General approaches to biopolymer-based Pickering emulsions

Pickering emulsion is a type of emulsion that uses solid particles or colloidal particles as emulsifiers rather than surfactants to adhere at oil-water interface. Pickering emulsions have gathered significant research attention recently due to their excellent stability and wide range of potential uses compared to traditional emulsions. Major advancements have been made in development of innovative Pickering emulsions using different colloidal particles by various techniques including homogenization, emulsification and ultrasonication. Use of biopolymer particles gives Pickering emulsions a more escalating possibilities. In this review paper, we seek to present a critical overview of development in food-grade particles that have been utilized to create Pickering emulsions with a focus on techniques and application of Pickering emulsions. Particularly, we have evaluated protein, lipid, polysaccharide-based particles and microalgal proteins that have emerged in recent years with respect to their potential to stabilize and add novel functionalities to Pickering emulsions. Some preparation methods of Pickering emulsions in brief, applications of Pickering emulsions are also highlighted. Encapsulation and delivery of bioactive compounds, fat substitutes, film formation and catalysis are potential applications of Pickering emulsions. Pickering double emulsions, nutraceutical and bioactive co-delivery, and preparation of porous materials are among research trends of food-grade Pickering emulsions.

Long-term trajectories of densely reported depressive symptoms during an extended period of the COVID-19 pandemic in Switzerland: Social worries matter

Previous mental health trajectory studies were mostly limited to the months before access to vaccination. They are not informing on whether public mental health has adapted to the pandemic. The aim of this analysis was to 1) investigate trajectories of monthly reported depressive symptoms from July 2020 to December 2021 in Switzerland, 2) compare average growth trajectories across regions with different stringency phases, and 3) explore the relative impact of self-reported worries related to health, economic and social domains as well as socio-economic indicators on growth trajectories. As part of the population-based Corona Immunitas program of regional, but harmonized, adult cohorts studying the pandemic course and impact, participants repeatedly reported online to the DASS-21 instrument on depressive symptomatology. Trajectories of depressive symptoms were estimated using a latent growth model, specified as a generalised linear mixed model. The time effect was modelled parametrically through a polynomial allowing to estimate trajectories for participants' missing time points. In all regions level and shape of the trajectories mirrored those of the KOF Stringency-Plus Index, which quantifies regional Covid-19 policy stringency. The higher level of average depression in trajectories of those expressing specific worries was most noticeable for the social domain. Younger age, female gender, and low household income went along with higher mean depression score trajectories throughout follow-up. Interventions to promote long-term resilience are an important part of pandemic preparedness, given the observed lack of an adaptation in mental health response to the pandemic even after the availability of vaccines in this high-income context.

Early mobilization of critically ill ICU patients: A survey of knowledge, perceptions, and practices of Malaysian physiotherapists

INTRODUCTION

Early mobilization and rehabilitation of critically ill patients in the Intensive care unit (ICU) is a topic of growing interest. Current evidence suggests that early mobilization is safe, feasible, and effective at reducing the incidence of ICU-acquired weakness. However, early mobilization is still not the standard of care in most ICUs worldwide. The aim of the study was to determine the level of knowledge, perceptions, and practice among ICU physiotherapists of early mobilization in critically ill ICU patients in Malaysia.

MATERIALS AND METHODS

A cross-sectional study was undertaken in 45 public, teaching, and private hospitals in Malaysia that provide ≥ 10 beds in their ICUs. Knowledge, perceived barriers, facilitators, and practice of early mobilization were assessed using a previously validated mobility survey questionnaire.

RESULTS

Only 35% of ICU physiotherapists reported receiving training/courses on early mobilization in the ICU. 100 (86%) physiotherapists underestimated the incidence of ICU-acquired weakness, and 88 (75%) were unfamiliar with the current literature on early mobilization in the ICU. The need for physician orders before mobilization, medical instability, excessive sedation, and risk of dislodgement of devices or lines were the most common barriers to early mobilization. Nearly half (49 [42%]) of the respondents reported physiotherapist as early mobilization clinical champion in their setting, but the most common physiotherapy treatment techniques in the ICU reported by the respondents' were still chest physiotherapy, range of motion exercises, and bed mobility.

