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Romanian Journal of Internal Medicine =... Dec 2018The irritable bowel syndrome (IBS) is the most common chronic gastrointestinal disorder referred to gastroenterologists. One of the most common manifestations of IBS is... (Review)
Review
The irritable bowel syndrome (IBS) is the most common chronic gastrointestinal disorder referred to gastroenterologists. One of the most common manifestations of IBS is bloating. Abdominal bloating is defined as subjective sensation of abdominal distension associated with girth increment. Therefore, it is described in the Rome IV criteria as bloating/abdominal distension. Bloating symptoms are reported by 10-30% of the general population and it was rated as the most bothersome symptom by 60% of IBS patients; the lack of specificity of this complaint prevented bloating to be included between the diagnostic criteria for IBS. Indeed, bloating may be reported also in healthy people or in other functional conditions. This paper looks to the evolutions of the concepts on bloating according to the Rome working groups from the beginning until now and it represents a comprehensive review on the prevalence and pathogenesis of bloating.
Topics: Abdomen; Humans; Irritable Bowel Syndrome
PubMed: 29894305
DOI: 10.2478/rjim-2018-0017 -
World Journal of Gastroenterology Dec 2019Gastro-oesphageal reflux disease is an increasing health burden. The mainstay of treatment has conventionally been medical therapy but since the introduction of...
Gastro-oesphageal reflux disease is an increasing health burden. The mainstay of treatment has conventionally been medical therapy but since the introduction of laparoscopic surgery laparoscopic anti-reflux surgery has been increasingly used for intractable symptoms or in patients unwilling to take long term medication. The Nissen 360 degree wrap has traditionally been considered the gold standard operation but can be associated with significant complications. These complications include "gas bloat" and dysphagia and can occur relatively frequently. Various modifications have been described to the original operation and some of these have been described. In addition alternative wraps have been described which seem to have a reduced incidence of complications associated with their use. This editorial discusses the various types of wrap that can be performed and the minimum requirements of the surgical technique. The evidence from a recent meta-analysis of the randomised data has suggested that an anterior wrap is associated with a lower rate of complications and gives just as good control of reflux symptoms. The advantages and disadvantages of an anterior wrap are discussed. The lack of long term follow up data concerns some practitioners and at the moment the choice of wrap carried out still rests with the individual surgeon.
Topics: Fundoplication; Gastroesophageal Reflux; Humans; Laparoscopy; Postoperative Complications; Treatment Outcome
PubMed: 31908391
DOI: 10.3748/wjg.v25.i48.6876 -
Journal of Clinical Medicine Nov 2023Endometriosis is a chronic inflammatory disease where endometrial-like lesions settle outside the uterus, resulting in extensive inflammatory reactions. It is a complex... (Review)
Review
Endometriosis is a chronic inflammatory disease where endometrial-like lesions settle outside the uterus, resulting in extensive inflammatory reactions. It is a complex disease that presents with a range of symptoms, with pain and infertility being the most common. Along with severe dysmenorrhea, cyclic and acyclic lower abdominal pain, cyclic dysuria and dyschezia, dyspareunia, and infertility, there are also nonspecific complaints that can cause confusion and make endometriosis the chameleon among gynecological diseases. These symptoms include unspecific intestinal complaints, cyclic diarrhea, but also constipation, nausea, vomiting, and stomach complaints. It appears that in addition to general bowel symptoms, there are also specific symptoms related to endometriosis such as cyclic bloating of the abdomen, known as endo belly. During the second half of the menstrual cycle leading up to menstruation, the abdomen becomes increasingly bloated causing discomfort and pain due to elevated sensitivity of the intestinal wall. Patients with endometriosis exhibit a reduced stretch pain threshold of the intestinal wall. Here, we review the endo belly, for the first time, pathophysiology and the influence of other diseases (such as irritable bowel syndrome-IBS), microbiome, hormonal levels, inflammation, and diet on the presentation of this condition.
