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Frontiers in Psychiatry 2022In patients with anorexia nervosa (AN), gastrointestinal (GI) symptoms are common and usually improve during or after nutritional rehabilitation. It is unclear when...
BACKGROUND
In patients with anorexia nervosa (AN), gastrointestinal (GI) symptoms are common and usually improve during or after nutritional rehabilitation. It is unclear when exactly GI symptoms change in the timecourse of treatment and to which extent. In this study, we analyzed the timecourse of GI symptoms and their relation to disease-specific, demographic, anthropometric, and psychological factors in inpatients with AN.
METHODS
In weekly intervals, the Gastrointestinal Symptom Rating Scale (GSRS) was completed, and body weight was measured over a mean of 9.5 weeks in inpatients with AN. A total of four self-report questionnaires assessing psychological factors were completed before and after inpatient treatment. Data from 38 inpatients with AN were analyzed using mixed linear models.
RESULTS
Abdominal pain and constipation improved significantly in the timecourse with 0.085 ( = 0.002) and 0.101 ( = 0.004) points per week on the GSRS and were predicted to normalize after 13 ( = 0.002) and 17 ( = 0.004) weeks, respectively. Total GI symptoms tended to normalize after 25 weeks ( = 0.079). Indigestion (borborygmus, abdominal distension, eructation, flatulence) was the most severely pathological symptom at admission and did not improve significantly ( = 0.197). Diarrhea and reflux were, on average, not pathological at admission and remained stable during treatment. In addition to treatment time, the strongest predictors were ED pathology at admission for the development of abdominal pain, constipation, reflux, and total GI symptoms; stress for the development of constipation and total GI symptoms; and depression for constipation.
CONCLUSIONS
Informing patients with AN about the course of GI symptoms and their improvement during weight rehabilitation may help support compliance during treatment.
PubMed: 36061281
DOI: 10.3389/fpsyt.2022.962837 -
Prostaglandins, Leukotrienes, and... Feb 2018Omega-3 fatty acids [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] are widely recommended for health promotion. Over the last decade, prescription omega-3... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Omega-3 fatty acids [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] are widely recommended for health promotion. Over the last decade, prescription omega-3 fatty acid products (RxOME3FAs) have been approved for medical indications. Nonetheless, there is no comprehensive analysis of safety and tolerability of RxOME3FAs so far.
METHODS
A systematic review of randomized controlled trials (RCTs) was carried out based on searches in six electronic databases. The studies involving marketed RxOME3FA products were included, and adverse-effect data were extracted for meta-analysis. Subgroup analysis and meta-regression were conducted to explore the sources of potential heterogeneity.
RESULTS
Among the 21 included RCTs (total 24,460 participants; 12,750 from RxOME3FA treatment cohort and 11,710 from control cohort), there was no definite evidence of any RxOME3FA-emerging serious adverse event. Compared with the control group, RxOME3FAs were associated with more treatment-related dysgeusia (fishy taste; p = 0.011) and skin abnormalities (eruption, itching, exanthema, or eczema; p < 0.001). Besides, RxOME3FAs had mild adverse effects upon some non-lipid laboratory measurements [elevated fasting blood sugar (p = 0.005); elevated alanine transaminase (p = 0.022); elevated blood urea nitrogen (p = 0.047); decreased hemoglobin (p = 0.002); decreased hematocrit (p = 0.009)]. Subgroup analysis revealed that EPA/DHA combination products were associated with more treatment-related gastrointestinal adverse events [eructation (belching; p = 0.010); nausea (p = 0.044)] and low-density lipoprotein cholesterol elevation (p = 0.009; difference in means = 4.106mg/dL).
CONCLUSION
RxOME3FAs are generally safe and well tolerated but not free of adverse effects. Post-marketing surveillance and observational studies are still necessary to identify long-term adverse effects and to confirm the safety and tolerability profiles of RxOME3FAs.
