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Cetiner OF, Dundar HE, Kantarcioglu-Coskun S, Torun S, Tokmak S. Metastatic Melanoma of the Common Bile Duct Presented with Dyspepsia. Korean J Gastroenterol 2024; 83:163-166. [PMID: 38659253 DOI: 10.4166/kjg.2024.011] [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] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/21/2024] [Accepted: 04/14/2024] [Indexed: 04/26/2024]
Abstract
Malignant melanoma (MM) is an aggressive tumor that can metastasize to any organ, but biliary tract metastasis is scarce. We describe a very rare case of MM metastasis to the common bile duct (CBD), presented with only dyspeptic symptoms. The patient had mildly elevated alkaline phosphatase and gamma-glutamyl transferase levels. Magnetic resonance cholangiopancreatography demonstrated a dilated common bile duct with a distal stricture. The MM diagnosis was established with the ampulla of Vater biopsy specimens obtained by endoscopic retrograde cholangiopancreatography (ERCP), and the patient's symptoms were resolved after biliary stenting. Both primary CBD cancer and other cancer types like MM that metastasize to CBD can cause obstruction and can be manifested only by dyspeptic symptoms. MM metastasis to CBD can cause obstruction manifested only by dyspeptic symptoms without obstructive jaundice. ERCP can be employed as a promising option for treatment and diagnosis. New-onset dyspeptic symptoms in patients with a history of MM should be investigated thoroughly, especially in the context of biliary metastasis.
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Affiliation(s)
| | | | | | - Serkan Torun
- Department of Gastroenterology, Internal Medicine, Faculty of Medicine, Duzce University, Duzce, Turkey
| | - Salih Tokmak
- Department of Gastroenterology, Internal Medicine, Faculty of Medicine, Duzce University, Duzce, Turkey
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He YQ, Zhang P, Mao YK, Li SY, Zeng F, Yin T. Neuroimaging research progress of acupuncture treatment for patients with functional dyspepsia. Zhen Ci Yan Jiu 2024; 49:192-197. [PMID: 38413041 DOI: 10.13702/j.1000-0607.20221289] [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] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Neuroimaging technology provides objective and visualized research tool to study the mechanisms of acupuncture effects. Building on a systematic review of previous clinical studies on acupuncture treatment for functional dyspepsia using neuroimaging technology, this paper summarizes and synthesizes past researches from 4 aspects: acupoint-specific effects, factors influencing the effects, different physiological responses, and predictive factors for acupuncture efficacy. It suggests that acupuncture treatment for FD involves central integration with disease-targeted (acupuncture treatment can target and regulate abnormal brain functional activity patterns in patients with FD), meridian-specific (stimulation of specific acupuncture points along the stomach meridian can significantly regulate abnormal brain functional activity patterns in FD patients), and dynamic conditional features(the effects of acupuncture treatment for FD are influenced by multiple factors). Lastly, considering the current research status, this paper outlines prospects in terms of research subjects, influencing factors, and result validation, aiming to provide references for future in-depth research.
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Affiliation(s)
- Yu-Qi He
- Acupuncture-moxibustion and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Pan Zhang
- Acupuncture-moxibustion and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
- Acupuncture-moxibustion and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu 611137
| | - Yang-Ke Mao
- Acupuncture-moxibustion and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
- Acupuncture-moxibustion and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu 611137
| | - Si-Yang Li
- Acupuncture-moxibustion and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Fang Zeng
- Acupuncture-moxibustion and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
- Acupuncture-moxibustion and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu 611137
- Key Laboratory of Sichuan Province for Acupuncture-moxibustion and Chronobiology, Chengdu 610075
| | - Tao Yin
- Acupuncture-moxibustion and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China.
- Acupuncture-moxibustion and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu 611137.
- Key Laboratory of Sichuan Province for Acupuncture-moxibustion and Chronobiology, Chengdu 610075.
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Volarić M, Šojat D, Majnarić LT, Vučić D. The Association between Functional Dyspepsia and Metabolic Syndrome-The State of the Art. Int J Environ Res Public Health 2024; 21:237. [PMID: 38397726 PMCID: PMC10888556 DOI: 10.3390/ijerph21020237] [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] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024]
Abstract
Functional dyspepsia is a common functional disorder of the gastrointestinal tract that is responsible for many primary care visits. No organic changes have been found to explain its symptoms. We hypothesize that modern lifestyles and environmental factors, especially psychological stress, play a crucial role in the high prevalence of functional dyspepsia and metabolic syndrome. While gastrointestinal tract diseases are rarely linked to metabolic disorders, chronic stress, obesity-related metabolic syndrome, chronic inflammation, intestinal dysbiosis, and functional dyspepsia have significant pathophysiological associations. Functional dyspepsia, often associated with anxiety and chronic psychological stress, can activate the neuroendocrine stress axis and immune system, leading to unhealthy habits that contribute to obesity. Additionally, intestinal dysbiosis, which is commonly present in functional dyspepsia, can exacerbate systemic inflammation and obesity, further promoting metabolic syndrome-related disorders. It is worth noting that the reverse is also true: obesity-related metabolic syndrome can worsen functional dyspepsia and its associated symptoms by triggering systemic inflammation and intestinal dysbiosis, as well as negative emotions (depression) through the brain-gut axis. To understand the pathophysiology and deliver an effective treatment strategy for these two difficult-to-cure disorders, which are challenging for both caregivers and patients, a psychosocial paradigm is essential.
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Affiliation(s)
- Mile Volarić
- Department of Family Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, 31000 Osijek, Croatia; (M.V.); (L.T.M.)
- Department of Gastroenterology and Hepatology, School of Medicine, University of Mostar Clinical Hospital, University of Mostar, Bijeli Brijeg bb, 88000 Mostar, Bosnia and Herzegovina
| | - Dunja Šojat
- Department of Family Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, 31000 Osijek, Croatia; (M.V.); (L.T.M.)
| | - Ljiljana Trtica Majnarić
- Department of Family Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, 31000 Osijek, Croatia; (M.V.); (L.T.M.)
| | - Domagoj Vučić
- Department of Cardiology, General Hospital “Dr. Josip Benčević”, A. Štampara, 35105 Slavonski Brod, Croatia;
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Fatusin BB, Fatusin AJ, Grema BA, Lewechi-Uke OT, Abubarkar A, Apanisile S, Baura M, Dannina Z. Relationship between Lifestyle Indicators and Un-investigated Dyspepsia Among Adult Patients in a Primary Care Setting in Northern Nigeria. West Afr J Med 2024; 41:65-73. [PMID: 38412405] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND Un-investigated dyspepsia has remained a common encounter among patients seen in primary care in sub-Saharan Africa. A preventive approach through counselling patients on modifications of lifestyle factors related to dyspepsia could be a cost-effective approach to dyspepsia management in primary care in low- and middle-income settings. OBJECTIVES The objectives were to describe the sociodemographic patterns of adult patients with un-investigated dyspepsia in the Family Medicine Clinics, Federal Medical Centre, Gusau, Nigeria, to describe the pattern of lifestyle factors among adult patients with un-investigated dyspepsia, to determine the relationship between lifestyle patterns and un-investigated dyspepsia and to describe the specific food types that precipitate dyspepsia among the respondents. METHODS A hospital-based cross-sectional study using the Short Form Leeds Dyspepsia Questionnaire to describe the presence and severity of dyspepsia and the Simple Lifestyle Indicator Questionnaire to describe the lifestyle patterns of participants. RESULTS Most respondents (66.9%) have healthy dietary patterns however more respondents 66(52.4%) engaged in unhealthy levels of physical exercise. The Stress level was intermediate in majority of respondents (66.1%). There was no statistically significant association between lifestyle indicators and severity of dyspepsia among the respondents although the linear regression model with p-value < 0.01 and < 0.05, revealed stress as a predictor of dyspepsia in this study. CONCLUSION There was no relationship between lifestyle indicators and Uninvestigated dyspepsia among the study participants. However, some specific local foods were identified as precipitants of dyspepsia. Primary care physicians may consider a targeted dietary modification counselling approach in managing patients with uninvestigated dyspepsia.
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Affiliation(s)
- B B Fatusin
- Department of Family Medicine, Federal Medical Centre, Abeokuta, Ogun State, Nigeria. . Phone number: +2348032206128
| | - A J Fatusin
- Department of Family Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| | - B A Grema
- Department of Family Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
- Federal Medical Centre, Gusau, Zamfara State, Nigeria
| | - O T Lewechi-Uke
- Department of Family Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| | - A Abubarkar
- Department of Psychiatry, Usmanu Danfodiyo University Teaching Hospital, Sokoto
| | - S Apanisile
- Federal Medical Centre, Gusau, Zamfara State, Nigeria
| | - M Baura
- Federal Medical Centre, Gusau, Zamfara State, Nigeria
| | - Z Dannina
- Federal Medical Centre, Gusau, Zamfara State, Nigeria
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Yan H, Wu M, Wang W, Wang D, Huang X, Dong J, Chen L, Li Z, Xu X. Dosimetry and acute radiation enteritis comparison between prone and supine position in IMRT for gynecological cancers. J Appl Clin Med Phys 2023; 24:e14135. [PMID: 37621141 PMCID: PMC10691632 DOI: 10.1002/acm2.14135] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 06/04/2023] [Accepted: 08/12/2023] [Indexed: 08/26/2023] Open
Abstract
PURPOSE To probe the differences of dosimetry and acute radiation enteritis between prone and supine position in gynecological cancer patients treated with intensity-modulate radiotherapy (IMRT). METHODS Gynecologic tumor patients who received IMRT from January 2020 to July 2021 were analyzed. 60 patients were enrolled and divided into the supine or prone position group according to different radiotherapy positions, including 34 patients in prone position and 26 patients in supine position. The dose-volume histogram of organs at risk (OARs) and the incidence of acute radiation enteritis were compared between the two groups. Multivariate logistic regression analysis was conducted to show the clinical characteristics and dose volume metrics to the association of acute radiation enteritis. RESULTS The percentage of volume receiving 5 Gy, 10 Gy, 15 Gy, 20 Gy, 30 Gy, 40 Gy, and 45 Gy doses for the small intestine were 79.0%, 67.4%, 59.6%, 44.3%, 17.0%, 8.9%, and 6.0%, respectively in the prone group, which were lower than those in the supine group (P < 0.05). The mean radiation dose (Dmean ) of the small intestine exposure in prone group was decreased (P < 0.001). Compared with the supine group, the prone group who suffered from acute radiation enteritis were much less. The probability of indigestion, nausea, vomiting, diarrhea, and abdominal pain in the prone position were 35.29%, 29.41%, 17.65%, 38.24%, and 5.88%, respectively. The differences in indigestion, nausea, and diarrhea between the two groups were statistically significant (P = 0.012, P = 0.029, and P = 0.041). Multivariate logistic regression analysis was shown that prone position was found to be protective against indigestion (P = 0.002), nausea (P = 0.013), vomiting (P = 0.035), and abdominal pain (P = 0.021). CONCLUSION Prone position in IMRT for gynecological cancers could significantly reduce radiation dose to the small bowel and colon, which would decrease the occurrence and severity of acute intestinal side effects possibly.
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Affiliation(s)
- Huamei Yan
- Department of Radiation OncologyThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Manya Wu
- Department of Radiation OncologyThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Wan Wang
- Department of Radiation OncologyThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Donghui Wang
- Department of Radiation OncologyThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Xiaoqing Huang
- Department of Radiation OncologyThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Jie Dong
- Department of Radiation OncologyThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Luxi Chen
- Department of Radiation OncologyThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Zhenghuan Li
- Department of Radiation OncologyThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Xiangying Xu
- Department of Radiation OncologyThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
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Burns GL, Potter M, Mathe A, Bruce J, Minahan K, Barnes JL, Pryor J, Nieva C, Sherwin S, Cuskelly A, Fairlie T, Cameron R, Bollipo S, Irani MZ, Foster R, Gan LT, Shah A, Koloski N, Foster PS, Horvat JC, Walker MM, Powell N, Veysey M, Duncanson K, Holtmann G, Talley NJ, Keely S. TRAV26-2 T-Cell Receptor Expression Is Associated With Mucosal Lymphocyte Response to Wheat Proteins in Patients With Functional Dyspepsia. Clin Transl Gastroenterol 2023; 14:e00638. [PMID: 37753952 PMCID: PMC10749711 DOI: 10.14309/ctg.0000000000000638] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023] Open
Abstract
INTRODUCTION An association between functional dyspepsia (FD) and wheat-containing foods has been reported in observational studies; however, an adaptive response has not been demonstrated. We examined whether antigens present in wheat could provoke a response from FD duodenal lymphocytes. METHODS Lamina propria mononuclear cells (LPMCs) were isolated from duodenal biopsies from 50 patients with FD and 23 controls. LPMCs were exposed to gluten (0.2 mg/mL) or gliadin (0.2 mg/mL) for 24 hours. Flow cytometry was performed to phenotype lymphocytes. Quantitative PCR was used to measure the expression of gliadin-associated T-cell receptor alpha variant ( TRAV ) 26-2. RESULTS In response to gliadin (but not gluten) stimulation, the effector Th2-like population was increased in FD LPMCs compared with that in controls and unstimulated FD LPMCs. Duodenal gene expression of TRAV26- 2 was decreased in patients with FD compared with that in controls. We identified a positive association between gene expression of this T-cell receptor variant and LPMC effector Th17-like cell populations in patients with FD, but not controls after exposure to gluten, but not gliadin. DISCUSSION Our findings suggest that gliadin exposure provokes a duodenal effector Th2-like response in patients with FD, supporting the notion that food antigens drive responses in some patients. Furthermore, these findings suggest that altered lymphocyte responses to wheat proteins play a role in FD pathogenesis.
