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Chen F, Tan N, Chen S, Zhuang Q, Zhang M, Xiao Y. The Disease Spectrum and Natural History of Patients With Abdominal Bloating or Distension: A Longitudinal Study. J Neurogastroenterol Motil 2024; 30:64-72. [PMID: 38173159 PMCID: PMC10774809 DOI: 10.5056/jnm22197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/23/2023] [Accepted: 03/26/2023] [Indexed: 01/05/2024] Open
Abstract
Background/Aims Abdominal bloating or distension (AB/D) is a common complaint in the outpatient of gastroenterology department. Since the potential contributors are numerous and complex, a longitudinal study on the disease spectrum and natural history of patients was performed to better understand the key factors of AB/D. Methods Consecutive patients with the chief complaint of AB/D referred to the outpatient clinic were screened. Functional gastrointestinal disorders (FGIDs) were diagnosed according to Rome IV criteria. A 3-year follow-up was performed to seek for the changes in symptoms as well as disease spectrum. Results A total of 261 participants were enrolled and 139 completed the follow-up. Most patients suffered from moderate to severe symptoms more than 1 day per week. Common causes of AB/D were FGIDs (51.7%) and organic diseases (17.2%). The latter group was older with lower body mass index (BMI). Functional dyspepsia was the most common type of FGIDs in AB/D. The symptoms of 18.0% of participants failed to improve at the end of the 3-year follow-up, and those diagnosed with FGIDs were most likely to continue to suffer. Abdominal pain was a positive predictive factor for good prognosis in the FGIDs group. Besides, only 22.7% of participants had a consistent diagnosis of FGIDs during follow-up. Conclusions FGIDs are the most common diagnosis in patients with AB/D. Symptoms were especially hard to be improved. Classification diagnoses of FGIDs in AB/D patients fluctuated significantly over time.
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Affiliation(s)
- Fangfei Chen
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Niandi Tan
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Songfeng Chen
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qianjun Zhuang
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Mengyu Zhang
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yinglian Xiao
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Wang YC, Jin XY, Lei Z, Liu XJ, Liu Y, Zhang BG, Gong J, Wang LT, Shi LY, Wan DY, Fu X, Wang LP, Ma AJ, Cheng YS, Yang J, He M, Jin XD, Kang Y, Wang B, Zhang ZW, Wu Q. Gastrointestinal manifestations of critical ill heatstroke patients and their associations with outcomes: A multicentre, retrospective, observational study. World J Gastroenterol 2024; 30:346-366. [PMID: 38313238 PMCID: PMC10835541 DOI: 10.3748/wjg.v30.i4.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/17/2023] [Accepted: 01/09/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Extreme heat exposure is a growing health problem, and the effects of heat on the gastrointestinal (GI) tract is unknown. This study aimed to assess the incidence of GI symptoms associated with heatstroke and its impact on outcomes. AIM To assess the incidence of GI symptoms associated with heatstroke and its impact on outcomes. METHODS Patients admitted to the intensive care unit (ICU) due to heatstroke were included from 83 centres. Patient history, laboratory results, and clinically relevant outcomes were recorded at ICU admission and daily until up to day 15, ICU discharge, or death. GI symptoms, including nausea/vomiting, diarrhoea, flatulence, and bloody stools, were recorded. The characteristics of patients with heatstroke concomitant with GI symptoms were described. Multivariable regression analyses were performed to determine significant predictors of GI symptoms. RESULTS A total of 713 patients were included in the final analysis, of whom 132 (18.5%) patients had at least one GI symptom during their ICU stay, while 26 (3.6%) suffered from more than one symptom. Patients with GI symptoms had a significantly higher ICU stay compared with those without. The mortality of patients who had two or more GI symptoms simultaneously was significantly higher than that in those with one GI symptom. Multivariable logistic regression analysis revealed that older patients with a lower GCS score on admission were more likely to experience GI symptoms. CONCLUSION The GI manifestations of heatstroke are common and appear to impact clinically relevant hospitalization outcomes.
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Affiliation(s)
- Yu-Cong Wang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xin-Yang Jin
- School of Pharmacy, Macau University of Science and Technology, Macau 999078, China
| | - Zheng Lei
- Department of Critical Care Medicine, The First People's Hospital of Ziyang City, Ziyang 641399, Sichuan Province, China
| | - Xiao-Jiao Liu
- Department of Critical Care Medicine, The First People's Hospital of Guanghan City, Chengdu 618399, Sichuan Province, China
| | - Yu Liu
- Department of Critical Care Medicine, Lezhi County Traditional Chinese Medicine Hospital, Chengdu 641599, Sichuan Province, China
| | - Bang-Guo Zhang
- Department of Critical Care Medicine, Chengdu Qingbaijiang District People's Hospital, Chengdu 610399, Sichuan Province, China
| | - Jian Gong
- Department of Critical Care Medicine, Ziyang People's Hospital, Chengdu 641399, Sichuan Province, China
| | - Lie-Tao Wang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lv-Yuan Shi
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ding-Yuan Wan
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xin Fu
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lu-Ping Wang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ai-Jia Ma
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi-Song Cheng
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jing Yang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Min He
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xiao-Dong Jin
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yan Kang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bo Wang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Zhong-Wei Zhang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Qin Wu
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Somvanapanich P, Pitisuttithum P, Sirimongkolkasem J, Rattanachaisit P, Jangsirikul S, Patcharatrakul T, Gonlachanvit S. Spot Hydrogen Breath Test for Predicting Response to Low Fermentable Oligo-, Di-, Mono-saccharides, and Polyols Dietary Advice in Patients With Bloating. J Neurogastroenterol Motil 2023; 29:513-519. [PMID: 37814438 PMCID: PMC10577458 DOI: 10.5056/jnm22214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 05/17/2023] [Accepted: 06/04/2023] [Indexed: 10/11/2023] Open
Abstract
Background/Aims An increase in postprandial intestinal gas plays a role in bloating symptoms. We aim to study the utility of spot breath hydrogen (H2) level in predicting the response to a low fermentable oligo-, di-, mono-saccharides, and polyols (FODMAPs) diet. Methods Patients with functional gastrointestinal disorders diagnosed by Rome IV criteria with bothersome bloating for > 6 months were prospectively enrolled. Patients completed 7-day food diaries and collected a breath sample 2 hours after their usual lunch at baseline and 4 weeks after low FODMAPs dietary advice by a dietitian. The responder was defined as an improvement of ≥ 30% bloating scores in the fourth week. Results Thirty-eight patients (32 female, 52.6 ± 13.8 years; 22 irritable bowel syndrome) completed the study. Twenty-one patients (55%) were classified as responders. Baseline global gastrointestinal symptoms, bloating, abdominal pain scores, and numbers of high FODMAPs items were similar between responders and non-responders. Both groups significantly decreased high FODMAPs items intake with similar numbers at the follow-up. The area under the curve for predicting low FODMAPs responsiveness using baseline H2 levels was 0.692 (95%CI, 0.51-0.86; P < 0.05), with the best cutoff at 8 parts per million (sensitivity 66.7%, specificity 82.4%). 66% of responders had baseline H2 level > 8 parts per million vs 17% of non-responders (P < 0.05). The baseline spot hydrogen level in responders was 9.5 (3.3-17.3) vs 4.5 (3.3-6.3) in non-responders (P < 0.05). Conclusions A higher baseline breath hydrogen level was associated with bloating improvement after low FODMAPs dietary advice. A spot breath test after lunch, a simple point-of-care test, is possibly helpful in managing patients with bloating.