Topics: Blood Glucose; Cholesterol, LDL; Dietary Supplements; Docosahexaenoic Acids; Dysgeusia; Eczema; Eicosapentaenoic Acid; Exanthema; Humans; Patient Safety; Randomized Controlled Trials as Topic
PubMed: 29482765
DOI: 10.1016/j.plefa.2018.01.001 -
Journal of Animal Science Aug 2022The hand-held laser methane detector (LMD) technique has been suggested as an alternative method for measuring methane (CH4) emissions from enteric fermentation of...
The hand-held laser methane detector (LMD) technique has been suggested as an alternative method for measuring methane (CH4) emissions from enteric fermentation of ruminants in the field. This study aimed to establish a standard procedure for using LMD to assess CH4 production in cattle and evaluate the efficacy of the protocol to detect differences in CH4 emissions from cattle fed with diets of different forage-to-concentrate (FC) ratios. Experiment 1 was conducted with four Hanwoo steers (584 ± 57.4 kg body weight [BW]) individually housed in metabolic cages. The LMD was installed on a tripod aimed at the animal's nostril, and the CH4 concentration in the exhaled gas was measured for 6 min every hour for 2 consecutive days. For the data processing, the CH4 concentration peaks were identified by the automatic multi-scale peak detection algorithm. The peaks were then separated into those from respiration and eructation by fitting combinations of two of the four distribution functions (normal, log-normal, gamma, and Weibull) using the mixdist R package. In addition, the most appropriate time and number of consecutive measurements to represent the daily average CH4 concentration were determined. In experiment 2, 30 Hanwoo growing steers (343 ± 24.6 kg BW), blocked by BW, were randomly divided into three groups. Three different diets were provided to each group: high FC ratio (35:65) with low-energy concentrate (HFC-LEC), high FC ratio with high-energy concentrate (HFC-HEC), and low FC ratio (25:75) with high-energy concentrate (LFC-HEC). After 10 d of feeding the diets, the CH4 concentrations for all steers were measured and analyzed in duplicate according to the protocol established in experiment 1. In experiment 1, the mean correlation coefficient between the CH4 concentration from respiration and eructation was highest when a combination of two normal distributions was assumed (r = 0.79). The most appropriate measurement times were as follows: 2 h and 1 h before, and 1 h and 2 h after morning feeding. Compared with LFC-HEC, HFC-LEC showed 49% and 57% higher CH4 concentrations in exhaled gas from respiration and eructation (P < 0.01). In conclusion, the LMD method can be applied to evaluate differences in CH4 emissions in cattle using the protocol established in this study.
Topics: Agriculture; Animal Feed; Animals; Body Weight; Cattle; Diet; Eructation; Lasers; Methane; Rumen
PubMed: 35671336
DOI: 10.1093/jas/skac211 -
Journal of Ayurveda and Integrative... 2021Dyspepsia (Amlapitta) is the commonest ailment found in the present time. Nowadays due to unawareness about Prakriti (psychosomatic constitution) people are practising...
BACKGROUND
Dyspepsia (Amlapitta) is the commonest ailment found in the present time. Nowadays due to unawareness about Prakriti (psychosomatic constitution) people are practising inappropriate diet and lifestyle which leads to disturbances in digestive system. Due to this pitta is imbalanced and common consequences are Amlapitta. If this pitta takes an upward course, then it is called Urdhwaga Amlapitta.
OBJECTIVE
This study was conducted to assess the effectiveness of Ayurveda treatment for UrdhwagaAmlapitta in terms of improvement in symptoms, cure rate, satisfaction and side effects if any.
MATERIAL AND METHODS
This was a single-arm exploratory open-label clinical trial. Patient with symptom of Urdhwaga Amlapitta were diagnosed as per Rome IV criteria and were further assessed as per eligibility criteria. Thirty patients were enrolled. They were given different herbo-mineral preparation as per ones Prakriti. These drugs were given for 28 days and patients were followed weekly in OPD for assessment of their symptom severity scores.
RESULT
Tiktamlodgar (acid eructation) and Gurukoshthatva (heaviness in abdomen) was the most commonly occurring symptom in 93% (n = 28) of participants. Seventy Percent (n = 21) of participants had Avipak severity of grade 2 or 3 followed by Gaurav in 50%. The patient was symptomatically relieved by all the symptoms of Urdhwaga Amlapitta by 3rd visit (21st day) and the difference in score was statistically significant. All participants express willingness take Ayurveda medicine in future.
