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Journal of Neurogastroenterology and... Apr 2024Although certain allergic diseases have been reported to be associated with the prevalence of functional dyspepsia (FD) and irritable bowel syndrome (IBS), it is unclear...
BACKGROUND/AIMS
Although certain allergic diseases have been reported to be associated with the prevalence of functional dyspepsia (FD) and irritable bowel syndrome (IBS), it is unclear whether the presence of multiple allergic diseases further increases the prevalence of FD and IBS. The aim of this study is to determine this issue in young people.
METHODS
A cohort of 8923 Japanese university students was enrolled and diagnoses of FD and IBS were confirmed using Rome III criteria. Allergic disorders diagnosed at medical institutions were obtained by means of a self-administered questionnaire.
RESULTS
The prevalence of FD, IBS, and their overlap was found to be 1.9%, 6.5%, and 1.1%, respectively. Pollen allergy was independently positively correlated with FD, IBS, and overlap of FD and IBS. Allergic rhinitis was positively linked to IBS. Drug allergy was positively associated with FD. The presence of multiple allergic diseases was positively correlated with FD and IBS (FD: adjusted OR for 2 allergic diseases: 1.95 [95% CI, 1.24-2.98], for trend = 0.003; and IBS: adjusted OR for 1 allergic disease: 1.40 [95% CI, 1.15-1.69], 2 allergic diseases 1.47 [95% CI, 1.12-1.91], and 3 or more allergic diseases: 2.22 [95% CI, 1.45-3.28], for trend = 0.001). Additionally, the concomitant existence of multiple allergic diseases was also demonstrated to have a trend that correlated with the overlap of FD and IBS ( for trend = 0.018).
CONCLUSION
Allergic disease multimorbidity is positively correlated with the prevalence of FD and IBS in a young population.
PubMed: 38576372
DOI: 10.5056/jnm23015 -
BMC Primary Care Apr 2024Dyspepsia is a commonly encountered clinical condition in Dutch general practice, which is often treated through the prescription of acid-reducing medication (ARM).... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Dyspepsia is a commonly encountered clinical condition in Dutch general practice, which is often treated through the prescription of acid-reducing medication (ARM). However, recent studies indicate that the majority of chronic ARM users lack an indication for their use and that their long-term use is associated with adverse outcomes. We developed a patient-focussed educational intervention aiming to reduce low-value (chronic) use of ARM.
METHODS
We conducted a randomized controlled study, and evaluated its effect on the low-value chronic prescription of ARM using data from a subset (n = 26) of practices from the Nivel Primary Care Database. The intervention involved distributing an educational waiting room posters and flyers informing both patients and general practitioners (GPs) regarding the appropriate indications for prescription of an ARM for dyspepsia, which also referred to an online decision aid. The interventions' effect was evaluated through calculation of the odds ratio of a patient receiving a low-value chronic ARM prescription over the second half of 2021 and 2022 (i.e. pre-intervention vs. post-intervention).
RESULTS
In both the control and intervention groups, the proportion of patients receiving chronic low-value ARM prescriptions slightly increased. In the control group, it decreased from 50.3% in 2021 to 49.7% in 2022, and in the intervention group it increased from 51.3% in 2021 to 53.1% in 2022. Subsequent statistical analysis revealed no significant difference in low-value chronic prescriptions between the control and intervention groups (Odds ratio: 1.11 [0.84-1.47], p > 0.05).
CONCLUSION
Our educational intervention did not result in a change in the low-value chronic prescription of ARM; approximately half of the patients of the intervention and control still received low-value chronic ARM prescriptions. The absence of effect might be explained by selection bias of participating practices, awareness on the topic of chronic AMR prescriptions and the relative low proportion of low-value chronic ARM prescribing in the intervention as well as the control group compared to an assessment conducted two years prior.
TRIAL REGISTRATION
10/31/2023 NCT06108817.
Topics: Humans; Drug Prescriptions; Dyspepsia; General Practice; General Practitioners; Patient Education as Topic; Netherlands
PubMed: 38575887
DOI: 10.1186/s12875-024-02351-2 -
Nutrients Mar 2024Anorexia nervosa (AN) is a severe eating disorder primarily affecting children and adolescents. Disorders of the gut-brain interaction (DGBIs) have gained recognition as...
Prevalence of Rome IV Pediatric Diagnostic Questionnaire-Assessed Disorder of Gut-Brain Interaction, Psychopathological Comorbidities and Consumption of Ultra-Processed Food in Pediatric Anorexia Nervosa.
