prevalent in lone FD subjects. In the multivariate logistic analysis, early satiety (OR, 3.0; 95 % CI, 1.2-7.5; p = 0.018) and epigastric pain (OR, 14.5; 95 % CI, 5.0-42.1; p = 0.000) in FD patients appeared as independent risk factors for overlap. Bloating (p = 0.026), <3 stools per week (p = 0.050), abdominal pain reduced by defecation (p = 0.002), abdominal pain severity score (p = 0.004), and overall symptom frequency score (p = 0.000) were more in overlap patients than IBS-alone patients. In IBS patients, bloating (OR, 3.6; CI, 2.0-6.5; p = 0.000) was found as potential symptom associated with IBS-FD overlap. CONCLUSION FD was a less prevalent disorder than IBS in our community, and significant overlap existed between the two disorders. Early satiety, epigastric pain, and bloating were important factors associated with overlap.
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Wang YH, Yin LT, Yang H, Li XL, Wu KG. Hypoglycemic and anti-depressant effects of Zuogui Jiangtang Jieyu formulation in a model of unpredictable chronic mild stress in rats with diabetes mellitus. Exp Ther Med 2014; 8:281-285. [PMID: 24944635 PMCID: PMC4061204 DOI: 10.3892/etm.2014.1681] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 03/28/2014] [Indexed: 12/17/2022] Open
Abstract
This study aimed to investigate the hypoglycemic, lipid-lowering and antidepressant effects of Zuogui Jiangtang Jieyu formulation (ZGJTJY) in a model of unpredictable chronic mild stress (UCMS) in rats with diabetes mellitus (DM; the UCMS-DM model). Sixty rats were randomly divided into blank control, vehicle (model plus vehicle), positive control (model plus metformin and fluoxetine), and high, medium and low dose ZGJTJY (model plus high, medium and low doses of ZGJTJY, respectively) groups. Following establishment of DM by a high-fat diet with intraperitoneal injection of streptozotocin (38 mg/kg), the depression model was established by application of UCMS for 28 days. The behavioral scores of the rats were detected in an open field test and Morris water maze test. The levels of blood glucose, glycosylated hemoglobin (HbA1c) and blood lipids were assayed. The total scores of the open field test and the space exploration times (SETs) in the Morris water maze test were significantly lower and the escape latency (EL) times in the Morris water maze test were significantly longer in the vehicle group compared with those in the blank control group. In addition, in the vehicle group, the levels of blood glucose, HbA1c, total cholesterol (TC), triglycerides (TGs) and low-density lipoprotein cholesterol (LDL-C) were significantly higher and the levels of high-density lipoprotein cholesterol (HDL-C) were significantly lower compared with those in the blank control group. The high dose of ZGJTJY decreased the locomotor activity levels in the open field test, the EL times of the model on day 4, the SETs in the Morris water maze test and the HDL-C levels, and reduced the blood glucose, HbA1c, TC, TG and LDL-C levels compared with those in the model group. Thus, ZGJTJY is a potential candidate for the prevention and treatment of the comorbidity of depression with DM.
