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Li S, Luo L, Wang S, Sun Q, Zhang Y, Huang K, Guan X. Regulation of gut microbiota and alleviation of DSS-induced colitis by vitexin. Eur J Nutr 2023; 62:3433-3445. [PMID: 37676484 DOI: 10.1007/s00394-023-03237-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 08/10/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE Vitexin is one of the flavonoids in millet and has a variety of biological activities. However, the function of vitexin on colitis is not clear. This research studied the regulation of vitexin on colitis and investigated the possible mechanisms. METHODS An in vitro fermentation model was used to evaluate the regulation of vitexin on gut microbiota of patients with inflammatory bowel disease (IBD). At the same time, an acute colitis mice model induced by dextran sodium sulfate (DSS) was used to evaluate the effects of vitexin on intestinal inflammation, barrier and gut microbiota. RESULTS In this study, it was found that vitexin altered the structure of gut microbiota by decreasing harmful bacteria, such as Veillonella, Terrisporobacter, Klebsiella, Paeniclostridium, and increasing beneficial bacteria, such as Parabacteroides, Flavonifractor, Blautia after in vitro fermentation with the feces of colitis patients. Further, DSS-induced colitis mice models revealed that vitexin treatment significantly improved colitis symptoms, maintained intestinal barrier and down-regulated the expression of inflammatory factors, such as IL-1β and TNF-α. In addition, vitexin also improved the diversity of gut microbiota of colitis mice by decreasing the abundance of harmful bacteria. CONCLUSION This research suggested that vitexin could alleviate colitis by regulating gut microbiota and attenuated gut inflammation.
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Affiliation(s)
- Sen Li
- School of Health Science and Engineering, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai, 200093, China
- National Grain Industry (Urban Grain and Oil Security) Technology Innovation Center, Shanghai, 200093, China
| | - Lei Luo
- School of Health Science and Engineering, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai, 200093, China
- National Grain Industry (Urban Grain and Oil Security) Technology Innovation Center, Shanghai, 200093, China
| | - Shuo Wang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai, 200093, China
- National Grain Industry (Urban Grain and Oil Security) Technology Innovation Center, Shanghai, 200093, China
| | - Qiqi Sun
- School of Health Science and Engineering, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai, 200093, China
- National Grain Industry (Urban Grain and Oil Security) Technology Innovation Center, Shanghai, 200093, China
| | - Yu Zhang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai, 200093, China
- National Grain Industry (Urban Grain and Oil Security) Technology Innovation Center, Shanghai, 200093, China
| | - Kai Huang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai, 200093, China
- National Grain Industry (Urban Grain and Oil Security) Technology Innovation Center, Shanghai, 200093, China
| | - Xiao Guan
- School of Health Science and Engineering, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai, 200093, China.
- National Grain Industry (Urban Grain and Oil Security) Technology Innovation Center, Shanghai, 200093, China.
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Li YD, Qu N, Yang J, Lv CY, Tang Y, Li P. Effects of an Omaha System-based follow-up regimen on self-care and quality of life in gastrointestinal surgery patients. World J Gastrointest Surg 2023; 15:2179-2190. [PMID: 37969724 PMCID: PMC10642477 DOI: 10.4240/wjgs.v15.i10.2179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/28/2023] [Accepted: 08/17/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Currently, a variety of new nursing methods and routine nursing have been widely used in the nursing of gastrointestinal surgery patients. AIM To investigate the effect of follow-up protocol based on the Omaha System on self-care ability and quality of life of gastrointestinal surgery patients. METHODS A total of 128 patients with inflammatory bowel disease in gastrointestinal surgery in gastrointestinal surgery from March 2019 to August 2021 were divided into A (n = 64) and B (n = 64) groups according to different nursing methods. The group A received a follow-up program Omaha System-based intervention of the group B, whereas the group B received the routine nursing intervention. Medical Coping Modes Questionnaire, Crohn's and Colitis Knowledge Score (CCKNOW), inflammatory bowel disease questionnaire (IBDQ), Exercise of Self-nursing Agency Scale (ESCA), The Modified Mayo Endoscopic Score, and Beliefs about Medicine Questionnaire (BMQ) were compared between the two groups. RESULTS Following the intervention, the group A were facing score significantly increased than group B, while the avoidance and yield scores dropped below of group B (all P < 0.05); in group A, the level of health knowledge, personal care abilities, self-perception, self-awareness score and ESCA total score were more outstanding than group B (all P < 0.05); in group A the frequency of defecation, hematochezia, endoscopic performance, the total evaluation score by physicians and the disease activity were lower than group B (all P < 0.05); in the group A, the total scores of knowledge in general, diet, drug, and complication and CCKNOW were higher than group B (all P < 0.05); in group A, the necessity of taking medicine, score of medicine concern and over-all score of BMQ were more significant than group B (all P < 0.05); at last in the group A, the scores of systemic and intestinal symptoms, social and emotional function, and IBDQ in the group A were higher than group B (all P < 0.05). CONCLUSION For gastrointestinal surgery patients, the Omaha System-based sequel protocol can improve disease awareness and intervention compliance, help them to face the disease positively, reduce disease activity, and improve patients' self-nursing ability and quality of life.