CONCLUSION

We observed strong enthusiasm for early mobilization among Malaysian physiotherapists. Most respondents believed that early mobilization is important and beneficial to ICU patients. However, there is still a big gap in knowledge and training of early mobilization in ICU patients among Malaysian physiotherapists.

ECCO Position on Harmonisation of Crohn's Disease Mucosal Histopathology

In inflammatory bowel disease [IBD], mucosal healing is a major therapeutic target and a reliable predictor of clinical course. However, endoscopic mucosal healing is not synonymous with histological healing, and the additional benefits of including histological remission as a target are unclear. In Crohn´s disease [CD], there are few studies highlighting the value of histological remission as a therapeutic target. Histological activity can persist in CD patients who are in endoscopic remission, and the absence of histological activity may be associated with lower relapse rates. Therefore, standardisation of procedures to evaluate CD histological activity is desirable. Topics that would benefit from standardisation and harmonisation include biopsy procedures, biopsy processing techniques, the content of histological scores, and the definitions of histological remission, histological response, and histological activity. In line with these needs, the European Crohn's and Colitis Organisation [ECCO] assembled a consensus group with the objective of developing position statements on CD histology based on published evidence and expert consensus. There was agreement that definitions of histological remission should include absence of erosion, ulceration, and mucosal neutrophils; that the absence of neutrophilic inflammation is an appropriate histological target in CD; that CD histological scores, such as the Global Histological Disease Activity Score, lack formal validation; and that histological scoring systems for ulcerative colitis, including the Geboes Score, Robarts Histopathology Index, and Nancy Histological Index, can be used for scoring intestinal biopsies in CD patients.

Nano reduction coupled with encapsulation as a novel technique for utilising millet proteins as future foods

Crocin (saffron bioactive) loaded protein nanoparticles were prepared from three underutilised cereal varieties viz., sorghum (SPCN), foxtail millet (FPCN) and pearl millet (PPCN) using ultrasonication technique. The particle size of crocin loaded protein complex was attained in the nano range with reduced polydispersity index and negative zeta potential. The encapsulation efficiency of crocin in protein nanoparticles was found to be 83.78% (FPCN), 78.74 % (SPCN) and 70.01% (PPCN). The topographical images of crocin loaded protein nano complex was revealed using field emission-scanning electron microscopy (FE-SEM). The attenuated total reflectance fourier transform infra-spectroscopy (ATR-FTIR) analysis showed the characteristic peaks of crocin at 956, 1700 and 3350 cm^-1 in protein-crocin nanocomplex as a confirmatory test for nanoencapsulation. The antimicrobial activity of crocin loaded protein nanocomplex against three strains (Escherichia coli, Staphylococcus aureus and Fusarium oxysporium) were also evaluated. In vitro release studies showed higher content of crocin released in simulated intestinal conditions ensuring its controlled release at target site. Bioactivity (anti-cancerous and anti-hypertensive) of crocin upon in-vitro digestion were well retained indicating that protein nanoparticles can act as an effective wall material. Our results suggest that protein nanoparticles prepared in this study can act as an effective oral delivery vehicle for crocin that could be used for development of functional foods.

Ultrasonication as an innovative approach to tailor the apple seed proteins into nanosize: Effect on protein structural and functional properties

In this study, protein was extracted from the apple seed flour using alkali-acid precipitation method. The main objective of this study was to evaluate the impact of ultrasonication on structural and techno-functional properties of apple seed protein. Both native (N-protein) and ultra-sonicated protein (US-protein) were characterized for size, zeta potential, structure, protein pattern, crystallinity, thermal stability and functional properties. The results revealed that the hydrodynamic diameter of N-protein and US-protein was 1.2 µm and 484 nm while zeta potential was -11 and -19 mV, respectively. Fourier transform infrared-spectroscopy and X-ray diffraction analysis showed change in the conformational characteristics and functional groups of proteins after nano-reduction. SEM revealed change in the surface morphology of protein molecule upon ultrasonication. Differential scanning calorimetry showed decreased denaturation temperature for US-protein compared to N-protein . SDS-PAGE depicted no change in protein pattern upon ultrasonication. Ultrasonicated protein exhibited increased functional properties like emulsification, foaming, hydrophobicity and oil absorbing properties and hence can be efficiently used as functional ingredient in food and nutraceutical industry.