Anorexia nervosa (AN) is a severe eating disorder primarily affecting children and adolescents. Disorders of the gut-brain interaction (DGBIs) have gained recognition as significant symptoms in individuals with AN. However, limited studies have explored GI symptoms in pediatric populations with AN using age-specific diagnostic tools. This study aims to investigate the prevalence of DGBIs, their associated psychopathological aspects and their potential correlations with ultra-processed food (UPF) consumption among pediatric AN patients. The study included AN patients who were under the care of a specialized multidisciplinary team. We assessed DGBI-related symptoms using the Rome IV Pediatric Diagnostic Questionnaire on Functional Gastrointestinal Disorders (R4PDQ) and conducted psychological evaluations. Dietary intake and UPF consumption were evaluated. Among 56 AN patients, we observed a lower prevalence of DGBIs (functional constipation: 61%; functional dyspepsia: 54%; irritable bowel syndrome: 25%) compared to the existing literature. The psychological assessments revealed high rates of depression (72%) and anxiety (70%). UPF consumption was inversely related to depression levels ( = 0.01) but positively correlated with functional constipation ( = 0.046). This study highlights the importance of using age-specific diagnostic tools and emphasizes the crucial role of a specialized multidisciplinary team in the treatment of AN.
Topics: Adolescent; Humans; Child; Anorexia Nervosa; Food, Processed; Prevalence; Rome; Irritable Bowel Syndrome; Constipation; Surveys and Questionnaires; Brain
PubMed: 38542728
DOI: 10.3390/nu16060817 -
Journal of Personalized Medicine Feb 2024Female sex hormones have been hypothesized to influence the higher prevalence of gastroparesis in females. This study investigated the effects of hormone replacement...
Female sex hormones have been hypothesized to influence the higher prevalence of gastroparesis in females. This study investigated the effects of hormone replacement therapy (HRT) on gastroparesis and its related symptoms, medication use, and diagnostic testing in post-menopausal women. Utilizing the TriNetX platform, we conducted a population-based cohort study involving post-menopausal women aged 50 or older, with and without HRT. One-to-one propensity score matching was performed to adjust for age, race, ethnicity, diabetes, body mass index (BMI), and hemoglobin A1c. The exclusion criteria included functional dyspepsia, cyclic vomiting syndrome, and surgical procedures. After applying the exclusion criteria, we identified 78,192 post-menopausal women prescribed HRT and 1,604,822 not prescribed HRT. Post-propensity matching, each cohort comprised 67,874 patients. A total of 210 of the post-menopausal women prescribed HRT developed an ICD encounter diagnosis of gastroparesis at least 30 days after being prescribed HRT compared to post-menopausal women not prescribed HRT (OR = 1.23, 95% CI [1.01-1.51] -value = 0.0395). These associations persisted in sensitivity analysis over 5 years (OR = 1.65, 95% CI [1.13-2.41] -value = 0.0086). HRT was associated with increased GI symptoms, including early satiety (OR = 1.22, 95% CI [1.03-1.45] -value = 0.0187), domperidone use (OR = 2.40, 95% CI [1.14-5.02] -value = 0.0163), and undergoing gastric emptying studies (OR = 1.67, 95% CI [1.39-2.01] -value < 0.0001). HRT is linked to an increased risk of developing an ICD encounter diagnosis of gastroparesis.
PubMed: 38541017
DOI: 10.3390/jpm14030275 -
Antibiotics (Basel, Switzerland) Feb 2024Growing antibiotic resistance complicates eradication, posing a public health challenge. Inconclusive research on sociodemographic and clinical factors emphasizes the...
Growing antibiotic resistance complicates eradication, posing a public health challenge. Inconclusive research on sociodemographic and clinical factors emphasizes the necessity for further investigations. Hence, this study aims to evaluate the correlation between demographic and clinical factors and the success rates of eradication. A group of 162 -positive patients were allocated randomly to receive either a ten-day moxifloxacin-based triple therapy or a levofloxacin-based sequential therapy. Eradication success was determined through the stool antigen test. Logistic regression analysis was utilized to figure out potential factors that contribute to eradication success. Significantly higher eradication rates were observed in the middle age group (COR: 3.671, = 0.007), among females ( = 0.035), those with BMI ≥ 25 (COR: 2.011, = 0.045), and non-smokers (COR: 2.718, = 0.018). In multivariate analysis, age and smoking emerged as significant predictors ( < 0.05). Patients with comorbidities, excluding diabetes and hypertension (COR: 4.432, = 0.019), dyspepsia (COR: 0.178, < 0.001), and moxifloxacin triple therapy (COR: 0.194, = 0.000), exhibited higher chances of eradication ( < 0.05). Further research is vital for tailored approaches to enhance eradication success.