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Affiliation(s)
- Ying-Dong Li
- Department of Gastroenterology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264100, Shandong Province, China
| | - Na Qu
- Department of Gastroenterology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264100, Shandong Province, China
| | - Jie Yang
- Department of Endoscopy Center, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264100, Shandong Province, China
| | - Chun-Yan Lv
- Department of Gastroenterology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264100, Shandong Province, China
| | - Yu Tang
- College of Basic Medicine, Binzhou Medical University, Yantai 264000, Shandong Province, China
| | - Ping Li
- Department of Nursing, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264100, Shandong Province, China
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Logel SN, Maru J, Whitehead J, Brady C, Walch A, Lasarev M, Rehm JL, Millington K. Higher Rates of Certain Autoimmune Diseases in Transgender and Gender Diverse Youth. Transgend Health 2023. [DOI: 10.1089/trgh.2022.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
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Radford SJ. The impact of Inflammatory Bowel Disease related fatigue on Health-Related Quality of Life: a qualitative semi-structured interview study. J Res Nurs 2022; 27:685-702. [PMID: 36530749 PMCID: PMC9755563 DOI: 10.1177/17449871211061048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023] Open
Abstract
Background Fatigue is a frequently reported symptom of Inflammatory Bowel Disease (IBD), having a negative impact on Health-Related Quality of Life (HRQoL). Patients' experiences of this have not been researched in IBD. Methods Semi-structured interviews were conducted with adults with Crohn's Disease from out-patient clinics in the United Kingdom. Interviews were audio-recorded and transcribed verbatim, then analysed using thematic analysis. Results Fourteen participant interviews were conducted. Three key themes were identified: 1) 'The new normal' established through adaptation and acceptance; 2) 'Energy as a resource' describing attempts to better manage fatigue through planning and prioritising tasks; 3) 'Keeping healthy' encompasses participants' beliefs that 'good health' allows better management of fatigue. Conclusion Participants establish a 'new' normality, through maintaining the same or similar level of employment/education activities. However, this is often at the expense of social activities. Further research is required to explore patient led self-management interventions in IBD fatigue.
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Affiliation(s)
- Shellie J Radford
- Senior Research Nurse, Nottingham Digestive Diseases Centre, School of Medicine, The University of Nottingham, Nottingham, UK; NIHR Nottingham Biomedical Research Centre, GI and Liver Theme, University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
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5
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Black J, Sweeney L, Yuan Y, Singh H, Norton C, Czuber‐Dochan W. Systematic review: the role of psychological stress in inflammatory bowel disease. Aliment Pharmacol Ther 2022; 56:1235-1249. [PMID: 36082403 PMCID: PMC9825851 DOI: 10.1111/apt.17202] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/27/2022] [Accepted: 08/21/2022] [Indexed: 01/30/2023]
Abstract
BACKGROUND Psychological stress is a possible factor in the disease course and poor psychosocial outcomes in inflammatory bowel disease (IBD). Understanding the exact relationship between stress and health has been hampered by methodological issues and how stress has been defined and measured. AIMS To explore the association between stress and disease outcomes, investigate the impact of stress on psychosocial outcomes, and evaluate the efficacy of interventions in reducing stress for people with IBD METHODS: We performed a systematic review, searching Medline, CINAHL, Embase and PsycInfo databases on 21 January 2021. We included prospective studies that recruited people with IBD who were aged 16 or over and that measured psychological stress or distress. Analyses included Critical Appraisal Skills Programme quality assessments of included studies and narrative analyses against each research question. RESULTS We reviewed 38 studies with 4757 people with IBD, and included 23 observational and 15 interventional studies using 36 different instruments to measure stress. Perceived stress was the most frequently studied concept and preceded IBD exacerbation. Only three studies examined the relationship between stress and psychosocial factors. Cognitive behavioural interventions may reduce stress and other interventions with disease-specific stress, but more studies are needed where groups have comparable baseline characteristics and potential harms are considered alongside benefits. CONCLUSION Psychological stress appears to precede IBD exacerbation, although what role it plays in psychosocial outcomes and how it is best managed is unclear. Further research needs to examine the differential effects of stress on disease subtypes and IBD in flare and remission.
