1
|
Jamalizadeh H, Ahmadi B, Shariffar F, Ansari M, Setayesh M, Shahesmaeili A, Tajadini H. Clinical evaluation of the effect of Zataria multiflora Boiss and Trachyspermum copticum (L.) on the patients with irritable bowel syndrome. Explore (NY) 2021; 18:342-346. [PMID: 34969608 DOI: 10.1016/j.explore.2021.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 11/30/2021] [Accepted: 12/11/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND AIM Irritable Bowel Syndrome (IBS) is the most common gastrointestinal dysfunction characterized by abdominal pain or discomfort, as well as changes in bowel movements and stool shape. Given the global trend towards the increased use of complementary and alternative medicine (CAM), the high prevalence of IBS, the lack of a standard treatment for all IBS subtypes, and patients' willingness to use CAM treatments, investigations into CAM treatments are needed. Accordingly, the present study aimed to investigate the effect of a mix of two herbal medicines (Zataria-Trachyspermum, ZT) on the clinical symptoms of patients with IBS. EXPERIMENTAL PROCEDURE The present study was performed on 3 groups including the positive control, experimental, and placebo groups. The sample size was calculated as 150 participants. Fifty patients were assigned to one of three parallel groups (ZT capsule, placebo, and mebeverine capsule) by block randomization. All three groups were treated for 4 weeks. The patients were monitored in the follow-up stage for 2 additional weeks. RESULTS After the fourth week of intervention, symptoms of pain, bloating, and reflux showed a significant decrease in the ZT group compared to the placebo and mebeverine groups (P <0.05). Moreover, the participants in the ZT group reported a significant decrease in fatigue compared to the other two groups (P <0.05). CONCLUSION This study confirmed the positive effect of ZT on IBS symptoms, especially pain, bloating, constipation, and bowel movements.
Collapse
Affiliation(s)
- Hossein Jamalizadeh
- Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran; Department of Persian Medicine, School of Traditional Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Bijan Ahmadi
- Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Fariba Shariffar
- Herbal and Traditional Medicine Research Center, Department of Pharmacogenosy, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Ansari
- Herbal and Traditional Medicine Research Center, Department of Pharmacogenosy, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Setayesh
- Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran; Department of Persian Medicine, School of Traditional Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Armita Shahesmaeili
- HIV/STI Surveillance Research Center, and WHO Collaborating center for HIV surveillance,Institute for Futures Studies in Health,Kerman University of Medical Sciences, Kerman, Iran
| | - Haleh Tajadini
- Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran; Department of Persian Medicine, School of Traditional Medicine, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
2
|
Pradeep S, Mehanna R. Gastrointestinal disorders in hyperkinetic movement disorders and ataxia. Parkinsonism Relat Disord 2021; 90:125-133. [PMID: 34544654 DOI: 10.1016/j.parkreldis.2021.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 08/24/2021] [Accepted: 09/08/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Gastrointestinal (GI) disorders have been thoroughly investigated in hypokinetic disorders such as Parkinson's disease, but much less is known about GI disorders in hyperkinetic movement disorders and ataxia. The aim of this review is to draw attention to the GI disorders that are associated with these movement disorders. METHODS References for this systematic review were identified by searches of PubMed through May 2020. Only publications in English were reviewed. RESULTS Data from 249 articles were critically reviewed, compared, and integrated. The most frequently reported GI symptoms overall in hyperkinetic movement disorders and ataxia are dysphagia, sialorrhea, weight changes, esophago-gastritis, gastroparesis, constipation, diarrhea, and malabsorption. We report in detail on the frequency, characteristics, pathophysiology, and management of GI symptoms in essential tremor, restless legs syndrome, chorea, and spinocerebellar ataxias. The limited available data on GI disorders in dystonias, paroxysmal movement disorders, tardive dyskinesias, myoclonus, and non-SCA ataxias are also summarized. CONCLUSION The purpose of our systematic review is to draw attention that, although primarily motor disorders, hyperkinetic movement disorders and ataxia can involve the GI system. Raising awareness about the GI symptom burden in hyperkinetic movement disorders and ataxia could contribute to a new research interest in that field, as well as improved patient care.
