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Na W, Sohn C. Food contributing to fermentable oligosaccharide, disaccharide, monosaccharide, and polyols intake in Korean adults. Nutr Res Pract 2023; 17:1201-1210. [PMID: 38053821 PMCID: PMC10694426 DOI: 10.4162/nrp.2023.17.6.1201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/10/2023] [Accepted: 09/27/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND/OBJECTIVES The dietary intake of foods with fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) is known to adversely affect patients with irritable bowel syndrome (IBS). However, the effects of FODMAP have been studied predominantly among Western populations. This study aimed to identify foods high in FODMAP content which form a part of the Korean adult diet and obtain basic data for the preparation of IBS guidelines. SUBJECTS/METHODS An online survey of 1,000 adults from the general population in the age group of 20 to 40 years was performed. Data from 787 participants (men, 386; women, 401) were analyzed. The general characteristics of the participants, health status, IBS diagnosis using the Rome III diagnostic criteria, semi-quantitative food frequency questionnaire findings, and food items causing symptoms were analyzed. RESULTS Overall, 169 participants (21.5%) had IBS. The contribution of the FODMAP nutrients in both IBS and healthy groups was as follows: fructan > lactose > excess fructose > sorbitol > mannitol > galacto-oligosaccharides (GOS). The fructan intake was 4.6 ± 2.2 g/day and 4.3 ± 2.5 g/day in the IBS and healthy groups (P = 0.014), respectively. In the IBS group, the ratio of the intake of fructan to the total FODMAP intake was 39.5%, 29.8%, and 5.8% through onions, garlic, and bananas, respectively. CONCLUSIONS Fructan was the FODMAP nutrient most consumed by Korean adults. Therefore, given the difference in the dietary habits of each country's population, the dietary guidelines for IBS should be country specific.
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Affiliation(s)
- Woori Na
- Department of Food and Nutrition, Wonkwang University, Iksan 54538, Korea
| | - Cheongmin Sohn
- Department of Food and Nutrition, Wonkwang University, Iksan 54538, Korea
- Institute of Life Science and Natural Resources, Wonkwang University, Iksan 54538, Korea
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Koo HS, Son HC, Lee HS, Goong HJ, Kim JS, Kim KB, Kwon YH, Kim JH, Shin HD, Shin JE, Jee SR. Survey-Based Analysis of the Clinical Treatment Status of Irritable Bowel Syndrome in Korea. J Korean Med Sci 2023; 38:e126. [PMID: 37096309 PMCID: PMC10125791 DOI: 10.3346/jkms.2023.38.e126] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND The quality-of-life of patients with irritable bowel syndrome is low; incorrect diagnosis/treatment causes economic burden and inappropriate consumption of medical resources. This survey-based study aimed to analyze the current status of irritable bowel syndrome treatment to examine differences in doctors' perceptions of the disease, and treatment patterns. METHODS From October 2019 to February 2020, the irritable bowel syndrome and Intestinal Function Research Study Group of the Korean Society of Neurogastroenterology and Motility conducted a survey on doctors working in primary, secondary, and tertiary healthcare institutions. The questionnaire included 37 items and was completed anonymously using the NAVER platform (a web-based platform), e-mails, and written forms. RESULTS A total of 272 doctors responded; respondents reported using the Rome IV diagnostic criteria (amended in 2016) for diagnosing and treating irritable bowel syndrome. Several differences were noted between the primary, secondary, and tertiary physicians' groups. The rate of colonoscopy was high in tertiary healthcare institutions. During a colonoscopy, the necessity of random biopsy was higher among physicians who worked at tertiary institutions. 'The patient did not adhere to the diet' as a reason for ineffectiveness using low-fermentable oligo-, di-, and mono-saccharides, and polyols diet treatment was higher among physicians in primary/secondary institutions, and 'There are individual differences in terms of effectiveness' was higher among physicians in tertiary institutions. In irritable bowel syndrome constipation predominant subtype, the use of serotonin type 3 receptor antagonist (ramosetron) and probiotics was higher in primary/secondary institutions, while serotonin type 4 receptor agonist was used more in tertiary institutions. In irritable bowel syndrome diarrhea predominant subtype, the use of antispasmodics was higher in primary/secondary institutions, while the use of serotonin type 3 receptor antagonist (ramosetron) was higher in tertiary institutions. CONCLUSION Notable differences were observed between physicians in primary/secondary and tertiary institiutions regarding the rate of colonoscopy, necessity of random biopsy, the reason for the ineffectiveness of low-fermentable oligo-, di-, and mono-saccharides, and polyols diet, and use of drug therapy in irritable bowel syndrome. In South Korea, irritable bowel syndrome is diagnosed and treated according to the Rome IV diagnostic criteria, revised in 2016.