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Affiliation(s)
- Grace L. Burns
- School of Biomedical Sciences & Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Michael Potter
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- School of Medicine & Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- Department of Gastroenterology, John Hunter Hospital, Newcastle, Australia
| | - Andrea Mathe
- School of Biomedical Sciences & Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Jessica Bruce
- School of Biomedical Sciences & Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Kyra Minahan
- School of Biomedical Sciences & Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Jessica L. Barnes
- School of Biomedical Sciences & Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Jennifer Pryor
- School of Biomedical Sciences & Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Cheenie Nieva
- School of Biomedical Sciences & Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Simonne Sherwin
- School of Biomedical Sciences & Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Annalisa Cuskelly
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- School of Psychological Sciences, College of Engineering, Science and Environment, University of Newcastle, Newcastle, Australia
| | - Thomas Fairlie
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
- Translational Research Institute, Brisbane, Australia.
| | - Raquel Cameron
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- School of Medicine & Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Steven Bollipo
- School of Medicine & Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- Department of Gastroenterology, John Hunter Hospital, Newcastle, Australia
| | - Mudar Zand Irani
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- School of Medicine & Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- Department of Gastroenterology, John Hunter Hospital, Newcastle, Australia
| | - Robert Foster
- Department of Gastroenterology, John Hunter Hospital, Newcastle, Australia
| | - Lay T. Gan
- Department of Gastroenterology, John Hunter Hospital, Newcastle, Australia
| | - Ayesha Shah
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
- Translational Research Institute, Brisbane, Australia.
| | - Natasha Koloski
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
- Translational Research Institute, Brisbane, Australia.
| | - Paul S. Foster
- School of Biomedical Sciences & Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Jay C. Horvat
- School of Biomedical Sciences & Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Marjorie M. Walker
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- School of Medicine & Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Nick Powell
- Division of Digestive Diseases, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Martin Veysey
- School of Medicine & Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- Hull-York Medical School, University of Hull, Hull, United Kingdom
| | - Kerith Duncanson
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- School of Medicine & Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Gerald Holtmann
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
- Translational Research Institute, Brisbane, Australia.
| | - Nicholas J. Talley
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- School of Medicine & Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Simon Keely
- School of Biomedical Sciences & Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
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Qiao T, Gao D, Lu G, Yi W, Lv Z. Association of gastrointestinal symptoms and skipping breakfast with anxiety and depressive symptoms in quarantined Chinese college students during the Shanghai 2022 lockdown: a cross sectional survey. BMC Psychiatry 2023; 23:889. [PMID: 38017419 PMCID: PMC10685502 DOI: 10.1186/s12888-023-05317-3] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 10/27/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the prevalence of anxiety and depressive symptoms among quarantined college students at school in Shanghai 2022 lockdown during the COVID-19 pandemic and investigate the association of gastrointestinal discomfort related-factors and skipping breakfast with anxiety and depressive symptoms. METHODS 384 quarantined college students in Shanghai China were recruited in this cross-sectional study from April 5th to May 29th, 2022. Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) were used to assess anxiety and depressive symptoms, respectively. RESULTS The prevalence of anxiety and depressive symptoms were 56.8% and 62.8%, respectively. Longer quarantine duration, higher education level, skipping breakfast, stomachache or abdominal pain, and nausea or dyspepsia were significantly associated with anxiety symptoms. Moreover, longer quarantine duration, being woman, skipping breakfast, stomachache or abdominal pain, and nausea or dyspepsia were markedly related to depressive symptoms. Notably, regularly physical exercising and taking positive attitude towards COVID-19 were negatively correlated with anxiety and depressive symptoms. CONCLUSIONS More attention should be paid to anxiety and depressive symptoms of quarantined college students and universities should provide timely psychological monitoring and intervention services to mitigate the impact of negative emotions on students. Effectively relieving gastrointestinal symptoms, insisting on eat breakfast, regularly exercising, and taking a positive attitude towards to COVID-19 might contribute to preventing the anxiety and depressive symptoms for those college students experiencing a long-term quarantine.
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Affiliation(s)
- Tingting Qiao
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yanchang Road, Jing'an District, Shanghai, 200072, China
| | - Dingwei Gao
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yanchang Road, Jing'an District, Shanghai, 200072, China
| | - Gaixia Lu
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yanchang Road, Jing'an District, Shanghai, 200072, China
| | - Wanwan Yi
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yanchang Road, Jing'an District, Shanghai, 200072, China.
| | - Zhongwei Lv
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yanchang Road, Jing'an District, Shanghai, 200072, China.
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8
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Tseng Y, Lin L, Mo S, Zhao S, Shen Q, Song H, Cui H, Zhang J, Zheng W, Luo Z, Luo F, Liu J. Unveiling the neuroinflammatory pathogenesis of persistent functional dyspepsia in H. pylori infection: Insights on MMP-9 as a therapeutic target. Clin Transl Med 2023; 13:e1456. [PMID: 37899692 PMCID: PMC10613753 DOI: 10.1002/ctm2.1456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/01/2023] [Accepted: 10/05/2023] [Indexed: 10/31/2023] Open
Affiliation(s)
- Yujen Tseng
- Department of Digestive DiseasesHuashan Hospital Fudan UniversityShanghaiChina
| | - Lingxi Lin
- Department of Digestive DiseasesHuashan Hospital Fudan UniversityShanghaiChina
| | - Shaocong Mo
- Department of Digestive DiseasesHuashan Hospital Fudan UniversityShanghaiChina
| | - Suhan Zhao
- Department of Digestive DiseasesHuashan Hospital Fudan UniversityShanghaiChina
| | - Qiwei Shen
- Department of General SurgeryHuashan Hospital Fudan UniversityShanghaiChina
| | - Huan Song
- Department of Digestive DiseasesHuashan Hospital Fudan UniversityShanghaiChina
| | - Haoshu Cui
- Department of Digestive DiseasesHuashan Hospital Fudan UniversityShanghaiChina
| | - Jun Zhang
- Department of Digestive DiseasesHuashan Hospital Fudan UniversityShanghaiChina
| | - Wanwei Zheng
- Department of Digestive DiseasesHuashan Hospital Fudan UniversityShanghaiChina
| | - Zhongguang Luo
- Department of Digestive DiseasesHuashan Hospital Fudan UniversityShanghaiChina
| | - Feifei Luo
- Department of Digestive DiseasesHuashan Hospital Fudan UniversityShanghaiChina
| | - Jie Liu
- Department of Digestive DiseasesHuashan Hospital Fudan UniversityShanghaiChina
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9
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Ford AC, Howden CW. Relative Cost-effectiveness of Management Strategies for Uninvestigated Dyspepsia. Clin Gastroenterol Hepatol 2023; 21:2986-2987. [PMID: 36806626 DOI: 10.1016/j.cgh.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/23/2023]
Affiliation(s)
- Alexander C Ford
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom; and, Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, United Kingdom
| | - Colin W Howden
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Tennessee College of Medicine, Memphis, Tennessee
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Keszthelyi D, Drenth JPH. Uninvestigated Dyspepsia: To Scope or Not to Scope? Clin Gastroenterol Hepatol 2023; 21:2985. [PMID: 36720297 DOI: 10.1016/j.cgh.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 02/02/2023]
Affiliation(s)
- Daniel Keszthelyi
- Division of Gastroenterology-Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Joost P H Drenth
- Department of Gastroenterology-Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands
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11
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VanWormer JJ, Bendixsen CG, Shukla SK. Dairy Farm Work and Protection from Gastrointestinal Illness. J Agromedicine 2023; 28:640-646. [PMID: 37128886 PMCID: PMC10664175 DOI: 10.1080/1059924x.2023.2209091] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Gastrointestinal (GI) disorders are a major public health burden in the United States. Due to close contact with animals, farmers may be a high risk subgroup for acute GI infections, though some studies suggest farm work is actually protective against GI illness. The purpose of this study was to examine associations between dairy farm work and GI symptoms over 3 years. A prospective, matched cohort study was used that included 70 adult dairy farm workers and 74 matched (age, gender, ZIP code) non-farm participants from central Wisconsin. The outcome was mean GI symptom scores for abdominal pain, diarrhea, constipation, dyspepsia, nausea, and reflux, per the 23-item Gastrointestinal Symptoms Severity Index (GISSI). After adjustment for potential confounding variables, linear regression results indicated dairy farm workers had significantly lower GISSI scores for abdominal pain (mean±SE = 4.3 ± 1.1 dairy vs. 7.6 ± 1.1 non-farm, p = .047), diarrhea (3.2 ± 1.0 dairy vs. 7.0 ± 1.0 non-farm, p = .010), constipation (2.0 ± 0.8 dairy vs. 6.6 ± 0.8 non-farm, p < .001), and dyspepsia (2.0 ± 0.6 dairy vs. 3.9 ± 0.5 non-farm, p = .026). Working on a dairy farm was associated with significantly less frequent and severe GI illness symptoms in adults. Future research should identify underlying causal pathways, including possible farm animal exposures, that influence beneficial gut microbiota that could inform therapeutic remedies to help prevent clinical GI disorders.
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Affiliation(s)
- Jeffrey J. VanWormer
- Center for Clinical Epidemiology & Population Health, Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Casper G. Bendixsen
- National Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Sanjay K. Shukla
- Center for Precision Medicine Research, Marshfield Clinic Research Institute, Marshfield, WI, USA
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12
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Adibi P, Esmaillzadeh A, Daghaghzadeh H, Hassanzadeh Keshteli A, Feizi A, Haghighatdoost F, Jafari M. Low fermentable oligosaccharides, disaccharides, monosaccharides and polyols diet is associated with increased risk of uninvestigated chronic dyspepsia and its symptoms in adults. Minerva Gastroenterol (Torino) 2023; 69:335-343. [PMID: 33971708 DOI: 10.23736/s2724-5985.21.02852-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Assessing the potential effects of a low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) diet on functional gastrointestinal symptoms, particularly upper gastrointestinal symptoms, is not clearly understood. The current study aimed to explore the association of a diet low in FODMAPs with uninvestigated chronic dyspepsia (UCD) and functional dyspeptic symptoms in a large population of Iranian adults. METHODS This cross-sectional study was conducted on 2987 adults. Dietary FODMAPs intake estimated using a validated food-frequency questionnaire. UCD, early satiation, postprandial fullness and gastric pain were determined using a modified and validated version of the Rome III Questionnaire. RESULTS After controlling for various confounders, consumption of a diet low in FODMAPs was associated with increased risk of UCD in the whole population (OR=1.85; 95% CI: 1.23-2.78; P=0.009) and women (OR=2.41; 95% CI: 1.46-3.95; P=0.004), but not in men. Higher consumption of a low-FODMAPs diet was related to increased risk of postprandial fullness (OR=1.38; 95% CI: 1.08-1.78; P=0.046). The inverse association between FODMAPs and epigastric pain tended to be significant after controlling for eating behaviors (OR=1.31; 95% CI: 0.98-1.76; P=0.084). No significant association was observed for early satiation. CONCLUSIONS Our data suggest that consumption of a low-FODMAPs diet may increase the risk of UCD and postprandial fullness; however, well-planned randomized controlled trials and prospective cohorts are required to ascertain the effect of FODMAPs on upper gastrointestinal symptoms.
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Affiliation(s)
- Payman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- School of Nutritional Sciences and Dietetics, Department of Community Nutrition, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Daghaghzadeh
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Awat Feizi
- School of Health, Department of Biostatistics and Epidemiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Jafari
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran -
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13
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Voirol-Perrin J, Stamm GM, Salvador Nunes L, Schoepfer A. [Functional dyspepsia : update 2023]. Rev Med Suisse 2023; 19:1554-1557. [PMID: 37650593 DOI: 10.53738/revmed.2023.19.839.1554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Functional dyspepsia is defined by epigastric pain/burning, postprandial fullness and/or early satiety that have been present for at least six months before diagnosis, including three consecutive months, without evidence of an organic cause likely to explain these symptoms. The pathogenesis is complex and incompletely understood. The initial assessment includes a thorough history, physical examination, blood work, celiac disease serology and ruling out Helicobacter pylori infection. Most patients will undergo upper gastrointestinal endoscopy and abdominal ultrasound to exclude organic differential diagnoses. The therapy is multi-facetted and includes, among others, proton pump inhibitors, Helicobacter pylori eradication, herbal agents, and neuromodulators.