Ferulic acid loaded pickering emulsions stabilized by resistant starch nanoparticles using ultrasonication: Characterization, in vitro release and nutraceutical potential

The use of starch based nanoparticles have gained momentum in stabilizing pickering emulsions for it's numerous advantages. In present study resistant starch (RS) was isolated from lotus stem using enzymatic digestion and subjected to nanoprecipitation and ultrasonication to yield resistant starch nanoparticles (RSN). RSN of varying concentrations (2%, 10% and 20%) were used to stabilize the flax seed-oil water mixture to form pickering emulsions. The emulsions were used to nanoencapsulate ferulic acid (FA) - a well known bioactive via ultrasonication. The emulsions were lyophilized to form FA loaded lyophilized pickering emulsion (FA-LPE). The FA-LPE (2%, 10 % and 20%) were characterized using dynamic light scattering (DLS), light microscopy, scanning electron microscopy (SEM), transmission electron microscopy (TEM), atomic force microscopy (AFM) and attenuated total reflectance fourier transform infra-spectroscopy (ATR-FTIR). AFM showed FA-LPE as spherical droplets embedded in the matrix with maximum peak height of 8.47 nm and maximum pit height of 1.69 nm. SEM presented FA-LPE as an irregular and continuous surface having multiple folds and holes. The ATR-FTIR spectra of all the samples displayed peaks of C = C aromatic rings of FA at 1600 cm^-1 and 1439 cm^-1, signifying successful encapsulation. In vitro release assay displayed more controlled release of FA from FA-LPE (20%). Bioactivity of FA-LPE was evaluated in terms of anti-cancer, anti-diabetic, angiotensin converting enzyme (ACE) inhibition and prevention against oxidative damage under simulated gastro-intestinal conditions (SGID). The bioactivity of FA-LPE (20%) was significantly higher than FA-LPE (2%) and FA-LPE (10%). Key findings reveal that pickering emulsions can prevent FA under harsh SGID conditions and provide an approach to facilitate the design of pickering emulsions with high stability for nutraceutical delivery in food and supplement products.

Parental Influence on Usage of Electronic Gadgets and Students' Grades: Primary Students' Perspective

This study intended to find out the children's usage of gadgets and the parents' role regarding their usage and finally its influence on grades. This cross-sectional study was conducted using quantitative method. A total of 340 students of class four were selected by a random sampling method from four schools. Data collection was done by face-to-face interview and the study tool was structured by pretested questionnaire. The study took place at Dhanmondi Govt. Boys' High School, Kamrunnessa Govt. Girls School, Dhanmondi, Bangladesh International School and College (BISC), Mohakhali and SOS Hermann Gmeiner College, Mirpur, Dhaka, Bangladesh. Data collection was carried out from May 2019 to October 2019. Then the analysis of data and results were prepared in November and December 2019. Among 340 respondents of this study, a maximum (78.2%) of students watch TV, 55.9% of them play with mobile and a half (50%) of the students use tablet daily. Maximum (91.8%) parents monitor the use and time of gadgets. About 53.8% of parents use gadgets as a parenting tool. The majority of parents have a positive opinion of electronic gadgets on their children's reading (52.9% somewhat positive and 24.7% very positive) and writing (56.8% somewhat positive and 20.3% very positive) skills. The parents had negative opinion regarding attention spans to studies (33.8% somewhat negative), physical activity (38.2% somewhat negative and 16.5% parents are very negative) and sleep (38.8% are somewhat negative and 17.9% are very negative). Children are the future generation of our country. It is the duty of the parents as well as the country to establish a balanced use of this modern invention in our children's life.