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Affiliation(s)
- Jacqueline Black
- King's College LondonFlorence Nightingale Faculty of Nursing, Midwifery, and Palliative CareJames Clerk Maxwell BuildingLondonUK
| | - Louise Sweeney
- King's College LondonFlorence Nightingale Faculty of Nursing, Midwifery, and Palliative CareJames Clerk Maxwell BuildingLondonUK,King's College LondonInstitute of Psychiatry, Psychology & NeuroscienceLondonUK
| | - Yuhan Yuan
- King's College LondonFlorence Nightingale Faculty of Nursing, Midwifery, and Palliative CareJames Clerk Maxwell BuildingLondonUK
| | | | - Christine Norton
- King's College LondonFlorence Nightingale Faculty of Nursing, Midwifery, and Palliative CareJames Clerk Maxwell BuildingLondonUK
| | - Wladyslawa Czuber‐Dochan
- King's College LondonFlorence Nightingale Faculty of Nursing, Midwifery, and Palliative CareJames Clerk Maxwell BuildingLondonUK
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Dent E, Davinson N, Wilkie S. The impact of gastrointestinal conditions on psychosocial factors associated with the biopsychosocial model of health: A scoping review. Appl Psychol Health Well Being 2021; 14:626-644. [PMID: 34866337 DOI: 10.1111/aphw.12323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/04/2021] [Indexed: 11/28/2022]
Abstract
The increase in the prevalence of gastrointestinal (GI) conditions is an emerging global health concern. Studies of the impact on the lives of individuals living with GI conditions such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) typically focus on biological elements, such as symptomology and treatment efficacy. Comparatively fewer studies have explored the psychological and social aspects of GI conditions, which could provide key information needed to better understand the impact of GI conditions on people and their lived experiences. In this review, existing literature concerning the psychosocial factors and well-being outcomes associated with GI conditions was reviewed using a scoping methodology. Sixty-eight studies were selected for inclusion. Of these studies, the well-being outcomes most frequently addressed, for both IBS and IBD, were quality of life and health-related quality of life, and the most frequently addressed psychosocial factors were social support and coping. These outcomes are largely consistent with those identified for other medical conditions explored using the biopsychosocial model of health, with some exploration of the lived experiences of those with a GI condition.