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Affiliation(s)
- Yu-Hong Wang
- Hunan Key Laboratory of Chinese Materia Medica Powder and Innovative Drugs Established by Provincial and Ministry, Changsha, Hunan 410007, P.R. China ; Key Laboratory of Internal Medicine of Traditional Chinese Medicine of Ministry of Education, The First Affiliated Hospital, Hunan University of Traditional Chinese Medicine, Hunan 410007, P.R. China
| | - Ling-Tao Yin
- College of Pharmacy, Hunan University of Chinese Medicine, Changsha, Hunan 410208, P.R. China
| | - Hui Yang
- Hunan Key Laboratory of Chinese Materia Medica Powder and Innovative Drugs Established by Provincial and Ministry, Changsha, Hunan 410007, P.R. China
| | - Xin-Liang Li
- College of Pharmacy, Hunan University of Chinese Medicine, Changsha, Hunan 410208, P.R. China
| | - Kai-Ge Wu
- Department of Traditional Chinese Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410219, P.R. China
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Futagami S, Yamawaki H, Shimpuku M, Izumi N, Wakabayashi T, Kodaka Y, Nagoya H, Shindo T, Kawagoe T, Sakamoto C. Impact of coexisting irritable bowel syndrome and non-erosive reflux disease on postprandial abdominal fullness and sleep disorders in functional dyspepsia. J NIPPON MED SCH 2014; 80:362-70. [PMID: 24189354 DOI: 10.1272/jnms.80.362] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS The association between clinical symptoms and sleep disorders in functional dyspepsia (FD)-overlap syndrome has not been studied in detail. METHODS The subjects were 139 patients with FD, 14 with irritable bowel syndrome (IBS), 12 with nonerosive reflux disease (NERD), and 41 healthy volunteers. Gastric motility was evaluated with the (13)C-acetate breath test. We used Rome III criteria to evaluate upper abdominal symptoms, and Self-Rating Questionnaire for Depression (SRQ-D) scores to determine depression status. Sleep disorders were evaluated with Pittsburgh Sleep Quality Index (PSQI) scores. RESULTS There were no significant differences in age, body-mass index, alcohol intake, and smoking rate between patients with FD alone and those with FD-overlap syndrome. The postprandial abdominal fullness score in patients with FD-NERD-IBS was significantly greater than that in patients with FD-NERD overlap syndrome (p<0.001) or FD alone (p<0.001). The score for the feeling of hunger in patients with FD-NERD-IBS was significantly greater than that in patients with FD alone (p=0.0025), FD-NERD overlap syndrome (p=0.0088), or FD-IBS overlap syndrome (p=0.0057). The heartburn score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone (p=0.0035) or FD-IBS overlap syndrome (p=0.0026). The Tmax in patients with FD-overlap syndrome or FD alone was significantly higher than that in healthy volunteers. The Pittsburgh Sleep Quality Index score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone. CONCLUSION Symptom scores, such as those for postprandial abdominal fullness, heartburn, and the feeling of hunger, in patients with FD-overlap syndromes are significantly greater than those in patients with FD alone. Further studies are necessary to clarify whether various symptoms are related to sleep disorders in patients with FD-NERD-IBS overlap syndrome.
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Affiliation(s)
- Seiji Futagami
- Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School
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Abstract
Dyspepsia refers to group of commonly occurring upper gastrointestinal symptoms. The majority of patients with dyspepsia suffer from functional (nonulcer) dyspepsia. Although there is a lack of epidemiological data from population-based or patient cohort studies in Korea, the current understanding of this condition has been updated using data from various recent research studies, which have facilitated the development of clinical guidelines for functional dyspepsia. According to a survey using the Rome III criteria, more than 40% of respondents who visited primary clinics and tertiary hospitals were defined as having functional dyspepsia, most of who were within a subgroup of patients with postprandial distress syndrome. In addition, a population-based cross-sectional survey revealed considerable overlap between functional dyspepsia and other functional gastrointestinal disorders, including gastroesophageal reflux disease (especially nonerosive reflux disease) and irritable bowel syndrome. In contrast to the results of Western trials, there is insufficient evidence to recommend a Helicobacter pylori test-and-treat strategy as an initial management approach to functional dyspepsia in Korea, suggesting the need for early endoscopic evaluation. Additional studies are necessary to adjust the cutoff age for implementation of immediate endoscopic evaluation of patients without alarm symptoms. Considering the prevalence of H. pylori infection and the limited efficacy of symptomatic relief after its eradication, further well-qualified studies in Korea are warranted.
