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Herter J, Stübing F, Lüth V, Zimmermann J, Lederer AK, Hannibal L, Huber R, Storz MA. Bowel health, defecation patterns and nutrient intake following adoption of a vegan diet: a randomized-controlled trial. Ann Med 2024; 56:2305693. [PMID: 38327148 PMCID: PMC10854443 DOI: 10.1080/07853890.2024.2305693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/10/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND The beneficial effects of a plant-based diet on gut microbiota diversity are well documented, however, its impact on clinical bowel health and defecation patterns are less well understood. Vegetarian diets have been associated with a higher bowel movement (BM) frequency as well as softer stools in cross-sectional studies. The effects of the de-novo adoption of a vegan diet on bowel health, however, have never been investigated in a randomized-controlled trial. MATERIALS AND METHODS The present study examined bowel health and defecation patterns in relation to diet and nutrient intake in a young and healthy sample of n = 65 physically-active German university students who were randomly assigned to either a vegan or a meat-rich diet for eight weeks. Bowel health assessment included the Bristol Stool Form Scale (BSFS), the Gastrointestinal Quality of Life Index (GIQLI) and the Cleveland Clinic Fecal Incontinence Score (CCFIS). Nutrient intake was assessed using weighed food diaries. The study was prospectively registered at the German Clinical Trial Register (DRKS00031541). RESULTS Weekly BM frequency slightly increased in vegans, whereas it remained unaltered in participants assigned to a meat-rich diet. Fiber intake increased significantly in vegans (34.89 (18.46) g/d) whereas it decreased in those assigned to the meat-rich group (22.79 (12.5) g/d). No significant intergroup differences in BSFS and CCFIS patterns were observed. Adoption of a vegan diet neither resulted in a transient increase in abdominal discomfort nor in a decreased gastrointestinal quality of life, which was comparable across the diet groups. CONCLUSIONS The short-term de-novo adoption of a vegan diet did not negatively affect markers of bowel health in this study.
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Affiliation(s)
- Julian Herter
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Frieda Stübing
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Volker Lüth
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Julia Zimmermann
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ann-Kathrin Lederer
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Luciana Hannibal
- Laboratory of Clinical Biochemistry and Metabolism, Department of General Pediatrics, Adolescent Medicine and Neonatology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Roman Huber
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maximilian Andreas Storz
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Mundet L, Raventós A, Carrión S, Bascompte C, Clavé P. Characterization of obstructive defecation from a structural and a functional perspective. GASTROENTEROLOGIA Y HEPATOLOGIA 2024:502219. [PMID: 38857752 DOI: 10.1016/j.gastrohep.2024.502219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/06/2024] [Accepted: 05/24/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND/AIMS Defecation disorders can occur as a consequence of functional or structural anorectal dysfunctions during voiding. The aims of this study is to assess the prevalence of structural (SDD) vs functional (FDD) defecation disorders among patients with clinical complaints of obstructive defecation (OD) and their relationship with patients' expulsive capacity. PATIENTS AND METHODS Retrospective study of 588 patients with OD studied between 2012 and 2020 with evacuation defecography (ED), and anorectal manometry (ARM) in a subgroup of 294. RESULTS 90.3% patients were women, age was 58.5±12.4 years. Most (83.7%) had SDD (43.7% rectocele, 45.3% prolapse, 19.3% enterocele, and 8.5% megarectum), all SDD being more prevalent in women except for megarectum. Functional assessments showed: (a) absence of rectification of anorectal angle in 51% of patients and poor pelvic descent in 31.6% at ED and (b) dyssynergic defecation in 89.9%, hypertonic IAS in 44%, and 33.3% rectal hyposensitivity, at ARM. Overall, 46.4% of patients were categorized as pure SDD, 37.3% a combination of SDD+FDD, and 16.3% as having pure FDD. Rectal emptying was impaired in 66.2% of SDD, 71.3% of FDD and in 78% of patients with both (p=0.017). CONCLUSIONS There was a high prevalence of SDD in middle-aged women with complaints of OD. Incomplete rectal emptying was more prevalent in FDD than in SDD although FDD and SDD frequently coexist. We recommend a stepwise therapeutic approach always starting with therapy directed to improve FDD and relaxation of striated pelvic floor muscles.