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Affiliation(s)
- Julia Voirol-Perrin
- Service de gastroentérologie et d'hépatologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Gian-Marco Stamm
- Service de gastroentérologie et d'hépatologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Luis Salvador Nunes
- Service de gastroentérologie et d'hépatologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Alain Schoepfer
- Service de gastroentérologie et d'hépatologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
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14
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Oshima T. Functional Dyspepsia: Current Understanding and Future Perspective. Digestion 2023; 105:26-33. [PMID: 37598673 DOI: 10.1159/000532082] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/18/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Functional dyspepsia (FD) is a common disorder characterized by chronic or recurrent upper abdominal pain or discomfort without any structural abnormalities in the gastrointestinal tract. FD is categorized into two subgroups based on symptoms: postprandial distress syndrome (PDS) and epigastric pain syndrome. SUMMARY The pathophysiology of FD involves several mechanisms. Delayed gastric emptying is observed in approximately 30% of FD patients but does not correlate with symptom patterns or severity. Impaired gastric accommodation is important in the pathophysiology, particularly for PDS. Visceral hypersensitivity, characterized by heightened sensitivity to normal activities, contributes to the perception of discomfort or pain in FD. Alterations to the duodenal mucosa, including impaired mucosal barrier function and low-grade inflammation, are also implicated in the pathogenesis of FD. Microbial dysbiosis and psychological factors such as stress can further exacerbate symptoms. Treatment options include dietary modifications, establishing a physician-patient relationship, acid suppressants, prokinetics, neuromodulators, and behavioral therapies. Dietary recommendations include eating smaller, more frequent meals, and avoiding trigger foods. Acid suppressants are used as the first-line treatment. Prokinetics and neuromodulators aim to improve gastric motility and central pain processing, respectively. Behavioral therapies, including cognitive behavioral therapy and hypnotherapy, have shown benefits for refractory FD. Severe and refractory cases may require combination therapies or experimental treatments. KEY MESSAGES FD is a disorder of gut-brain interaction involving diverse pathophysiological mechanisms. Individualized treatment based on symptoms and responses to interventions is crucial. Further research is needed to improve the understanding of FD and advance the development of effective therapies.
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Affiliation(s)
- Tadayuki Oshima
- Department of Gastroenterology, Okazaki City Medical Association Public Health Center, Okazaki, Japan
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15
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Ebell MH. British Society of Gastroenterology Guidelines for the Evaluation and Management of Dyspepsia. Am Fam Physician 2023; 108:Online. [PMID: 37440724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
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16
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Varni JW, Chumpitazi BP, Febo-Rodriguez L, Shulman RJ. Gastrointestinal Symptoms Profile in Gastroparesis Compared to Other Functional and Organic Gastrointestinal Diseases. J Pediatr Gastroenterol Nutr 2023; 77:e1-e7. [PMID: 37098108 DOI: 10.1097/mpg.0000000000003806] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
OBJECTIVES The primary objective was to compare the patient-reported gastrointestinal symptoms profiles of pediatric patients with gastroparesis to pediatric patients with 1 of 7 other functional gastrointestinal disorders and organic gastrointestinal diseases using the Pediatric Quality of Life Inventory (PedsQL) Gastrointestinal Symptoms Scales. METHODS The gastrointestinal symptoms profiles of 64 pediatric patients with gastroparesis who manifested abnormal gastric retention based on gastric emptying scintigraphy testing were compared to 582 pediatric patients with 1 of 7 physician-diagnosed gastrointestinal disorders (functional abdominal pain, irritable bowel syndrome, functional dyspepsia, gastroesophageal reflux disease, functional constipation, Crohn disease, ulcerative colitis). The PedsQL Gastrointestinal Symptoms Scales encompass 10 individual multi-item scales which measure stomach pain, stomach discomfort when eating, food and drink limits, trouble swallowing, heartburn and reflux, nausea and vomiting, gas and bloating, constipation, blood in poop, and diarrhea/fecal incontinence, with an overall total gastrointestinal symptoms score. RESULTS The gastrointestinal symptoms profile analysis identified significantly worse overall total gastrointestinal symptoms scores between pediatric patients with gastroparesis compared to all other gastrointestinal groups except for irritable bowel syndrome (most P s < 0.001), with significant differences for stomach discomfort when eating compared to all 7 other gastrointestinal groups (most P s < 0.001). Nausea and vomiting were significantly worse for gastroparesis compared to all other gastrointestinal groups except for functional dyspepsia (all P s < 0.001). CONCLUSIONS Pediatric patients with gastroparesis self-reported significantly worse overall total gastrointestinal symptoms compared to all other gastrointestinal diagnostic groups except for irritable bowel syndrome, with stomach discomfort when eating and nausea and vomiting symptoms exhibiting the greatest differences compared to most gastrointestinal diagnostic groups.
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Affiliation(s)
- James W Varni
- From the Department of Pediatrics, College of Medicine, Texas A&M University, College Station, TX
- the Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, TX
| | - Bruno P Chumpitazi
- the Department of Pediatrics, Baylor College of Medicine, Houston, TX
- Children's Nutrition Research Center, Agriculture Research Services, United States Department of Agriculture, Houston, TX
| | | | - Robert J Shulman
- the Department of Pediatrics, Baylor College of Medicine, Houston, TX
- Children's Nutrition Research Center, Agriculture Research Services, United States Department of Agriculture, Houston, TX
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17
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高 旭, 刘 娜, 郝 宇, 张 晓, 杨 倩, 蒋 潇, 刘 奕, 蔡 雅, 宋 萍, 纪 泛, 王 进. [Prevalence Survey of Functional Dyspepsia and Irritable Bowel Syndrome in Chinese College Students Based on Rome Ⅳ Diagnostic Criteria]. Sichuan Da Xue Xue Bao Yi Xue Ban 2023; 54:574-578. [PMID: 37248586 PMCID: PMC10475438 DOI: 10.12182/20230560208] [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] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Indexed: 05/31/2023]
Abstract
Objective To investigate the prevalence and risk factors of functional dyspepsia (FD) and irritable bowel syndrome (IBS) among college students in China. Methods An online questionnaire survey of college students aged 17-35 from across China was conducted. The online questionnaire survey was supplemented by an offline survey. A total of 2025 valid samples were included for statistical analysis. χ 2 test and logistic regression were performed for statistical analysis. Results The prevalence of FD among college students who met the Rome Ⅳ diagnostic criteria was 5.5% (112/2025), with most of them, or 66.1% (74/112), suffering from postprandial discomfort syndrome (PDS). Smoking (odds ratio [ OR]=2.334, 95% confidence interval [ CI]: 1.187-4.589, P=0.014), depression ( OR=2.447, 95% CI: 1.421-4.214, P=0.001), and insomnia ( OR=1.947, 95% CI: 1.291-2.937, P=0.001) were positively correlated with the prevalence of FD. The prevalence of IBS was 1.9% (38/2025), with IBS-diarrhea dominant (IBS-D) being the most important subtype that accounted for 44.7%. Anxiety ( OR=3.63, 95% CI: 1.34-9.88, P=0.012) and insomnia ( OR=2.35, 95% CI: 1.18-4.68, P=0.015) were positively correlated with the prevalence of IBS. Conclusion Based on Rome Ⅳ criteria, IBS and FD are not uncommon among Chinese university students. Psychological disorders and some related lifestyle factors may be related to the development of the disease. In the future, more series of studies based on different diagnostic criteria, different regions, and multiple factors should be conducted in China.
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Affiliation(s)
- 旭 高
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 娜 刘
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 宇杰 郝
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 晓辉 张
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 倩 杨
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 潇洒 蒋
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 奕辛 刘
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 雅琴 蔡
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 萍 宋
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 泛扑 纪
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
| | - 进海 王
- 西安交通大学第二附属医院 消化内科 (西安 710004)Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China
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18
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Mbadu Mbuzi E, Weber IP, Humair JP, Gillabert C, Bastid C. [Dyspepsia: a more complex approach]. Rev Med Suisse 2022; 18:1784-1787. [PMID: 36170129 DOI: 10.53738/revmed.2022.18.797.1784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Dyspepsia is defined as epigastric pain that lasts at least one month and may be associated with a range of other upper gastrointestinal symptoms. Approximately 2/3 of outpatients with dyspepsia have a functional dyspepsia. The clinical assessment of dyspepsia is based on age of patients as well and the search for severity criteria. The endoscopy in cases of new-onset dyspepsia is recommended from an age of 55-60 and the presence of at least 1 severity criteria. A non-invasive test for Helicobacter pylori (HP) should be performed in all patients and followed by HP eradication when HP test is positive. The first-choice treatment of functional dyspepsia is a proton pump inhibitor (PPI) at maximal dose for 8 weeks. A therapeutic trial with a prokinetic or a central neuromodulator are alternatives to consider in case of failure of PPI treatment.
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Affiliation(s)
- Eminence Mbadu Mbuzi
- Service de médecine de premier recours, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Irène Paola Weber
- Service de médecine de premier recours, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Jean-Paul Humair
- Service de médecine de premier recours, Hôpitaux universitaires de Genève, 1211 Genève 14
| | | | - Caroline Bastid
- Service de gastroentérologie et hépatologie, Hôpitaux universitaires de Genève, 1211 Genève 14
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Peng T, Huang X, Zhu M, Hou X, Xiong Y, Fang X, Lin Z, Liu L, Lan W, Lin X. Effect of different acupuncture and moxibustion methods on functional dyspepsia caused by sequelae of COVID-19: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e30770. [PMID: 36197210 PMCID: PMC9508946 DOI: 10.1097/md.0000000000030770] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Functional dyspepsia (FD) is a group of diseases that cannot be explained after routine clinical examination, and is characterized by postprandial fullness, early satiety, and upper abdominal pain or burning. According to the statistics, FD continues to become one of the high-risk sequelae of coronavirus disease 2019 (COVID-19), affecting patients' quality of life, increasing psychological burden and increasing economic costs. However, its optimal treatment is still an urgent problem. A large number of studies have shown that acupuncture and moxibustion is effective and safe in the treatment of FD caused by sequelae of COVID-19, which is of research value. Therefore, based on the current literatures, the effectiveness and safety of different acupuncture and moxibustion methods were systematically evaluated to provide possible alternative therapy on FD. METHODS Studies search for eligible randomized controlled trials that use different acupuncture and moxibustion methods as the sole treatment on FD and their data extraction will be done by 2 researchers. In case of disagreement, a third researcher will be introduced for arbitration. Mean difference or relative risk with fixed or random effect model in terms of 95% confidence interval will be adopted for the data synthesis. To evaluate the risk of bias, the Cochrane risk of bias assessment tool will be utilized. The sensitivity or subgroup analysis will also be conducted when meeting high heterogeneity (I2 > 50%). RESULTS This meta-analysis will provide an authentic synthesis of different acupuncture and moxibustion methods on FD caused by sequelae of COVID-19. CONCLUSION This meta-analysis will evaluate the effect of acupuncture and moxibustion on FD caused by sequelae of COVID-19, providing evidence as to the treatment in these patients.
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Affiliation(s)
- Tianzhong Peng
- Nanchang Hongdu Hospital of Traditional Chinese Medicine, Jiangxi, China
| | - Xuedi Huang
- Jiangxi Province Hospital of Integrated Chinese Western Medicine, Jiangxi, China
| | - Manhua Zhu
- Nanchang Hongdu Hospital of Traditional Chinese Medicine, Jiangxi, China
| | - Xinju Hou
- Nanchang Hongdu Hospital of Traditional Chinese Medicine, Jiangxi, China
| | - Yue Xiong
- Jiangxi Province Hospital of Integrated Chinese Western Medicine, Jiangxi, China
| | - Xinyue Fang
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zitong Lin
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lu Liu
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wanning Lan
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xingzhen Lin
- Nanchang Hongdu Hospital of Traditional Chinese Medicine, Jiangxi, China
- *Correspondence: Xingzhen Lin, Nanchang Hongdu Hospital of Traditional China Medicine, No. 1399, Diezihu Avenue, Honggutan District, Nanchang, Jiangxi, China (e-mail: )
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20
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Ji S, You Y, Peng B, Zhong T, Kuang Y, Li S, Du L, Chen L, Sun X, Dai J, Huang S, Wu Y, Liu Y. Multi-omics analysis reveals the metabolic regulators of duodenal low-grade inflammation in a functional dyspepsia model. Front Immunol 2022; 13:944591. [PMID: 36091013 PMCID: PMC9453867 DOI: 10.3389/fimmu.2022.944591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 07/28/2022] [Indexed: 11/27/2022] Open
Abstract
Several gastrointestinal phenotypes and impairment of duodenal mucosal barrier have been reported in clinical studies in patients with functional dyspepsia (FD). Due to the preferential colonization of the mucosa, intestinal microbes and their metabolites are commonly involved in host metabolism and immune responses. However, there are no studies on the intertwined correlation among multi-level data. For more comprehensive illustrating, a multi-omics analysis focusing on the duodenum was performed in the FD rat model. We found that differential microbiomes in the duodenum were significantly correlated with the biosynthesis of lipopolysaccharide and peptidoglycan. The innate immune response-related genes, which were upregulated in the duodenum, were associated with the TLR2/TLR4-NFκB signaling pathway. More importantly, arachidonyl ethanolamide (anandamide, AEA) and endocannabinoid analogues showed linear relationships with the FD phenotypes. Taken together, multi-level data from microbiome, transcriptome and metabolome reveal that AEA may regulate duodenal low-grade inflammation in FD. These results suggest an important cue of gut microbiome–endocannabinoid system axis in the pathogenesis of FD.