CONCLUSION
Combination of Ayurveda drugs as per ones Prakriti and severity of symptoms, given to the patient of Urdhwaga Amlapitta was found to effectively cure patients within 28 days. These drugs were found to be well-tolerated, safe and acceptable.
PubMed: 33546994
DOI: 10.1016/j.jaim.2020.12.004 -
Neurogastroenterology and Motility May 2022Upper esophageal sphincter (UES) function has been extensively studied in the context of swallowing and antegrade bolus transit, but relatively little attention has been...
Upper esophageal sphincter (UES) function has been extensively studied in the context of swallowing and antegrade bolus transit, but relatively little attention has been paid to its retrograde function to facilitate belching. Indeed, prior to 2019, there were only three case reports in the world literature of individuals with a physiologically demonstrated inability to belch due to failure of the UES to relax after gas venting from the stomach and ensuing low-pressure esophageal distention. In this minireview, that disorder is termed retrograde UES dysfunction (R-UESD). The associated symptom complex includes some combination of chest pain, gurgling noises in the chest, bloating, nausea, hiccups, and flatulence. The obscurity of R-UESD has recently been challenged by two large series published in the ENT literature of circumstantially demonstrated R-UESD that was resolved by botulinum toxin (BT) injection to the cricopharyngeus. The field has now further advanced with the publication in this issue of the Journal by Oude Nijhuis et al. of 8 cases of R-UESD demonstrated by high-resolution impedance manometry (HRIM) with a provocative challenge of carbonated water. These individuals were also treated with BT and at 3-month follow-up had both an encouraging symptomatic response and HRIM demonstrated resolution of R-UESD.
Topics: Deglutition; Eructation; Esophageal Sphincter, Upper; Flatulence; Humans; Manometry; Stomach
PubMed: 35122356
DOI: 10.1111/nmo.14328 -
Alimentary Pharmacology & Therapeutics Apr 2011Rumination syndrome, characterised by the effortless, often repetitive, regurgitation of recently ingested food into the mouth, was originally described in children and... (Review)
Review
BACKGROUND
Rumination syndrome, characterised by the effortless, often repetitive, regurgitation of recently ingested food into the mouth, was originally described in children and in the developmentally disabled. It is now well-recognised that rumination syndrome occurs in patients of all ages and cognitive abilities.
AIM
To review a scholarly review on our current understanding of the rumination syndrome.
METHODS
The review was conducted on the basis of a medline search to identify relevant publications pertaining to the pathophysiology, clinical diagnosis and management of rumination syndrome.
RESULTS
The Rome III consensus established diagnostic criteria for rumination syndrome in adults, children and infants. A typical history can be highly suggestive but oesophageal (high resolution) manometry/impedance with ingestion of a meal may help to distinguish rumination syndrome from other belching/regurgitation disorders. The pathophysiology is incompletely understood, but involves a rise in intra-gastric pressure, generated by a voluntary, but often unintentional, contraction of the abdominal wall musculature, at a time of low pressure in the lower oesophageal sphincter, causing retrograde movement of gastric contents into the oesophagus. To date, controlled trials in the treatment rumination syndrome are lacking. The mainstay of treatment for rumination syndrome is explanation and behavioural treatment which consists of habit reversal techniques that compete with the urge to regurgitate. Chewing gum, prokinetics, baclofen and even antireflux surgery have been proposed as adjunctive therapies, but high quality studies are generally lacking.
CONCLUSIONS
Rumination is an under-recognised condition with incompletely understood pathophysiology. Behavioural therapy seems effective, but controlled treatment trials are lacking.
Topics: Adolescent; Adult; Bulimia; Child; Diagnosis, Differential; Eructation; Gastroesophageal Reflux; Gastrointestinal Motility; Humans; Syndrome; Vomiting
PubMed: 21303399
DOI: 10.1111/j.1365-2036.2011.04584.x -
World Journal of Gastroenterology Sep 2014To explore whether clinical presentations of gastric small gastrointestinal tumors (GISTs) mimics gastrointestinal dyspepsia symptoms.