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Affiliation(s)
- Hyuk Lee
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Hye-Kyung Jung
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Kyu Chan Huh
- Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea
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Huang ZP, Yang XF, Lan LS, Liu T, Liu CL, Li JL, Liang ZH. Correlation between social factors and anxiety-depression in function dyspepsia: do relationships exist? PRZEGLAD GASTROENTEROLOGICZNY 2014; 9:348-53. [PMID: 25653730 PMCID: PMC4300350 DOI: 10.5114/pg.2014.47897] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 05/25/2014] [Accepted: 07/06/2014] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Function dyspepsia (FD) may cause patients to suffer from anxiety and depression, and psychosocial disorders would have a significant effect on FD symptoms. AIM To examine the prevalence of anxiety and depression among function dyspepsia (FD) patients and to identify social factors of anxiety-depression among FD patients. MATERIAL AND METHODS Patients with FD, who fulfilled the Rome III criteria, were enrolled. All patients were administered a validated Chinese version of the self-rating scale (SDS) and self-rating anxiety scale (SAS), and investigated regarding the patients' social factors. RESULTS A total of 907 patients were enrolled, including 516 (56.89%) FD patients within anxiety-depression status; SDS mean scores were 51.57 ±8.22; SAS mean scores were 51.04 ±7.53; 52.28% were male and 64.25% were female (χ(2) = 262.54, p < 0.01); 56.16% were aged 18-29 years, 54.15% were aged 30-39 years, 54.77% were aged 40-49 years, 62.02% were aged 50-59 years, 69.23% were aged above 60 years (χ(2) = 18.14, p < 0.01); 67.44% were the retirees; 63.31% were manual workers; 55.10% were soldiers; 43.57% were mental workers; 38.89% were students (χ(2) = 716.53, p < 0.01); 64.20% had junior high school degree or below; 57.36% had high school degrees; 42.03% had college degrees; 44.44% had master's or above degrees (χ(2) = 27.21, p < 0.05); 38.10% were in good health condition; 61.90% were in poor health condition (χ(2) = 7.94, p < 0.01); 20.31% had correlative family history; and 79.69% had no correlative family history (χ(2) = 2.23, p > 0.05). CONCLUSIONS The FD patients have higher rates of anxiety and depression. Gender, age, occupation, education level, and health condition have a significant effect on anxiety and depression status. Female gender, advanced age, high-stress occupation, lower education level, and poor health condition all are risk factors. Family history has no relationship with anxiety and depression among FD patients.
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Affiliation(s)
- Zhen-Peng Huang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xian-Fen Yang
- Department of Gastroenterology, 303 Hospital PLA China, Nanning, Guangxi, China
| | - Li-Sa Lan
- Department of Gastroenterology, 303 Hospital PLA China, Nanning, Guangxi, China
| | - Tao Liu
- Department of Gastroenterology, 303 Hospital PLA China, Nanning, Guangxi, China
| | - Cheng-Li Liu
- Department of Gastroenterology, 303 Hospital PLA China, Nanning, Guangxi, China
| | - Jin-Li Li
- Department of Gastroenterology, 303 Hospital PLA China, Nanning, Guangxi, China
| | - Zhong-Hui Liang
- Department of Gastroenterology, 303 Hospital PLA China, Nanning, Guangxi, China
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Yamawaki H, Futagami S, Shimpuku M, Sato H, Wakabayashi T, Maruki Y, Kodaka Y, Nagoya H, Shindo T, Kawagoe T, Sakamoto C. Impact of sleep disorders, quality of life and gastric emptying in distinct subtypes of functional dyspepsia in Japan. J Neurogastroenterol Motil 2013; 20:104-12. [PMID: 24466451 PMCID: PMC3895596 DOI: 10.5056/jnm.2014.20.1.104] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 10/23/2013] [Accepted: 10/30/2013] [Indexed: 12/14/2022] Open
Abstract
Background/Aims The association between clinical symptoms, gastric emptying, quality of life and sleep disorders in distinct functional dyspepsia (FD) patients has not been studied yet in detail. Methods We enrolled 79 FD patients (postprandial distress syndrome [PDS], n = 65; epigastric pain syndrome [EPS], n = 47; EPS-PDS overlap, n = 33) and 44 healthy volunteers. Gastric motility was evaluated. We used Rome III criteria to evaluate clinical symptoms and State-Trait Anxiety Inventory (STAI) scores to determine anxiety status. Sleep disorder was evaluated using the Pittsburgh Sleep Quality Index scores. Results There were no significant differences in age, sex and Helicobacter pylori positivity between FD subtypes and healthy volunteers. The scores of Glasgow dyspepsia severity scores (GDSS), SF-8 and Pittsburgh Sleep Quality Index (PSQI) in distinct subtypes of FD patients were significantly different from those in healthy volunteers. However, there were not significant differences in these scores, Tmax and T1/2 among 3 subtypes of FD patients. PSQI score was significantly (P = 0.027, P = 0.002 and P = 0.039, respectively) associated with GDSS among EPS, PDS and EPS-PDS overlap patients. In addition, 8-item short form health survey (SF-8; Physical Component Score and Mental Component Score) was significantly associated with global PSQI score in PDS and EPS-PDS overlap patients. In contrast, SF-8 (Mental Component Score) only was significantly linked to global PSQI score in EPS patients. Conclusions Prevalences for sleep disorders, gastric motility and quality of life in 3 subtypes of FD patients were similar levels. In PDS and EPS-PDS overlap patients, SF-8 was significantly associated with global PSQI score.