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Affiliation(s)
- Shuai Ji
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Yanting You
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Baizhao Peng
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Tianyu Zhong
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Yuxiang Kuang
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shasha Li
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lijing Du
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Liqian Chen
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Xiaomin Sun
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Jiaojiao Dai
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Suiping Huang
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- *Correspondence: Yanyan Liu, ; Yuyao Wu, ; Suiping Huang,
| | - Yuyao Wu
- Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
- *Correspondence: Yanyan Liu, ; Yuyao Wu, ; Suiping Huang,
| | - Yanyan Liu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
- *Correspondence: Yanyan Liu, ; Yuyao Wu, ; Suiping Huang,
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21
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Gong ST. [Improve the understanding of functional dyspepsia syndrome in infant and toddler]. Zhonghua Er Ke Za Zhi 2022; 60:615-617. [PMID: 35768345 DOI: 10.3760/cma.j.cn112140-20220509-00429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- S T Gong
- Department of Gastroenterology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, National Children's Medical Center for South Central Region, Guangzhou 510623, China
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22
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Ali SM, Farrukh SZUI, Haqqi SAUH, Siddiqui AR, Sadiq M, Niaz SK. Frequency And Factors Leading To Helicobacter Pylori Infection Among Dyspeptic Patients. J Ayub Med Coll Abbottabad 2022; 34:507-510. [PMID: 36377165 DOI: 10.55519/jamc-03-10745] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Helicobacter pylori is infecting 50 percent or more of the world's population, putting it the most ubiquitous infection on the world. This study is done with the objective to determine the frequency and risk factors of Helicobacter pylori infection among dyspepsia patients at Patel Hospital Karachi. METHODS This cross-sectional study was conducted at the gastroenterology department at the Patel Hospital in Karachi from 10th Jan to 10th July 2021. All patients with dyspepsia for at least 6 months having age 20-60 years of either gender were included. Three samples from stomach (2 from antrum,1 from corpus) for biopsies were collected from each patient. The specimen was sent to the microbiology department of the hospital and was reported as having histopathological confirmation of Helicobacter pylori infection. RESULTS Of 111 patients with dyspepsia, mean age of the patients was 44.19±16.41 years. Most of the patients (n=65, 58.6%) were males and 46 (41.4%) were females. The mean duration of dyspepsia was 11.48±5.53 months. Helicobacter pylori was discovered to be present in 93 percent of individuals (83.8 percent). The odds of Helicobacter pylori infection were found to be 7.99 times higher among patients over 40 years old (AOR: 7.99, 95 percent CI: 2.02-31.64, p: 0.003), 3.93 times higher among patients with >9 months of dyspepsia (AOR: 3.93, 95 percent CI: 1.09-14.16, p: 0.036), and 11.85 times higher among smokers as compared to non-smokers (AOR: 11.85, 95 percent CI: 1.42-99.08, p-value 0.023). CONCLUSIONS The rate of Helicobacter pylori infection in patients with dyspepsia was found to be higher. Furthermore, increasing age, increase duration of dyspepsia and smoking is found to be independent risk factors.
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Affiliation(s)
| | | | | | | | - Muneer Sadiq
- Altibri Medical College and Hospital Karachi, Pakistan
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Wang N, Liu X, Ye W, Shi Z, Bai T. Impact of shift work on irritable bowel syndrome and functional dyspepsia: A meta-analysis. Medicine (Baltimore) 2022; 101:e29211. [PMID: 35758349 PMCID: PMC9276432 DOI: 10.1097/md.0000000000029211] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 03/17/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The possible association between shift work with irritable bowel syndrome (IBS) and functional dyspepsia (FD) remains controversial. The purpose of the study is to conduct a meta-analysis to explore the potential association between shift work with IBS/FD. METHODS We searched relevant observational studies on Medline (PubMed) and Embase until June 30, 2021. Two different investigators extracted data and assessed the quality of each study independently. The meta-analysis was used to evaluate the pooled odds risk (OR) between shift work and IBS/FD. RESULTS Eight studies were included ultimately. Shift workers were more likely to suffer from IBS. The OR of shift work was 1.81 (95% confidence interval 1.42; 2.32) with low heterogeneity (P < .05, I2 = 0%) for IBS. However, no evidence of the association was observed between shift work and the risk of FD. The OR of shift work was 0.87 (95% confidence interval 0.62; 1.23) (P > .05) for FD. CONCLUSIONS There was a positive association between shift work and IBS. The prevalence of IBS was 81% higher among shift workers than among non-shift workers. Shift work was probably a risk factor for IBS. The low heterogeneity supports the reliability of the results. However, there was no significant association between shift work and FD. The strength of the evidence was limited and further prospective cohort studies were needed.
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Affiliation(s)
- Nian Wang
- Division of Gastroenterology, Wuhan No. 1 Hospital, 215 Zhongshan Road, Wuhan, China
| | - Xinghuang Liu
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, China
| | - Weixiang Ye
- Division of Gastroenterology, Wuhan No. 1 Hospital, 215 Zhongshan Road, Wuhan, China
| | - Zhaohong Shi
- Division of Gastroenterology, Wuhan No. 1 Hospital, 215 Zhongshan Road, Wuhan, China
| | - Tao Bai
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, China
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Agah S, Aminianfar A, Hassanzadeh Keshteli A, Bitarafan V, Adibi P, Esmaillzadeh A, Feinle-Bisset C. Association between Dietary Macronutrient Intake and Symptoms in Uninvestigated Dyspepsia: Evidence from a Population-Based, Cross-Sectional Study. Nutrients 2022; 14:nu14132577. [PMID: 35807757 PMCID: PMC9268281 DOI: 10.3390/nu14132577] [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] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/18/2022] [Accepted: 06/20/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Background: Limited evidence from laboratory-based studies suggests that specific dietary macronutrients, particularly fat, can induce dyspeptic symptoms. Through a population-based study, we investigated the relationship between dietary macronutrients and dyspeptic symptoms and sought to determine macronutrient intake thresholds to predict or prevent dyspepsia and reduce symptoms in patients with dyspepsia. (2) Methods: A total of 4763 Iranian people were enrolled in this population-based, cross-sectional study. Uninvestigated dyspepsia (UD) and its symptoms, including postprandial fullness, early satiation, and epigastric pain, were evaluated using a modified Persian version of the Rome III criteria. The dietary intakes of participants were evaluated using a validated food−frequency questionnaire. Receiver operating characteristic (ROC) curve analysis was used to calculate threshold intakes of dietary macronutrients to prevent UD in the general population. The analysis was then repeated in those with UD to calculate intake thresholds for reducing UD symptoms. (3) Results: Early satiation occurred in 6.3% (n = 302), postprandial fullness in 8.0% (n = 384) and epigastric pain in 7.8% (n = 371) of participants. The prevalence of UD was 15.2%. Compared with individuals without UD, those with UD had a lower intake of carbohydrates (48.2% vs. 49.1%) and a higher intake of fats (38.3% vs. 37.4%), while protein and energy intakes did not differ. Higher dietary fat and protein intakes were associated with a higher prevalence of postprandial fullness and epigastric pain, respectively. Macronutrient intakes to predict UD in the general population were <49% of energy from carbohydrates, >14.7% from protein, and >37.7% from fats. Carbohydrate, protein, and fat intakes to prevent symptoms among those with UD were calculated to be >48.2%, <14.6%, and <38.6%, respectively. (4) Conclusion: Higher carbohydrate intake and lower fat or protein intakes were associated with a lower likelihood of UD. Prospective studies carefully manipulating dietary macronutrient composition are warranted to investigate the value of dietary changes to improve symptoms in people with UD.
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Affiliation(s)
- Shahram Agah
- Colorectal Research Centre, Iran University of Medical Sciences, Tehran 1445613131, Iran;
- Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia;
| | - Azadeh Aminianfar
- Research Centre for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan 8715988141, Iran;
| | - Ammar Hassanzadeh Keshteli
- Department of Medicine, University of Alberta, Edmonton, AB T6G 2P5, Canada;
- Integrative Functional Gastroenterology Research Centre, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Vida Bitarafan
- Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia;
- Centre of Research Excellence in Translating Nutritional Sciences to Good Health, University of Adelaide, Adelaide, SA 5005, Australia
| | - Peyman Adibi
- Gastroenterology and Hepatology Research Centre, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran;
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 1416634793, Iran
- Obesity and Eating Habits Research Centre, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran 1416634793, Iran
- Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
- Correspondence: (A.E.); (C.F.-B.)
| | - Christine Feinle-Bisset
- Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia;
- Centre of Research Excellence in Translating Nutritional Sciences to Good Health, University of Adelaide, Adelaide, SA 5005, Australia
- Correspondence: (A.E.); (C.F.-B.)
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Karpe AV, Liu JW, Shah A, Koloski N, Holtmann G, Beale DJ. Utilising lipid and, arginine and proline metabolism in blood plasma to differentiate the biochemical expression in functional dyspepsia (FD) and irritable bowel syndrome (IBS). Metabolomics 2022; 18:38. [PMID: 35687195 DOI: 10.1007/s11306-022-01900-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 10/18/2021] [Accepted: 05/25/2022] [Indexed: 02/07/2023]
Abstract
Functional gastrointestinal disorders (FGID) such as functional dyspepsia (FD) and irritable bowel syndrome (IBS) are highly prevalent and debilitating attributed to altered gut function and gut-brain interactions. FGID can be reliably diagnosed based upon the symptom pattern; but in the clinical setting FD or IBS a frequent diagnoses of exclusion after relevant structural causes of symptoms have been ruled out by appropriate testing. Thus far, there is no established biomarker for FGIDs. To address this limitation, we utilised multi-omics and chemometrics integration to characterise the blood plasma biochemistry in patients with IBS, FD, an overlap of FD/IBS, and controls using liquid chromatography-mass spectrometry (LC-MS) techniques.Cholesterol metabolism products Cholest-5,24-dien-3β-ol, 3-O-β-D-glucopyranoside, energy pathway metabolites, immunoglobulin-γ2 and immunoglobulin-κ, and carbonic anhydrase-1 proteins were particularly elevated in IBS. Furthermore, arginine and proline metabolisms, thyroid hormone synthesis, ferroptosis and, complementary and coagulation cascades were particularly upregulated in patients with IBS. Cer(d18:1/26:1(17Z)) and PI(14:0/22:1(11Z)) lipids were elevated in FD and FD-IBS but were depleted in IBS. Markers of central carbon metabolism and lipidome profiles allowed better discrimination and model predictability than metaproteome profile in healthy and FGID conditions.Overall, the multi-omics integration allowed the discrimination of healthy controls and FGID patients. It also effectively differentiated the biochemistry of FGID subtypes including FD, IBS and FD-IBS co-occurrence. This study points towards the possibility of multi-omics integration for rapid and high throughput analysis of plasma samples to support clinicians screen and diagnose patients with suspected FGIDs.
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Affiliation(s)
- Avinash V Karpe
- CSIRO Land and Water, P. O. Box 2583, 4001, Dutton Park, QLD, Australia
- Department of Chemistry & Biotechnology, School of Science, Computing & Engineering Technologies (SoSCET), Swinburne University of Technology, 3122, Hawthorn, VIC, Australia
| | - Jian-Wei Liu
- CSIRO Land and Water, Black Mountain, Clunies Ross Street, 2601, Acton, ACT, Australia
| | - Ayesha Shah
- Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, 4103, Woolloongabba, QLD, Australia
| | - Natasha Koloski
- Faculty of Health and Medicine, University of Newcastle, 2308, Callaghan, NSW, Australia
- School of Medicine, The University of Queensland, 4072, St. Lucia, QLD, Australia
| | - Gerald Holtmann
- Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, 4103, Woolloongabba, QLD, Australia
- School of Medicine, The University of Queensland, 4072, St. Lucia, QLD, Australia
| | - David J Beale
- CSIRO Land and Water, P. O. Box 2583, 4001, Dutton Park, QLD, Australia.
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Furukawa S, Yamamoto Y, Watanabe J, Kato A, Kusumoto K, Takeshita E, Ikeda Y, Yamamoto N, Okada K, Kohara K, Saheki S, Saeki Y, Hiasa Y. Frequency, Intensity, and Partner of Exercise Habit Is Inversely Associated with Functional Dyspepsia in Young Japanese Population. Dig Dis Sci 2022; 67:2293-2298. [PMID: 33945062 DOI: 10.1007/s10620-021-07017-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 03/05/2021] [Accepted: 04/17/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Functional dyspepsia (FD) has a high prevalence worldwide and reduces patients' quality of life. The etiology of FD is likely multifactorial. Although two studies showed an inverse association between exercise habits and FD, evidence regarding the association between exercise habits and FD remains scarce. AIMS This study aimed to investigate the association between exercise habits and FD among the young Japanese population, taking the presence or absence of an exercise partner as an additional variable. METHODS The study subjects consisted of 8923 Japanese university students. The definition of FD was based on the Rome III criteria. Information on exercise frequency, exercise intensity, and exercise partners was obtained from a self-administered questionnaire. RESULTS The prevalence of FD was 1.9% in this cohort. Low, moderate, and high frequency of exercise was independently inversely associated with FD (adjusted odds ratio [OR] was low: OR 0.69 [95% confidence interval (CI) 0.47-0.997], moderate: OR 0.53 [95% CI 0.34-0.81] and high: OR 0.53 [95% CI 0.30-0.88], p for trend p = 0.002). Moderate and high intensity of exercise was independently inversely associated with FD (moderate: OR 0.56 [95% CI 0.36-0.84] and high: OR 0.49 [95% CI 0.30-0.76], p for trend p = 0.001). Exercise with groups and with friends was independently inversely associated with FD whereas the association between exercising alone and FD was not significant (groups: OR 0.28 [95% CI 0.14-0.50] and friends: OR 0.44 [95% CI 0.24-0.74]). CONCLUSION Among the young Japanese population, frequency and intensity of exercise may be independently inversely associated with FD. Additionally, exercise with groups and with friends but not by oneself was inversely associated with exercise and FD, respectively.