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Affiliation(s)
- Pochara Somvanapanich
- Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Thai Red Cross Society, Bangkok, Thailand
| | - Panyavee Pitisuttithum
- Divisions of General Internal Medicine, Department of Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Faculty of Medicine, Center of Excellence in Neurogastroenterology and Motility, Chulalongkorn University, Bangkok, Thailand
| | - Jarongkorn Sirimongkolkasem
- Division of Hospital and Ambulatory Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Faculty of Medicine, Center of Excellence in Neurogastroenterology and Motility, Chulalongkorn University, Bangkok, Thailand
| | - Pakkapon Rattanachaisit
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Faculty of Medicine, Center of Excellence in Neurogastroenterology and Motility, Chulalongkorn University, Bangkok, Thailand
| | - Sureeporn Jangsirikul
- Faculty of Medicine, Center of Excellence in Neurogastroenterology and Motility, Chulalongkorn University, Bangkok, Thailand
| | - Tanisa Patcharatrakul
- Divisions of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Faculty of Medicine, Center of Excellence in Neurogastroenterology and Motility, Chulalongkorn University, Bangkok, Thailand
| | - Sutep Gonlachanvit
- Divisions of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Faculty of Medicine, Center of Excellence in Neurogastroenterology and Motility, Chulalongkorn University, Bangkok, Thailand
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Salimi Zadak R, Khalili G, Motamedi M, Bakhtiari S. The effect of chamomile on flatulence after the laparoscopic cholecystectomy: A randomized triple-blind placebo-controlled clinical trial. J Ayurveda Integr Med 2023; 14:100735. [PMID: 37336118 PMCID: PMC10300205 DOI: 10.1016/j.jaim.2023.100735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/09/2023] [Accepted: 05/19/2023] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVE Flatulence is one of the main post-operative Ileus-related complications, especially in abdominal surgeries, which can be largely due to the effects of anesthesia. There are various kinds of therapeutic methods used for their treatment though sometimes their effects are limited. Thus, it is essential to find alternative treatments to decrease the implications of the disease. The present study is aimed to investigate the effect of Chamomilla recutita on flatulence after Laparoscopic cholecystectomy. METHODS This randomized controlled trial was carried out in 2020 at Isfahan in Iran. Patients randomly fell into either chamomile (n = 32) or placebo groups (n = 32). The intervention was performed 1 h before the operation. The severity and the frequency of flatulence were recorded using a visual analog scale in both groups in three stages before the operation, after the operation in recovery, and 2 h after the operation. RESULTS The flatulence was not observed before the operation and on arrival in the recovery room. Before leaving the recovery room, the frequency of flatulence was the same in both the groups. However, in the surgical ward, the frequency of flatulence in the chamomile group was significantly lower than in the placebo group. The mean of flatulence severity has significantly increased in both groups over time but in the chamomile group, this increase was significantly lower than in the placebo group. CONCLUSION These results suggest that chamomile has a potential therapeutic effect on the gastrointestinal and can reduce flatulence. In laparoscopic surgeries, using chamomile drops as a preventive drug seems to be effective in reducing the incidence of postoperative flatulence.
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Affiliation(s)
- Razieh Salimi Zadak
- Student Research Committee, Faculty of Nursing and Midwifery, Isfahan University of Medical Science, Isfahan, Iran
| | - Gholamreza Khalili
- Department of Anesthesia, Isfahan University of Medical Science, Isfahan, Iran
| | | | - Soheila Bakhtiari
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Science, Isfahan, Iran.
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Rose DJ, Poudel R, Van Haute MJ, Yang Q, Wang L, Singh M, Liu S. Pulse processing affects gas production by gut bacteria during in vitro fecal fermentation. Food Res Int 2021; 147:110453. [PMID: 34399455 DOI: 10.1016/j.foodres.2021.110453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/17/2021] [Accepted: 05/26/2021] [Indexed: 12/18/2022]
Abstract
Flatulence is one barrier to pulse consumption for many people. Therefore, we examined how processing affects gas production by the microbiome in three classes of pulses. Processing did not affect gas production from Navy beans. However, in Pardina lentils and green peas, (-1.9 ± 0.3 mL/24 h, p < 0.001; -2.3 ± 0.3 mL/24 h, p < 0.001, respectively). In Pardina lentils and green peas, germination diminished carbohydrate utilization by the microbiome compared with unprocessed samples. In Pardina lentils germination reduced abundance germination resulted in the greatest reduction in gas production among six processing methods of amplicon sequence variants (ASVs) from Bacteroides and Lachnospiraceae and reduced propionate production compared with unprocessed samples. In green peas, germination reduced ASVs from Lachnospiraceae, including one from Roseburia, and reduced proportion of butyrate production during fermentation. Three ASVs from Clostridium sensu stricto (cluster 1), Megasphaera elsdenii, and unclassified Veillonellaceae, were strongly associated with increased gas production across all samples (ρ = 0.67-0.69, p < 0.001). This study showed that processing can reduce gas production by the microbiome in some pulses, but also reduces saccharolytic fermentation and production of beneficial microbial metabolites.