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Affiliation(s)
- Hiroshi Yamawaki
- Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - Seiji Futagami
- Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - Mayumi Shimpuku
- Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - Hitomi Sato
- Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - Taiga Wakabayashi
- Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - Yuuta Maruki
- Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - Yasuhiro Kodaka
- Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - Hiroyuki Nagoya
- Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - Tomotaka Shindo
- Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - Tetsuro Kawagoe
- Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - Choitsu Sakamoto
- Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
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Xu Y, Zhang L, Shao T, Ruan L, Wang L, Sun J, Li J, Zhu X, O'Donnell JM, Pan J. Ferulic acid increases pain threshold and ameliorates depression-like behaviors in reserpine-treated mice: behavioral and neurobiological analyses. Metab Brain Dis 2013; 28:571-83. [PMID: 23584961 DOI: 10.1007/s11011-013-9404-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 03/24/2013] [Indexed: 12/17/2022]
Abstract
Depression-pain dyad involves a series of pathological changes including the dysfunction of neuroendocrine and immune networks. Depression and pain influence each other, but the mechanisms are still obscure. The present study aimed to investigate the effect of ferulic acid (FA) on reserpine-induced pain and depression-like behaviors in mice. The results showed that reserpine (1 mg/kg for 3 days, i.p.) led to a significant decrease in nociceptive threshold in thermal hyperalgesia and mechanical allodynia, as well as a significant increase in the immobility time in mouse models of despair test. The neurochemical assays suggested the decreased neurotransmitters (dopamine, norepinephrine and serotonin) along with the increased oxidative stress, inflammatory cytokines, and apoptotic parameters in the frontal cortex and hippocampus of the reserpinised mice. Treatment with FA (40 or 80 mg/kg, p.o.) reversed the behavioral abnormalities and decreased norepinephrine, serotonin and dopamine levels in the hippocampus and frontal cortex induced by reserpine. The higher dose of FA effectively antagonized the oxidative and nitrosative stress and inflammation as evidenced by down-regulated nitrite, LPO, IL-1β, TNF-α, and up-regulated GSH and SOD. Furthermore, FA produced a dose dependent decrease in substance P, NF-κβ p65 and caspase-3 levels in the frontal cortex and hippocampus of reserpinised mice. The findings suggest that FA exerts the effects on reserpine-induced pain and depression-like behaviors through regulating monoaminergic system, oxidative/antioxidant defense, inflammatory and apoptotic signaling pathways. Understanding the mechanism by which FA ameliorates depression and pain as a multi-targeted compound could open new avenues for the development of innovative treatments for depression coupled with pain.
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Affiliation(s)
- Ying Xu
- Institute of Experimental Neurobiology, Wenzhou Medical College, Wenzhou, Zhejiang Province, 325035, People's Republic of China,
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Choung RS. [Natural history and overlap of functional gastrointestinal disorders]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2013; 60:345-8. [PMID: 23242016 DOI: 10.4166/kjg.2012.60.6.345] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Functional gastrointestinal (GI) disorders are common in the general population. Based on the Rome III classification, these disorders are mutually exclusive disorders keeping the homogeneity of each functional GI disorder in research area. In contrast, many population and clinical studies have reported a considerably high rate of overlap between functional GI disorders. The overlap of functional GI disorders over other intestinal diseases might simply occur by chance due to a highly prevalent disorder. Moreover, functional GI disorders is considered a chronic stable disorder that may wax and wane for several years. However, a recent study about the natural history of functional GI disorders showed substantial transition among functional GI disorders over time. The natural history of functional GI disorders with overlapping other functional GI disorders are still in infancy and better understanding of these will be important in determining the efficacy of future therapeutic interventions.