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Affiliation(s)
- Shinya Furukawa
- Health Services Center, Ehime University, Matsuyama, Ehime, 790-8577, Japan.
| | | | - Junichi Watanabe
- Department of Rehabilitation, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan
| | - Aki Kato
- Health Services Center, Ehime University, Matsuyama, Ehime, 790-8577, Japan
| | - Katsunori Kusumoto
- Health Services Center, Ehime University, Matsuyama, Ehime, 790-8577, Japan
| | - Eiji Takeshita
- Department of Inflammatory Bowel Diseases and Therapeutics, Ehime University Graduate School of Medicine, Matsuyama, Ehime, Japan
| | - Yoshio Ikeda
- Endoscopy Center, Ehime University Hospital, Toon, Ehime, Japan
| | - Naofumi Yamamoto
- Faculty of Collaborative Regional Innovation, Ehime University, Matsuyama, Ehime, Japan
| | | | - Katsuhiko Kohara
- Department of Internal Medicine, Anbiru Hospital, Kagoshima, Japan
| | - Syuichi Saheki
- Health Services Center, Ehime University, Matsuyama, Ehime, 790-8577, Japan
| | - Yuka Saeki
- Health Services Center, Ehime University, Matsuyama, Ehime, 790-8577, Japan
- Community Health Systems for Nursing, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Yoichi Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
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Rothschild M, Airy M. An overlooked cause of dyspepsia? J Fam Pract 2022; 71:7. [PMID: 35259324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Kaosombatwattana U, Charatcharoenwitthaya P, Pausawasdi N, Maneerattanaporn M, Limsrivilai J, Leelakusolvong S, Kachintorn U. Value of age and alarm features for predicting upper gastrointestinal malignancy in patients with dyspepsia: an endoscopic database review of 4664 patients in Thailand. BMJ Open 2021; 11:e052522. [PMID: 34706958 PMCID: PMC8552171 DOI: 10.1136/bmjopen-2021-052522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Age and alarm features are commonly used as indicators for endoscopy in dyspeptic patients; however, the age cut-off and the predictive value of these parameters for identifying upper gastrointestinal (UGI) malignancies are uncertain. DESIGN Cross-sectional study. SETTING Data were extracted from the Gastrointestinal Endoscopy Centre of Siriraj Hospital, Thailand, during 2005-2011. PARTICIPANTS Consecutive patients underwent a first-time upper endoscopy for dyspepsia. Patients with previous surgery, suspected UGI malignancy by imaging, or indefinite biopsy results on prior examination were excluded. MAIN OUTCOME MEASURES Alarm features included dysphagia, unintentional weight loss, GI bleeding/anaemia, and persistent vomiting. The diagnostic performance of each alarm feature and different age cut-off values were evaluated. RESULTS A total of 4664 patients (mean age: 52.0±14.4 years, 66% female) were included. Alarm symptoms were presented in 21.6%. The prevalence of active Helicobacter pylori infection was 26.3%. Fifty-eight (1.2%) patients had UGI malignancy. The prevalence of malignancy significantly increased with increasing age (0.6% in patients aged <50 years, and 1.8% in patients aged >60 years (p<0.001)). Cancer was found in two patients aged <50 years who did not have alarm features. Patients with alarm features had a higher prevalence of malignancy (OR 22.3, 95% CI 10.5 to 47.4; p<0.001) than those without. The pooled sensitivity, specificity, positive predictive value and negative predictive value of alarm features for UGI malignancy were 87.0%, 79.1%, 4.7% and 99.8%, respectively. Among all age groups, persistent vomiting had a positive likelihood ratio (PLR) >10, while dysphagia and GI bleeding/anaemia had a PLR >10 in patients <50 years old. CONCLUSION Despite the overall limited value of age and alarm features, persistent vomiting, dysphagia, and GI bleeding/anaemia are strong predictors for malignancy in patients aged <50 years. Without these symptoms, cancer prevalence is negligible; thus, they are worthy guidance for endoscopic evaluation in this age group.
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Affiliation(s)
- Uayporn Kaosombatwattana
- Gastroenterology Division, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj GI Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Phunchai Charatcharoenwitthaya
- Gastroenterology Division, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj GI Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nonthalee Pausawasdi
- Gastroenterology Division, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj GI Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Monthira Maneerattanaporn
- Gastroenterology Division, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj GI Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Julajak Limsrivilai
- Gastroenterology Division, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj GI Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Somchai Leelakusolvong
- Gastroenterology Division, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj GI Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Udom Kachintorn
- Gastroenterology Division, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj GI Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Talley NJ, Powell N, Walker MM, Jones MP, Ronkainen J, Forsberg A, Kjellström L, Hellström PM, Aro P, Wallner B, Agréus L, Andreasson A. Role of smoking in functional dyspepsia and irritable bowel syndrome: three random population-based studies. Aliment Pharmacol Ther 2021; 54:32-42. [PMID: 33983640 DOI: 10.1111/apt.16372] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/12/2021] [Accepted: 03/31/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND It is uncertain if functional dyspepsia (FD) or irritable bowel syndrome (IBS) are linked to smoking, and smoking cessation is not part of the routine advice provided to these patients. AIM To assess if smoking is an independent risk factor for FD and IBS. METHODS Three population-based endoscopy studies in Sweden with 2560 community individuals in total (mean age 51.5 years, 46% male). IBS (14.9%), FD (33.5%), and associated symptoms were assessed using the validated abdominal symptom questionnaire, and smoking (17.9%) was obtained from standardised questions during a clinic visit. The effect of smoking on symptom status was analysed in an individual person data meta-analysis using mixed effect logistic regression, adjusted for snuffing, age and sex. RESULTS Individuals smoking cigarettes reported significantly higher odds of postprandial distress syndrome (FD-PDS) (OR 10-19 cig/day = 1.42, 95% CI 1.04-1.98 P = 0.027, OR ≥20 cig/day = 2.16, 95% CI 1.38-3.38, P = 0.001) but not epigastric pain. Individuals smoking 20 or more cigarettes per day reported significantly higher odds of IBS-diarrhoea (OR = 2.40, 95% CI 1.12-5.16, P = 0.025), diarrhoea (OR = 2.01, 95%CI 1.28-3.16, P = 0.003), urgency (OR = 2.21, 95%CI 1.41-3.47, P = 0.001) and flatus (OR = 1.77, 95%CI 1.14-2.76, P = 0.012) than non-smokers. Smoking was not associated with IBS-constipation or IBS-mixed. CONCLUSION Smoking is an important environmental risk factor for postprandial distress syndrome, the most common FD subgroup, with over a twofold increased odds of PDS in heavy smokers. The role of smoking in IBS-diarrhoea, but not constipation, is also likely important.
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Affiliation(s)
- Nicholas J Talley
- Faculty of Health and Medicine, University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, Australia, 2305, Australia
- NHMRC Centre for Research Excellence in Digestive Health, Australia
| | | | - Marjorie M Walker
- Faculty of Health and Medicine, University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, Australia, 2305, Australia
- NHMRC Centre for Research Excellence in Digestive Health, Australia
| | - Mike P Jones
- NHMRC Centre for Research Excellence in Digestive Health, Australia
- Department of Psychology, Macquarie University, North Ryde, NSW, Australia
| | - Jukka Ronkainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Primary Health Care Centre, Tornio, Finland
| | - Anna Forsberg
- Department of Medicine Solna, Karolinska Institutet, Solna, Sweden
| | | | - Per M Hellström
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Bengt Wallner
- Department of Surgical and Perioperatve Sciences, Umeå University, Umeå, Sweden
| | - Lars Agréus
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Anna Andreasson
- Department of Psychology, Macquarie University, North Ryde, NSW, Australia
- Department of Medicine Solna, Karolinska Institutet, Solna, Sweden
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
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Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8602, Japan.
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Oshima T, Siah KTH, Yoshimoto T, Miura K, Tomita T, Fukui H, Miwa H. Impacts of the COVID-19 pandemic on functional dyspepsia and irritable bowel syndrome: A population-based survey. J Gastroenterol Hepatol 2021; 36:1820-1827. [PMID: 33197076 PMCID: PMC7753727 DOI: 10.1111/jgh.15346;] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/22/2020] [Accepted: 11/07/2020] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND AIM Functional gastrointestinal disorders are a group of stress-sensitive gut-brain disorders. The COVID-19 outbreak has caused immense stress and anxiety among the general public. Strict measures to counter COVID-19 emergency, including physical distancing, have also taken a toll on physical and mental health. We investigated the impact of the COVID-19 pandemic on the gastrointestinal and psychological symptoms of functional dyspepsia (FD) and irritable bowel syndrome (IBS). METHODS An online survey was conducted in Japan for a group of randomly assigned panelists from May 26 to 27, 2020. Each respondent answered a questionnaire on stress, physical distancing, and worries about COVID-19. Gastrointestinal symptoms were assessed to diagnose FD and IBS (Rome III), and psychological symptoms were assessed using the Hospital Anxiety and Depression Scale. RESULTS A total of 5157 subjects were finally enrolled, with FD in 8.5%, IBS in 16.6%, and FD-IBS overlap in 4.0%. For both gastrointestinal and psychological symptoms, respondents with FD-IBS overlap showed the worst scores, followed by IBS-alone, then FD-alone respondents. During the COVID-19 pandemic, 11.9% of respondents reported deterioration and 2.8% reported improvement of gastrointestinal symptoms. FD-IBS overlap, psychological disease comorbidity, and stress at work/school were significantly associated with symptom deterioration. Younger age, commuting by public transport, and work/study from home were associated with symptom improvement. CONCLUSIONS The COVID-19 pandemic negatively affected FD/IBS subjects, with respondents showing FD-IBS overlap syndrome as the most important independent factor associated with deterioration in gastrointestinal symptoms. Physicians need to take extra care of FD/IBS patients in the post-COVID period.
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Affiliation(s)
- Tadayuki Oshima
- Division of Gastroenterology and Hepatology, Department of Internal MedicineHyogo College of MedicineNishinomiyaJapan
| | - Kewin Tien Ho Siah
- Department of Medicine, Yong Loo Lin School of MedicineNational University of SingaporeSingapore
- Division of Gastroenterology and Hepatology, Department of MedicineNational University HospitalSingapore
| | - Takanori Yoshimoto
- Division of Gastroenterology and Hepatology, Department of Internal MedicineHyogo College of MedicineNishinomiyaJapan
| | - Ko Miura
- Division of Gastroenterology and Hepatology, Department of Internal MedicineHyogo College of MedicineNishinomiyaJapan
| | - Toshihiko Tomita
- Division of Gastroenterology and Hepatology, Department of Internal MedicineHyogo College of MedicineNishinomiyaJapan
| | - Hirokazu Fukui
- Division of Gastroenterology and Hepatology, Department of Internal MedicineHyogo College of MedicineNishinomiyaJapan
| | - Hiroto Miwa
- Division of Gastroenterology and Hepatology, Department of Internal MedicineHyogo College of MedicineNishinomiyaJapan
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Nam K, Kim N, Song HJ, Baik GH, Choi SC, Kim HJ, Lee JY, Park KS, Park SY, Park SJ. Gender difference in the overlap of irritable bowel syndrome and functional dyspepsia: a prospective nationwide multicenter study in Korea. J Gastroenterol 2021; 56:537-546. [PMID: 33687537 DOI: 10.1007/s00535-021-01775-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/22/2020] [Accepted: 02/27/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The overlap between functional dyspepsia (FD) and irritable bowel syndrome (IBS) is associated with more severe gastrointestinal (GI) symptoms and lower quality of life. However, the gender differences in FD-IBS overlap remain unclear. This study aimed to investigate the gender differences in patients with FD-IBS overlap. METHODS Controls and cases were prospectively enrolled from July 2019 to June 2020 at nine tertiary referral centers. The patients underwent esophagogastroduodenoscopy, and their symptoms were evaluated using a questionnaire including GI symptom-related items and the Hospital Anxiety Depression Scale (HADS). FD and IBS were diagnosed according to the Rome IV criteria, and the clinical characteristics of the FD-IBS overlap group were compared with those of the FD-only or IBS-only group. RESULTS Among 667 subjects (334 healthy controls, 168 with FD-only, 37 with IBS-only, 128 with FD-IBS overlap), the FD-IBS overlap group (19.2%) showed a higher rate of preference for dairy products, a higher rate of history of Helicobacter pylori eradication, and higher HADS scores than the non-overlap group (P < 0.05). In the FD-IBS overlap group, men complained of reflux symptom and loose/watery stools more than women (P < 0.05), whereas women showed more severe GI symptoms, especially epigastric pain/burning symptoms, and higher depression scores than men (all P < 0.05). CONCLUSIONS FD-IBS overlap patients are associated with severe upper GI symptoms and depression compared to non-overlap patients. Moreover, women with FD-IBS overlap experience more severe GI and depression symptoms than men.