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Affiliation(s)
- Hoon Sup Koo
- Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Hui Chang Son
- Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Hong Sub Lee
- Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
| | - Hyeon Jeong Goong
- Department of Internal Medicine, Soonchunhyang University Hospital, Bucheon, Korea
| | - Ju Seok Kim
- Chungnam National University School of Medicine, Daejeon, Korea
| | - Ki Bae Kim
- Chungbuk National University Hospital, College of Medicine, Cheongju, Korea
| | - Yong Hwan Kwon
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae Hak Kim
- Department of Internal Medicine, Dongguk University College of Medicine, Goyang, Korea
| | - Hyun Deok Shin
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Ji Eun Shin
- Department of Biomedical Informatics, Konyang University, College of Medicine, Daejeon, Korea
| | - Sam Ryong Jee
- Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea.
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Shin SY, Cha BK, Kim WS, Park JY, Kim JW, Choi CH. The Effect of Phloroglucinol in Patients With Diarrhea-predominant Irritable Bowel Syndrome: A Randomized, Double-blind, Placebo-controlled Trial. J Neurogastroenterol Motil 2020; 26:117-127. [PMID: 31917916 PMCID: PMC6955199 DOI: 10.5056/jnm19160] [Citation(s) in RCA: 10] [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: 08/20/2019] [Revised: 10/24/2019] [Accepted: 11/08/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND/AIMS We aim to evaluate the efficacy and safety of phloroglucinol in patients with diarrhea-predominant irritable bowel syndrome (IBS-D). METHODS Seventy-two patients with IBS-D who met Rome III criteria were 1:1 randomized in a parallel, double-blind design to receive phloroglucinol or placebo for 2 weeks. Patients were followed for 1 week after the end of treatment. The primary outcome was the proportion of responders, defined as those who answered "moderate or more of improvement" to the subject global assessment for at least 1 week of the 2-week treatment period. Secondary outcomes included the proportion of these patients during the 3-week period including 1 week of follow-up, IBS symptoms (abdominal pain/discomfort, diarrhea, urgency, mucus in stool, bloating, and passage of gas), stool frequency and consistency, and IBS quality of life (IBS-QOL). RESULTS The proportion of responders during 2-week treatment period tended to be higher in the phloroglucinol group than in the placebo group, although the difference did not reach statistical significance (55.6% vs 30.6%, P = 0.056). The proportion of responders during the 3-week period was significantly higher in the phloroglucinol group than in the placebo group (61.6% vs 30.6%, P = 0.013). Individual symptom scores, IBS-QOL, stool frequency and consistency tended to improve in the phloroglucinol group, but there were no statistical significances compared to those of the placebo group. No serious adverse events were reported in both groups. CONCLUSIONS Phloroglucinol could be a safe and beneficial option for the management of overall IBS symptoms in patients with IBS-D. Further large scaled studies are warranted.