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An J, Noh H, Kim E, Lee J, Woo K, Kim H. Neuromuscular blockade reversal with sugammadex versus pyridostigmine/glycopyrrolate in laparoscopic cholecystectomy: a randomized trial of effects on postoperative gastrointestinal motility. Korean J Anesthesiol 2019; 73:137-144. [PMID: 31636242 PMCID: PMC7113156 DOI: 10.4097/kja.19360] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/17/2019] [Indexed: 12/19/2022] Open
Abstract
Background Acetylcholinesterase inhibitors (e.g., pyridostigmine bromide) are used for neuromuscular blockade (NMB) reversal in patients undergoing surgery under general anesthesia (GA). Concurrent use of anticholinergic agents (e.g., glycopyrrolate) decreases cholinergic side effects but can impede bowel movements. Sugammadex has no cholinergic effects; its use modifies recovery of gastrointestinal (GI) motility following laparoscopic cholecystectomy compared to pyridostigmine/glycopyrrolate. This study evaluated the contribution of sugammadex to the recovery of GI motility compared with pyridostigmine and glycopyrrolate. Methods We conducted a prospective study of patients who underwent laparoscopic cholecystectomy. Patients were randomly allocated to the experimental group (sugammadex, Group S) or control group (pyridostigmine-glycopyrrolate, Group P). After anesthesia (propofol and rocuronium, and 2% sevoflurane), recovery was induced by injection of sugammadex or a pyridostigmine-glycopyrrolate mixture. As a primary outcome, patients recorded the time of their first passage of flatus (‘gas-out time’) and defecation. The secondary outcome was stool types. Results One-hundred and two patients participated (Group S [n = 49], Group P [n = 53]). Mean time from injection of NMB reversal agents to gas-out time was 15.03 (6.36–20.25) h in Group S and 20.85 (16.34–25.86) h in Group P (P = 0.001). Inter-group differences were significant. Time until the first defecation as well as types of stools was not significantly different. Conclusions Sugammadex after laparoscopic cholecystectomy under GA resulted in an earlier first postoperative passage of flatus compared with the use of a mixture of pyridostigmine and glycopyrrolate. These findings suggest that the use of sugammadex has positive effects on the recovery of GI motility.
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Affiliation(s)
- Jihyun An
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Heeyun Noh
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Eunju Kim
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Jihyang Lee
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Kyeongyoon Woo
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Hyunkyum Kim
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
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Sørensen J, Schantz Laursen B, Drewes AM, Krarup AL. The Incidence of Sexual Dysfunction in Patients With Irritable Bowel Syndrome. Sex Med 2019; 7:371-383. [PMID: 31604682 PMCID: PMC6963115 DOI: 10.1016/j.esxm.2019.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/19/2019] [Accepted: 08/22/2019] [Indexed: 02/07/2023] Open
Abstract
Introduction Several studies have suggested that patients with irritable bowel syndrome (IBS) frequently have symptoms of sexual dysfunction. Aim The current study aims to map the current knowledge about the burden of sexual dysfunction in patients with IBS. Methods A literature review was conducted on PubMed and EMBASE using the following search terms or combinations thereof: irritable bowel syndrome; functional colonic disease; sexual function; sexual health; sexual behavior; sexual dysfunction; dyspareunia; erectile dysfunction; quality of life; and questionnaire. Main Outcome Measure Sexual dysfunction. Results 1,273 texts were found, 331 duplicates were removed, and 844 texts were excluded because they did not meet the inclusion criteria, leaving 98 full text articles. These were examined and it was found that 41 fulfilled the criteria. 4 questionnaires were found; Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire, the Irritable Bowel Syndrome – Quality of Life (IBSQOL) questionnaire, the Irritable Bowel Syndrome-36 question (IBS-36) questionnaire, and the Arizona Sexual Experience Scale. Subscores for sexual relations in IBS-QOL ranged from 37.7−100 (11.9) for patients with IBS and 82.2−100 (6.6) for controls. The IBSQOL and IBS-36 subscores for sexual relations ranged from 49.7−90.5 (9) to 3.9−5.4 (0.8) with no healthy controls for comparison. After interventions were implemented, there was an improvement in subscores (the IBS-QOL mean changed to 10.5%, IBSQOL mean changed to 3.8%, and the IBS-36 mean changed to 40%). The study using Arizona Sexual Experience Scale showed that 51% of patients with IBS had sexual dysfunction and also scored lower on the IBSQOL questionnaire. Conclusion The information about sexual dysfunction in patients with IBS is sparse and emerges primarily from quality of life questionnaires. It seems as though patients with IBS have more sexual problems compared to controls, but further investigation regarding the extent and type of sexual dysfunction is needed. Sørensen J, Schantz Laursen B, Drewes AM, et al. The Incidence of Sexual Dysfunction in Patients With Irritable Bowel Syndrome. Sex Med 2019;7:371–383.
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Affiliation(s)
- Jeanette Sørensen
- Centre of Neurogastroenterologic Research, Clinic Medicine, The North Regional Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark; Centre for Clinical Research, The North Regional Hospital, Denmark
| | - Birgitte Schantz Laursen
- Sexological Research Centre, Department of Clinical Medicine, Aalborg University, Denmark; Clinical Nursing Research Unit, Aalborg University Hospital, Denmark
| | - Asbjørn Mohr Drewes
- Department of Clinical Medicine, Aalborg University, Denmark; MechSense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Denmark
| | - Anne Lund Krarup
- Centre of Neurogastroenterologic Research, Clinic Medicine, The North Regional Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark; MechSense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Denmark.
