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BMC Infectious Diseases Jun 2023Acute gastrointestinal infections can lead to post-infectious irritable bowel syndrome (PI-IBS). Moreover, coronavirus disease (COVID-19) is related to long-term...
BACKGROUND
Acute gastrointestinal infections can lead to post-infectious irritable bowel syndrome (PI-IBS). Moreover, coronavirus disease (COVID-19) is related to long-term gastrointestinal sequelae. In this study, the frequency, disease spectrum, and risk factors for post-infection functional gastrointestinal disease (PI-FGID) in COVID-19 patients and healthy controls were prospectively examined.
METHODS
Validated Rome III and Rome IV questionnaires and limited objective assessment were used to assess the incidence of PI-FGID in 190 COVID-19 patients, and 160 healthy controls prospectively followed for 1, 3, and 6 months.
RESULTS
Six(3.2%), 1(0.5%), 3(1.6%), 5(2.6%), 6(3.2%)COVID-19 patients had diarrhea, abdominal pain, constipation, dyspepsia and their overlap at 1 month, respectively, while 4(2.1%), 1(0.5%), 4(2.1%), 4(2.1%), and 6(3.2%)COVID-19 patients had diarrhea, abdominal pain, constipation, dyspepsia and their overlap at three months, respectively. Furthermore, 2(1.3%), 4(2.5%), and 3(1.9%)healthy controls developed constipation, dyspepsia, and their overlap at one month, respectively (P = 0.193), while 2(1.3%), 4(2.5%), and 2(1.3%)healthy controls developed constipation, dyspepsia and their overlap at three months, respectively (P = 0.286). FGIDs incidence was higher among COVID-19 patients(8.9%) than in healthy controls(3.1%) at 6-month follow-up (P = 0.025). Moreover, 7 (3.7%), 5 (2.6%), 3 (1.6%), and 2 (1.1%) COVID-19 patients developed IBS, functional dyspepsia(FD), functional diarrhea(FDr), functional constipation(FC)at six months, respectively, while only 2 (1.3%) and 3 (1.9%) healthy controls developed IBS and FD at six months, respectively. Notably, gastrointestinal(GI)symptoms at onset were the independent risk factors for post-COVID-19 FGIDs at six months.
CONCLUSIONS
COVID-19 increases new-onset PI-FGID at six months compared with healthy controls. GI symptom at the onset of COVID-19 is an independent risk factor for post-COVID-19 FGIDs.
Topics: Humans; Dyspepsia; Irritable Bowel Syndrome; Follow-Up Studies; Prospective Studies; COVID-19; Gastrointestinal Diseases; Abdominal Pain; Diarrhea; Constipation; Surveys and Questionnaires
PubMed: 37344782
DOI: 10.1186/s12879-023-08401-x -
Gut and Liver May 2022Following acute gastroenteritis (AGE) due to bacteria, viruses, or protozoa, a subset of patients develop new onset Rome criteria positive irritable bowel syndrome... (Review)
Review
Following acute gastroenteritis (AGE) due to bacteria, viruses, or protozoa, a subset of patients develop new onset Rome criteria positive irritable bowel syndrome (IBS), called postinfection IBS (PI-IBS). The pooled prevalence of PI-IBS following AGE was 11.5%. PI-IBS is the best natural model that suggests that a subset of patients with IBS may have an organic basis. Several factors are associated with a greater risk of development of PI-IBS following AGE including female sex, younger age, smoking, severity of AGE, abdominal pain, bleeding per rectum, treatment with antibiotics, anxiety, depression, somatization, neuroticism, recent adverse life events, hypochondriasis, extroversion, negative illness beliefs, history of stress, sleep disturbance, and family history of functional gastrointestinal disorders (FGIDs), currently called disorder of gut-brain interaction. Most patients with PI-IBS present with either diarrhea-predominant IBS or the mixed subtype of IBS, and overlap with other FGIDs, such as functional dyspepsia is common. The drugs used to treat non-constipation IBS may also be useful in PI-IBS treatment. Since randomized controlled trials on the efficacy of drugs to treat PI-IBS are rare, more studies are needed on this issue.
Topics: Dyspepsia; Female; Gastroenteritis; Gastrointestinal Diseases; Humans; Irritable Bowel Syndrome; Risk Factors
PubMed: 34789582
DOI: 10.5009/gnl210208 -
Cleveland Clinic Journal of Medicine May 2024Functional dyspepsia is defined as persistent symptoms of postprandial bloating, early satiety, or pain in the center of the upper abdomen, without findings on upper... (Review)
Review
Functional dyspepsia is defined as persistent symptoms of postprandial bloating, early satiety, or pain in the center of the upper abdomen, without findings on upper endoscopy such as peptic ulcer disease to explain these symptoms. It is common, affecting up to 30% of the global population, but it often goes undiagnosed for years. There are 2 subtypes: epigastric pain syndrome (burning and pain) and postprandial distress syndrome (bloating and satiety). The authors discuss how to diagnose and treat both subtypes.