Ultrasonics as a tool for development of pine-needle extract loaded bee wax edible packaging for value addition of Himalayan cheese

In the present study, Himalayan cheese, kradi was coated with beeswax loaded with pine needle extract (PNE) to increase its shelf life and nutraceutical potential. PNE was extracted via ultrasonication and incorporated into beeswax at concentrations, 2:1, 1:1, and 2:3 (grams of beeswax to mL of PNE). The dispersion of PNE in the coatings was carried out using an ultrasonic probe at a frequency of 20 kHz for 15 min and at power rating of 500 W. The coatings were characterised using scanning electron microscopy, light microscopy, dynamic light scattering (DLS), fourier transmission infrared spectroscopy. DLS revealed a hydrodynamic diameter and zeta potential of 12.11 ± 0.41 µm and -19.32 ± 0.61 mV for coating loaded with highest concentration of PNE. The bioactivities of the coating including antioxidant, antidiabetic and antibacterial assays revealed significantly higher values with the increase in PNE concentration. Shelf life and sensory evaluation study including microbiological and sensory analysis revealed inhibition of mould growth and good score of texture and appearance with the increase in concentration of PNE. The study provides a future perspective for application of beeswax loaded PNE coatings in cheese industry.

Resistant starch type 2 from lotus stem: Ultrasonic effect on physical and nutraceutical properties

Resistant starch type 2 (RS) was isolated from lotus stem using enzymatic digestion method. The isolated RS was subjected to ultrasonication (US) at different sonication power (100-400 W). The US treated and untreated RS samples were characterized using dynamic light scattering (DLS), scanning electron microscopy (SEM), light microscopy and Fourier transform infrared spectroscopy (FT-IR). DLS revealed that particle size of RS decreased from 12.80 µm to 413.19 nm and zeta potential increased from -12.34 mV to -26.09 mV with the increase in sonication power. SEM revealed smaller, disintegrated and irregular shaped RS particles after ultrasonication. FT-IR showed the decreased the band intensity at 995 cm^-1 and 1047 cm^-1 signifying that US treatment decreased the crystallinity of RS and increased its amorphous character. The bile acid binding, anti-oxidant and pancreatic lipase inhibition activity of samples also increased significantly (p < 0.05) with the increase in sonication power. Increase in US power however increased the values of hydrolysis from 23.11 ± 1.09 to 36.06 ± 0.13% and gylcemic index from 52.39 ± 0.38 to 59.50 ± 0.11. Overall, the non-thermal process of ultrasonic treatment can be used to change the structural, morphological and nutraceutical profile of lotus stem resistant starch which can have great food and pharamaceutical applications.

Valorization of natural colors as health-promoting bioactive compounds: Phytochemical profile, extraction techniques, and pharmacological perspectives

Color is the prime attribute with a large impact on consumers' perception, selection, and acceptance of foods. However, the belief in bio-safety protocols, health benefits, and the nutritional importance of food colors had focused the attention of the scientific community across the globe towards natural colorants that serve to replace their synthetic toxic counterparts. Moreover, multi-disciplinary applications of greener extraction techniques and their hyphenated counterparts for selective extraction of bioactive compounds is a hot topic focusing on process intensification, waste valorization, and retention of highly stable bioactive pigments from natural sources. In this article, we have reviewed available literature to provide all possible information on various aspects of natural colorants, including their sources, photochemistry and associated biological activities explored under in-vitro and in-vivo animal and human studies. However a particular focus is given on innovative technological approaches for the effective extraction of natural colors for nutraceutical and pharmaceutical applications.

Exploitation of polyphenols and proteins using nanoencapsulation for anti-viral and brain boosting properties - Evoking a synergistic strategy to combat COVID-19 pandemic

The world is currently under the threat of COVID pandemic and has focused every dimension of research in finding a cure to this novel disease. In this current situation, people are facing mental stress, agony, fear, depression and other associated symptoms which are taking a toll on their overall mental health. Nanoencapsulation of certain brain boosting polyphenols including quercetin, caffeine, cocoa flavanols and proteins like lectins can become new area of interest in the present scenario. Besides the brain boosting benefits, we have also highlighted the anti- viral activities of these compounds which we assume can play a possible role in combating COVID-19 given to their previous history of action against certain viruses. This review outlines the nanoencapsulation approaches of such synergistic compounds as a novel strategy to take the ongoing research a step ahead and also provides a new insight in bringing the role of nanotechnology in addressing the issues related to COVID pandemic.