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Affiliation(s)
- Rok Seon Choung
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
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Futagami S, Yamawaki H, Izumi N, Shimpuku M, Kodaka Y, Wakabayashi T, Nagoya H, Shindo T, Kawagoe T, Gudis K, Itoh T, Sakamoto C. Impact of sleep disorders in Japanese patients with functional dyspepsia (FD): nizatidine improves clinical symptoms, gastric emptying and sleep disorders in FD patients. J Gastroenterol Hepatol 2013; 28:1314-20. [PMID: 23611167 DOI: 10.1111/jgh.12236] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/04/2013] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS The association between functional dyspepsia (FD) and sleep disorders has yet to be studied in detail. The aim of this study is to evaluate the risk factors associated with sleep disorders and the clinical response to nizatidine therapy for sleep disorders in Rome III-based FD patients. METHODS We enrolled 94 FD patients and 52 healthy volunteers. We used Rome III criteria to evaluate upper abdominal symptoms, and the Self-Rating Questionnaire for Depression scores to determine depression status. Sleep disorder was evaluated using Pittsburgh Sleep Quality Index (PSQI) scores, and degree of anxiety by the State-Trait Anxiety Inventory. Gastric motility was evaluated. Thirty-four FD patients were treated with nizatidine (300 mg/day) or placebo for 4 weeks in a crossover trial. The primary end point of this study was to determine whether nizatidine could improve clinical symptoms and sleep disorders in FD patients. RESULTS The global PSQI score for FD patients was significantly (P < 0.001) higher compared with healthy volunteers. There were significant correlations between global PSQI scores and total Gastrointestinal Symptom Rating Scale and Self-Rating Questionnaire for Depression scores (P < 0.001, P < 0.0001, respectively) in FD patients than in healthy volunteers. We found significant relationships between subjective sleep quality and both Tmax and T1/2 values in FD patients. Nizatidine significantly improved certain clinical symptoms, gastric emptying, and global PSQI score compared with placebo treatment. CONCLUSION Sleep disorders in FD patients correlated significantly with both clinical symptoms of dyspepsia and depression compared with healthy volunteers. Nizatidine significantly improved gastroesophageal reflux symptoms, gastric emptying, and sleep disorders in FD patients.
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Affiliation(s)
- Seiji Futagami
- Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
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Filipović BF, Randjelovic T, Ille T, Markovic O, Milovanović B, Kovacevic N, Filipović BR. Anxiety, personality traits and quality of life in functional dyspepsia-suffering patients. Eur J Intern Med 2013; 24:83-6. [PMID: 22857883 DOI: 10.1016/j.ejim.2012.06.017] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 06/26/2012] [Accepted: 06/29/2012] [Indexed: 02/06/2023]
Abstract
BACKGROUND Psychosocial stressors either acute or more sustained frequently precede the onset and exacerbation of the symptoms of the functional dyspepsia (FD). Depressive mood and quality of life have been already reported for interference in functional dyspepsia suffering patients. METHODS The examination were performed on 60 FD patients (30 females and 30 males), aged 20-79 years, 60 peptic ulcer subjects and 60 healthy volunteers in which we have investigate levels of anxiety and depression, personality traits and quality of life. RESULT According to the Hamilton Depression and Anxiety Rating Scales, the population with FD had the average score which classified them into the group of patients with the moderate depression (20.57 ± 4.45). Personality traits estimation based on data obtained by the Eysenck personality questionnaire revealed higher neuroticism scores in the group with functional dyspepsia. Both parameters, level of the neuroticism and anxiety level, expressed highly significant level of mutual concordance. Patients with functional dyspepsia reported a greater adverse impact of symptoms of emotional distress and food and drink problems. CONCLUSION Results are indicating that the depression and anxiety level is the highest in patients with functional dyspepsia and that anxiety level corroborates with the neuroticism level from the Eysenck scale. Psychological disturbances are influencing the quality of life mostly in patients with dyspepsia in the form of emotional distress and the problem with the food and beverage intake.