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Affiliation(s)
- Seung Yong Shin
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Bong Ki Cha
- Department of Internal Medicine, Chung-Ang Medical Health Care System Hyundae Hospital, Seoul,
Korea
| | - Won-Seok Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Jae Yong Park
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Jeong Wook Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Chang Hwan Choi
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
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Kim JH, Jee SR. Irritable Bowel Syndrome. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2019; 73:84-91. [DOI: 10.4166/kjg.2019.73.2.84] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 01/28/2019] [Accepted: 02/01/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Jae Hak Kim
- Department of Internal Medicine, Dongguk University College of Medicine, Goyang, Korea
| | - Sam Ryong Jee
- Department of Internal Medicine, Inje University College of Medicine, Busan, Korea
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Song KH, Jung HK, Kim HJ, Koo HS, Kwon YH, Shin HD, Lim HC, Shin JE, Kim SE, Cho DH, Kim JH, Kim HJ. Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition. J Neurogastroenterol Motil 2018; 24:197-215. [PMID: 29605976 PMCID: PMC5885719 DOI: 10.5056/jnm17145] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 02/11/2018] [Accepted: 02/27/2018] [Indexed: 12/12/2022] Open
Abstract
In 2011, the Korean Society of Neurogastroenterology and Motility (KSNM) published clinical practice guidelines on the management of irritable bowel syndrome (IBS) based on a systematic review of the literature. The KSNM planned to update the clinical practice guidelines to support primary physicians, reduce the socioeconomic burden of IBS, and reflect advances in the pathophysiology and management of IBS. The present revised version of the guidelines is in continuity with the previous version and targets adults diagnosed with, or suspected to have, IBS. A librarian created a literature search query, and a systematic review was conducted to identify candidate guidelines. Feasible documents were verified based on predetermined inclusion and exclusion criteria. The candidate seed guidelines were fully evaluated by the Guidelines Development Committee using the Appraisal of Guidelines for Research and Evaluation II quality assessment tool. After selecting 7 seed guidelines, the committee prepared evidence summaries to generate data exaction tables. These summaries comprised the 4 main themes of this version of the guidelines: colonoscopy; a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; probiotics; and rifaximin. To adopt the core recommendations of the guidelines, the Delphi technique (ie, a panel of experts on IBS) was used. To enhance dissemination of the clinical practice guidelines, a Korean version will be made available, and a food calendar for patients with IBS is produced.
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Affiliation(s)
- Kyung Ho Song
- Department of Internal Medicine, Konyang University College of Medicine, Daejeon,
Korea
- Konyang University Myunggok Medical Research Institute Daejeon,
Korea
| | - Hye-Kyung Jung
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul,
Korea
- Correspondence: Hye-Kyung Jung, MD, PhD Department of Internal Medicine, Ewha Womans University Medical Center, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea, Tel: +82-2-2650-2874, Fax: +82-2-2655-2874, E-mail:
| | - Hyun Jin Kim
- Department of Internal Medicine, Gyeongsang National University, College of Medicine, Jinju,
Korea
| | - Hoon Sup Koo
- Department of Internal Medicine, Konyang University College of Medicine, Daejeon,
Korea
| | - Yong Hwan Kwon
- Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu,
Korea
| | - Hyun Duk Shin
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan,
Korea
| | - Hyun Chul Lim
- Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin,
Korea
| | - Jeong Eun Shin
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan,
Korea
| | - Sung Eun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan,
Korea
| | - Dae Hyeon Cho
- Department of Internal Medicine, Sungkyunkwan University School of Medicine, Changwon,
Korea
| | - Jeong Hwan Kim
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul,
Korea
| | - Hyun Jung Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul,
Korea
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Jung HK. Review of the Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2018. [DOI: 10.4166/kjg.2018.72.5.252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Hye-Kyung Jung
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