Characterisation and utilisation of nano-reduced starch from underutilised cereals for delivery of folic acid through human GI tract

Ball milling offers green approach for size reduction of starch granules to nano scale size. In this research work, the starch from two underutilised cereal varieties viz. foxtail starch (FS) and sorghum starch (SS) were milled to achieve the desired nanometric range with mean particle diameter of 467.98 and 271.12 nm for nano foxtail (FSN) and nano sorghum starch (SSN), which were highly stable as revealed by zeta potential analysis. Functional attributes like solubility, swelling index, apparent amylose content, emulsifying and pasting properties were evaluated. Scanning electron microscopy (SEM) clearly revealed damaged starch granules produed by the process of milling. X-ray diffraction (XRD) displayed decrease in crystallinity upon milling to 16.08% (SSN) and 18.56% (FSN) and disappearance of some peaks. Attenuated total reflectance-fourier transform infrared spectroscopy (ATR-FTIR) also revealed reduced crystallinity as confirmed by the decreased absorbance ratio of 1047/1022 cm-1 in nano starch particles. Rheological analysis displayed shear thinning behaviour of nano starch samples as evaluated using Herschel-bulkely model and Power law. The nano starch samples exhibited comparatively low thermal gelatinisation temperatures as compared to native counter particles. Moreover, the nano-encapsulated starch samples offered more resistance to in-vitro digestion and showed control release of folic acid at target sites.

PTSD symptoms and suicidal ideation in US female firefighters

BACKGROUND

Little is known regarding the mental health of women firefighters.

AIMS

To identify demographic, work-related and mental health characteristics associated with post-traumatic stress disorder (PTSD) symptoms and lifetime suicidal ideation in female firefighters compared with male colleagues.

METHODS

Participants were firefighters (75 women and 2564 men) employed in a large urban fire department in the USA. Chi-square, correlations, t-tests and analyses of variance were conducted to examine the predictors of PTSD symptoms and lifetime suicide ideation in men and women.

RESULTS

Approximately 20% of women scored positively for PTSD and 30% reported lifetime suicidal ideation. Women with PTSD symptoms were more likely to be in their mid-career years (11-20) than in their first 10 years (87% versus 44%; χ2 = 8.77, P < 0.05) and to have received counselling (53% versus 14%; χ2 = 8.11, P < 0.01). Being single (73% versus 58%; χ2 = 6.02, P < 0.05), having a second job (68% versus 38%; χ2 = 5.79, P < 0.05) and having received counselling (41% versus 11%; χ2 = 8.51, P < 0.01) predicted suicide ideation. Depression and general stress positively predicted PTSD symptoms and suicide ideation. PTSD also predicted suicide ideation.

CONCLUSIONS

Compared to male firefighters, women were at high risk for PTSD symptoms and suicide ideation. Particularly for women, few socio-demographic and work-related variables were associated with these outcomes. Mental health variables predicted depression and suicide ideation for both gender groups. Therefore, in screening and intervention efforts, it may be most fruitful to focus on mental health risk correlates of PTSD and suicide ideation.

Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases

Background

The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals.

Methods

Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2).

Results

Data were collected on 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals.

Conclusion

Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care.

Synovial sarcoma of neck mimicking thyroid carcinoma

Synovial sarcoma (SS) in the neck is a very rare condition. Here we report a case of poorly differentiated synovial sarcoma in the neck of a 20 years old male patient presented with painless swelling in thyroid gland region. Initially he was diagnosed as thyroid mass clinically, by imaging and also by FNAC (Both in Bangladesh & India). But at surgery, it revealed paraoesophageal soft tissue tumor and subsequent histopathology showed synovial sarcoma. In young patient with neck swelling, the possibility of synovial sarcoma should be considered. As it does not have overall good prognosis, early detection and regular follow up is necessary.

Amalgam use and waste management by Pakistani dentists: an environmental perspective

To assess amalgam use and waste management protocols practised by Pakistani dentists, a cross-sectional study was made of 239 dentists in Islamabad and Rawalpindi, recruited by convenience and cluster sampling. Amalgam was the most frequently used restorative material, with the choice dictated by patients' financial constraints. While 90.4% of dentists perceived amalgam as a health risk, only 46.4% considered it an environmental hazard. The majority disposed of amalgam waste in the trash, down the sink or as hospital waste. Very few (5.9%) had an amalgam separator installed in their dental office. Amalgam waste management protocols and mercury recycling should be introduced in Pakistan.

Peripheral arterial ischemia by a primary lung tumour invading left atrium

Peripheral arterial embolism from a malignant tumour is an uncommon manifestation of a neoplasm. Here, we present a case of acute upper limb ischemia due to an embolus originating from primary lung malignancy invading the left atrium.