Topics: Humans; Dyspepsia; Abdominal Pain; Postprandial Period
PubMed: 38692696
DOI: 10.3949/ccjm.91a.23062 -
Frontiers in Psychiatry 2020Functional dyspepsia is a common functional gastrointestinal disease that is characterized by postprandial fullness, early satiation, epigastric pain, and/or epigastric... (Review)
Review
Functional dyspepsia is a common functional gastrointestinal disease that is characterized by postprandial fullness, early satiation, epigastric pain, and/or epigastric burning. Eating a meal is a key factor in the occurrence of symptoms during functional dyspepsia, and patients frequently request dietary advice that could relieve these symptoms. Eating behaviors, irregular meal patterns, and moderate-to-fast eating rates are significantly associated with functional dyspepsia. The role of diet is complex; fat ingestion increases the occurrence of symptoms in dyspeptic patients, which might be affected by cognitive factors and palatability. Data concerning the role of carbohydrates are conflicting. Wheat may induce symptoms in patients with nonceliac gluten/wheat sensitivity, and gluten-free diets might be beneficial. Data concerning the role of FODMAPs (Fructo, Oligo, Di-, Monosaccharides, And Polyols) in functional dyspepsia are lacking; however, as there is a frequent overlap between functional dyspepsia and irritable bowel syndrome, a diet that is low in FODMAPs might be useful in relieving some symptoms. Data concerning alcohol are also conflicting. Adherence to a Mediterranean diet seems to be associated with a decrease in dyspepsia symptoms. Finally, data concerning diet modifications are conflicting, and the impact of diet modifications on symptom intensity or frequency has never been reported in randomized prospective studies. Common sense dietary recommendations, such as eating slowly and regularly, as well as decreasing the fat content of meals, can be provided in daily clinical practice.
PubMed: 32116840
DOI: 10.3389/fpsyt.2020.00023 -
Neurogastroenterology and Motility Feb 2021Contemporary treatments for functional dyspepsia have limitations. Herbal medicine has been suggested as adjunctive treatment. With growing scientific recognition and... (Review)
Review
BACKGROUND
Contemporary treatments for functional dyspepsia have limitations. Herbal medicine has been suggested as adjunctive treatment. With growing scientific recognition and public interests, an in-depth review of this is timely.
AIMS/PURPOSE
To evaluate the therapeutic potential and problems that may be associated with the adoption of herbal medicines in functional dyspepsia.
METHODS
We reviewed the treatment landscape of functional dyspepsia and assessed the scientific community's interest in herbal medicine. Preclinical pharmacological and clinical trial data were reviewed for several herbal medicines available in the market. Challenges associated with adoption of herbal medicine in mainstream medicine were critically evaluated.
RESULTS
We found that herbal medicines frequently comprise a combination of herbs with multiple reported pharmacological effects on gastrointestinal motility and secretory functions, as well as cytoprotective and psychotropic properties. We identified a number of commercially available herbal products that have undergone rigorous clinical trials, involving large numbers of well-defined subjects, reporting both efficacy and safety for functional dyspepsia. Persisting concerns include lack of rigorous assessments for majority of products, toxicity, consistency of ingredients, dose standardizations, and quality control. We provide a quality framework for its evaluation.
CONCLUSIONS
We commend herbal medicine as a viable future option in managing functional dyspepsia. An attractive appeal of herbal medicine is the prospect to simultaneously target multiple pathophysiological mechanisms. Wider adoption and acceptance of herbal medicines in treatment algorithms of functional dyspepsia will require the application of the scientific rigor expected of chemical therapies, to all stages of their development and evaluation.
Topics: Gastrointestinal Diseases; Herbal Medicine; Humans; Phytotherapy; Plant Preparations
PubMed: 33258198
DOI: 10.1111/nmo.14044 -
Frontiers in Neuroscience 2022
PubMed: 35864983
DOI: 10.3389/fnins.2022.941810 -
Research Square Oct 2023Peptic ulcer disease (PUD) and Helicobacter pylori (HP) are associated with dyspepsia, but the role of gastric intestinal metaplasia (IM) has not been described. The...
BACKGROUND
Peptic ulcer disease (PUD) and Helicobacter pylori (HP) are associated with dyspepsia, but the role of gastric intestinal metaplasia (IM) has not been described. The objective of this study is to examine the association between gastric IM and dyspepsia.
METHODS
We developed a cohort of consecutive patients referred to gastroenterology between Jan 2019 and July 2020 for dyspepsia and iron deficiency anemia (IDA) and completed an upper endoscopy with biopsies in a safety-net health system. The primary outcome was the prevalence of gastric IM in patients with dyspepsia compared to IDA. Secondary outcomes included prevalence of HP, chronic gastritis (CG) and chronic active gastritis (CAG) in the dyspepsia and IDA groups. A multivariable analysis was performed to assess the independent association between gastric IM and dyspepsia.
RESULTS
Compared to the IDA cohort (n = 366), patients with dyspepsia (n = 349) were more likely to be female (65% vs. 47%, p < 0.01), harbor gastric IM (20.3% vs. 14.2%, p = 0.03), and less likely to have CAG (12.0% vs. 26.5%, p < 0.01) or HP (10.9% vs. 21.3%, p < 0.01). After adjusting for pathological findings, race, ethnicity, gender and age, the association strengthened between IM and dyspepsia (adj OR 1.81 from OR 1.54, 95% CI 1.19-2.76, p < 0.01).