Collapse
Affiliation(s)
- Swati Pradeep
- Department of Neurology, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
| | - Raja Mehanna
- Department of Neurology, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA.
| |
Collapse
|
3
|
Prakash S, Prakash A. Dopa responsive irritable bowel syndrome: restless bowel syndrome or a gastrointestinal variant of restless legs syndrome? BMJ Case Rep 2021; 14:e240686. [PMID: 33762285 PMCID: PMC7993228 DOI: 10.1136/bcr-2020-240686] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 12/14/2022] Open
Abstract
In addition to the legs, restless legs syndrome (RLS) affects various other parts of the body, including the arms, abdomen, face, head-neck, oral cavity, genital area and bladder. RLS is also associated with several comorbid conditions, including irritable bowel syndrome (IBS). We are reporting two cases of RLS who also had IBS, fulfilling the Rome IV criteria. The administration of levodopa and dopamine agonists provided a complete improvement in both IBS and RLS. Review of the literature suggest that the clinical semiology and clinical pattern of IBS (urge to defaecate, abdominal pain, abdominal distension, bloating, disturbed sleep and circadian rhythm) simulate the semiology and pattern of RLS. Similarities are also noted in the associated comorbid conditions, effective drugs and proposed hypotheses for both clinical syndromes. We hypothesise that RLS may affect intestine, and IBS-like symptoms in a subset of patients with RLS may be the part of RLS symptoms complex.
Collapse
Affiliation(s)
- Sanjay Prakash
- Neurolgy, Smt BK Shah Medical Institute and Research Centre, Vadodara, Gujarat, India
| | - Anurag Prakash
- Parul University Parul Institute of Medical Sciences & Research, Vadodara, Gujarat, India
| |
Collapse
|
4
|
Çam M, Kutluana U. Evaluation of upper endoscopic findings in patients with restless legs syndrome and gastric complaints. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:217-223. [PMID: 32294750 DOI: 10.1590/0004-282x20190192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 11/10/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND The effect of gastrointestinal system disorders on Restless Legs Syndrome/Willis-Ekbom disease (RLS/WED) has been previously demonstrated by using serological tests. However, this association has not been supported by histopathological studies so far. OBJECTIVE To investigate the relationship between RLS/WED, upper endoscopic imaging and histopathological results in patients diagnosed with RLS who underwent endoscopy because of gastrointestinal system (GIS) complaints. METHODS Case-control study, including 100 patients diagnosed with RLS who presented dyspeptic complaints and underwent upper GIS endoscopy and 106 age- and sex-matched controls. RLS diagnosis was evaluated according to the four main diagnostic criteria determined by the International RLS Study Group. All patients underwent upper GIS endoscopic intervention and at least one gastric and/or antral biopsy. RESULTS There was no significant difference between patients and controls in relation to endoscopically seen gastric ulcer, duodenal ulcer, gastroesophageal reflux disease (GERD) findings and Helicobacter pylori (HP) positivity (p>0.05). Intestinal metaplasia and mucosal atrophy were more common in RLS/WED patients compared to controls (p=0.026 and p=0.017, respectively). Additionally, ferritin levels were found to be lower than the reference value. CONCLUSIONS The detection of increased severity of intestinal metaplasia, mucosal atrophy, and gastric inflammation in RLS/WED patients with dyspeptic complaints may entail the close gastrointestinal system evaluation of these patients. However, larger randomized and controlled trials are required on this subject where patients are evaluated by upper GIS endoscopic biopsy.