Diagnostic accuracy of transabdominal sonography in the evaluation of pelvic mass of gynecological origin

A study of 97 cases having clinical manifestations of pelvic mass in female was carried out in the department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University with the cooperation of the department of Obstetrics and Gynecology. This study was designed to determine accuracy of transabdominal sonography in the diagnosis of pelvic mass in female. The findings of transabdominal sonography were compared with histopathological examination. Transabdominal sonography had 87.6% accuracy, but only 3.1% false positive and 9.3% false negative rates. It can be concluded that ultrasonographic findings of different pelvic masses are highly dependable, can be used for preoperative decision making.

Effects of cisapride on symptoms and postcibal small-bowel motor function in patients with irritable bowel syndrome

BACKGROUND

Irritable bowel syndrome is a common cause of abdominal pain and discomfort and may be related to disordered gastrointestinal motility. Our aim was to assess the effects of long-term treatment with a prokinetic agent, cisapride, on postprandial jejunal motility and symptoms in the irritable bowel syndrome (IBS).

METHODS

Thirty-eight patients with IBS (constipation-predominant, n = 17; diarrhoea-predominant, n = 21) underwent 24-h ambulatory jejunal manometry before and after 12 week's treatment [cisapride, 5 mg three times daily (n = 19) or placebo (n = 19)].

RESULTS

In diarrhoea-predominant patients significant differences in contraction characteristics were observed between the cisapride and placebo groups. In cisapride-treated diarrhoea-predominant patients the mean contraction amplitude was higher (29.3 +/- 3.2 versus 24.9 +/- 2.6 mm Hg, cisapride versus placebo (P < 0.001); pretreatment, 25.7 +/- 6.0 mm Hg), the mean contraction duration longer (3.4 +/- 0.2 versus 3.0 +/- 0.2 sec, cisapride versus placebo (P < 0.001); pretreatment, 3.1 +/- 0.5 sec), and the mean contraction frequency lower (2.0 +/- 0.2 versus 2.5 +/- 0.4 cont./min, cisapride versus placebo (P < 0.001); pretreatment, 2.5 +/- 1.1 cont./min] than patients treated with placebo. No significant differences in jejunal motility were found in the constipation-predominant IBS group. Symptoms were assessed by using a visual analogue scale before and after treatment. Symptom scores relating to the severity of constipation were lower in cisapride-treated constipation-predominant IBS patients [score, 54 +/- 5 versus 67 +/- 14 mm, cisapride versus placebo (P < 0.05); pretreatment, 62 +/- 19 mm]. Diarrhoea-predominant IBS patients had a higher pain score after cisapride therapy [score, 55 +/- 15 versus 34 +/- 12 mm, cisapride versus placebo (P < 0.05); pretreatment, 67 +/- 19 mm].

CONCLUSION

Cisapride affects jejunal contraction characteristics and some symptoms in IBS.

Large-scale ambulatory study of postprandial jejunal motility in irritable bowel syndrome

BACKGROUND

The relationship of small-bowel dysmotility to dietary intake in irritable bowel syndrome (IBS) is obscure.

METHODS

This study evaluated postprandial jejunal motility in IBS patients classified as constipation-predominant (n = 25) or diarrhoea-predominant (n = 35) and compared results against 18 volunteers. Twenty-four-hour ambulatory jejunal manometry was carried out in all subjects, and recordings were analysed by microcomputer and visual assessment.

RESULTS

By means of analysis of variance (fitting factors for channels, meals, and time periods) postprandial contraction frequency was greater in both patient groups compared with normal (constipation-predominant versus normal, diarrhoea-predominant versus normal; P < 0.001). In the constipation-predominant cohort, contraction amplitudes were lower (constipation-predominant versus normal; P < 0.002). Discrete cluster contractions occurred with similar frequency and duration in both patient and volunteer groups.

CONCLUSIONS

Quantitative differences of postprandial jejunal contraction characteristics have been shown between patients with IBS and healthy volunteers. Contraction frequency is greater than normal in both diarrhoea- and constipation-predominant categories, whereas contraction amplitudes are lower in constipation-predominant patients.