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Affiliation(s)
- Lluís Mundet
- Gastrointestinal Motility Unit, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Catalonia, Spain; Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas (CIBERehd), Instituto de Salud Carlos III, Spain.
| | - Alba Raventós
- Gastrointestinal Motility Unit, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Catalonia, Spain
| | - Sílvia Carrión
- Gastrointestinal Motility Unit, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Catalonia, Spain
| | - Cristina Bascompte
- Gastrointestinal Motility Unit, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Catalonia, Spain
| | - Pere Clavé
- Gastrointestinal Motility Unit, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Catalonia, Spain; Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas (CIBERehd), Instituto de Salud Carlos III, Spain
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Haghbin H, Zakirkhodjaev N, Gangwani MK, Beran A, Lee-Smith W, Piper MH, Aziz M. Efficacy and safety of vibrating capsule in treatment of chronic idiopathic constipation: a systematic review and meta-analysis of randomized controlled trials. Transl Gastroenterol Hepatol 2024; 9:8. [PMID: 38317751 PMCID: PMC10838609 DOI: 10.21037/tgh-23-64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/10/2023] [Indexed: 02/07/2024] Open
Abstract
Background Multiple pharmacological interventions and modalities are available for managing chronic idiopathic constipation (CIC), with variable efficacy. Vibrating capsule (VC) is a device that has shown variable results in alleviating constipation by tactile stimulation of the colonic wall and inducing peristalsis. This meta-analysis is to investigate the efficacy and safety of this modality. Methods Comprehensive literature search was performed through June 14th, 2023, on databases including Embase, PubMed/MEDLINE, Cochrane Central, Web of Science, Global Index Medicus, and Google Scholar. Core concepts of VC, constipation, and bowel movement were searched. The DerSimonian-Laird method and random effects model were utilized. We calculated odds ratio (OR) and mean difference (MD) for proportional and continuous variables, respectively, with 95% confidence interval (CI) and a P value of <0.05 considered statistically significant. Results The search strategy yielded 117 articles. Four studies with 705 total patients were finalized comparing VC to placebo/sham treatment. The pooled complete spontaneous bowel movement (CSBM), defined as bowel movement without use of laxatives within the last 48 hours with sense of complete evacuation did not achieve statistical improvement with VC (MD =0.153; 95% CI: -0.218 to 0.523; P=0.422). However, spontaneous bowel movement (SBM), defined as bowel movement without use of laxatives within the last 48 hours, showed statistical improvement with VC (MD =0.159; 95% CI: 0.095 to 0.223; P<0.001). VC didn't show an increase in pooled adverse events (OR =1.431; 95% CI: 0.702 to 2.916; P=0.324). Conclusions The systematic review and meta-analysis suggest that VC is safe and efficacious in some outcomes, however, larger randomized controlled trials (RCTs) and real-world data are needed to establish this.
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Affiliation(s)
- Hossein Haghbin
- Division of Gastroenterology, Ascension Providence Hospital, Southfield, MI, USA
| | - Nurruddinkhodja Zakirkhodjaev
- Division of Occupational and Environmental Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Azizullah Beran
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Wade Lee-Smith
- University of Toledo Libraries, University of Toledo, Toledo, OH, USA
| | - Michael H. Piper
- Division of Gastroenterology, Ascension Providence Hospital, Southfield, MI, USA
| | - Muhammad Aziz
- Division of Gastroenterology and Hepatology, University of Toledo, Toledo, OH, USA
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Zhang T, Zullo AR, James HO, Lee Y, Taylor DCA, Daiello LA. The Burden and Treatment of Chronic Constipation Among US Nursing Home Residents. J Am Med Dir Assoc 2023; 24:1247-1252.e5. [PMID: 37308090 PMCID: PMC10642798 DOI: 10.1016/j.jamda.2023.05.006] [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: 12/19/2022] [Revised: 05/01/2023] [Accepted: 05/05/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To evaluate the burden of chronic constipation (CC) and the use of drugs to treat constipation (DTC) in 2 complementary data sources. DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS US nursing home residents aged ≥65 years with CC. METHODS We conducted 2 retrospective cohort studies in parallel using (1) 2016 electronic health record (EHR) data from 126 nursing homes and (2) 2014-2016 Medicare claims, each linked with the Minimum Data Set (MDS). CC was defined as (1) the MDS constipation indicator and/or (2) chronic DTC use. We described the prevalence and incidence rate of CC and the use of DTC. RESULTS In the EHR cohort, we identified 25,739 residents (71.8%) with CC during 2016. Among residents with prevalent CC, 37% received a DTC, with an average duration of use of 19 days per resident-month during follow-up. The most frequently prescribed DTC classes included osmotic (22.6%), stimulant (20.9%), and emollient (17.9%) laxatives. In the Medicare cohort, a total of 245,578 residents (37.5%) had CC. Among residents with prevalent CC, 59% received a DTC and slightly more than half (55%) were prescribed an osmotic laxative. Duration of use was shorter (10 days per resident-month) in the Medicare (vs EHR) cohort. CONCLUSIONS AND IMPLICATIONS The burden of CC is high among nursing home residents. The differences in the estimates between the EHR and Medicare data confirm the importance of using secondary data sources that include over-the-counter drugs and other treatments unobservable in Medicare Part D claims to assess the burden of CC and DTC use in this population.