Collapse
Affiliation(s)
- Mustafa Çam
- Canakkale Onsekiz Mart University, School of Medicine, Department of Neurology, Canakkale, Turkey
| | - Ufuk Kutluana
- Uşak Univerrity School of Medicine, Department of Internal Medicine, Uşak, Turkey
| |
Collapse
|
5
|
Hsu YC, Yang HY, Huang WT, Chen SCC, Lee HS. Use of antidepressants and risks of restless legs syndrome in patients with irritable bowel syndrome: A population-based cohort study. PLoS One 2019; 14:e0220641. [PMID: 31369638 PMCID: PMC6675099 DOI: 10.1371/journal.pone.0220641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 07/19/2019] [Indexed: 12/12/2022] Open
Abstract
Previous research has suggested an association between antidepressants use and clinical restless legs syndrome (RLS) in patients, but there has never been a single study investigating the risk of RLS in irritable bowel syndrome (IBS) patients treated with antidepressants. Hence, we aimed to explore the association between IBS and RLS and to examine the risk of RLS in IBS patients treated with antidepressants. With the use of the National Health Insurance Research Database of Taiwan, 27,437 adults aged ≥ 20 years with newly diagnosed IBS (ICD-9-CM Code 564.1) and gender- and age-matched 54,874 controls without IBS were enrolled between 2000 and 2012. All patients were followed-up until RLS diagnosis, withdrawal from the National Health Insurance program, or end of 2013. We used the Cox proportional hazards model to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of RLS. RLS was more prevalent in IBS patients than in the non-IBS group (7.57 versus 3.36 per 10,000 person-years), with an increased risk of RLS (adjusted HR [aHR], 1.91; 95% CI, 1.52-2.40). Multivariate Cox proportional hazards analysis identified older age (age, 51-65 years; aHR, 1.67; 95% CI, 1.09-2.56; and age > 65; aHR, 1.59; 95% CI, 1.02-2.48), hypothyroidism (aHR, 4.24; 95% CI, 1.92-9.37), CAD (aHR, 1.70; 95% CI, 1.17-2.48), and depression (aHR, 3.15; 95% CI, 2.14-4.64) as independent RLS risk factors in IBS patients. In addition, the male SSRIs users were associated with significantly higher risk of RLS (aHR, 3.05 95% CI, 1.34-6.92). Our study showed that the IBS group has higher risk of RLS. Moreover, SSRIs use may increase the risk of RLS in male IBS patients.
Collapse
Affiliation(s)
- Yung-Chu Hsu
- Division of Neurology, Department of Internal medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan
| | - Hsin-Yi Yang
- Clinical Medicine Research Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan
- * E-mail: (HYY); (HSL)
| | - Wan-Ting Huang
- Clinical Medicine Research Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan
| | - Solomon Chih-Cheng Chen
- Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Pediatrics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Herng-Sheng Lee
- Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- * E-mail: (HYY); (HSL)
| |
Collapse
|
6
|
Rezvani F, Sayadnasiri M, Rezaei O. Restless legs syndrome in patients infected withHelicobacter pylori. Neurol Res 2018; 40:581-585. [DOI: 10.1080/01616412.2018.1454704] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Farzaneh Rezvani
- Department of Clinical Psychology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mohammad Sayadnasiri
- Neurology, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Omid Rezaei
- Psychiatry, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| |
Collapse
|
7
|
Acar BA, Acar MAG, Acar T, Varım C, Alagöz AN, Demiryürek EB, Doğan Güngen B, Güzey Aras Y. Patients with primary restless legs syndrome have higher prevalence of autonomic dysfunction and irritable bowel syndrome. Singapore Med J 2018; 59:539-544. [PMID: 29372261 DOI: 10.11622/smedj.2018010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Given the limited data on autonomic dysfunction in patients with primary restless legs syndrome (pRLS), we compared autonomic dysfunction and presence of irritable bowel syndrome (IBS) between patients with pRLS and control patients. METHODS Consecutive adult drug-naïve patients with pRLS, and age- and gender-matched healthy control patients were enrolled in this study. Diagnoses, based on validated self-reported questionnaires, were made using the following guidelines: Rome III classification system for functional gastrointestinal disorders for IBS; Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) for the presence of anxiety and depression, respectively; Pittsburgh Sleep Quality Index (PSQI) for severity of sleep disturbances; and Scales for Outcomes in Parkinson's disease-Autonomic (SCOPA-AUT) for autonomic dysfunction. RESULTS There were 88 patients with pRLS (18 male, 70 female) and 128 control patients (40 men, 88 women). The mean age of the pRLS patients and control patients was 50.3 ± 9.3 years and 49.7 ± 8.2 years, respectively. Overall, 41 (46.6%) of the patients with pRLS and 16 (12.5%) of the control patients had IBS. Among patients with pRLS, IBS was significantly more common and the total autonomic SCOPA-AUT scores were higher than those found among control patients. Among pRLS patients with IBS, total autonomic SCOPA-AUT, PSQI, BAI and BDI scores were significantly higher than among pRLS patients without IBS. The presence of IBS did not affect the severity of restless legs syndrome. CONCLUSION The presence of autonomic nervous system impairment in patients with pRLS and the strong link between IBS and pRLS merit further, more extensive investigation.