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Affiliation(s)
- Elizabeth Dent
- School of Psychology, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Nicola Davinson
- School of Psychology, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Stephanie Wilkie
- School of Psychology, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
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Koch AK, Schöls M, Haller H, Anheyer D, Cinar Z, Eilert R, Kofink K, Engler H, Elsenbruch S, Cramer H, Dobos G, Langhorst J. Comprehensive Lifestyle Modification Influences Medium-Term and Artificially Induced Stress in Ulcerative Colitis-A Sub-Study within a Randomized Controlled Trial Using the Trier Social Stress Test. J Clin Med 2021; 10:5070. [PMID: 34768588 PMCID: PMC8584874 DOI: 10.3390/jcm10215070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/20/2021] [Accepted: 10/26/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The present study presents long-term results of stress-related outcomes of a prospective RCT that evaluated effects of a ten-week comprehensive lifestyle-modification program (LSM) in patients with inactive ulcerative colitis (UC). In addition, exploratory results of a sub-study applying a laboratory stress protocol (Trier Social Stress Test; TSST) conducted within the RCT are reported. METHODS Ninety-seven patients with inactive UC were randomized to LSM (n = 47; 50.28 ± 11.90 years; 72.3% female) or self-care (n = 50; 45.54 ± 12.49 years; 70% female). Patients' perceived stress, anxiety, flourishing and depression were assessed at week 0, 12, 24 and 48. After the respective intervention, 16 female patients (LSM: n = 8; 44.6 ± 14.3 years; Self-care: n = 8; 49.25 ± 4.30 years) additionally underwent the TSST. State anxiety, blood pressure, pulse, complete blood counts, adrenocorticotropic hormone (ACTH), cortisol, adrenalin and noradrenalin were measured at baseline (-15 min), stress (+10 min), recovery1 (+20 min) and recovery2 (+55 min). Statistical significance was set at p < 0.05; for the exploratory sub-study using the TSST, p-values < 0.10 were considered significant. RESULTS Patients' perceived stress declined significantly after the LSM (p < 0.001) compared with control. This lasted until week 24 (p = 0.023) but did not persist until week 48 (p = 0.060). After 48 weeks, patients' flourishing was significantly increased compared with control (p = 0.006). In response to the TSST, significant group differences were evident for pulse (p = 0.015), adrenaline (p = 0.037) and anxiety (p = 0.066). After 55 min, group differences were found for ACTH (p = 0.067) and systolic blood pressure (p = 0.050). CONCLUSIONS LSM has a medium-term positive effect on perceived stress. First indications show that it is promising to investigate these effects further under laboratory conditions. It is also desirable to find out how the effects of LSM can be maintained in the long term.
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Affiliation(s)
- Anna K. Koch
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276 Essen, Germany; (A.K.K.); (M.S.); (H.H.); (D.A.); (Z.C.); (R.E.); (K.K.); (H.C.); (G.D.)
- Department of Internal and Integrative Medicine, Klinikum Bamberg, Sozialstiftung Bamberg, 96049 Bamberg, Germany
| | - Margarita Schöls
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276 Essen, Germany; (A.K.K.); (M.S.); (H.H.); (D.A.); (Z.C.); (R.E.); (K.K.); (H.C.); (G.D.)
| | - Heidemarie Haller
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276 Essen, Germany; (A.K.K.); (M.S.); (H.H.); (D.A.); (Z.C.); (R.E.); (K.K.); (H.C.); (G.D.)
| | - Dennis Anheyer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276 Essen, Germany; (A.K.K.); (M.S.); (H.H.); (D.A.); (Z.C.); (R.E.); (K.K.); (H.C.); (G.D.)
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW 2480, Australia
| | - Zehra Cinar
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276 Essen, Germany; (A.K.K.); (M.S.); (H.H.); (D.A.); (Z.C.); (R.E.); (K.K.); (H.C.); (G.D.)
| | - Ronja Eilert
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276 Essen, Germany; (A.K.K.); (M.S.); (H.H.); (D.A.); (Z.C.); (R.E.); (K.K.); (H.C.); (G.D.)
| | - Kerstin Kofink
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276 Essen, Germany; (A.K.K.); (M.S.); (H.H.); (D.A.); (Z.C.); (R.E.); (K.K.); (H.C.); (G.D.)
| | - Harald Engler
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany;
| | - Sigrid Elsenbruch
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University, 44801 Bochum, Germany;
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276 Essen, Germany; (A.K.K.); (M.S.); (H.H.); (D.A.); (Z.C.); (R.E.); (K.K.); (H.C.); (G.D.)
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW 2480, Australia
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276 Essen, Germany; (A.K.K.); (M.S.); (H.H.); (D.A.); (Z.C.); (R.E.); (K.K.); (H.C.); (G.D.)