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Affiliation(s)
- Tingting Zhang
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA
| | - Andrew R Zullo
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, RI, USA; Department of Pharmacy, Lifespan-Rhode Island Hospital, Providence, RI, USA
| | - Hannah O James
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA
| | - Yoojin Lee
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA
| | | | - Lori A Daiello
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA.
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Frändemark Å, Törnblom H, Hreinsson JP, Andresen V, Benninga MA, Corazziari ES, Fukudo S, Mulak A, Santos J, Sperber AD, Bangdiwala SI, Palsson OS, Simrén M. Work productivity and activity impairment in disorders of gut-brain interaction: Data from the Rome Foundation Global Epidemiology Study. United European Gastroenterol J 2023. [PMID: 37332146 DOI: 10.1002/ueg2.12425] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/10/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Disorders of Gut-Brain Interaction (DGBI) are highly prevalent worldwide, but their effect on work productivity has not gained much attention. AIMS AND METHODS We aimed to compare work productivity and activity impairment (WPAI) in persons with and without DGBI in a large population-based cohort and identify factors independently associated with WPAI in subjects with DGBI. Data were collected from Germany, Israel, Italy, Japan, the Netherlands, Poland, Spain and Sweden via Internet surveys as part of the Rome Foundation Global Epidemiology Study. Apart from the Rome IV diagnostic questionnaire, questionnaires evaluating WPAI related to general health (WPAI:GH), psychological distress (PHQ-4), somatic symptom severity (PHQ-15) and other factors were assessed. RESULTS Of the 16,820 subjects, 7111 met the criteria for DGBI according to the Rome IV diagnostic questionnaire. Subjects with DGBI were younger (median (interquartile range) age 43 (31-58) vs. 47 (33-62)) and more often female (59.0% vs. 43.7%) compared to subjects without DGBI. Subjects with DGBI had higher absenteeism, presenteeism (poor work productivity due to illness), overall work impairment and activity impairment (p < 0.001) compared with subjects without. For subjects with DGBI affecting more than one anatomical region, WPAI was incrementally higher for each additional region. There were significant differences in WPAI for subjects with DGBI in different countries. Subjects from Sweden had the highest overall work impairment and from Poland the lowest. Using multiple linear regression, male sex, fatigue, psychological distress, somatic symptom severity and number of anatomical regions were independently associated with overall work impairment (p < 0.05 for all). CONCLUSION In the general population, people with DGBI have substantial WPAI compared with those without DGBI. The reasons for these findings should be explored further, but having multiple DGBI, psychological distress, fatigue and somatic symptom severity seem to contribute to this impairment associated with DGBI.