Collapse
Affiliation(s)
| | - Mustafa Atahan Gürkan Acar
- Department of Surgery, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Türkan Acar
- Department of Neurology, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | - Ceyhun Varım
- Department of Internal Medicine, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | | | - Enis Bekir Demiryürek
- Department of Neurology, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | - Belma Doğan Güngen
- Department of Neurology, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | - Yeşim Güzey Aras
- Department of Neurology, Sakarya University Education and Research Hospital, Sakarya, Turkey
| |
Collapse
|
8
|
Yılmaz S, Çiğdem B, Gökçe ŞF, Ceyhan-Doğan S, Balaban H. Severity and frequency of restless legs syndrome in patients with familial Mediterranean fever. J Int Med Res 2017; 45:1340-1346. [PMID: 28606022 PMCID: PMC5625534 DOI: 10.1177/0300060517704789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Objective: Restless legs syndrome (RLS) is a common sensory motor disorder. RLS an urge to move the extremities that may be accompanied by dysesthesias, and significantly affects quality of life of affected patients. The frequency of RLS is higher in different systemic inflammatory diseases. Familial Mediterranean fever (FMF) is an inherited inflammatory disease characterized by attacks of polyserositis, arthritis, and fever. The prevalence of RLS in patients with FMF is unknown. This study aimed to evaluate the prevalence rate of RLS in a sample of patients with FMF and compare this prevalence with that of a matched normal population. Method: A total of 60 patients with FMF and 60 healthy controls were studied. All participants underwent a neurological examination. Diagnostic criteria as proposed by the International Restless Legs Syndrome Study Group (IRLSSG) were used to define RLS. The IRLSSG rating scale for the severity of RLS was applied to determine the severity of symptoms. Results: The prevalence of RLS was not significantly different between patients and controls. Although the mean International Restless Legs Syndrome Rating Scale (IRLSRS) scores tended to be higher in patients compared with controls, this difference was not significant. When each item of the severity scale was compared between the two groups, significantly higher scores were found in some items of the IRLSRS in patients with FMF compared with controls. Conclusion: According to this result, RLS symptoms in patients with FMF were more frequent and lasted longer than those in controls.
Collapse
Affiliation(s)
- Samet Yılmaz
- 1 Department of Neurology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Burhanettin Çiğdem
- 1 Department of Neurology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Şeyda Figül Gökçe
- 1 Department of Neurology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Sevil Ceyhan-Doğan
- 2 Department of Physical Medicine and Rehabilitation Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Hatice Balaban
- 1 Department of Neurology, Cumhuriyet University School of Medicine, Sivas, Turkey
| |
Collapse
|
9
|
Acay A, Bal A, Oruc S, Ozkececi T, Sariaydin M, Demirbas H, Acarturk G. Does frequency of restless legs syndrome and poor sleep quality increase with age in irritable bowel syndrome? Wien Klin Wochenschr 2016; 128:604-609. [DOI: 10.1007/s00508-016-1065-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 07/29/2016] [Indexed: 01/29/2023]
|
10
|
A review of the clinical manifestations, pathophysiology and management of opioid bowel dysfunction and narcotic bowel syndrome. Middle East J Dig Dis 2014; 6:5-12. [PMID: 24829698 PMCID: PMC4005483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 12/22/2013] [Indexed: 11/24/2022] Open
Abstract
Opioids are widely used for the treatment of malignant and non-malignant pains. These medications are accompanied by adverse effects, in particular gastrointestinal symptoms known as opioid bowel dysfunction (OBD). The most common symptom of OBD is refractory constipation that is usually stable regardless of the use of laxatives. Narcotic bowel syndrome (NBS) is a subset of OBD described as ambiguous chronic pain aggravated by continual or increased opioid use for pain relief. Pathophysiology of these disorders are not definitely disentangled. Some challenging hypothesis have been posed leading to specific management in order to mitigate the adverse effects. This article is a review of the literature on the prevalence, pathophysiology and management of OBD and NBS.
Collapse
|