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Kim JI, Kim P, Lee JH, Kim YJ, Yang NR, Baeg MK, Choi JS, Kim HJ, Kim J, Sunwoo YY, Lee JH, Ha H, Park TY. Effect of herbal extract granules combined with otilonium bromide on irritable bowel syndrome with diarrhoea: a study protocol for a randomised controlled trial. BMJ Open 2017; 7:e018362. [PMID: 29196484 PMCID: PMC5719308 DOI: 10.1136/bmjopen-2017-018362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Irritable bowel syndrome (IBS), known as a functional and organic gastrointestinal disorder, is a collection of symptoms that occur together and generally include pain or discomfort in the abdomen and changes in bowel movement patterns. Due to the limitations of conventional treatments, alternative IBS treatments are used by many patients worldwide. Samryungbaekchulsan (SRS), a herbal formula, has long been used for alleviating diarrhoea-predominant IBS (D-IBS) in traditional Korean medicine. Otilonium bromide (OB) is an antimuscarinic compound used to relieve spasmodic pain in the gut, especially in IBS. Although herbal formulae and Western drugs are commonly coadministered for various diseases in Korea, few clinical studies have been conducted regarding the synergic effects of these treatments for any disease, including D-IBS. METHODS AND ANALYSIS This trial is a randomised, double-blinded, placebo-controlled, double-dummy, four-arm, parallel study. After a 2-week preparation period, 80 patients with D-IBS will be randomly assigned to one of four treatment groups consisting of SRS (water extract granules, 5 g/pack, three times a day) with OB (tablet form, one capsule three times a day) or their placebos, with treatment lasting for 8 weeks. Post-treatment follow-up will be conducted 4 weeks after the end of treatment. The primary outcome is the finding obtained using the Subject's Global Assessment of Relief method. The secondary outcomes are the severity of symptoms related to D-IBS, determined using a 10-point scale, and the change in symptoms. ETHICS AND DISSEMINATION This trial has full ethical approval of the Ethics Committee of Catholic Kwandong University International St. Mary's Hospital (IS15MISV0033) and the Korean Ministry of Food and Drug Safety (30769). The results of the study will be disseminated through a peer-reviewed journal and/or conference presentations. TRIAL PROTOCOL VERSION IS15MISV0033 version 4.0 (25 July 2016). TRIAL REGISTRATION NUMBER KCT0001621 (approval date: 10 August 2015).
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Affiliation(s)
- Joong Il Kim
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Pumsoo Kim
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Jin-Hyun Lee
- Department of Rehabilitation Medicine of Korean Medicine, College of Korean Medicine, Wonkwang University, Iksan, Jeonbuk, Republic of Korea
| | - Yoo-Jin Kim
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Na-rae Yang
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Myong Ki Baeg
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Ja Sung Choi
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Hye-Jung Kim
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Jayoung Kim
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Yun-Young Sunwoo
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Jung-Han Lee
- Department of Rehabilitation Medicine of Korean Medicine, College of Korean Medicine, Wonkwang University, Iksan, Jeonbuk, Republic of Korea
| | - Hyekyung Ha
- K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Tae-Yong Park
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
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Ghoshal UC, Shukla R, Ghoshal U. Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy. Gut Liver 2017; 11:196-208. [PMID: 28274108 PMCID: PMC5347643 DOI: 10.5009/gnl16126] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 07/07/2016] [Accepted: 07/11/2016] [Indexed: 12/13/2022] Open
Abstract
The pathogenesis of irritable bowel syndrome (IBS), once thought to be largely psychogenic in origin, is now understood to be multifactorial. One of the reasons for this paradigm shift is the realization that gut dysbiosis, including small intestinal bacterial overgrowth (SIBO), causes IBS symptoms. Between 4% and 78% of patients with IBS and 1% and 40% of controls have SIBO; such wide variations in prevalence might result from population differences, IBS diagnostic criteria, and, most importantly, methods to diagnose SIBO. Although quantitative jejunal aspirate culture is considered the gold standard for the diagnosis of SIBO, noninvasive hydrogen breath tests have been popular. Although the glucose hydrogen breath test is highly specific, its sensitivity is low; in contrast, the early-peak criteria in the lactulose hydrogen breath test are highly nonspecific. Female gender, older age, diarrhea-predominant IBS, bloating and flatulence, proton pump inhibitor and narcotic intake, and low hemoglobin are associated with SIBO among IBS patients. Several therapeutic trials targeting gut microbes using antibiotics and probiotics have further demonstrated that not all symptoms in patients with IBS originate in the brain but rather in the gut, providing support for the micro-organic basis of IBS. A recent proof-of-concept study showing the high frequency of symptom improvement in patients with IBS with SIBO further supports this hypothesis.