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Nelson RL, Go C, Darwish R, Gao J, Parikh R, Kang C, Mahajan A, Habeeb L, Zalavadiya P, Patnam M. Cesarean delivery to prevent anal incontinence: a systematic review and meta-analysis. Tech Coloproctol 2019; 23:809-820. [PMID: 31273486 DOI: 10.1007/s10151-019-02029-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 06/20/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cesarean delivery (CD), is increasingly recommended as a mode of delivery that prevents the anal incontinence (AI) that arises in some women after vaginal delivery (VD). The assessment of the efficacy of CD in this regard was the subject of this systematic review. METHODS Searches were conducted in Medline, EMBASE and the Cochrane Library. Both randomized (RCTs) and non-randomized trials (NRTs) comparing the risk of sustained fecal and/or flatus incontinence after VD or CD were sought from 1966 to 1 January, 2019. Studies were eligible if they assessed AI more than 6 months after birth, and had statistical adjustment for at least one of the three major confounders for AI: age, maternal weight or parity. In addition, each study was required to contain more than 250 participants, more than 50 CDs and more than 25 cases of AI. Data after screening and selection were abstracted and entered into Revman for meta-analysis. Analyses were done for combined fecal and flatus incontinence (comAI), fecal incontinence (FI), gas incontinence (GI), CD before or during labor, time trend of incontinence after delivery, assessment of both statistical and clinical heterogeneity, parity and late incident AI. RESULTS Out of the 2526 titles and abstracts found, 24 eligible studies were analyzed, 23 NRTs and one RCT. These included women with 29,597 VDs and women with 6821 CDs. Among the primary outcomes, VD was found not to be a significant predictor of postpartum comAI compared to CD in 6 studies, incorporating 18,951 deliveries (OR = 0.74; 0.54-1.02). VD was also not a significant predictor of FI in 14 studies, incorporating 29,367 deliveries, (OR = 0.89; 0.76-1.05). VD was not a significant predictor of GI in six studies, incorporating 6724 deliveries (OR = 0.96; 0.79-1.18). The strength of the grading of recommendations, assessment, development and evaluations (GRADE) evidence for each of these was low for comAI and moderate for FI and GI (upgrade for lack of expected effect). Time trend FI showed incontinence at 3 months often resolved at 1 year. Other secondary analyses assessing parity, delayed incidence of FI, clinical and statistical heterogeneity, spontaneous VD only, late risk of incidence of AI, and CD in or prior to labor all had similar results as in the primary outcomes. CONCLUSIONS There are three components of pelvic floor dysfunction that are thought to be caused by VD and hopefully prevented by CD: AI, urinary incontinence and pelvic floor prolapse. Of these, AI was not found to be reliably prevented by CD in this review.
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Affiliation(s)
- R L Nelson
- Epidemiology/Biometry Division, University of Illinois School of Public Health, Chicago, IL, USA.
| | - C Go
- Honors College, University of Illinois at Chicago, Chicago, IL, USA
| | - R Darwish
- Honors College, University of Illinois at Chicago, Chicago, IL, USA
| | - J Gao
- Honors College, University of Illinois at Chicago, Chicago, IL, USA
| | - R Parikh
- Honors College, University of Illinois at Chicago, Chicago, IL, USA
| | - C Kang
- Honors College, University of Illinois at Chicago, Chicago, IL, USA
| | - A Mahajan
- Honors College, University of Illinois at Chicago, Chicago, IL, USA
| | - L Habeeb
- Honors College, University of Illinois at Chicago, Chicago, IL, USA
| | - P Zalavadiya
- Honors College, University of Illinois at Chicago, Chicago, IL, USA
| | - M Patnam
- Honors College, University of Illinois at Chicago, Chicago, IL, USA
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Mahmoudpour Z, Shokri J, Kamalinejad M, Meftah N, Khafri S, Mozaffarpur SA, Shirafkan H. The efficacy of a Persian herbal formulation on functional bloating: A double-blind randomized controlled trial. J Integr Med 2019; 17:344-350. [PMID: 31201146 DOI: 10.1016/j.joim.2019.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/21/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Bloating is a common gastrointestinal complaint which is difficult to treat. OBJECTIVE This study investigated the efficacy and compliance of a formulation called KAASER comprised of Trachyspermum ammi (L.) Sprague seed, Zingiber officinale Roscoe. rhizome and Piper nigrum L. berry in the treatment of functional bloating. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION A total of 106 patients with functional bloating, between 20 and 50 years of age, participated in this double-blind randomized controlled trial. Patients were divided into 3 parallel groups that received 500 mg of placebo, dimethicone or KAASER, three times a day for 2 weeks. MAIN OUTCOME MEASURES The frequency and severity of bloating were primary outcomes, while the frequencies of eructation, defecation, borborygmus and early satiation were secondary outcomes. All parameters were evaluated at the beginning (week 0), and also weeks 2, 4 and 10 of the study, through self-report checklists with a scoring system. RESULTS Among the 84 patients who completed the study, the frequency and severity of bloating (P < 0.001), the frequencies of eructation, defecation and borborygmus (P = 0.03) were significantly improved in the group receiving KAASER (36 patients) compared with the dimethicone (35 patients) and placebo (35 patients) groups, during the 3 phases of follow-up. These significant differences persisted through the 2 and 8 weeks of follow-ups after cessation of medication (week 4 and 10). In early satiation, no significant differences were observed among the 3 groups. CONCLUSION The results showed that KAASER can be effectively used to treat patients suffering from bloating. Bloating, eructation, defecation and borborygmus in the KAASER group remained significantly improved after 2 and 8 weeks of cessation of medication, making this mechanism an interesting area for further investigation. TRIAL REGISTRATION Registration trial IRCT2015100324327N on Iranian Registry of Clinical Trials.