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Affiliation(s)
- Kwangwoo Nam
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, 13620, Korea.
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
| | - Hyun Joo Song
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Gwang Ho Baik
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Suck Chei Choi
- Department of Internal Medicine, Digestive Disease Research Institute, Wonkwang University College of Medicine, Iksan, Korea
| | - Hyun Jin Kim
- Department of Internal Medicine and Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Ju Yup Lee
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Kyung Sik Park
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Sun-Young Park
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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Affiliation(s)
- Raj K Goyal
- From the Division of Gastroenterology, Department of Medicine, Veterans Affairs Boston Healthcare System, West Roxbury, and the Division of Gastroenterology, Hepatology, and Endoscopy, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston - both in Massachusetts
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Duncanson K, Burns G, Pryor J, Keely S, Talley NJ. Mechanisms of Food-Induced Symptom Induction and Dietary Management in Functional Dyspepsia. Nutrients 2021; 13:1109. [PMID: 33800668 PMCID: PMC8066021 DOI: 10.3390/nu13041109] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/23/2021] [Accepted: 03/25/2021] [Indexed: 12/12/2022] Open
Abstract
Functional dyspepsia (FD) is a common disorder of gut-brain interaction, characterised by upper gastrointestinal symptom profiles that differentiate FD from the irritable bowel syndrome (IBS), although the two conditions often co-exist. Despite food and eating being implicated in FD symptom induction, evidence-based guidance for dietetic management of FD is limited. The aim of this narrative review is to collate the possible mechanisms for eating-induced and food-related symptoms of FD for stratification of dietetic management. Specific carbohydrates, proteins and fats, or foods high in these macronutrients have all been reported as influencing FD symptom induction, with removal of 'trigger' foods or nutrients shown to alleviate symptoms. Food additives and natural food chemicals have also been implicated, but there is a lack of convincing evidence. Emerging evidence suggests the gastrointestinal microbiota is the primary interface between food and symptom induction in FD, and is therefore a research direction that warrants substantial attention. Objective markers of FD, along with more sensitive and specific dietary assessment tools will contribute to progressing towards evidence-based dietetic management of FD.
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Affiliation(s)
- Kerith Duncanson
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (G.B.); (J.P.); (S.K.)
- Centre for Research Excellence, Digestive Health, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Grace Burns
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (G.B.); (J.P.); (S.K.)
- Centre for Research Excellence, Digestive Health, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Jennifer Pryor
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (G.B.); (J.P.); (S.K.)
- Centre for Research Excellence, Digestive Health, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Simon Keely
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (G.B.); (J.P.); (S.K.)
- Centre for Research Excellence, Digestive Health, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Nicholas J. Talley
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (G.B.); (J.P.); (S.K.)
- Centre for Research Excellence, Digestive Health, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Department of Gastroenterology, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
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Medić B, Babić Ž, Banić M, Ljubičić L. Modern Approach to Dyspepsia. Acta Clin Croat 2021; 60:731-738. [PMID: 35734496 PMCID: PMC9196234 DOI: 10.20471/acc.2021.60.04.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/18/2020] [Indexed: 11/26/2022] Open
Abstract
Dyspepsia is a disorder characterized by dyspeptic symptoms which are located in the epigastrium and related to digestion of food in the initial part of the digestive system. In functional dyspepsia, unlike organic dyspepsia, there is no underlying organic disease that would cause dyspeptic symptoms. Immune and mucosal function changes, gastric dysmotility, different composition of the gastrointestinal microbiota, and altered central nervous system processing are considered responsible for the onset of the disorder. The diagnosis is based on history, clinical presentation, and exclusion of other organic diseases of the gastrointestinal tract manifested by dyspeptic symptoms. Therapy includes eradication of Helicobacter pylori infection, proton pump inhibitors, prokinetics, neuromodulators, and herbal preparations. Unfortunately, in some patients, this therapy leads to little or no improvement. The prevalence of functional dyspepsia is increasing. It has become one of the more common gastroenterological diagnoses. In order to reduce the costs associated with the diagnosis and treatment of the disorder itself, its mechanisms need to be fully elucidated and thus enable finding appropriate therapy for all patient subgroups.
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Abstract
Dyspepsia affects a large percentage of the general population and can lead to lost work productivity and reduced quality of life. Patients with dyspepsia younger than 60 should not routinely undergo endoscopy but instead should pursue Helicobacter pylori test-and-treat approach. For patients 60 and older, endoscopy should be performed. Patients without any identifiable cause for their symptoms are diagnosed with functional dyspepsia. Guideline-based treatment includes H pylori eradication and proton pump inhibitor use. If acid suppression is not adequate, treatment with a tricyclic antidepressant followed by a prokinetic agent and psychological therapy are considered. Complementary therapies are not recommended due to limited evidence.
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Affiliation(s)
- Alia Chisty
- Division of General Internal Medicine, Penn State College of Medicine, Penn State Health Milton S. Hershey Medical Center, 500 University Drive, PO Box 850, Hershey, PA 17033, USA.
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Kim YM, Jang SI, Cho JH, Koh DH, Kwon CI, Lee TH, Jeong S, Lee DK. Litholytic agents as an alternative treatment modality in patients with biliary dyspepsia. Medicine (Baltimore) 2020; 99:e21698. [PMID: 32846787 PMCID: PMC7447440 DOI: 10.1097/md.0000000000021698] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 01/19/2023] Open
Abstract
Biliary dyspepsia presents as biliary colic in the absence of explanatory structural abnormalities. Causes include gallbladder dyskinesia, sphincter of Oddi dysfunction, biliary tract sensitivity, microscopic sludges, and duodenal hypersensitivity. However, no consensus treatment guideline exists for biliary dyspepsia. We investigated the effects of medical treatments on biliary dyspepsia.We retrospectively reviewed the electronic medical records of 414 patients who had biliary pain and underwent cholescintigraphy from 2008 to 2018. We enrolled patients who received litholytic agents and underwent follow-up scans after medical treatment. We divided the patients into the GD group (biliary dyspepsia with reduced gallbladder ejection fraction [GBEF]) and the NGD group (biliary dyspepsia with normal GBEF). We compared pre- and post-treatment GBEF and symptoms.Among 57 patients enrolled, 40 (70.2%) patients had significant GBEF improvement post-treatment, ranging from 34.4 ± 22.6% to 53.8 ± 26.8% (P < .001). In GD group (n = 35), 28 patients had GBEF improvement after medical treatment, and value of GBEF significantly improved from 19.5 ± 11.0 to 47.9 ± 27.3% (P < .001). In NGD group (n = 22), 12 patients had GBEF improvement after medical treatment, but value of GBEF did not have significant change. Most patients (97.1% in GD group and 81.8% in NGD group) had improved symptoms after medical treatment. No severe complication was reported during treatment period.Litholytic agents improved biliary colic in patients with biliary dyspepsia. Therefore, these agents present an alternative treatment modality for biliary dyspepsia with or without gallbladder dyskinesia. Notably, biliary colic in patients with gallbladder dyskinesia resolved after normalization of the GBEF. Further prospective and large-scale mechanistic studies are warranted.
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Affiliation(s)
- Young Min Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul
| | - Sung Ill Jang
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul
| | - Jae Hee Cho
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul
- Department of Internal Medicine, Gachon University College of Medicine, Gil Medical Center, Incheon
| | - Dong Hee Koh
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine
| | - Chang-Il Kwon
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam
| | - Tae Hoon Lee
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan
| | - Seok Jeong
- Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea
| | - Dong Ki Lee
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul
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Crafa P, Franceschi M, Rodriguez Castro KI, Barchi A, Russo M, Franzoni L, Antico A, Baldassarre G, Panozzo MP, Di Mario F. Functional Dyspesia. Acta Biomed 2020; 91:e2020069. [PMID: 32921764 PMCID: PMC7716988 DOI: 10.23750/abm.v91i3.10150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 07/06/2020] [Indexed: 12/26/2022]
Abstract
Dyspepsia is a functional GI disorder consisting in a wide range of symptoms. The main diagnostic challenge has been whether to perform an EGD or an abdominal US in order not to miss organic lesions, but to avoid unnecessary and sometimes invasive tests. Pepsinogen serology has been proposed as an useful non-invasive test to explore the status of the gastric mucosa, suggesting this strategy as an adequate approach in management of dyspepsia. In a primary care setting, 266 dyspeptic patients were investigated to establish the proper diagnosis. The workup included upper GI endoscopy with biopsies, a structured questionnaire including type and severity of symptoms, serological determination of serum pepsinogens, gastrin 17 and IgG against Hp. Inclusion criteria were dyspeptic symptoms (epigastric pain, nausea and/or vomiting, post prandial fullness, early satiation) lasting more than 1 year and the association between symptoms and food ingestion.. Helicobacter pylori infection was present in 114 subjects, characterized by high levels of pepsinogen II and IgG against Hp. Twenty subjects were classified according with the diagnosis of chronic body atrophic gastritis. Nausea and post prandial fullness were the most frequent symptoms (48% and 41%, respectively) in the studied population, followed by epigastric pain and early satiation (37% and 26% respectively). A diagnosis of normality by serological diagnosis was found in half of patients experiencing epigastric pain and in about 60% of subjects with the three other symptoms (nausea, post prandial fullness, and early satiation). In conclusion, this experience confirms the clinical usefulness of serology in dyspepsia, contributing to correctly diagnosing CAG and H.p. infection in such patients and providing a good correlation with the clinical picture.
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Affiliation(s)
- Pellegrino Crafa
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Marilisa Franceschi
- Endoscopy Unit, Department of Medicine, ULSS7 Pedemontana, Hospital AltoVicentino, Santorso (VI), Italy.
| | | | - Alberto Barchi
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Michele Russo
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Lorella Franzoni
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Antonio Antico
- Laboratory of Clinical Pathology, ULSS7 Pedemontana, Hospital AltoVicentino, Santorso (VI), Italy.
| | - Gianluca Baldassarre
- Endoscopy Unit, Department of Medicine, ULSS7 Pedemontana, Hospital AltoVicentino, Santorso (VI), Italy.
| | - Maria Piera Panozzo
- Laboratory of Clinical Pathology, ULSS7 Pedemontana, Hospital AltoVicentino, Santorso (VI), Italy.
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Potter MDE, Duncanson K, Jones MP, Walker MM, Keely S, Talley NJ. Wheat Sensitivity and Functional Dyspepsia: A Pilot, Double-Blind, Randomized, Placebo-Controlled Dietary Crossover Trial with Novel Challenge Protocol. Nutrients 2020; 12:nu12071947. [PMID: 32629906 PMCID: PMC7400003 DOI: 10.3390/nu12071947] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/24/2020] [Accepted: 06/27/2020] [Indexed: 02/07/2023] Open
Abstract
Introduction: Functional dyspepsia (FD), characterised by symptoms of epigastric pain or early satiety and post prandial distress, has been associated with duodenal eosinophilia, raising the possibility that it is driven by an environmental allergen. Non-coeliac gluten or wheat sensitivity (NCG/WS) has also been associated with both dyspeptic symptoms and duodenal eosinophilia, suggesting an overlap between these two conditions. The aim of this study was to evaluate the role of wheat (specifically gluten and fructans) in symptom reduction in participants with FD in a pilot randomized double-blind, placebo controlled, dietary crossover trial. Methods: Patients with Rome III criteria FD were recruited from a single tertiary centre in Newcastle, Australia. All were individually counselled on a diet low in both gluten and fermentable oligo-, di-, mono-saccharides, and polyols (FODMAPs) by a clinical dietitian, which was followed for four weeks (elimination diet phase). Those who had a ≥30% response to the run-in diet, as measured by the Nepean Dyspepsia Index, were then re-challenged with ‘muesli’ bars containing either gluten, fructan, or placebo in randomised order. Those with symptoms which significantly reduced during the elimination diet, but reliably reappeared (a mean change in overall dyspeptic symptoms of ≥30%) with gluten or fructan re-challenge were deemed to have wheat induced FD. Results: Eleven participants were enrolled in the study (75% female, mean age 43 years). Of the initial cohort, nine participants completed the elimination diet phase of whom four qualified for the rechallenge phase. The gluten-free, low FODMAP diet led to an overall (albeit non-significant) improvement in symptoms of functional dyspepsia in the diet elimination phase (mean NDI symptom score 71.2 vs. 47.1, p = 0.087). A specific food trigger could not be reliably demonstrated. Conclusions: Although a gluten-free, low-FODMAP diet led to a modest overall reduction in symptoms in this cohort of FD patients, a specific trigger could not be identified. The modified Salerno criteria for NCG/WS identification trialled in this dietary rechallenge protocol was fit-for-purpose. However, larger trials are required to determine whether particular components of wheat induce symptoms in functional dyspepsia.