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Klinikum Bamberg, Sozialstiftung Bamberg, 96049 Bamberg, Germany
- Department for Integrative Medicine and Translational Gastroenterology, Medical Faculty, University of Duisburg-Essen, Sozialstiftung Bamberg, 96049 Bamberg, Germany
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Gelech J, Desjardins M, Mazurik K, Duerksen K, McGuigan-Scott K, Lichtenwald K. Understanding Gut Feelings: Transformations in Coping With Inflammatory Bowel Disease Among Young Adults. QUALITATIVE HEALTH RESEARCH 2021; 31:1918-1936. [PMID: 33980095 PMCID: PMC8446882 DOI: 10.1177/10497323211011442] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Past studies have revealed a dizzying array of coping techniques employed by persons living with inflammatory bowel disease (IBD). Unfortunately, research has provided little insight into when and why individuals adopt or abandon particular coping strategies. Using a retrospective narrative approach, we explored how participants made sense of changes in their approach to coping over time. Shifts in coping strategies were associated with particular illness experiences that wrought new understandings of IBD and novel identity challenges. They followed a common processual form and were marked by a movement away from techniques of purification, normalization, and banalization toward the development of a more communicative body. This was accompanied by notable shifts in identity work. Notably, participants moved from a preoccupation with maintaining continuity and sameness to permitting their extraordinary bodies to occupy a place in their public and personal identities. Implications of this process for theory and practice are discussed.
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Affiliation(s)
- Jan Gelech
- University of Saskatchewan,
Saskatoon, Saskatchewan, Canada
| | | | | | - Kari Duerksen
- University of Victoria, Victoria,
British Columbia, Canada
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Lainé A, Laurent A, Nancey S, Flourié B. Spécificité des stratégies de coping des patients en rémission de la maladie de Crohn : une étude qualitative. PRAT PSYCHOL 2021. [DOI: 10.1016/j.prps.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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10
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Langhorst J, Schöls M, Cinar Z, Eilert R, Kofink K, Paul A, Zempel C, Elsenbruch S, Lauche R, Ahmed M, Haller D, Cramer H, Dobos G, Koch AK. Comprehensive Lifestyle-Modification in Patients with Ulcerative Colitis-A Randomized Controlled Trial. J Clin Med 2020; 9:E3087. [PMID: 32987894 PMCID: PMC7599849 DOI: 10.3390/jcm9103087] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/17/2020] [Accepted: 09/21/2020] [Indexed: 12/15/2022] Open
Abstract
Patients with ulcerative colitis suffer from impaired health-related quality of life (HrQoL). Comprehensive lifestyle-modification might increase HrQoL and decrease disease activity. Ninety-seven patients in clinical remission with impaired HrQoL were randomly assigned to a 10 week comprehensive lifestyle-modification program (LSM; n = 47; 50.28 ± 11.90 years) or control (n = 50; 45.54 ± 12.49 years) that received a single workshop of intense training in naturopathic self-help strategies. Primary outcome was HrQoL (Inflammatory Bowel Disease Questionnaire; IBDQ) at week 12. Secondary outcomes included IBDQ subscales; generic HrQoL; disease activity and microbiome. Both groups showed improvement in HrQoL from baseline to post-treatment at week 12. The IBDQ sum score showed no significant group difference (p = 0.251). If patients attended more than 50% of the training sessions, a significant group effect (p = 0.034) was evident in favor of LSM. In addition, the SF-36 mental component summary (p = 0.002) was significantly different between the groups in favor of LSM. Disease activity microbiome and adverse events did not differ. Both a single workshop and a 10-week comprehensive lifestyle-modification program can improve HrQoL in patients with ulcerative colitis in remission with no apparent effects on clinical disease activity. A treatment difference was observed when examining a subsample of patients who attended ≥ 50% of sessions.
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Affiliation(s)
- Jost Langhorst
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Germany, Chair for Integrative Medicine, University of Duisburg-Essen, Buger Straße 80, 96049 Bamberg, Germany
- Integrative Gastroenterology, University of Duisburg-Essen, Evang. Kliniken-Essen-Mitte, Am Deimelsberg 34 a, 45276 Essen, Germany; (M.S.); (Z.C.); (R.E.); (K.K.)
| | - Margarita Schöls
- Integrative Gastroenterology, University of Duisburg-Essen, Evang. Kliniken-Essen-Mitte, Am Deimelsberg 34 a, 45276 Essen, Germany; (M.S.); (Z.C.); (R.E.); (K.K.)
| | - Zehra Cinar
- Integrative Gastroenterology, University of Duisburg-Essen, Evang. Kliniken-Essen-Mitte, Am Deimelsberg 34 a, 45276 Essen, Germany; (M.S.); (Z.C.); (R.E.); (K.K.)