CONCLUSIONS
We observed a significant relationship between the presence of gastric IM and dyspepsia symptoms, which increased after adjusting for confounding factors. Future studies should verify the relationship between IM and dyspepsia, the effect of IM regression, and possible mediators of gastric IM on symptoms.
PubMed: 37886477
DOI: 10.21203/rs.3.rs-3335631/v1 -
Revista de Gastroenterologia de Mexico... 2023To characterize a university hospital population of Chilean adult patients with celiac disease.
INTRODUCTION AND AIM
To characterize a university hospital population of Chilean adult patients with celiac disease.
PATIENTS AND METHOD
We retrospectively reviewed the records of patients under control that were diagnosed with celiac disease through clinical characteristics, serology, and histology.
RESULTS
A total of 149 patients were included, 119 (79.9%) of whom were women. Mean patient age was 42 years at diagnosis and 13.4% of patients had a family history of celiac disease. Mean body mass index was 24.3kg/m, 55.3% presented with normal weight, 37.9% with overweight and obesity, and 6.8% with underweight. The main reasons for consultation were diarrhea (47%), weight loss (31%), dyspepsia (43%), and fatigue (26.1%). Anemia (26.1%), elevated transaminases (17.4%), low ferritin (11.4%), and hypovitaminosis D (9.3%) stood out, among others, in the initial laboratory work-up. The more frequent associated diseases were hypothyroidism (15.4%) and depressive disorder (11.4%). Small intestinal bacterial overgrowth was found in 10.1% and lactose malabsorption in 15.4%. The primary histologic diagnosis was celiac disease, with Marsh stage 3a villous atrophy (34.9%).
CONCLUSION
Our results were similar to those of other case series on adults, finding that celiac disease was more frequent in women, disease began in the fourth decade of life, extraintestinal symptoms predominated, and there was an association with other autoimmune diseases. An important percentage of patients were also overweight and obese.
Topics: Humans; Adult; Female; Male; Celiac Disease; Retrospective Studies; Overweight; Chile; Dyspepsia; Obesity
PubMed: 35504830
DOI: 10.1016/j.rgmxen.2022.03.007 -
The American Journal of Gastroenterology Jun 2022There has been a dramatic increase in clinical studies examining the relationship between disorders of gut-brain interactions and symptoms evoked by food ingestion in... (Review)
Review
There has been a dramatic increase in clinical studies examining the relationship between disorders of gut-brain interactions and symptoms evoked by food ingestion in the upper and lower gastrointestinal tract, but study design is challenging to verify valid endpoints. Consequently, mechanistic studies demonstrating biological relevance, biomarkers and novel therapeutic targets are greatly needed. This review highlights emerging mechanisms related to nutrient sensing and tasting, maldigestion, physical effects with underlying visceral hypersensitivity, allergy and immune mechanisms, food-microbiota interactions and gut-brain signaling, with a focus on patients with functional dyspepsia and irritable bowel syndrome. Many patients suffering from disorders of gut-brain interactions exhibit these mechanism(s) but which ones and which specific properties may vary widely from patient to patient. Thus, in addition to identifying these mechanisms and the need for further studies, biomarkers and novel therapeutic targets are identified that could enable enriched patient groups to be studied in future clinical trials examining the role of food in the generation of gut and non-gut symptoms.
Topics: Brain; Dyspepsia; Gastrointestinal Microbiome; Humans; Hypersensitivity; Irritable Bowel Syndrome; Microbiota
PubMed: 35506862
DOI: 10.14309/ajg.0000000000001812 -
The Keio Journal of Medicine Mar 2021In 2016, the Rome criteria were updated as Rome IV, and only minor changes were introduced for functional dyspepsia (FD). The major symptoms of FD now include not only... (Review)
Review
In 2016, the Rome criteria were updated as Rome IV, and only minor changes were introduced for functional dyspepsia (FD). The major symptoms of FD now include not only postprandial fullness, but also epigastric pain and burning, and early satiation at above the "bothersome" level. Investigations into the effect of meal ingestion on symptom generation have indicated that not only postprandial fullness and early satiety but also epigastric pain and burning sensation and nausea (not vomiting) may increase after meals. Helicobacter pylori infection is considered to be the cause of dyspepsia if successful eradication leads to sustained resolution of symptoms for more than 6 months, and such a condition has been termed H. pylori-associated dyspepsia. Prompt esophagogastroduodenoscopy and H. pylori "test and treat" may be beneficial, especially in regions with a high prevalence of gastric cancer, such as east Asia. In terms of treatment, acotiamide, tandospirone, and rikkunshito are newly listed in Rome IV as treatment options for FD. Clinical studies in the field of FD should be strictly based on the Rome IV criteria until the next Rome V is published in 2026.
Topics: Dyspepsia; Helicobacter Infections; Helicobacter pylori; Humans; Pancreatitis, Chronic
PubMed: 32612016
DOI: 10.2302/kjm.2020-0006-OA