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Affiliation(s)
- Michael D. E. Potter
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (M.D.E.P.); (M.P.J.); (M.M.W.); (S.K.); (N.J.T)
- Australian Gastrointestinal Research Alliance (AGIRA), Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Department of Gastroenterology, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
| | - Kerith Duncanson
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (M.D.E.P.); (M.P.J.); (M.M.W.); (S.K.); (N.J.T)
- Australian Gastrointestinal Research Alliance (AGIRA), Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Correspondence:
| | - Michael P. Jones
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (M.D.E.P.); (M.P.J.); (M.M.W.); (S.K.); (N.J.T)
- Australian Gastrointestinal Research Alliance (AGIRA), Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Psychology Department, Macquarie University, Macquarie Park, Sydney, NSW 2109, Australia
| | - Marjorie M. Walker
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (M.D.E.P.); (M.P.J.); (M.M.W.); (S.K.); (N.J.T)
- Australian Gastrointestinal Research Alliance (AGIRA), Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Simon Keely
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (M.D.E.P.); (M.P.J.); (M.M.W.); (S.K.); (N.J.T)
- Australian Gastrointestinal Research Alliance (AGIRA), Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Nicholas J. Talley
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (M.D.E.P.); (M.P.J.); (M.M.W.); (S.K.); (N.J.T)
- Australian Gastrointestinal Research Alliance (AGIRA), Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Department of Gastroenterology, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
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Santonicola A, Gagliardi M, Asparago G, Carpinelli L, Angrisani L, Iovino P. Anhedonia and functional dyspepsia in obese patients: Relationship with binge eating behaviour. World J Gastroenterol 2020; 26:2632-2644. [PMID: 32523316 PMCID: PMC7265144 DOI: 10.3748/wjg.v26.i20.2632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 12/31/2019] [Revised: 05/09/2020] [Accepted: 05/16/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obese patients (Ob) with a binge eating disorders (BED) behavior pattern have a higher prevalence of postprandial distress syndrome (PDS) compared to Ob without a BED behavior pattern, while an increase of PDS has been described in Ob after sleeve gastrectomy (SG). Hedonic response to a meal is dissociable from satiation in healthy subjects. Anhedonia is the lowered ability to experience pleasure. There are no studies investigating the presence of anhedonia in Ob with and without SG and its relationship to PDS symptoms.
AIM To assess the relationship among anhedonia, BED and upper gastrointestinal symptoms in two group of morbidly Ob with and without SG.
METHODS Eighty-one Ob without SG, 45 Ob with SG and 55 healthy controls (HC) were studied. All subjects fulfilled the binge eating scale (BES) to investigate BED, the validated 14 items Snaith-Hamilton pleasure scale (SHAPS) to assess Anhedonia as well as the Beck Depression Inventory-II (BDI II) and State Trait Anxiety Inventory (STAI) questionnaires to screen for depression and anxiety. All patients underwent a standardized questionnaire investigating the intensity-frequency scores (0-6) of upper gastrointestinal symptoms and were diagnosed for the presence of functional dyspepsia (FD) and its subtypes according to ROME IV criteria.
RESULTS Ob without SG who were positive for BED had a 4.7 higher risk of FD compared to Ob without SG who were negative for BED (OR: 4.7; 95.0%CI 1.23-18.24; P = 0.02). STAI-Y2 scores were significantly higher in Ob without SG positive for BED (42.2 ± 1.5 vs Ob negative for BED: 39.6 ± 1 .0, P = 0.04), while SHAPS scores and BDI II did not differ in the two groups (1.16 ± 1.30 vs 0.89 ± 1.02, P = 0.49). A lower prevalence of BED (BES > 17: 11.4% vs 40.7%, P = 0.001) and BDI-II (6.8 ± 1.2 vs 13.8 ± 1.9, P = 0.005) was reported in Ob with SG than Ob without SG, on the contrary total mean scores of STAI-Y1 and STAI-Y2 were significantly higher in Ob with SG than Ob without SG. Thirty-five percent of Ob with SG fulfilled the diagnosis of FD. SHAPS mean scores and the prevalence of anhedonia did not differ among the two groups (18.2 vs 8.1%, P = 0.2). Fifty-four percent of Ob with SG achieved surgical success excess weight loss > 50%. Excess weight loss was negatively related to SHAPS total mean scores [adjusted B: -7. 099 (95%CI: -13.91 to -0.29), P = 0.04].
CONCLUSION Ob without SG showed a higher prevalence of PDS, mood disorders and anxiety when positive for BE behavior compared to those negative for BE behavior, whereas no differences were found in SHAPS score. Ob with SG showed a higher prevalence of PDS compared to Ob without SG. Concerning psychological aspect, BED and depression are less frequent in the Ob with SG, while both state and trait anxiety are significantly higher. Moreover, the more an Ob with SG is anhedonic, less surgical success was achieved.
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Affiliation(s)
- Antonella Santonicola
- Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy
| | - Mario Gagliardi
- Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy
| | - Giovanni Asparago
- Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy
| | - Luna Carpinelli
- Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy
| | - Luigi Angrisani
- General and Endoscopic Surgery Unit, San Giovanni Bosco Hospital, Naples 80100, Italy
| | - Paola Iovino
- Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy
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Affiliation(s)
- Dejan Micic
- From the Department of Internal Medicine, Sections of Gastroenterology, Hepatology, and Nutrition (D.M., M.R.C.) and Infectious Diseases (J.-L.B.), and the Department of Radiology (A.O.), University of Chicago Medicine, and the Department of Internal Medicine, University of Chicago Medicine, and the MacLean Center for Clinical Medical Ethics, University of Chicago (M.S.) - all in Chicago
| | - Aytekin Oto
- From the Department of Internal Medicine, Sections of Gastroenterology, Hepatology, and Nutrition (D.M., M.R.C.) and Infectious Diseases (J.-L.B.), and the Department of Radiology (A.O.), University of Chicago Medicine, and the Department of Internal Medicine, University of Chicago Medicine, and the MacLean Center for Clinical Medical Ethics, University of Chicago (M.S.) - all in Chicago
| | - Michael R Charlton
- From the Department of Internal Medicine, Sections of Gastroenterology, Hepatology, and Nutrition (D.M., M.R.C.) and Infectious Diseases (J.-L.B.), and the Department of Radiology (A.O.), University of Chicago Medicine, and the Department of Internal Medicine, University of Chicago Medicine, and the MacLean Center for Clinical Medical Ethics, University of Chicago (M.S.) - all in Chicago
| | - Jean-Luc Benoit
- From the Department of Internal Medicine, Sections of Gastroenterology, Hepatology, and Nutrition (D.M., M.R.C.) and Infectious Diseases (J.-L.B.), and the Department of Radiology (A.O.), University of Chicago Medicine, and the Department of Internal Medicine, University of Chicago Medicine, and the MacLean Center for Clinical Medical Ethics, University of Chicago (M.S.) - all in Chicago
| | - Mark Siegler
- From the Department of Internal Medicine, Sections of Gastroenterology, Hepatology, and Nutrition (D.M., M.R.C.) and Infectious Diseases (J.-L.B.), and the Department of Radiology (A.O.), University of Chicago Medicine, and the Department of Internal Medicine, University of Chicago Medicine, and the MacLean Center for Clinical Medical Ethics, University of Chicago (M.S.) - all in Chicago
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Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, Li J, Zhao D, Xu D, Gong Q, Liao J, Yang H, Hou W, Zhang Y. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020; 395:809-815. [PMID: 32151335 PMCID: PMC7159281 DOI: 10.1016/s0140-6736(20)30360-3] [Citation(s) in RCA: 2195] [Impact Index Per Article: 548.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/08/2020] [Accepted: 02/08/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were based on information from the general population. Limited data are available for pregnant women with COVID-19 pneumonia. This study aimed to evaluate the clinical characteristics of COVID-19 in pregnancy and the intrauterine vertical transmission potential of COVID-19 infection. METHODS Clinical records, laboratory results, and chest CT scans were retrospectively reviewed for nine pregnant women with laboratory-confirmed COVID-19 pneumonia (ie, with maternal throat swab samples that were positive for severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) who were admitted to Zhongnan Hospital of Wuhan University, Wuhan, China, from Jan 20 to Jan 31, 2020. Evidence of intrauterine vertical transmission was assessed by testing for the presence of SARS-CoV-2 in amniotic fluid, cord blood, and neonatal throat swab samples. Breastmilk samples were also collected and tested from patients after the first lactation. FINDINGS All nine patients had a caesarean section in their third trimester. Seven patients presented with a fever. Other symptoms, including cough (in four of nine patients), myalgia (in three), sore throat (in two), and malaise (in two), were also observed. Fetal distress was monitored in two cases. Five of nine patients had lymphopenia (<1·0 × 10⁹ cells per L). Three patients had increased aminotransferase concentrations. None of the patients developed severe COVID-19 pneumonia or died, as of Feb 4, 2020. Nine livebirths were recorded. No neonatal asphyxia was observed in newborn babies. All nine livebirths had a 1-min Apgar score of 8-9 and a 5-min Apgar score of 9-10. Amniotic fluid, cord blood, neonatal throat swab, and breastmilk samples from six patients were tested for SARS-CoV-2, and all samples tested negative for the virus. INTERPRETATION The clinical characteristics of COVID-19 pneumonia in pregnant women were similar to those reported for non-pregnant adult patients who developed COVID-19 pneumonia. Findings from this small group of cases suggest that there is currently no evidence for intrauterine infection caused by vertical transmission in women who develop COVID-19 pneumonia in late pregnancy. FUNDING Hubei Science and Technology Plan, Wuhan University Medical Development Plan.
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Affiliation(s)
- Huijun Chen
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China; Clinical Medicine Research Centre of Prenatal Diagnosis and Birth Health in Hubei Province, Wuhan, Hubei, China
| | - Juanjuan Guo
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China; Clinical Medicine Research Centre of Prenatal Diagnosis and Birth Health in Hubei Province, Wuhan, Hubei, China
| | - Chen Wang
- Department of Obstetrics and Gynaecology, Peking University First Hospital, Beijing, China
| | - Fan Luo
- State Key Laboratory of Virology/Institute of Medical Virology, School of Basic Medical Sciences, Wuhan University, Wuhan, Hubei, China
| | - Xuechen Yu
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China; Clinical Medicine Research Centre of Prenatal Diagnosis and Birth Health in Hubei Province, Wuhan, Hubei, China
| | - Wei Zhang
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jiafu Li
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China; Clinical Medicine Research Centre of Prenatal Diagnosis and Birth Health in Hubei Province, Wuhan, Hubei, China
| | - Dongchi Zhao
- Department of Paediatrics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Dan Xu
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China; Clinical Medicine Research Centre of Prenatal Diagnosis and Birth Health in Hubei Province, Wuhan, Hubei, China
| | - Qing Gong
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China; Clinical Medicine Research Centre of Prenatal Diagnosis and Birth Health in Hubei Province, Wuhan, Hubei, China
| | - Jing Liao
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China; Clinical Medicine Research Centre of Prenatal Diagnosis and Birth Health in Hubei Province, Wuhan, Hubei, China
| | - Huixia Yang
- Department of Obstetrics and Gynaecology, Peking University First Hospital, Beijing, China.
| | - Wei Hou
- State Key Laboratory of Virology/Institute of Medical Virology, School of Basic Medical Sciences, Wuhan University, Wuhan, Hubei, China.
| | - Yuanzhen Zhang
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China; Clinical Medicine Research Centre of Prenatal Diagnosis and Birth Health in Hubei Province, Wuhan, Hubei, China.
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Pesce M, Cargiolli M, Cassarano S, Polese B, De Conno B, Aurino L, Mancino N, Sarnelli G. Diet and functional dyspepsia: Clinical correlates and therapeutic perspectives. World J Gastroenterol 2020; 26:456-465. [PMID: 32089623 PMCID: PMC7015717 DOI: 10.3748/wjg.v26.i5.456] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 11/15/2019] [Revised: 12/24/2019] [Accepted: 01/18/2020] [Indexed: 02/06/2023] Open
Abstract
Hypervigilance and symptoms anticipation, visceral hypersensitivity and gastroduodenal sensorimotor abnormalities account for the varied clinical presentation of functional dyspepsia (FD) patients. Many patients recognize meals as the main triggering factor; thus, dietary manipulations often represent the first-line management strategy in this cohort of patients. Nonetheless, scarce quality evidence has been produced regarding the relationship between specific foods and/or macronutrients and the onset of FD symptoms, resulting in non-standardized nutritional approaches. Most dietary advises are indeed empirical and often lead to exclusion diets, reinforcing in patients the perception of “being intolerant” to food and self-perpetuating some of the very mechanisms underlying dyspepsia physiopathology (i.e., hypervigilance and symptom anticipation). Clinicians are often uncertain regarding the contribution of specific foods to dyspepsia physiopathology and dedicated professionals (i.e., dietitians) are only available in tertiary referral settings. This in turn, can result in nutritionally unbalanced diets and could even encourage restrictive eating behaviors in severe dyspepsia. In this review, we aim at evaluating the relationship between dietary habits, macronutrients and specific foods in determining FD symptoms. We will provide an overview of the evidence-based nutritional approach that should be pursued in these patients, providing clinicians with a valuable tool in standardizing nutritional advises and discouraging patients from engaging into indiscriminate food exclusions.