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Affiliation(s)
- Zienab Mahmoudpour
- Student Research Committee, Babol University of Medical Sciences, Babol 47745-47176, Iran; Department of Persian Medicine, School of Persian Medicine, Babol University of Medical Sciences, Babol 47745-47176, Iran
| | - Javad Shokri
- Department of Internal Medicine, Babol University of Medical Sciences, Babol 47745-47176, Iran
| | - Mohammad Kamalinejad
- School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran 19968-35113, Iran
| | - Neda Meftah
- Department of Internal Medicine, Babol University of Medical Sciences, Babol 47745-47176, Iran
| | - Soraya Khafri
- Biostatistics and Epidemiology Department, Medicine Faculty, Babol University of Medical Sciences, Babol 47745-47176, Iran
| | - Seyyed Ali Mozaffarpur
- Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47745-47176, Iran.
| | - Hoda Shirafkan
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari 48471-16548, Iran
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10
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Bepary RH, Wadikar DD. HPLC profiling of flatulence and non-flatulence saccharides in eleven ricebean ( Vigna umbellata) varieties from North-East India. J Food Sci Technol 2019; 56:1655-1662. [PMID: 30956347 DOI: 10.1007/s13197-019-03675-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 02/16/2019] [Accepted: 02/21/2019] [Indexed: 10/27/2022]
Abstract
HPLC method was optimized for analysis eight flatulence and non-flatulence saccharides in 11 ricebean varieties using Spherisorb NH2 chromatographic column within 20 min by isocratic mobile phase containing acetonitrile and water in ratio of 70:30 at flow rate of 1 mL/min. The glucose, sucrose, raffinose, stachyose, verbascose and ajugose content in these varieties ranged from 157.63-365.08, 202.61-997.74, 196.29-429.5, 692.7-1480.67, 47.66-130.36 and 0.27-8.82 mg/100 g, respectively. The total flatulence saccharides (FS) were range between 937.13 ± 44.31 (JCR-08-12) and 1944.55 ± 83.57 (JCR-08-32) mg/100 g. Among the total FS, the content of stachyose was found highest in all varieties than other FS. Principal component analysis (PCA) revealed that glucose, sucrose, raffinose, stachyose, verbascose, ajugose, and total FS contributed 50.03% variation among the varieties. The eleven varieties were classified into three groups based on saccharides content by PCA. The group-A (JCR-08-12) and group-B (JCR-08-7, JCR-08-16, JCR-50, JCR-13-11, JCR-13-13 and Nagadal) had very low and low content of total FS, respectively.
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Affiliation(s)
- Rejaul Hoque Bepary
- DRDO-Defence Food Research Laboratory, Siddartha Nagar, Mysore, Karnataka State 570011 India
| | - D D Wadikar
- DRDO-Defence Food Research Laboratory, Siddartha Nagar, Mysore, Karnataka State 570011 India
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11
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Tortora A, La Sala D, Vitale M. Switch from tablet levothyroxine to oral solution resolved reduced absorption by intestinal parasitosis. Endocrinol Diabetes Metab Case Rep 2019; 2019:EDM190026. [PMID: 30897550 PMCID: PMC6432983 DOI: 10.1530/edm-19-0026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/04/2019] [Indexed: 12/23/2022] Open
Abstract
Reduced intestinal absorption of levothyroxine (LT4) is the most common cause of failure to achieve an adequate therapeutic target in hypothyroid patients under replacement therapy. We present the case of a 63-year-old woman with autoimmune hypothyroidism previously well-replaced with tablet LT4 who became unexpectedly no more euthyroid. At presentation, the patient reported the onset of acute gastrointestinal symptoms characterized by nausea, loss of appetite, flatulence, abdominal cramps and diarrhea, associated with increase of thyrotropin levels (TSH: 11 mIU/mL). Suspecting a malabsorption disease, a thyroxine solid-to-liquid formulation switch, at the same daily dose, was adopted to reach an optimal therapeutic target despite the gastrointestinal symptoms persistence. Oral LT4 solution normalized thyroid hormones. Further investigations diagnosed giardiasis, and antibiotic therapy was prescribed. This case report is compatible with a malabsorption syndrome caused by an intestinal parasite (Giardia lamblia). The reduced absorption of levothyroxine was resolved by LT4 oral solution. Learning points: The failure to adequately control hypothyroidism with oral levothyroxine is a common clinical problem. Before increasing levothyroxine dose in a patient with hypothyroidism previously well-controlled with LT4 tablets but no more in appropriate therapeutic target, we suggest to investigate non adhesion to LT4 therapy, drug or food interference with levothyroxine absorption, intestinal infection, inflammatory intestinal disease, celiac disease, lactose intolerance, short bowel syndrome after intestinal or bariatric surgery, hepatic cirrhosis and congestive heart failure. LT4 oral solution has a better absorptive profile than the tablet. In hypothyroid patients affected by malabsorption syndrome, switch of replacement therapy from tablet to liquid LT4 should be tested before increasing the dose of LT4.
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Affiliation(s)
- Anna Tortora
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
| | - Domenico La Sala
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
| | - Mario Vitale
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
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12
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Mahboubi M. Mentha spicata L. essential oil, phytochemistry and its effectiveness in flatulence. J Tradit Complement Med 2021; 11:75-81. [PMID: 33728265 DOI: 10.1016/j.jtcme.2017.08.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 07/18/2017] [Accepted: 08/15/2017] [Indexed: 11/23/2022] Open
Abstract
Flatulence as the continuous feeling of abdominal distension is equal to "Nafkh" in Iranian Traditional Medicine. Nafkh is believed to derive from the amount of stomach temperature, humidity of food or abnormal humidity in digestive tract and their interactions. Mentha spicata as cool and spicy plant with astringent and digestive property is recommended for treatment of flatulence. The information was extracted from accessible international databases, traditional books, electronic resources, and unpublished data. M. spicata essential oil with main component of carvone has potency for treatment of flatulence related to indigestion, cesarean section and dysmenorrhea. Also, it can reduce the pain severity during the colonoscopy or dysmenorrheal conditions. No hazardous effects were reported for M. spicata essential oil, if it is used in proper dosages. M. spicata essential oil can be applied for other intestinal complaints with pain and flatulence such as Irritable Bowel Syndrome (IBS) that needs more deep clinical trials for demonstrating its potential.