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Matsuzaki J, Suzuki H, Asakura K, Fukushima Y, Inadomi JM, Takebayashi T, Hibi T. Classification of functional dyspepsia based on concomitant bowel symptoms. Neurogastroenterol Motil 2012; 24:325-e164. [PMID: 22235936 PMCID: PMC3386482 DOI: 10.1111/j.1365-2982.2011.01859.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Functional dyspepsia (FD) is a heterogeneous disease, and categorized into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). However, many FD patients have overlap of both PDS and EPS. The present study was designed to examine whether FD could be categorized based on the presence of concomitant gastrointestinal symptoms. METHODS A web survey comprised of the Gastrointestinal Symptom Rating Scale (GSRS), Rome III criteria of FD, and demographic information was sent to public participants who have no history of severe illness. Factor and cluster analyses were conducted to identify sub-categories of FD based on GSRS. KEY RESULTS A total of 8038 participants completed the survey. A total of 563 participants met the criteria for FD, whereas 6635 participants did not have dyspepsia symptoms. The remainder had either organic disease (377) or uninvestigated dyspepsia (463). The cluster analysis categorized participants as constipation predominant (cluster C), diarrhea predominant (cluster D), or having neither diarrhea nor constipation (cluster nCnD). Cluster C and D were significantly associated with the presence of FD [odds ratio (OR) 2.57, 95% confidence interval (CI) 2.06-3.21; OR 2.80; 95% CI 2.27-3.45, respectively]. In FD, especially in PDS cases, the scores of upper gastrointestinal symptoms were higher in cluster C or D than in cluster nCnD. CONCLUSIONS & INFERENCES The severity of dyspepsia symptoms is associated with the presence of bowel symptoms especially in PDS. This novel categorization of FD based on concomitant constipation or diarrhea may improve classification of patients.
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Affiliation(s)
- J. Matsuzaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - H. Suzuki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - K. Asakura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Y. Fukushima
- Department of Internal Medicine, Tokyo-Eki Center-Building Clinic, Tokyo, Japan
| | - J. M. Inadomi
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - T. Takebayashi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - T. Hibi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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Suzuki H, Hibi T. Overlap syndrome of functional dyspepsia and irritable bowel syndrome - are both diseases mutually exclusive? J Neurogastroenterol Motil 2011; 17:360-5. [PMID: 22148104 PMCID: PMC3228975 DOI: 10.5056/jnm.2011.17.4.360] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Revised: 07/09/2011] [Accepted: 07/14/2011] [Indexed: 12/13/2022] Open
Abstract
Among functional gastrointestinal (GI) disorders, functional dyspepsia (FD) and irritable bowel syndrome (IBS) are important to public health around the world and are frequently encountered in general practice. Upper GI symptoms such as heartburn, postprandial fullness, early satiety, epigastric pain or burning and lower GI symptoms such as constipation and diarrhea often coexist. Although the prevalence of FD-IBS overlap would be influenced by the selection of the study population, the overlap rate of FD-IBS could be in the range of 11%-27%. Specifically, FD-IBS overlap is associated with more severe symptoms than FD alone or IBS alone. Since clinical overlap, especially FD-IBS overlap, is very common, the 2 syndromes should not be treated in a mutually exclusive fashion.
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Affiliation(s)
- Hidekazu Suzuki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
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Abstract
PURPOSE OF REVIEW This review summarizes the recent progress in the epidemiology, pathophysiology and treatment of functional dyspepsia. RECENT FINDINGS Epidemiological, pathophysiological and therapeutic studies continue to examine the Rome III-proposed subdivision of functional dyspepsia into epigastric pain syndrome and postprandial distress syndrome. Although epidemiological studies support the subdivision, studies in patient samples show major overlap. Several studies identified overlapping functional disorders and psychosocial comorbidity as major contributors to the severity of functional dyspepsia and its impact on quality of life. Central processing of visceral stimuli, and its role in the pathogenesis of functional dyspepsia, as well as low-grade inflammation in the duodenum are important emerging topics in pathophysiology research. Therapeutic studies have reported on prokinetic and fundus-relaxing drugs. Acotiamide is a first-in-class drug with both prokinetic and fundus-relaxing properties that was evaluated in the recent phase 2 and phase 3 trials in functional dyspepsia. SUMMARY There is gradual progress in our understanding of the symptom pattern, impact and pathophysiology of functional dyspepsia. The areas of recent advances including the recognition of low-grade duodenal inflammation, central nervous system processing and the exploration of novel pharmacotherapeutic approaches are summarized in this review.
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