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Affiliation(s)
- Åsa Frändemark
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hans Törnblom
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jóhann Páll Hreinsson
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Viola Andresen
- Department of Medicine, Israelitic Hospital, Hamburg, Germany
| | - Marc A Benninga
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Amsterdam, The Netherlands
| | | | - Shin Fukudo
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Agata Mulak
- Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wroclaw, Poland
| | - Javier Santos
- Department of Gastroenterology, University Hospital Vall d'Hebron, Autonomous University of Barcelona & Neuro-Inmuno-Gastroenterology Lab, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Ami D Sperber
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shrikant I Bangdiwala
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Olafur S Palsson
- Center for Functional GI & Motility Disorders, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Magnus Simrén
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Rao SSC, Quigley EMM, Chey WD, Sharma A, Lembo AJ. Randomized Placebo-Controlled Phase 3 Trial of Vibrating Capsule for Chronic Constipation. Gastroenterology 2023; 164:1202-1210.e6. [PMID: 36822371 DOI: 10.1053/j.gastro.2023.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/27/2023] [Accepted: 02/02/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND & AIMS Despite therapeutic advances, effective treatments for chronic constipation remain an unmet need. The vibrating capsule is a nonpharmacologic, orally ingested, programmable capsule that vibrates intraluminally to induce bowel movements. We aimed to determine the efficacy and safety of the vibrating capsule in patients with chronic constipation. METHODS We conducted a phase 3, double-blind, placebo-controlled trial of patients with chronic constipation, who were randomized to receive either a vibrating or placebo capsule, once daily, 5 days a week for 8 weeks. The primary efficacy end points were an increase of 1 or more complete spontaneous bowel movements per week (CSBM1 responder) or 2 or more CSBMs per week (CSBM2) from baseline during at least 6 of the 8 weeks. Safety analyses were performed. RESULTS Among 904 patients screened, 312 were enrolled. A greater percentage of patients receiving the vibrating capsule achieved both primary efficacy end points compared with placebo (39.3% vs 22.1%, P = .001 for CSBM1; 22.7% vs 11.4% P = .008 for CSBM2). Significantly greater improvements were seen with the vibrating capsule for the secondary end points of straining, stool consistency, and quality-of-life measures compared with placebo. Adverse events were mild, gastrointestinal in nature, and similar between groups, except that a mild vibrating sensation was reported by 11% of patients in the vibrating capsule group, but none withdrew from the trial. CONCLUSIONS In patients with chronic constipation, the vibrating capsule was superior to placebo in improving bowel symptoms and quality of life. The vibrating capsule was safe and well tolerated. (Clinical trials.gov, Number: NCT03879239).
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Affiliation(s)
- Satish S C Rao
- Division of Gastroenterology/Hepatology, Augusta University, Augusta, Georgia.
| | - Eamonn M M Quigley
- Lynda K. and David M. Underwood Center for Digestive Disorders, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas
| | | | - Amol Sharma
- Division of Gastroenterology/Hepatology, Augusta University, Augusta, Georgia
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Fawaz SI, Elshatby NM, El-Tawab SS. The effect of spinal magnetic stimulation on the management of functional constipation in adults. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2023. [DOI: 10.1186/s43166-023-00184-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Abstract
Background
Functional constipation is a type of functional bowel disorder characterized by difficult defecation with a sense of incomplete evacuation. It is a common disorder with an increasing prevalence, and the underlying cause is poorly identified. Nonpharmacological management of functional constipation includes lifestyle and dietary modification, regular physical activity, advice about toileting posture, and behavioral therapy. Biofeedback training as part of the behavioral training showed great efficacy with long-term results. Spinal magnetic stimulation is the application of extracorporeal magnetic stimuli to the spinal nerves and deep pelvic muscles to enhance bowel evacuation without surgical drawbacks. This study was designed to enhance bowel elimination in functional constipation patients through the dual effect of biofeedback and spinal magnetic stimulation. This work aimed to study the efficacy of spinal magnetic stimulation and biofeedback training versus biofeedback alone in the management of functional constipation.
Results
There was a statistically significant difference between before and after the intervention in both studied groups regarding the mean weekly spontaneous bowel movement, a Numerical Rating Scale for pain assessment, and the Patient Assessment of Constipation Quality of Life questionnaire. When comparing the two groups after the intervention, the spinal magnetic stimulation showed superiority in the mean weekly spontaneous bowel movement and manometric anal pressure at rest.
Conclusions
Spinal magnetic stimulation in addition to biofeedback pelvic floor muscle training could increase the mean weekly complete spontaneous bowel movements and manometric anal pressure at rest in patients with functional constipation. It did not show any additive benefits in improving pain during defecation or patient quality of life.