| | - Ronja Eilert
- Integrative Gastroenterology, University of Duisburg-Essen, Evang. Kliniken-Essen-Mitte, Am Deimelsberg 34 a, 45276 Essen, Germany; (M.S.); (Z.C.); (R.E.); (K.K.)
| | - Kerstin Kofink
- Integrative Gastroenterology, University of Duisburg-Essen, Evang. Kliniken-Essen-Mitte, Am Deimelsberg 34 a, 45276 Essen, Germany; (M.S.); (Z.C.); (R.E.); (K.K.)
| | - Anna Paul
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34 a, 45276 Essen, Germany; (A.P.); (C.Z.); (H.C.); (G.D.); (A.K.K.)
| | - Christina Zempel
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34 a, 45276 Essen, Germany; (A.P.); (C.Z.); (H.C.); (G.D.); (A.K.K.)
| | - Sigrid Elsenbruch
- Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Universitätsstraße 150, 44801 Bochum, Germany;
| | - Romy Lauche
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, Lismore Campus, Military Rd, Lismore, NSW 2480, Australia;
| | - Mohamed Ahmed
- Technical University of Munich, Chair of Nutrition and Immunology, Gregor-Mendel-Str. 2, 85354 Freising-Weihenstephan, Germany; (M.A.); (D.H.)
| | - Dirk Haller
- Technical University of Munich, Chair of Nutrition and Immunology, Gregor-Mendel-Str. 2, 85354 Freising-Weihenstephan, Germany; (M.A.); (D.H.)
- ZIEL-Institute for Food and Health, Technical University of Munich, 85354 Freising, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34 a, 45276 Essen, Germany; (A.P.); (C.Z.); (H.C.); (G.D.); (A.K.K.)
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34 a, 45276 Essen, Germany; (A.P.); (C.Z.); (H.C.); (G.D.); (A.K.K.)
| | - Anna K. Koch
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34 a, 45276 Essen, Germany; (A.P.); (C.Z.); (H.C.); (G.D.); (A.K.K.)
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11
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Lawrence R, Choudhary C. Barriers to Psychosocial Support and Quality of Life for Patients With Inflammatory Bowel Disease: A Survey Study. CROHN'S & COLITIS 360 2020; 2:otaa068. [PMID: 36777760 PMCID: PMC9802200 DOI: 10.1093/crocol/otaa068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Indexed: 11/14/2022] Open
Abstract
Background Psychological comorbidities are common among people with inflammatory bowel disease (IBD) and are associated with worse disease outcomes. Evidence-based psychotherapy is an effective means to increase psychosocial support. This study aimed to identify the barriers to attending psychotherapy. Methods This electronic survey study included a demographic, quality of life, and barriers to psychotherapy questionnaire. Quality of life was assessed using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Barriers were assessed using the Perceived Barriers to Psychological Treatments scale (PBPT). Linear regression was used to identify participant characteristics associated with higher PBPT scores. Results One hundred eighty-seven participants completed the study. Fifty-eight percent of participants had ≥1 significant barrier. Time (28%), knowledge about the availability of services (25%), and cost (19%) were the most common barriers. Least common were stigma (14%), lack of motivation (12%), and emotional concerns (7%). Lower SIBDQ scores, being male, not being full-time employed, having Crohn disease, and being in disease remission were associated with higher PBPT scores. Conclusions Knowledge about the availability of services, time constraints, and cost are the leading barriers to psychotherapy among people with IBD. Care providers should develop a network of psychotherapists available to those with IBD. Being male and not being full-time employed may be risk factors for greater barriers. Further research is needed on barriers among groups underrepresented in this study and on novel psychotherapy solutions, like telehealth and low-cost options.