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Affiliation(s)
- Uday C Ghoshal
- Department of Gastroenterology and Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Ratnakar Shukla
- Department of Gastroenterology and Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Ujjala Ghoshal
- Department of Gastroenterology and Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Urinary incontinence among Muslim women in Israel: risk factors and help-seeking behavior. Int Urogynecol J 2017; 29:539-546. [PMID: 28779417 DOI: 10.1007/s00192-017-3438-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 07/17/2017] [Indexed: 12/17/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The prevalence of urinary incontinence (UI) varies among women in different cultures. Muslim women with UI have complex issues related to the need for cleaning (ablution) before prayer. The aim was to assess the prevalence of UI, factors associated with it, its effect on quality of life, and help-seeking behavior among Muslim women. METHODS This was a cross-sectional study. Self-administered questionnaires completed by women 18-75 years of age who visited the primary care clinic between 21 June 2015 and 9 October 2015 and additional data collected from their medical records. RESULTS A total of 492 women (mean age 31.8 ± 9.5 years) participated in the study. Of these, 43% suffered from UI and 19% from severe to very severe UI. The mean score for interference in daily life (0-10) was 6.3 ± 3.7. Sixty percent of women with UI had stress incontinence, 23% urge incontinence, and 9% mixed incontinence. Only 10% had consulted previously with their physician regarding UI. Increased BMI (OR = 1.048, 95% CI 1.009-1.089) and polygamy (OR = 1.943, 95% CI 1.007-3.749) were associated with severe to very severe UI. Age, parity, and more severe degrees of UI were associated with help-seeking behavior (OR = 1.065 95% CI 1.008-1.125, OR = 0.763 95% CI 0.624-0.934, OR = 4.073 95% CI 1.410-11.765 respectively). CONCLUSIONS Urinary incontinence is very common among Muslim women in primary care in southern Israel and significantly impairs their quality of life. Only a small percentage consults with their physician.
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Kim JH. Diet and Nutritional Management in Functional Gastrointestinal Disorder: Irritable Bowel Syndrome. ACTA ACUST UNITED AC 2016. [DOI: 10.3904/kjm.2016.90.2.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Müller A, Franke H, Resch KL, Fryer G. Effectiveness of osteopathic manipulative therapy for managing symptoms of irritable bowel syndrome: a systematic review. J Osteopath Med 2015; 114:470-9. [PMID: 24917634 DOI: 10.7556/jaoa.2014.098] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
CONTEXT Irritable bowel syndrome (IBS) is a common and often lifelong functional gastrointestinal disorder. There is a scarcity of effective management options for IBS. OBJECTIVE To assess the effectiveness of osteopathic manipulative therapy (OMTh) for managing the symptoms of IBS. DATA SOURCES Articles without language or publication-date restriction were searched in PubMed, Embase, Cochrane Library, PEDro, OSTMED.DR, and Osteopathic Research Web. Search terms included irritable bowel syndrome, IBS, functional colonic disease, colon irritable, osteopath*, osteopathic manipulation, osteopathic medicine, clinical trial, and randomized clinical trial. Experts in the field of visceral osteopathy were also contacted to identify additional studies. STUDY SELECTION The authors evaluated randomized controlled trials (RCTs) of OMTh for IBS in adults in whom IBS was diagnosed using Rome (I-III) criteria. If OMTh was not the sole intervention in the intervention group and if the same additional interventions were not applied to the control group, the study was excluded. DATA EXTRACTION Citation identification, study selection, and data extraction were independently undertaken by 2 reviewers with a data extraction form from the Cochrane Collaboration. A consensus method was used to resolve disagreements concerning the assessment of the methodologic quality of the RCTs that were reviewed. RESULTS The search identified 10 studies that examined OMTh for patients with IBS; 5 studies (204 patients) met the inclusion criteria. All studies were assessed as having low risk of bias according to the Cochrane Collaboration criteria, although there was heterogeneity in the outcome measures and control interventions. Three studies used visual analog scales for abdominal pain, whereas others used the IBS severity score and the Functional Bowel Disorder Severity Index. A variety of secondary outcomes were used. All studies reported more pronounced short-term improvements with OMTh compared with sham therapy or standard care only. These differences remained statistically significant after variable lengths of follow-up in 3 studies. CONCLUSION The present systematic review provides preliminary evidence that OMTh may be beneficial in the treatment of patients with IBS. However, caution is required in the interpretation of these findings because of the limited number of studies available and the small sample sizes.