PubMed: 38002788
DOI: 10.3390/jcm12227176 -
Nutrients May 2019Acute diarrhea is a major cause of childhood morbidity and an economic burden for families. The aim of this study is to explore the effect of probiotics on clinical... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Acute diarrhea is a major cause of childhood morbidity and an economic burden for families. The aim of this study is to explore the effect of probiotics on clinical symptoms, intestinal microbiota, and inflammatory markers during childhood diarrhea.
METHODS
Children ( = 81) aged six months to six years (mean age 2.31 years) hospitalized for acute diarrhea were randomized to receive probiotics ( variety ; = 42) or no probiotics ( = 39) orally twice daily for seven days. Feces samples were also collected to evaluate microbial content using a traditional agar plate and next-generation sequencing. Immunoglobulin A (IgA), lactoferrin, and calprotectin were determined by enzyme-linked immunosorbent assay (ELISA) and compared in different groups. Other clinical symptoms or signs, including fever, vomiting, diarrhea, abdominal pain, bloated abdomen, daily intake, appetite, and body weight were also assessed.
RESULTS
Data were collected from 81 individuals across three different time points. Total fecal IgA levels in fecal extracts of the probiotics group were higher than those in the control group, reaching statistical significance ( 0.05). Concentrations of fecal lactoferrin and calprotectin were significantly downregulated in patients with probiotic variety (Lc) consumption compared to those of the control ( 0.05). Probiotic Lc administration may be beneficial for gut-microbiota modulation, as shown by the data collected at one week after enrollment. Counts of and species were elevated in stool culture of the probiotic group. Appetite and oral intake, body-weight gain, abdominal pain, bloating, as well as bowel habits (diarrhea) were much better in children receiving probiotics compared with those in the control group.
CONCLUSION
Fecal IgA increased during acute diarrhea under Lc treatment; in contrast, fecal lactoferrin and calprotectin were downregulated during acute diarrhea under Lc treatment. Probiotic Lc may be a useful supplement for application in children during acute diarrhea to reduce clinical severity and intestinal inflammatory reaction.
Topics: Acute Disease; Age Factors; Child; Child, Preschool; Diarrhea; Down-Regulation; Feces; Female; Gastrointestinal Microbiome; Humans; Immunoglobulin A; Infant; Inflammation Mediators; Lacticaseibacillus casei; Lactoferrin; Leukocyte L1 Antigen Complex; Male; Probiotics; Prospective Studies; Taiwan; Time Factors; Treatment Outcome
PubMed: 31126062
DOI: 10.3390/nu11051150 -
American Family Physician Mar 2019
Topics: Eructation; Flatulence; Humans
PubMed: 30811169
DOI: No ID Found -
American Journal of Pharmaceutical... Apr 2023The syllabus is the cornerstone for directing faculty and student interaction within the didactic and experiential settings. Within each syllabus is both essential and... (Review)
Review
The syllabus is the cornerstone for directing faculty and student interaction within the didactic and experiential settings. Within each syllabus is both essential and optional information to guide students, faculty, and administration in course expectations as well as to explain how the course aligns within current curricular requirements to maintain program accreditation. Most syllabi contain a plethora of information that continues to grow each year, warranting concerns of syllabus bloat combined with dwindling student attention to syllabus detail. This paper summarizes best practices related to designing effective course syllabi and recommendations to promote clear and concise communication between students, faculty, and administrators involved in pharmacy education.