PubMed: 38534646
DOI: 10.3390/antibiotics13030211 -
Oxford Medical Case Reports Mar 2024Japanese noodle 'udon' is an original Asian noodle popular in Japan. Udon is one of the most elastic noodle, and which is required to take more than several hours to...
Japanese noodle 'udon' is an original Asian noodle popular in Japan. Udon is one of the most elastic noodle, and which is required to take more than several hours to digest in a certain case. We encountered a case of enteropathy caused by consumption of udon. A fifteen-year-old girl visited the outpatient clinic with a symptom of epigastralgia persistent from the previous night. She had eaten noodles for dinner the night before. Clinical images showed patient's stomach filled with udon. Noodle-associated enteropathy is not rare in our community, however, there had not been reported in other Asian countries.
PubMed: 38532762
DOI: 10.1093/omcr/omae021 -
Cureus Feb 2024Open-access oesophagogastroduodenoscopy (OAO) is defined as the performance of oesophagogastroduodenoscopy (OGD) requested by referring physicians without a prior...
BACKGROUND
Open-access oesophagogastroduodenoscopy (OAO) is defined as the performance of oesophagogastroduodenoscopy (OGD) requested by referring physicians without a prior specialist consultation. With the increasing demand for specialist appointments, the use of OAO has helped to reduce healthcare utilization by decreasing prior clinic visits. This also allows endoscopies to be scheduled and performed earlier. This study aims to evaluate our experience in providing OAO services to patients with non-alarming dyspepsia symptoms under the age of 60.
METHODS
The records of patients scheduled for OAO from January 2019 to December 2022 at Singapore General Hospital (SGH) Department of Gastroenterology were analyzed.
RESULTS
Five hundred sixty-nine patients were scheduled for OAO, and 436 patients underwent the procedure. The mean age of patients was 45.7 (SD=10.9) years old. Thirty-six percent were males, and there were 80.8% Chinese, 5.3% Malay, 8.6% Indian, and 5.3% others. The median waiting time for endoscopy was 23 days (IQR 16-36), and no major adverse events were reported. Over half of the endoscopies were unremarkable (n=231, 53%). There were 25 (5.7%) patients with major findings; three had upper gastrointestinal adenocarcinoma (one oesophageal and two gastric), one had oesophageal varices, and 21 had peptic ulcer disease (10 gastric and 11 duodenal ulcers). A rapid urease test was conducted on 409 patients, and 55 (13.4%) were positive.
CONCLUSION
OAO is a safe and effective strategy for providing timely diagnostic OGD to normal-risk patients at our center. Primary care physicians are encouraged to refer non-alarming dyspepsia symptoms patients under 60 years for OAO over the conventional route.
PubMed: 38529453
DOI: 10.7759/cureus.54792 -
Frontiers in Neurology 2024Early-onset (EOMG) and late-onset (LOMG) are distinct groups of MG patients. It is unclear if treatment strategies and treatment-related adverse events may differ...
INTRODUCTION
Early-onset (EOMG) and late-onset (LOMG) are distinct groups of MG patients. It is unclear if treatment strategies and treatment-related adverse events may differ according to the age of MG onset.
METHODS
This single-center retrospective study includes all MG patients followed at a tertiary center since 2007. We reviewed the electronic clinical records.
RESULTS
In total, 212 patients were identified, 142 (67.0%) females, with a median disease duration of 10 years. The median age of symptom onset was 42.0 (26.0-64.5) years, with 130 (61.3%) EOMG cases and 82 (38.7%) LOMG. EOMG were more frequently female, had longer disease duration and often more generalized MG ( < 0.001). Comorbidities were significantly more frequent in LOMG (67.1%) compared to EOMG (53.1%) ( = 0.002). Steroid-related adverse effects motivating the switch to steroid-sparing agents (82.0%) were different between groups, with hypertension, hypercholesterolemia, diabetes mellitus and malignancies being more common in LOMG. At the same time, osteoporosis and dyspepsia were more frequent in EOMG ( < 0.001). The most common first-line choice was azathioprine (45.8%), and rituximab was used in 4 patients (1.9%).
CONCLUSION
Our study shows that treatment modalities are similar between EOMG and LOMG, while steroid-related adverse events appear to be distinct.