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Affiliation(s)
- Axel Müller
- From the Institute for Osteopathic Studies in Siegen, Germany (Mr Müller and Mr Franke); the University of Dresden and German Institute for Health Research (Dr Resch); and the College of Health and Biomedicine and the Institute of Sport, Exercise and Active Living at Victoria University in Melbourne, Australia (Dr Fryer)
| | - Helge Franke
- From the Institute for Osteopathic Studies in Siegen, Germany (Mr Müller and Mr Franke); the University of Dresden and German Institute for Health Research (Dr Resch); and the College of Health and Biomedicine and the Institute of Sport, Exercise and Active Living at Victoria University in Melbourne, Australia (Dr Fryer)
| | - Karl-Ludwig Resch
- From the Institute for Osteopathic Studies in Siegen, Germany (Mr Müller and Mr Franke); the University of Dresden and German Institute for Health Research (Dr Resch); and the College of Health and Biomedicine and the Institute of Sport, Exercise and Active Living at Victoria University in Melbourne, Australia (Dr Fryer)
| | - Gary Fryer
- From the Institute for Osteopathic Studies in Siegen, Germany (Mr Müller and Mr Franke); the University of Dresden and German Institute for Health Research (Dr Resch); and the College of Health and Biomedicine and the Institute of Sport, Exercise and Active Living at Victoria University in Melbourne, Australia (Dr Fryer)
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Park SH, Han KS, Kang CB. Relaxation Therapy for Irritable Bowel Syndrome: A Systematic Review. Asian Nurs Res (Korean Soc Nurs Sci) 2014. [DOI: 10.1016/j.anr.2014.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Schmulson M, Bielsa MV, Carmona-Sánchez R, Hernández A, López-Colombo A, López Vidal Y, Peláez-Luna M, Remes-Troche JM, Tamayo JL, Valdovinos MA. Microbiota, gastrointestinal infections, low-grade inflammation, and antibiotic therapy in irritable bowel syndrome: an evidence-based review. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2014; 79:96-134. [PMID: 24857420 DOI: 10.1016/j.rgmx.2014.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 01/22/2014] [Accepted: 01/23/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Post-infectious irritable bowel syndrome (PI-IBS) prevalence, small intestinal bacterial overgrowth (SIBO), altered microbiota, low-grade inflammation, and antibiotic therapy in IBS are all controversial issues. AIMS To conduct an evidence-based review of these factors. METHODS A review of the literature was carried out up to July 2012, with the inclusion of additional articles as far as August 2013, all of which were analyzed through the Oxford Centre for Evidence-Based Medicine (OCEBM) system. RESULTS 1.There is greater SIBO probability in IBS when breath tests are performed, but prevalence varies widely (2-84%). 2.The gut microbiota in individuals with IBS is different from that in healthy subjects, but a common characteristic present in all the patients has not been established. 3.The incidence and prevalence of PI-IBS varies from 9-10% and 3-17%, respectively, and the latter decreases over time. Bacterial etiology is the most frequent but post-viral and parasitic cases have been reported. 4.A sub-group of patients has increased enterochromaffin cells, intraepithelial lymphocytes, and mast cells in the intestinal mucosa, but no differences between PI-IBS and non-PI-IBS have been determined. 5.Methanogenic microbiota has been associated with IBS with constipation. 6.Rifaximin at doses of 400mg TID/10days or 550mg TID/14days is effective treatment for the majority of overall symptoms and abdominal bloating in IBS. Retreatment effectiveness appears to be similar to that of the first cycle. CONCLUSIONS Further studies are required to determine the nature of the gut microbiota in IBS and the differences in low-grade inflammation between PI-IBS and non-PI-IBS. Rifaximin has shown itself to be effective treatment for IBS, regardless of prior factors.