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Affiliation(s)
- Marcella Pesce
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
- GI Physiology Unit, University College London Hospital, London NW1 2BU, United Kingdom
| | - Martina Cargiolli
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
| | - Sara Cassarano
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
| | - Barbara Polese
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
| | - Barbara De Conno
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
| | - Laura Aurino
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
| | - Nicola Mancino
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
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M RW. Endoscopy in Patients with Dyspeptic Symptoms in a Tertiary Hospital. J Assoc Physicians India 2020; 68:88. [PMID: 31979838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Kasugai K, Funaki Y, Ogasawara N. [Clinical course and overlap syndromes of functional dyspepsia]. Nihon Shokakibyo Gakkai Zasshi 2020; 117:856-865. [PMID: 33041297 DOI: 10.11405/nisshoshi.117.856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Kunio Kasugai
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine
| | - Yasushi Funaki
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine
| | - Naotaka Ogasawara
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine
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Barros LL, Farias AQ, Rezaie A. Gastrointestinal motility and absorptive disorders in patients with inflammatory bowel diseases: Prevalence, diagnosis and treatment. World J Gastroenterol 2019; 25:4414-4426. [PMID: 31496621 PMCID: PMC6710178 DOI: 10.3748/wjg.v25.i31.4414] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [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: 05/01/2019] [Revised: 07/04/2019] [Accepted: 07/19/2019] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel diseases (IBD), Crohn`s disease and ulcerative colitis, are chronic conditions associated with high morbidity and healthcare costs. The natural history of IBD is variable and marked by alternating periods of flare and remission. Even though the use of newer therapeutic targets has been associated with higher rates of mucosal healing, a great proportion of IBD patients remain symptomatic despite effective control of inflammation. These symptoms may include but not limited to abdominal pain, dyspepsia, diarrhea, urgency, fecal incontinence, constipation or bloating. In this setting, commonly there is an overlap with gastrointestinal (GI) motility and absorptive disorders. Early recognition of these conditions greatly improves patient care and may decrease the risk of mistreatment. Therefore, in this review we describe the prevalence, diagnosis and treatment of GI motility and absorptive disorders that commonly affect patients with IBD.
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Affiliation(s)
- Luísa Leite Barros
- Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo 05403-000, Brazil
| | - Alberto Queiroz Farias
- Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo 05403-000, Brazil
| | - Ali Rezaie
- Division of Gastroenterology, Department of Medicine, Cedars Sinai Medical Center, Los Angeles, CA 90048, United States
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Ben-Arie E, Kao PY, Ho WC, Lee YC. Acupuncture effect on digestion in critically ill postoperative oral and hypopharyngeal cancer patients: A protocol for double-blind randomized control trial. Medicine (Baltimore) 2019; 98:e16944. [PMID: 31464933 PMCID: PMC6736481 DOI: 10.1097/md.0000000000016944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Head and neck cancer patients are at a high risk to suffer from malnourishment, a risk that increases in postoperative condition and with the use of enteral nutrition (EN). Until now patients who are suffering from indigestion in the intensive care unit (ICU) received treatment in the form of prokinetic drugs, drugs that can lead to serious side effects and only can partially improve digestion functions. Acupuncture was used successfully in several clinical trials to improve postoperative indigestion in cancer patients without any reported adverse events. The study aims are to investigate acupuncture effect in combination with prokinetic drugs in the treatment of indigestion in postoperative oral and hypopharyngeal cancer patients in the ICU. METHODS Single-center, double-blind randomized control trial will compare between 2 equal groups. A total of 28 patients that will meet the inclusion criteria: age 30 to 80, postplastic surgery for oral cancer or hypopharyngeal cancer, developed feeding intolerance 2 times in the first postoperative day, Apache score <20, and needed EN. Patients will be randomly divided (1:1) into treatment group or control group for 3 treatments in 3 days along with routine ICU treatment. The main outcome measurement will be the number of days a patient needs to reach his total energy expenditure. EXPECTED OUTCOME The results will shed light on the effectiveness and safety of acupuncture in a double-blind design treating postoperative ICU cancer patients. In addition, the study presents a revolutionary double-blind design that if, will prove as successful might influence the way double-blind acupuncture studies are performed today. OTHER INFORMATION The study will be conducted in the surgical ICU department, of China medical university hospital, Taichung 404, Taiwan. The study is conducted on stable ICU patients and is anticipated to have minimum risk for adverse events. Patients enrollment and data collection will start from May 15, 2019. The study expected completion time: June 2021.
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Affiliation(s)
- Eyal Ben-Arie
- Graduate Institute of Acupuncture Science (Collage of Chinese Medicine) China Medical University
| | - Pei-Yu Kao
- Division of Thoracic Surgery, Department of Surgery
- Surgical Intensive Care Unit
| | - Wen-Chao Ho
- Department of Public Health, China Medical University
- Department of Nursing and Graduate Institute of Nursing, Asia University, Taichung, Taiwan
| | - Yu Chen Lee
- Graduate Institute of Acupuncture Science (Collage of Chinese Medicine) China Medical University
- Department of Acupuncture, China Medical University Hospital
- Chinese Medicine Research Center, China Medical University
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Di Ciaula A, Molina-Molina E, Bonfrate L, Wang DQH, Dumitrascu DL, Portincasa P. Gastrointestinal defects in gallstone and cholecystectomized patients. Eur J Clin Invest 2019; 49:e13066. [PMID: 30592298 PMCID: PMC8118136 DOI: 10.1111/eci.13066] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 12/25/2018] [Accepted: 12/27/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIM Several gallstone patients complain of dyspeptic symptoms, irrespective of the presence of typical colicky pain. Symptoms often persist after a cholecystectomy. Systematic studies on dyspepsia and dynamic gastrointestinal motor function are missing in gallstone patients with preserved gallbladder or after a cholecystectomy. MATERIALS AND METHODS Forty-six gallstone patients (age 55 ± 2 years; 15M, 31F) and 24 cholecystectomized patients (age 57 ± 2 years; 6M, 18F) (no difference in type and volume of gallstones between the two groups) were compared against a group of 65 healthy controls (age 51 ± 2 years; 30M, 35F). Dyspepsia occurring in the prior months was assessed by a questionnaire, gastric and gallbladder emptying by functional ultrasonography and orocecal transit time by a hydrogen breath test using a lactulose-enriched standard liquid meal. RESULTS Gallstone patients had significantly greater dyspepsia, fasting and residual gallbladder volumes, and slower gallbladder emptying, gastric emptying and small intestinal transit time than controls. In cholecystectomized patients, gastric emptying further delayed, compared to gallstone patients and controls. CONCLUSION Gallstone patients with the gallbladder "in situ" or after a cholecystectomy display dyspeptic symptoms. Symptoms are associated with multiple gastrointestinal motility defects involving the gallbladder, stomach and small intestine. After cholecystectomy, gastric emptying worsens.
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Affiliation(s)
- Agostino Di Ciaula
- Division of Internal Medicine, Hospital of Bisceglie, ASL BAT, Bisceglie, Italy
| | - Emilio Molina-Molina
- Department of Biomedical Sciences and Human Oncology, Clinica Medica “A. Murri”, University of Bari Medical School, Bari, Italy
| | - Leonilde Bonfrate
- Department of Biomedical Sciences and Human Oncology, Clinica Medica “A. Murri”, University of Bari Medical School, Bari, Italy
- Division of Geriatrics and Gerontology, Hospital “Miulli”, Acquaviva delle Fonti, Italy
| | - David Q.-H. Wang
- Department of Medicine, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Albert Einstein College of Medicine, Bronx, New York
| | - Dan L. Dumitrascu
- 2nd Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Piero Portincasa
- Department of Biomedical Sciences and Human Oncology, Clinica Medica “A. Murri”, University of Bari Medical School, Bari, Italy
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Roncoroni L, Bascuñán KA, Vecchi M, Doneda L, Bardella MT, Lombardo V, Scricciolo A, Branchi F, Elli L. Exposure to Different Amounts of Dietary Gluten in Patients with Non-Celiac Gluten Sensitivity (NCGS): An Exploratory Study. Nutrients 2019; 11:nu11010136. [PMID: 30634655 PMCID: PMC6356445 DOI: 10.3390/nu11010136] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/06/2019] [Accepted: 01/07/2019] [Indexed: 12/27/2022] Open
Abstract
It is unclear whether patients with non-celiac gluten sensitivity (NCGS) can tolerate gluten. We have evaluated the changes of both gastrointestinal symptoms and quality of life for NCGS patients after the re-introduction of dietary gluten. Twenty-two NCGS patients reporting functional gastroenterological symptoms and on gluten-free diet (GFD) for the previous three weeks were exposed to incremental gluten-containing diets. Three groups were compared at baseline (immediately after 3-weeks on GFD) and immediately after the return of symptomatology: (i) a group tolerating a low-gluten diet (3.5 g gluten/day, week 1, n = 8), (ii) a group tolerating a mid-gluten diet (8 g gluten/day, week 2, n = 6), and (iii) a group tolerating a high-gluten diet (13 g gluten/day, week 3, n = 8). Their gastrointestinal symptoms and quality of life were assessed at baseline and post-intervention. The most common symptoms were: constipation (46%), abdominal pain (50%) and dyspepsia (38%). A decrease in several short form health survey (SF-36) sub-scores (all p < 0.03) after gluten re-introduction was only observed in the group tolerating the low-gluten diet; the same group showed a lower post-intervention role-emotional SF-36 score (p = 0.01). Most gastrointestinal symptoms remained similar after gluten re-introduction. However, a decrease in the general perception of well-being was only found after gluten re-introduction in the group tolerating a low-gluten diet (p = 0.01); the same was true when comparing the post-intervention general well-being perception among the three groups (p = 0.050). In conclusion, dissimilar responses from patients with NCGS were observed after the re-introduction of gluten, with gluten at a low dosage affecting the quality of life and general well-being of a group of patients, whereas others tolerate even higher doses of dietary gluten.
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Affiliation(s)
- Leda Roncoroni
- Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20135 Milan, Italy.
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20133 Milan, Italy.
| | - Karla A Bascuñán
- Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20135 Milan, Italy.
- Department of Nutrition, School of Medicine, University of Chile, 8380453 Santiago, Chile.
| | - Maurizio Vecchi
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.
- Gastroenterology and Endoscopic Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy.
| | - Luisa Doneda
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20133 Milan, Italy.
| | - Maria T Bardella
- Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20135 Milan, Italy.
| | - Vincenza Lombardo
- Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20135 Milan, Italy.
| | - Alice Scricciolo
- Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20135 Milan, Italy.
| | - Federica Branchi
- Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20135 Milan, Italy.
| | - Luca Elli
- Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20135 Milan, Italy.
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Koo MM, von Wagner C, Abel GA, McPhail S, Hamilton W, Rubin GP, Lyratzopoulos G. The nature and frequency of abdominal symptoms in cancer patients and their associations with time to help-seeking: evidence from a national audit of cancer diagnosis. J Public Health (Oxf) 2018; 40:e388-e395. [PMID: 29385513 PMCID: PMC6166582 DOI: 10.1093/pubmed/fdx188] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 12/18/2017] [Accepted: 12/22/2017] [Indexed: 12/28/2022] Open
Abstract
Background Raising awareness of possible cancer symptoms is important for timely help-seeking; recent campaigns have focused on symptom groups (such as abdominal symptoms) rather than individual alarm symptoms associated with particular cancer sites. The evidence base supporting such initiatives is still emerging however; understanding the frequency and nature of presenting abdominal symptoms among cancer patients could inform the design and evaluation of public health awareness campaigns. Methods We examined eight presenting abdominal symptoms (abdominal pain, change in bowel habit, bloating/distension, dyspepsia, rectal bleeding, dysphagia, reflux and nausea/vomiting) among 15 956 patients subsequently diagnosed with cancer in England. We investigated the cancer site case-mix and variation in the patient interval (symptom-onset-to-presentation) by abdominal symptom. Results Almost a quarter (23%) of cancer patients presented with abdominal symptoms before being diagnosed with one of 27 common and rarer cancers. The patient interval varied substantially by abdominal symptom: median (IQR) intervals ranged from 7 (0-28) days for abdominal pain to 30 (4-73) days for dysphagia. This variation persisted after adjusting for age, sex and ethnicity (P < 0.001). Conclusions Abdominal symptoms are common at presentation among cancer patients, while time to presentation varies by symptom. The need for awareness campaigns may be greater for symptoms associated with longer intervals to help-seeking.
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Affiliation(s)
| | | | - Gary A Abel
- University of Exeter Medical School, St Luke’s Campus, Heavitree Road, Exeter, UK
| | - Sean McPhail
- National Cancer Registration and Analysis Service, Public Health England Zone A, 2nd Floor, Skipton House, 80 London Road, London, UK
| | - William Hamilton
- University of Exeter Medical School, St Luke’s Campus, Heavitree Road, Exeter, UK
| | - Greg P Rubin
- Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, UK
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