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13
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Soghomonyan S, Abdel-Rasoul M, Zuleta-Alarcon A, Grants I, Davila V, Yu J, Zhang C, Whitaker EE, Bergese SD, Stoicea N, Arsenescu R, Christofi FL. Clopidogrel IBS Patients Have Higher Incidence of Gastrointestinal Symptoms Influenced by Age and Gender. Dig Dis Sci 2017; 62:2728-2743. [PMID: 28840395 PMCID: PMC6075816 DOI: 10.1007/s10620-017-4707-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 07/31/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Clopidogrel is an irreversible antagonist of P2Y12 receptors (P2Y12Rs) used as an antiplatelet drug to reduce risk of thrombosis. P2Y12Rs are expressed in gastrointestinal (GI) tract where they might regulate GI function. AIM To evaluate if blockade of P2Y12Rs by clopidogrel is associated with higher incidence of GI symptoms in patients with irritable bowel syndrome (IBS). METHODS A retrospective analysis of our institutional database was conducted for a 13-year period. IBS patients were identified, and their demographics, GI symptoms and clopidogrel therapy were collected. Logistic regression models were used to characterize symptoms in clopidogrel versus no-clopidogrel IBS-groups, adjusting for Age and Sex differences. An additional study characterized the P2Y12R distribution in human gut. RESULTS The search identified 7217 IBS patients (6761 no-clopidogrel/456 clopidogrel). There were a higher proportion of patients with GI symptoms on clopidogrel (68%) compared to controls (60%, p = 0.0011) that were Females (70 vs. 60%, p = 0.0003) not Males (61 vs. 60%; p = 0.8312). In Females, clopidogrel was associated with higher incidence of GI symptoms (Age adjusted; p < 0.0001) for pain, constipation, gastroparesis (p ≤ 0.0001) and psychogenic pain (p = 0.0006). Age or Sex (adjusted models) influenced one or more GI symptoms (i.e., pain, p < 0.0001; constipation, p < 0.0001/p = 0.008; diarrhea, flatulence, p = 0.01). P2Y12R immunoreactivity was abundant in human ENS; glial-to-neuron ratio of P2Y12Rs expressed in Females ≫ Males. CONCLUSIONS Irreversible blockade of P2Y12R by clopidogrel is associated with higher incidence of GI symptoms in Female IBS patients, although Age or Sex alone contributes to symptomatology. Prospective studies can determine clinical implications of P2Y12Rs in IBS.
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Affiliation(s)
- Suren Soghomonyan
- Department of Anesthesiology, The Wexner Medical Center, The Ohio State University, 420 West 12th Ave, Room 226, Columbus, OH 43210, USA
| | - Mahmoud Abdel-Rasoul
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University, 1800 Cannon Drive, Room 320, Columbus, OH 43210, USA
| | - Alix Zuleta-Alarcon
- Department of Anesthesiology, The Wexner Medical Center, The Ohio State University, 420 West 12th Ave, Room 226, Columbus, OH 43210, USA
| | - Iveta Grants
- Department of Anesthesiology, The Wexner Medical Center, The Ohio State University, 420 West 12th Ave, Room 226, Columbus, OH 43210, USA
| | - Victor Davila
- Department of Anesthesiology, The Wexner Medical Center, The Ohio State University, 420 West 12th Ave, Room 226, Columbus, OH 43210, USA
| | - Jeffrey Yu
- Department of Anesthesiology, The Wexner Medical Center, The Ohio State University, 420 West 12th Ave, Room 226, Columbus, OH 43210, USA
| | - Cheng Zhang
- Department of Internal Medicine, Wexner Medical Center, The Ohio State University, 395 West 12th Ave, Suite 200, Columbus, OH 43210, USA
| | - Emmett E. Whitaker
- Department of Anesthesiology, The Wexner Medical Center, The Ohio State University, 420 West 12th Ave, Room 226, Columbus, OH 43210, USA,Department of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA
| | - Sergio D. Bergese
- Department of Anesthesiology, The Wexner Medical Center, The Ohio State University, 420 West 12th Ave, Room 226, Columbus, OH 43210, USA
| | - Nicoleta Stoicea
- Department of Anesthesiology, The Wexner Medical Center, The Ohio State University, 420 West 12th Ave, Room 226, Columbus, OH 43210, USA
| | - Razvan Arsenescu
- Department of Internal Medicine, Wexner Medical Center, The Ohio State University, 395 West 12th Ave, Suite 200, Columbus, OH 43210, USA,Atlantic Inflammatory Bowel Disease Center of Excellence, Atlantic Digestive Health Institute, 435 South Street, Suite 205, Morristown, NJ 07960, USA
| | - Fievos L. Christofi
- Department of Anesthesiology, The Wexner Medical Center, The Ohio State University, 420 West 12th Ave, Room 226, Columbus, OH 43210, USA
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14
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Larijani B, Esfahani MM, Moghimi M, Shams Ardakani MR, Keshavarz M, Kordafshari G, Nazem E, Hasani Ranjbar S, Mohammadi Kenari H, Zargaran A. Prevention and Treatment of Flatulence From a Traditional Persian Medicine Perspective. Iran Red Crescent Med J 2016; 18:e23664. [PMID: 27275398 PMCID: PMC4893422 DOI: 10.5812/ircmj.23664] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 10/06/2014] [Accepted: 10/20/2014] [Indexed: 01/25/2023]
Abstract
Context The feeling of abdominal fullness, bloating, and movement of gas in the abdomen is a very uncomfortable sensation termed flatulence. Since flatulence is one of the most common gastrointestinal symptoms that is bothersome to patients, it is important to identify effective methods to resolve this issue. In modern medicine, management of flatulence is often not satisfactory. On the other hand, traditional systems of medicine can be considered good potential sources to find new approaches for preventing and treating flatulence. The aim of this study is to review flatulence treatments from a traditional Persian medicine (TPM) viewpoint. Evidence Acquisition In this study, the reasons for flatulence and methods for its prevention and treatment are reviewed in traditional Persian medicine (TPM) texts and then related with evidence from modern medicine by searching in databases, including PubMed, Scopus, Google Scholar, and IranMedex. Results From a traditional Persian scholar viewpoint, one of the most important causes of flatulence is an incorrect manner of eating; valuable advice to correct bad eating habits will be illustrated. In addition, traditional practitioners describe some herbs and vegetables as well as herbal compounds that are effective food additives to relieve flatulence. The anti-flatulent effect of most of these herbs has been experimentally verified using modern medicine. Conclusions Attention to TPM can lead to the identification of new preventive and curative approaches to avoid and treat flatulence. In addition, Persian viewpoints from the medieval era regarding flatulence are historically important.