PubMed: 38529037
DOI: 10.3389/fneur.2024.1277420 -
European Journal of Pediatrics Jun 2024Functional gastrointestinal disorders (FGIDs) are characterized by chronic or recurrent gastrointestinal symptoms (GS) that are not explained by structural or...
Functional gastrointestinal disorders (FGIDs) are characterized by chronic or recurrent gastrointestinal symptoms (GS) that are not explained by structural or biochemical abnormalities. FGIDs are related to lower quality of life, increased demands on medical resources, and greater somatization and emotional instability. Furthermore, GS appears to be an indicator of dysbiosis in gut-microbiota, affecting the gut-microbiota-brain relationship. To develop and evaluate the psychometric properties of a new instrument called the Gastrointestinal Symptom Severity Scale (GSSS) using a web-based survey in a sample of neurotypical children and adolescents from Spain. Instrument development and validation processes were applied to the GSSS following its administration as part of an online survey. The sample included 1242 neurotypical children and adolescents. The mean age of participants was 13.95 years, with a standard deviation of 1.37 years. Overall, 13.8% suffered infectious diarrhea, 12.6% suffered abdominal pain, 5% suffered dyspepsia and 2.6% suffered gastro-esophageal reflux. A single-factor model produced good fit indices. Furthermore, internal consistency and test-retest reliability outcomes were acceptable. The GSSS was found to have acceptable metric measurement invariance. Significant correlations with other instruments were produced and were of expected direction and magnitude, confirming scale validity for hypothesis testing. Conclusions: The GSSS shows promising psychometric properties for assessing GS in neurotypical Spanish adolescents and children. What is Known: • To the best of our knowledge, instruments assessing the severity of gastrointestinal symptoms in children and adolescents are still too few. What is New: • The GSSS shows promising psychometric properties for assessing GS in neurotypical adolescents and children. The GSSS may help improve understanding of GS involvement in the gut-brain microbiota axis in children and adolescents.
Topics: Humans; Adolescent; Male; Female; Psychometrics; Child; Spain; Severity of Illness Index; Gastrointestinal Diseases; Reproducibility of Results; Surveys and Questionnaires; Quality of Life
PubMed: 38526598
DOI: 10.1007/s00431-024-05504-8 -
Cureus Feb 2024Background () is one of the most prevalent causes of chronic gastritis that can lead to gastric cancer if left untreated. Currently, endoscopy and histology are the...
Background () is one of the most prevalent causes of chronic gastritis that can lead to gastric cancer if left untreated. Currently, endoscopy and histology are the gold standard tests for the diagnosis of gastritis. Recently, studies have shown the utility of narrow-band imaging (NBI) in predicting gastritis. Therefore, we aimed to determine the diagnostic accuracy of NBI in predicting gastritis in patients with dyspepsia. Methodology After obtaining approval from the Ethical Review Committee, Sindh Institute of Urology and Transplantation, this cross-sectional study was conducted in the outpatient Clinic of Hepatogastroenterology of the institute. Inclusion criteria involved all patients of either gender aged 18 to 65 years with dyspeptic symptoms. We excluded patients with a history of proton pump inhibitor use within two weeks before endoscopy, heart failure, previous gastrectomy, portal gastropathy, cirrhosis, use of antiplatelet medications, non-steroidal anti-inflammatory drugs or anticoagulant medication, and hemorrhagic or thrombophilia disorders. Each patient underwent endoscopy-guided NBI studies followed by biopsies from the antrum and body of the stomach. Multivariate logistic regression analysis was performed for the type of NBI pattern predicting infection. The diagnostic accuracy was obtained individually for each NBI type and then for the presence of either two or all three NBI types in predicting gastritis. Results Out of the total 775 patients enrolled in the study, abnormal NBI patterns were observed in 401 (51.7%) patients. The presence of abnormal NBI antral mucosal pattern on endoscopy was significantly associated with infection (p < 0.001) with excellent diagnostic accuracy. Among the three NBI types, individually, NBI type III had excellent specificity and better diagnostic accuracy in predicting gastritis than the other two types. Furthermore, the presence of all three abnormal NBI patterns (I+II+III) together was significantly associated with the presence of gastritis with a sensitivity of 94.54%, specificity of 86.55%, and diagnostic accuracy of 90.32%. Conclusions NBI on endoscopy shows excellent diagnostic accuracy in identifying gastritis in patients with dyspepsia. However, multicenter studies are required not only to validate our results but also to predict the pre-cancerous lesions on NBI in patients with gastritis.
PubMed: 38524000
DOI: 10.7759/cureus.54756