Topics: Humans; Education, Pharmacy; Curriculum; Students, Pharmacy; Faculty; Program Development
PubMed: 35487683
DOI: 10.5688/ajpe8995 -
World Journal of Gastroenterology Oct 2014Bloating is one of the most common and bothersome symptoms complained by a large proportion of patients. This symptom has been described with various definitions, such... (Review)
Review
Bloating is one of the most common and bothersome symptoms complained by a large proportion of patients. This symptom has been described with various definitions, such as sensation of a distended abdomen or an abdominal tension or even excessive gas in the abdomen, although bloating should probably be defined as the feeling (e.g. a subjective sensation) of increased pressure within the abdomen. It is usually associated with functional gastrointestinal disorders, like irritable bowel syndrome, but when bloating is not part of another functional bowel or gastrointestinal disorder it is included as an independent entity in Rome III criteria named functional bloating. In terms of diagnosis, major difficulties are due to the lack of measurable parameters to assess and grade this symptom. In addition, it is still unclear to what extent the individual patient complaint of subjective bloating correlates with the objective evidence of abdominal distension. In fact, despite its clinical, social and economic relevance, bloating lacks a clear pathophysiology explanation, and an effective management endorsement, turning this common symptom into a true challenge for both patients and clinicians. Different theories on bloating etiology call into questions an increased luminal contents (gas, stools, liquid or fat) and/or an impaired abdominal empting and/or an altered intra-abdominal volume displacement (abdomino-phrenic theory) and/or an increased perception of intestinal stimuli with a subsequent use of empirical treatments (diet modifications, antibiotics and/or probiotics, prokinetic drugs, antispasmodics, gas reducing agents and tricyclic antidepressants). In this review, our aim was to review the latest knowledge on bloating physiopathology and therapeutic options trying to shed lights on those processes where a clinician could intervene to modify disease course.
Topics: Animals; Enteric Nervous System; Gastrointestinal Agents; Gastrointestinal Diseases; Gastrointestinal Motility; Gastrointestinal Tract; Humans; Mechanotransduction, Cellular; Pressure; Sensory Thresholds; Terminology as Topic; Treatment Outcome
PubMed: 25339827
DOI: 10.3748/wjg.v20.i39.14407 -
Gastroenterology & Hepatology Feb 2022
PubMed: 35505815
DOI: No ID Found -
Advances in Nutrition (Bethesda, Md.) Dec 2022Nondigestible carbohydrates (NDCs) are food components, including nonstarch polysaccharides and resistant starches. Many NDCs are classified as dietary fibers by the US... (Review)
Review
Nondigestible carbohydrates (NDCs) are food components, including nonstarch polysaccharides and resistant starches. Many NDCs are classified as dietary fibers by the US FDA. Because of their beneficial effects on human health and product development, NDCs are widely used in the food supply. Although there are dietary intake recommendations for total dietary fiber, there are no such recommendations for individual NDCs. NDCs are heterogeneous in their chemical composition and physicochemical properties-characteristics that contribute to their tolerable intake levels. Guidance on tolerable intake levels of different NDCs is needed because overconsumption can lead to undesirable gastrointestinal side effects, further widening the gap between actual and suggested fiber intake levels. In this review, we synthesize the literature on gastrointestinal effects of NDCs that the FDA accepts as dietary fibers (β-glucan, pectin, arabinoxylan, guar gum, alginate, psyllium husk, inulin, fructooligosaccharides and oligofructose, galactooligosaccharides, polydextrose, cellulose, soy fiber, resistant maltodextrin/dextrin) and present tolerable intake dose recommendations for their consumption. We summarized the findings from 103 clinical trials in adults without gastrointestinal disease who reported gastrointestinal effects, including tolerance (e.g., bloating, flatulence, borborygmi/rumbling) and function (e.g., transit time, stool frequency, stool consistency). These studies provided doses ranging from 0.75-160 g/d and lasted for durations ranging from a single-meal tolerance test to 28 wk. Tolerance was NDC specific; thus, recommendations ranged from 3.75 g/d for alginate to 25 g/d for soy fiber. Future studies should address gaps in the literature by testing a wider range of NDC doses and consumption forms (solid compared with liquid). Furthermore, future investigations should also adopt a standard protocol to examine tolerance and functional outcomes across studies consistently.
Topics: Adult; Humans; Gastrointestinal Tract; Carbohydrates; Dietary Fiber; Feces; Alginates
PubMed: 36041173
DOI: 10.1093/advances/nmac094