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Affiliation(s)
- M Schmulson
- Laboratorio de Hígado, Páncreas y Motilidad (HIPAM), Departamento de Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Hospital General de México, México DF, México.
| | - M V Bielsa
- Departamento de Gastroenterología, Facultad de Medicina, Universidad Autónoma de Guadalajara, Guadalajara, Jalisco, México
| | - R Carmona-Sánchez
- Servicio de Gastroenterología, Servicio de Medicina Interna, Hospital Ángeles-CMP, San Luis Potosí, San Luis Potosí, México
| | - A Hernández
- Servicio de Endoscopia, Instituto Nacional de Cancerología, México DF, México
| | - A López-Colombo
- Coordinación Delegacional de Investigación en Salud, Instituto Mexicano del Seguro Social, Puebla, Puebla, México
| | - Y López Vidal
- Programa de Inmunología Molecular Microbiana, Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), México DF, México
| | - M Peláez-Luna
- Laboratorio de Hígado, Páncreas y Motilidad (HIPAM), Departamento de Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Hospital General de México, México DF, México
| | - J M Remes-Troche
- Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz, Veracruz, México; Facultad de Medicina «Miguel Alemán Valdés», Universidad Veracruzana, Veracruz, Veracruz, México
| | - J L Tamayo
- Centro de Investigación y Docencia en Ciencias de la Salud, Universidad Autónoma de Sinaloa, Hospital Civil de Culiacán, Culiacán, Sinaloa, México
| | - M A Valdovinos
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México DF, México
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Schmulson M, Bielsa MV, Carmona-Sánchez R, Hernández A, López-Colombo A, Vidal YL, Peláez-Luna M, Remes-Troche JM, Tamayo JL, Valdovinos MA. Microbiota, gastrointestinal infections, low-grade inflammation, and antibiotic therapy in irritable bowel syndrome (IBS): an evidence-based review. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2014. [DOI: 10.1016/j.rgmxen.2014.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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15
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Kim JH, Sung IK. Current Issues on Irritable Bowel Syndrome: Diet and Irritable Bowel Syndrome. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2014; 64:142-7. [DOI: 10.4166/kjg.2014.64.3.142] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- 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
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16
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AbuKaraky AE, Afifeh KA, Khatib AA, Khdairi NO, Habarneh HM, Ahmad WKH, Hamdan AAS, Sawair FA. Antibiotics prescribing practices in oral implantology among jordanian dentists. A cross sectional, observational study. BMC Res Notes 2011; 4:266. [PMID: 21798040 PMCID: PMC3160395 DOI: 10.1186/1756-0500-4-266] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Accepted: 07/28/2011] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND In oral implantology, there is no consensus on the most appropriate regimen for antibiotics prescribing, the decision to prescribe antibiotic is usually based on procedure, patient and clinician related factors. The aim of this study was to investigate the rationale of antibiotic prescribing among Jordanian clinicians who practice oral implantology. FINDINGS The target sample for the study was the 250 Jordan Dental Implant Group members. A five page questionnaire contained 41 questions, both closed and open questions were used to collect data. Statistical analysis was performed using SPSS Windows 16.0 (SPSS Inc., Chicago, IL, USA). Descriptive statistics were generated.The response rate was (70.4%) 176/250. Mean age was 37.2 yrs, 49.4% always prescribe antibiotics mainly oral amoxicillin and amoxicillin with clavulinic acid. Antibiotics prescribing increased with flap raising, multiple implants and sinus or bone augmentation. Patient medical condition, periodontitis and oral hygiene were the most important clinical factors in antibiotic prescribing, non-clinical factors were; reading scientific materials, courses and lectures, knowledge gained during training, and the effectiveness and previous experience with the drug. CONCLUSIONS Wide variations in antibiotics types, routes, dose and duration of administration were found. Recommendations on antibiotic prescribing are needed to prevent antibiotic overprescribing and misuse.
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Affiliation(s)
- Ashraf E AbuKaraky
- Department of Oral and Maxillofacial Surgery, Oral Medicine, Oral Pathology, and Periodontology, Faculty of Dentistry, The University of Jordan, Amman, Jordan
| | | | - Adel A Khatib
- Faculty of Dentistry, The University of Jordan, Amman, Jordan
| | | | | | - Waleed KH Ahmad
- Faculty of Dentistry, The University of Jordan, Amman, Jordan
| | - Ahmad AS Hamdan
- Department of Oral and Maxillofacial Surgery, Oral Medicine, Oral Pathology, and Periodontology, Faculty of Dentistry, The University of Jordan, Amman, Jordan
| | - Faleh A Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine, Oral Pathology, and Periodontology, Faculty of Dentistry, The University of Jordan, Amman, Jordan
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