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Affiliation(s)
- Bagher Larijani
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Medhi Esfahani
- Qoran, Hadis and Teb Sciences Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Maryam Moghimi
- School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Maryam Moghimi, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9125135631, E-mail:
| | | | - Mansoor Keshavarz
- School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
| | | | - Esmaiel Nazem
- School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Shirin Hasani Ranjbar
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | | | - Arman Zargaran
- Pharmaceutical Sciences Research Center and Department of Traditional Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IR Iran
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15
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Pérez y López N, Torres-López E, Zamarripa-Dorsey F. Clinical response in Mexican patients with irritable bowel syndrome treated with a low diet low in fermentable carbohydrates (FODMAP). Rev Gastroenterol Mex 2015; 80:180-5. [PMID: 26300323 DOI: 10.1016/j.rgmx.2015.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 06/10/2015] [Accepted: 06/11/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND The low FODMAP diet eliminates carbohydrates and fermentable alcohols because they are not absorbed by the intestine, but are fermented by the microbiota, causing bloating and flatulence. AIMS To evaluate the clinical response to the low FODMAP diet in patients with the different clinical subtypes of irritable bowel syndrome (IBS). MATERIALS AND METHODS Patients attended to at the Gastroenterology Department in 2014 that were diagnosed with IBS based on the Rome III criteria were included in the study. They were managed with a low FODMAP diet for 21 days and their response to the symptoms of abdominal pain, bloating, flatulence, and stool form pre and post-diet were evaluated through the visual analogue scale, Bristol scale, and patient overall satisfaction. The results were analyzed by means, 95% CI, and the Student's t test. RESULTS Of the 31 patients included in the study, 87% were women and the mean age was 46.48 years. Distribution was: IBS-C 64.5%, IBS-D 22.6%, and IBS-M 12.9%. The score for pain was 6.0 (95% CI 5.04-6.96) and the post-diet score was 2.77 (95% CI 1.60-3.95) (P<.001). The score for bloating was 7.10 (95% CI 6.13-8.06) and the post-diet score was 4.19 (95% CI 2.95-5.44) (P<.001). The score for flatulence was 5.94 (95% CI 4.79-7.08) and the post-diet score was 3.06 (IC95% 1.99-4.14) (P<.001). The pre-diet Bristol Scale result was 3.68 (95% CI 3.14-4.22) and the post-diet result was 4.10 (95% CI 3.66-4.54) (P=.1). The satisfaction percentage was 70.9%. CONCLUSIONS In this first study on a Mexican population with IBS, there was significant improvement of the main symptoms, including pain, bloating, and flatulence after treatment with a low FODMAP diet.
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Affiliation(s)
- N Pérez y López
- Laboratorio de Motilidad Gastrointestinal y Clínica de ERGE y trastornos funcionales digestivos, SSA, México D.F., México.
| | - E Torres-López
- Servicio de Cirugía General, Hospital Ángeles Lindavista, México D.F., México
| | - F Zamarripa-Dorsey
- Servicio de Gastroenterología, Hospital Juárez de México, SSA, México D.F., México
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16
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Compare D, Rocco A, Sgamato C, Coccoli P, Campo SMA, Nazionale I, Larussa T, Luzza F, Chiodini P, Nardone G. Lactobacillus paracasei F19 versus placebo for the prevention of proton pump inhibitor-induced bowel symptoms: a randomized clinical trial. Dig Liver Dis 2015; 47:273-9. [PMID: 25660822 DOI: 10.1016/j.dld.2015.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/15/2014] [Accepted: 01/11/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Proton pump inhibitors may foster intestinal dysbiosis and related bowel symptoms. AIM To evaluate the effect of Lactobacillus paracasei F19 on bowel symptom onset in patients on long-term proton pump inhibitors. METHODS In this randomized, double-blind, placebo-controlled study, patients with typical gastroesophageal reflux disease symptoms receiving pantoprazole 40 mg/d for six months were randomly assigned to receive: (A) Lactobacillus paracasei F19 bid for three days/week for six months; (B) placebo bid for three days/week for six months; (C) Lactobacillus paracasei F19 bid for three days/week for three months and placebo bid for three days/week for the following three months; (D) placebo bid for three days/week for three months and Lactobacillus paracasei F19 bid for three days/week for the following three months. Bloating, flatulence, abdominal pain and bowel habit were assessed monthly. RESULTS 100/312 patients were enrolled. In the parallel groups, the treatment-by-time interaction affected bloating (p = 0.015), while Lactobacillus paracasei F19 treatment alone affected flatulence (p = 0.011). Moreover, the treatment-by-time interaction significantly affected the mean score of bloating (p = 0.01) and flatulence (p < 0.0001), the mean stool form (p = 0.03) and mean stool frequency/week (p = 0.016). Analysis of the cross-over groups, limited to the first three months because of carry-over effect, confirmed these results. CONCLUSION Lactobacillus paracasei F19 supplementation prevents bowel symptom onset in patients on long-term proton pump inhibitors.
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Affiliation(s)
- Debora Compare
- Department of Clinical Medicine and Surgery, Gastroenterology Unit, University Federico II, Naples, Italy
| | - Alba Rocco
- Department of Clinical Medicine and Surgery, Gastroenterology Unit, University Federico II, Naples, Italy
| | - Costantino Sgamato
- Department of Clinical Medicine and Surgery, Gastroenterology Unit, University Federico II, Naples, Italy
| | - Pietro Coccoli
- Department of Clinical Medicine and Surgery, Gastroenterology Unit, University Federico II, Naples, Italy
| | | | | | - Tiziana Larussa
- Department of Health Science, University Magna Graecia, Catanzaro, Italy
| | - Francesco Luzza
- Department of Health Science, University Magna Graecia, Catanzaro, Italy
| | - Paolo Chiodini
- Medical Statistics Unit, Second University of Naples, Complesso Didattico di S. Patrizia, Naples, Italy
| | - Gerardo Nardone
- Department of Clinical Medicine and Surgery, Gastroenterology Unit, University Federico II, Naples, Italy.