Trial registration
ClinicalTrials.gov, 0305398. https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000BQ0H&selectaction=Edit&uid=U0004JW0&ts=2&cx=-xmnims
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Yin T, He Z, Ma P, Sun R, Xie K, Liu T, Chen L, Chen J, Hou L, Teng Y, Guo Y, Tian Z, Xiong J, Wang F, Li S, Yang S, Zeng F. Aberrant functional brain network dynamics in patients with functional constipation. Hum Brain Mapp 2021; 42:5985-5999. [PMID: 34533251 PMCID: PMC8596972 DOI: 10.1002/hbm.25663] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/25/2021] [Accepted: 09/06/2021] [Indexed: 12/17/2022] Open
Abstract
The aberrant static functional connectivity of brain network has been widely investigated in patients with functional constipation (FCon). However, the dynamics of brain functional connectivity in FCon patients remained unknown. This study aimed to detect the brain dynamics of functional connectivity states and network topological organizations of FCon patients and investigate the correlations of the aberrant brain dynamics with symptom severity. Eighty-three FCon patients and 80 healthy subjects (HS) were included in data analysis. The spatial group independent component analysis, sliding-window approach, k-means clustering, and graph-theoretic analysis were applied to investigate the dynamic temporal properties and coupling patterns of functional connectivity states, as well as the time-variation of network topological organizations in FCon patients. Four reoccurring functional connectivity states were identified in k-means clustering analysis. Compared to HS, FCon patients manifested the lower occurrence rate and mean dwell time in the state with a complex connection between default mode network and cognitive control network, as well as the aberrant anterior insula-cortical coupling patterns in this state, which were significantly correlated with the symptom severity. The graph-theoretic analysis demonstrated that FCon patients had higher sample entropy at the nodal efficiency of anterior insula than HS. The current findings provided dynamic perspectives for understanding the brain connectome of FCon and laid the foundation for the potential treatment of FCon based on brain connectomics.
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Affiliation(s)
- Tao Yin
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Zhaoxuan He
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Key Laboratory of Sichuan Province for Acupuncture and ChronobiologyChengduSichuanChina
| | - Peihong Ma
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Ruirui Sun
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Kunnan Xie
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Tianyu Liu
- School of SportChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Li Chen
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Jingwen Chen
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Likai Hou
- Sichuan Bayi Rehabilitation CenterChengduSichuanChina
| | - Yuke Teng
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Yuyi Guo
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Zilei Tian
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Jing Xiong
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Fumin Wang
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Shenghong Li
- State Key Laboratory of Southwestern Chinese Medicine Resources/Innovative Institute of Chinese Medicine and PharmacyChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Sha Yang
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Key Laboratory of Sichuan Province for Acupuncture and ChronobiologyChengduSichuanChina
| | - Fang Zeng
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
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Smart pills for gastrointestinal diagnostics and therapy. Adv Drug Deliv Rev 2021; 177:113931. [PMID: 34416311 DOI: 10.1016/j.addr.2021.113931] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/03/2021] [Accepted: 08/13/2021] [Indexed: 12/13/2022]
Abstract
Ingestible smart pills have the potential to be a powerful clinical tool in the diagnosis and treatment of gastrointestinal disease. Though examples of this technology, such as capsule endoscopy, have been successfully translated from the lab into clinically used products, there are still numerous challenges that need to be overcome. This review gives an overview of the research being done in the area of ingestible smart pills and reports on the technical challenges in this field.
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10
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Shin A. The changing prevalence of functional constipation: why words matter. Lancet Gastroenterol Hepatol 2021; 6:600-602. [PMID: 34090580 DOI: 10.1016/s2468-1253(21)00140-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Andrea Shin
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
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Khayat A, Algethami G, Baik S, Alhajori M, Banjar D. The Effect of Using Rome IV Criteria on the Prevalence of Functional Abdominal Pain Disorders and Functional Constipation among Children of the Western Region of Saudi Arabia. Glob Pediatr Health 2021; 8:2333794X211022265. [PMID: 34104704 PMCID: PMC8170292 DOI: 10.1177/2333794x211022265] [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] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/10/2021] [Indexed: 12/31/2022] Open
Abstract
Functional gastrointestinal disorders are characterized by absence of anatomical and biochemical alterations, and are diagnosed and classified based on symptomatology. We aim to explore the prevalence of functional abdominal pain disorders and Functional constipation using Rome IV criteria. An online questionnaire was distributed randomly via social media targeting the general population of the western region of Saudi Arabia. Parents who have at least 1 child in the age group 3 to 18 years were included. Children with mental disabilities, or any organic gastrointestinal disorder were excluded. Five hundred thirty-two responded and 215 were excluded. The overall prevalence of functional abdominal pain disorders was 3.1%. The prevalence of functional constipation was 4.7%. Conclusions: Rome IV criteria seems to give a lower functional abdominal pain prevalence than Rome III, online learning did not seem to affect the prevalence of both disorders, but a family stressor seems to increase functional constipation prevalence.