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Affiliation(s)
- Rebecca Lawrence
- Sidney Kimmel College of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Cuckoo Choudhary
- Sidney Kimmel College of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA,Division of Gastroenterology and Hepatology, Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA,Address correspondence to: Cuckoo Choudhary, MD, Division of Gastroenterology and Hepatology, Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, 132 South 10th Street, Main Building, Suite 480, Philadelphia, PA 19107 ()
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Chlorogenic Acid Attenuates Dextran Sodium Sulfate-Induced Ulcerative Colitis in Mice through MAPK/ERK/JNK Pathway. BIOMED RESEARCH INTERNATIONAL 2019; 2019:6769789. [PMID: 31139644 PMCID: PMC6500688 DOI: 10.1155/2019/6769789] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/28/2019] [Accepted: 04/03/2019] [Indexed: 02/07/2023]
Abstract
Objective Observe the protective effect of chlorogenic acid on dextran sulfate-induced ulcerative colitis in mice and explore the regulation of MAPK/ERK/JNK signaling pathway. Methods Seventy C57BL/6 mice (half males and half females) were randomly divided into 7 groups, 10 in each group: control group (CON group), UC model group (UC group), and sulfasalazine-positive control group (SASP group), chlorogenic acid low dose group (CGA-L group), chlorogenic acid medium dose group (CGA-M group), chlorogenic acid high dose group (CGA-H group), and ERK inhibitor + chlorogenic acid group (E+CGA group). The effects of chlorogenic acid on UC were evaluated by colon mucosa damage index (CMDI), HE staining, immunohistochemistry, ELISA, and Western blot. The relationship between chlorogenic acid and MAPK/ERK/JNK signaling pathway was explored by adding ERK inhibitor. Results The UC models were established successfully by drinking DSS water. Chlorogenic acid reduces DSS-induced colonic mucosal damage, inhibits DSS-induced inflammation, oxidative stress, and apoptosis in colon, and reduces ERK1/2, p -ERK, p38, p-p38, JNK, and p-JNK protein expression. ERK inhibitor U0126 reversed the protective effect of chlorogenic acid on colon tissue. Conclusion Chlorogenic acid can alleviate DSS-induced ulcerative colitis in mice, which can significantly reduce tissue inflammation and apoptosis, and its mechanism is related to the MAPK/ERK/JNK signaling pathway.
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Rudnik A, Piotrowicz G, Basińska MA, Rashedi V. The importance of cognitive flexibility and flexibility in coping with stress for the quality of life in inflammatory bowel disease patients during biological therapy. A preliminary report. PRZEGLAD GASTROENTEROLOGICZNY 2019; 14:121-128. [PMID: 31616526 PMCID: PMC6791139 DOI: 10.5114/pg.2018.81081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 11/19/2018] [Indexed: 01/09/2023]
Abstract
INTRODUCTION There are studies demonstrating the relation between psychological factors and efficiency of treatment in the course of inflammatory bowel diseases (IBD). AIM To investigate the relation between cognitive flexibility and flexibility in coping with stress and the quality of life, as well as the sense of satisfaction with life, in patients undergoing the biological treatment. MATERIAL AND METHODS The study group consisted of 33 adults who were diagnosed with Crohn's disease (CD) or ulcerative colitis (UC). The Flexibility in Coping with Stress Questionnaire (FCSQ-14), the Cognitive Flexibility Inventory (CFI), the Quality of Life SF36v2 Questionnaire, the Satisfaction with Life Scale (SWLS), and the socio-demographic questionnaire were used to gather the data. RESULTS A total of 14 females and 19 males were included in this analysis. The results did not prove that the disease diagnosis (UC or CD) differed the level of psychological resources. However, older respondents achieved lower results in cognitive flexibility. A positive correlation was observed between both cognitive flexibility and flexibility in coping with stress and different dimensions of quality of life and satisfaction with life. CONCLUSIONS There is a relationship between both cognitive flexibility and flexibility in coping with stress and health-related quality of life. These factors can be considered to be a kind of resource that helps to cope with challenges posed by a chronic illness, including IBD. Therefore, it is significant to increase their level by applying tailored therapeutic methods.
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Affiliation(s)
- Agata Rudnik
- Institute of Psychology, University of Gdansk, Gdansk, Poland
- Department of Gastroenterology, Independent Public Health Care of the Ministry of the Internal Affairs, Gdansk, Poland
| | - Grażyna Piotrowicz
- Department of Gastroenterology, Independent Public Health Care of the Ministry of the Internal Affairs, Gdansk, Poland
| | | | - Vahid Rashedi
- School of Behavioural Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
- Iranian Research Centre on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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