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Singh N, Srivastava G, Talat M, Raghubanshi H, Srivastava ON, Kayastha AM. Cicer α-galactosidase immobilization onto functionalized graphene nanosheets using response surface method and its applications. Food Chem 2013; 142:430-8. [PMID: 24001862 DOI: 10.1016/j.foodchem.2013.07.079] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 06/28/2013] [Accepted: 07/18/2013] [Indexed: 10/26/2022]
Abstract
Cicer α-galactosidase was immobilized onto functionalized graphene with immobilization efficiency of 84% using response surface methodology (Box-Behnken design). The immobilized enzyme had higher thermal stability than the soluble one, attractive for industrial applications. Immobilization of the enzyme lowered the Km to 1/3rd compared to the soluble enzyme. Raffinose family oligosaccharides (RFOs) are mainly responsible for flatulence by taking soybean derived food products. The immobilized enzyme can be used effectively for the hydrolysis of RFOs. After ten successive runs, the immobilized enzyme still retained approximately 60% activity, with soybean RFOs. The easy availability of enzyme source, ease of its immobilization on matrices, non-toxicity, increased stability of immobilized enzyme and effective hydrolysis of RFOs increase the Cicer α-galactosidase application in food processing industries.
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Affiliation(s)
- Neelesh Singh
- School of Biotechnology, Faculty of Science, Banaras Hindu University, Varanasi 221005, India
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18
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Hegar B, Hutapea EI, Advani N, Vandenplas Y. A double-blind placebo-controlled randomized trial on probiotics in small bowel bacterial overgrowth in children treated with omeprazole. J Pediatr (Rio J) 2013; 89:381-7. [PMID: 23796359 DOI: 10.1016/j.jped.2012.12.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 12/28/2012] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To evaluate the incidence of small bowel bacterial overgrowth (SBBO) in children treated with omeprazole, and to test whether probiotics influence the incidence. METHODS A double-blinded, placebo-controlled trial was performed in 70 children treated orally during four weeks with 20mg omeprazole per day. Lactobacillus rhamnosus R0011 (1.9×10(9) cfu) and Lactobacillus acidophilus R0052 (0.1×10(9) cfu) were simultaneously given daily to 36 subjects (probiotic group), while 34 subjects received placebo (placebo group). The diagnosis of SBBO was based on the development of suggestive symptoms, in combination with a positive glucose breath test. RESULTS After one month of proton pump inhibitor (PPI) treatment, 30% (21/70) had a positive breath test suggesting SBBO; of these 62% were symptomatic. Five children developed SBBO-like symptoms, but had a negative breath test; and 44 (63%) were symptom free and had a negative breath test. There was no difference in the incidence of positive breath tests in the probiotic versus the placebo group (33% vs 26.5%; p=0.13). CONCLUSIONS Since symptoms suggesting SBBO developed in 26% of PPI-treated children, and since the glucose breath test was abnormal in 72% of these, this side-effect should be more frequently considered. The probiotic tested did not decrease the risk to develop SBBO.
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Affiliation(s)
- Badriul Hegar
- Department of Child Health, University of Indonesia, Dopok, Indonesia
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Mohsenzadeh Ledari F, Barat S, Delavar MA, Banihosini SZ, Khafri S. Chewing sugar-free gum reduces ileus after cesarean section in nulliparous women: a randomized clinical trial. Iran Red Crescent Med J 2013; 15:330-4. [PMID: 24083008 PMCID: PMC3785909 DOI: 10.5812/ircmj.6458] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 02/26/2013] [Accepted: 01/08/2013] [Indexed: 01/03/2023]
Abstract
Background Gum chewing after cesarean section may stimulate bowel motility and decrease duration of postoperative ileus. Objectives The current study assessed the effect of chewing sugar-free gum on the return of bowel function, where cesarean section had been performed in nulliparous women. Materials and Methods In a randomized clinical trial, 60 patients, scheduled for cesarean section were randomly divided in to 2 groups gum-chewing group (n = 30) and control group (n = 30) postoperatively. The patients in the gum-chewing group postoperatively chewed sugar free gum 3 times daily each time for 1 hour until discharge. The patients' demographic characteristics, duration of surgery, mean hunger time, flatus and bowel motility were compared in the two groups. Results There was no significant difference between the 2 groups regarding patient demographics, intraoperative, and postoperative care. In the gum-chewing and the control group there was a significant difference in the mean postoperative interval of the first bowel movement (20.89 ± 8.8 versus 27.93 ± 9.3 hours, P = 0.004), the first feeling of hunger (10.37 ± 6.0 versus 16.33 ± 9.3 hours, P = 0.005), the first passage of flatus (25.02 ± 5.8 versus 31.08 ± 9.7 hours, P = 0.003), and the first defecation (31.17 ± 5.3versus 40.08 ± 8.8 hours, P = 0.000) respectively, which were significantly shorter in the gum-chewing group compared to those of the control group. There were no major complications in either group. All patients in the gum-chewing group tolerated it without any major complications and side effects. Conclusions The study results demonstrated that bowel motility after cesarean section in nulliparous women can be accelerated by gum chewing which is a useful, inexpensive and well-tolerated method for mothers in post-cesarean section.
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Affiliation(s)
- Farideh Mohsenzadeh Ledari
- Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran
- Corresponding author: Farideh Mohsenzadeh Ledari, Department of Midwifery, Babol University of Medical Sciences, Ganjafrooze Ave, 47176, Babol, IR Iran, Tel/Fax: +98-1112298582, E-mail:
| | - Shanaz Barat
- Fatemeh Zahra Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, IR Iran
| | - Mouloud Agajani Delavar
- Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran
- Fatemeh Zahra Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, IR Iran
| | | | - Soriya Khafri
- Fatemezahra Infertility and Reproductive Health Research Center, Department of Social Medicine, Babol University of Medical Sciences, Babol, IR Iran
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