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Affiliation(s)
- Ammar Khayat
- Department of Pediatrics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ghady Algethami
- Department of Pediatrics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Sama Baik
- Department of Pediatrics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mai Alhajori
- Department of Pediatrics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Dhayy Banjar
- Department of Pediatrics, Umm Al-Qura University, Makkah, Saudi Arabia
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Patel S, Doerfler B, Boutros K, Ng S, Manuel M, DeSimone E. Review of Treatment Options for Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipation. Int J Gen Med 2021; 14:1457-1468. [PMID: 33907450 PMCID: PMC8071080 DOI: 10.2147/ijgm.s274568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 03/11/2021] [Indexed: 12/15/2022] Open
Abstract
Irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) are two common disorders of gut-brain interaction. Affected patients often first present to their primary care providers seeking care for symptoms of constipation, abdominal pain, and bloating, which have a significant impact on their health-related quality of life. These patients often require extensive counseling and reassurance, and knowledge of reliable diagnostic criteria and treatment options is imperative to managing their conditions. Family medicine practitioners, including nurse practitioners and physician assistants, are uniquely qualified to provide a diagnosis and safe, effective management of these disorders. This article reviews the latest evidence and provides practical advice related to diagnosis and management of IBS-C and CIC.
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Affiliation(s)
- Sarah Patel
- Department of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY, USA
- Rutgers University, Piscataway, NJ, USA
| | - Bethany Doerfler
- Division of Gastroenterology, Northwestern Medicine, Chicago, IL, USA
| | - Katerine Boutros
- Global Medical Affairs Gastroenterology & Hepatology, AbbVie Inc, Madison, NJ, USA
| | - Samson Ng
- Global Medical Affairs Gastroenterology & Hepatology, AbbVie Inc, Madison, NJ, USA
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Pereira JC, Figueiredo IAD, de Oliveira FRMB, Ferreira SRD, Aires Moreno GT, da Silva TMS, Pinheiro UDS, Santos BVDO, da Silva BA, Cavalcante FDA. Oceanapia magna Sponge Presents Dual Effect on the Gastrointestinal Motility of Rodents: In Vitro and In Vivo Assays. Front Pharmacol 2021; 11:572574. [PMID: 33424588 PMCID: PMC7793637 DOI: 10.3389/fphar.2020.572574] [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: 06/14/2020] [Accepted: 11/23/2020] [Indexed: 11/13/2022] Open
Abstract
Oceanapia magna Santos-Neto, Nascimento, Cavalcanti and Pinheiro sponges are distributed across tropical worldwide seas. Some studies of marine products have shown interesting activities in smooth muscle models. Hence, we assessed the effect of the ethanolic extract of Oceanapia magna. (OC-EtOH) on acute toxicity and gastrointestinal motility (in vitro and in vivo) in rodent models. On guinea pig ileum, OC-EtOH induced a concentration dependent contraction on basal tonus, which was not inhibited by atropine, but in the presence of pyrilamine or verapamil, the effect was antagonized. Contrastingly, on KCl- or histamine-induced contractions, OC-EtOH presented a transient contraction followed by a concentration-dependent relaxation. Moreover, OC-EtOH presented a relaxant profile on cumulative curves to CaCl2 and tonic contraction induced by S-(-)-BayK8644, through Cav blockade. The acute toxicity assay showed that OC-EtOH (2,000 mg/kg, p.o.) did not present any sign of toxicity in female mice. Additionally, OC-EtOH presented antidiarrheal effect in mice, increased the intestinal normal transit and reduced the castor oil-induced intestinal transit. Thus, OC-EtOH presented a dual effect on guinea pig ileum promoting contraction through activation of H1 and CaV, and relaxation through CaV blockade, besides the effect on upper gastrointestinal transit in mice, showing a potential medicinal use of this sponge in intestinal diseases such as diarrhea.
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Affiliation(s)
- Joedna Cavalcante Pereira
- Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, Universidade Federal da Paraíba, João Pessoa, Brazil
| | | | | | - Sarah Rebeca Dantas Ferreira
- Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, Universidade Federal da Paraíba, João Pessoa, Brazil
| | | | | | | | - Barbara Viviana de Oliveira Santos
- Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, Universidade Federal da Paraíba, João Pessoa, Brazil.,Departmento de Ciências Farmacêuticas, Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Bagnólia Araújo da Silva
- Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, Universidade Federal da Paraíba, João Pessoa, Brazil.,Departmento de Ciências Farmacêuticas, Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Fabiana de Andrade Cavalcante
- Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, Universidade Federal da Paraíba, João Pessoa, Brazil.,Departamento de Fisiologia e Patologia, Universidade Federal da Paraíba, João Pessoa, Brazil
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