AIM
To explore whether clinical presentations of gastric small gastrointestinal tumors (GISTs) mimics gastrointestinal dyspepsia symptoms.
METHODS
The endosonographic data of 167 patients who underwent endoscopic submucosal dissection at the Tianjin Medical University General Hospital, China between 2009 and 2011 were analyzed. GISTs and leiomyomas had a similar intragastric distribution and similar locations within the gastric wall. Therefore, patients with GISTs were chosen as the study group and those with leiomyomas were chosen as the control group. Dyspepsia symptom questionnaires were used to investigate and compare the gastrointestinal symptoms of patients with GISTs and those with gastric leiomyomas before and after endoscopic submucosal dissection (ESD). The questionnaires evaluated symptoms such as epigastric pain, heartburn, regurgitation, epigastric discomfort, nausea and vomiting, abdominal bloating, and eructation. Symptoms were assessed using a four-point scoring scale.
RESULTS
GISTs were the most common gastric submucosal lesion (67 cases, 40.12%), followed by leiomyomas (38 cases, 22.75%). Both groups were similar in terms of gender distribution (P = 0.49), intragastric location (P = 0.525), and originating layer within the gastric wall (P = 0.449), but leiomyomas were more commonly found in the proximal fundus (P < 0.05). Overall, 94.2% of the patients with small GISTs and 93.5% of those with gastric leiomyomas experienced some dyspepsia; however, total symptom scores were significantly lower in the GIST group than in the leiomyoma group (1.34 ± 1.27 vs 2.20 ± 1.70, P < 0.05). Each component of the symptom score demonstrated a statistically significant improvement in the GIST patients after ESD (P < 0.05), including epigastric pain (0.80 ± 0.90 vs 0.13 ± 0.46), heartburn (0.63 ± 1.08 vs 0.13 ± 0.41), regurgitation (0.55 ± 0.87 vs 0.22 ± 0.57), epigastric discomfort (0.70 ± 0.98 vs 0.32 ± 0.47), nausea and vomiting (0.27 ± 0.62 vs 0.05 ± 0.21), abdominal bloating (0.70 ± 0.90 vs 0.27 ± 0.49), and eructation (0.36 ± 0.61 vs 0.21 ± 0.46). For leiomyoma patients, symptoms such as heartburn, nausea, vomiting, and eructation improved after treatment; however, these improvements were not statistically significant (P > 0.05). Thus, the pathophysiology of dyspepsia symptoms may be different between the two groups.
CONCLUSION
Symptoms of gastric small GISTs may mimic those of functional dyspepsia. An alternative diagnosis should be considered in patients with functional dyspepsia and treatment failure.
Topics: Adult; Aged; Case-Control Studies; Dissection; Dyspepsia; Endosonography; Female; Gastrointestinal Stromal Tumors; Gastroscopy; Humans; Leiomyoma; Male; Middle Aged; Predictive Value of Tests; Stomach Neoplasms; Surveys and Questionnaires; Tumor Burden
PubMed: 25206285
DOI: 10.3748/wjg.v20.i33.11800 -
Animals : An Open Access Journal From... Dec 2022The aim of this study was to investigate variability in enteric CH emission rate and emissions per unit of milk across lactations among dairy cows on commercial farms in...
The aim of this study was to investigate variability in enteric CH emission rate and emissions per unit of milk across lactations among dairy cows on commercial farms in the UK. A total of 105,701 CH spot measurements were obtained from 2206 mostly Holstein-Friesian cows on 18 dairy farms using robotic milking stations. Eleven farms fed a partial mixed ration (PMR) and 7 farms fed a PMR with grazing. Methane concentrations (ppm) were measured using an infrared CH analyser at 1s intervals in breath samples taken during milking. Signal processing was used to detect CH eructation peaks, with maximum peak amplitude being used to derive CH emission rate (g/min) during each milking. A multiple-experiment meta-analysis model was used to assess effects of farm, week of lactation, parity, diet, and dry matter intake (DMI) on average CH emissions (expressed in g/min and g/kg milk) per individual cow. Estimated mean enteric CH emissions across the 18 farms was 0.38 (s.e. 0.01) g/min, ranging from 0.2 to 0.6 g/min, and 25.6 (s.e. 0.5) g/kg milk, ranging from 15 to 42 g/kg milk. Estimated dry matter intake was positively correlated with emission rate, which was higher in grazing cows, and negatively correlated with emissions per kg milk and was most significant in PMR-fed cows. Mean CH emission rate increased over the first 9 weeks of lactation and then was steady until week 70. Older cows were associated with lower emissions per minute and per kg milk. Rank correlation for CH emissions among weeks of lactation was generally high. We conclude that CH emissions appear to change across and within lactations, but ranking of a herd remains consistent, which is useful for obtaining CH spot measurements.
PubMed: 36611765
DOI: 10.3390/ani13010157 -
PloS One 2022Aerophagia is a common functional gastrointestinal disorder among children. The disease leads to symptoms related to air in the intestine leading to burping, abdominal... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Aerophagia is a common functional gastrointestinal disorder among children. The disease leads to symptoms related to air in the intestine leading to burping, abdominal distension, and excessive flatus. We aimed to perform a systematic review and a meta-analysis to assess the epidemiology of aerophagia in children.
METHODS
We conducted a thorough electronic databases (MEDLINE, EMBASE, PsycINFO and Web of Science) search for all epidemiological surveys conducted in children on aerophagia. All selected studies were assessed for their scientific quality and the extracted data were pooled to create a pooled prevalence of aerophagia.
RESULTS
The initial search identified 76 titles. After screening and in depth reviewing, 19 studies representing data from 21 countries with 40129 children and adolescents were included in the meta-analysis. All studies have used standard Rome definitions to diagnose aerophagia. The pooled prevalence of aerophagia was 3.66% (95% Confidence interval 2.44-5.12). There was significant heterogeneity between studies [I2 98.06% with 95% Confidence interval 97.70-98.37). There was no gender difference in prevalence of aerophagia in children. The pooled prevalence of aerophagia was highest in Asia (5.13%) compared to other geographical regions.
CONCLUSION
In this systematic review and meta-analysis, we found aerophagia has a significant prevalence across the world.
Topics: Adolescent; Aerophagy; Child; Eructation; Gastrointestinal Diseases; Humans; Prevalence; Surveys and Questionnaires
PubMed: 35905055
DOI: 10.1371/journal.pone.0271494 -
Animals : An Open Access Journal From... Dec 2021The aim of this study was to investigate the use of signal processing to detect eructation peaks in CH released by cows during robotic milking, and to compare recordings...
The aim of this study was to investigate the use of signal processing to detect eructation peaks in CH released by cows during robotic milking, and to compare recordings from three gas analysers (Guardian SP and NG, and IRMAX) differing in volume of air sampled and response time. To allow comparison of gas analysers using the signal processing approach, CH in air (parts per million) was measured by each analyser at the same time and continuously every second from the feed bin of a robotic milking station. Peak analysis software was used to extract maximum CH amplitude (ppm) from the concentration signal during each milking. A total of 5512 CH spot measurements were recorded from 65 cows during three consecutive sampling periods. Data were analysed with a linear mixed model including analyser × period, parity, and days in milk as fixed effects, and cow ID as a random effect. In period one, air sampling volume and recorded CH concentration were the same for all analysers. In periods two and three, air sampling volume was increased for IRMAX, resulting in higher CH concentrations recorded by IRMAX and lower concentrations recorded by Guardian SP ( < 0.001), particularly in period three, but no change in average concentrations measured by Guardian NG across periods. Measurements by Guardian SP and IRMAX had the highest correlation; Guardian SP and NG produced similar repeatability and detected more variation among cows compared with IRMAX. The findings show that signal processing can provide a reliable and accurate means to detect CH eructations from animals when using different gas analysers.
PubMed: 35011131
DOI: 10.3390/ani12010026