scholarly journals Increased psychological distress and somatization in patients with irritable bowel syndrome compared with functional diarrhea or functional constipation, based on Rome IV criteria

Author(s):  
Mohamed G. Shiha ◽  
Zohaib Asghar ◽  
Mo Thoufeeq ◽  
Matthew Kurien ◽  
Alex J. Ball ◽  
...  
2019 ◽  
Vol 91 (2) ◽  
pp. 25-31 ◽  
Author(s):  
A I Parfenov ◽  
N I Belostotsky ◽  
S G Khomeriki ◽  
O V Akhmadullina ◽  
S V Bykova ◽  
...  

Aim. To evaluate the effectiveness of enteroprotector Rebamipide in the treatment of enteropathy with impaired membrane digestion (EIMD). Materials and methods. We examined 102 patients aged 18 to 50 years (41 men and 61 women) with clinical signs of irritable bowel syndrome (n=65), functional diarrhea (n=33), and functional constipation (n=4) according to Rome IV criteria (2016). The activities of glucoamylase (GA), maltase, sucrase and lactase were determined by Dahlquist-Trinder method in duodenal biopsies obtained during esophagogastroduodenoscopy. The control group consisted of 20 healthy people aged 23-47. They showed following average enzyme activity: lactase - 42±13 ng glucose on 1 mg of tissue per minute, GA - 509±176, maltase - 1735±446, sucrase - 136±35 ng glucose on 1 mg of tissue per minute. These numbers were taken as the norm. Results and discussion. The activity of the disaccharidases was reduced in 89.2% out of 102 patients, and they were diagnosed with EIMD. Thirteen patients with EIMD were recommended to maintain the FODMAP diet and take enteroprotector Rebamipide 100 mg 3 times a day for 12 weeks. After 3 months 11 patients reported decreased or no flatulence, abdominal pain, stool disorder; 2 patients reported no change. The activity of GA increased to an average of 149±82 (by 78%, p=0.016), maltase - to 864±472 (by 131%, p=0.0019), sucrase - 63±35 (by 95%, p=0.0041) and lactase - 10±8 ng glucose on 1 mg of tissue per minute. The activity of lactase did not change. Conclusion. We discovered a previously unknown phenomenon of the disaccharidases activity increase in duodenal mucosa and improved carbohydrates tolerance in the patients with EIMD taking Rebamipide in the dose 300 mg/day for 12 weeks.


2020 ◽  
Author(s):  
Monica Tosto ◽  
Paola D’Andrea ◽  
Ignazio Salamone ◽  
Salvatore Pellegrino ◽  
Stefano Costa ◽  
...  

Abstract Background: Rome IV criteria for functional gastrointestinal disorders state that children suspected of having Irritable Bowel Syndrome (IBS) with Constipation (IBS-C) should be preliminarily treated for constipation. We aimed at verifying if functional constipation may indeed lead to an erroneous diagnosis of IBS with diarrhea (IBS-D) or IBS with mixed pattern of diarrhea and constipation (IBS-M). Methods: We prospectively enrolled in an unblinded fashion 10 and 16 consecutive children referred to our center who met Rome IV criteria for a diagnosis of IBS-D and IBS-M, respectively. Patients who fulfilled criteria for suspect “occult constipation” were then given a bowel cleaning regimen with Polyethylene glycol 3350, re-evaluated at 2 months and followed up for at least 6 months. Sixteen additional patients with IBS with Constipation (IBS-C) referred in the same period served as control. The endpoints were: 1) a decrease of more than 50% in abdominal pain intensity and frequency scores; and 2) for patients with IBS-D and IBS-M: resolution of diarrhea. Results: The endpoints were met by 8 (80%) and 14 (87%) of the patients with IBS-D and IBS-M, respectively, with decrease of abdominal pain and resolution of “diarrhea”. The response was not significantly different from that observed in 15 (93%) of the IBS-C control group. Conclusion: Acknowledging the limitations of the small number of patients and of the uncontrolled nature of the study, we suggest that a possibly large number of patients labeled as IBS-D or IBS-M may actually simply present functional constipation and should be managed as such.


2020 ◽  
Vol 158 (6) ◽  
pp. S-879-S-880
Author(s):  
Koji Otani ◽  
Toshio Watanabe ◽  
Yuji Nadatani ◽  
Shusei Fukunaga ◽  
Shuhei Hosomi ◽  
...  

2020 ◽  
Author(s):  
Monica Tosto ◽  
Paola D’Andrea ◽  
Ignazio Salamone ◽  
Salvatore Pellegrino ◽  
Stefano Costa ◽  
...  

Abstract Background Rome IV criteria for functional gastrointestinal disorders state that children suspected of having Irritable Bowel Syndrome (IBS) with Constipation (IBS-C) should be preliminarily treated for constipation. We aimed at verifying if functional constipation may indeed lead to an erroneous diagnosis of IBS with diarrhea (IBS-D) or IBS with mixed pattern of diarrhea and constipation (IBS-M).Methods We prospectively enrolled in an unblinded fashion 10 and 16 consecutive children referred to our center who met Rome IV criteria for a diagnosis of IBS-D and IBS-M, respectively. Patients who fulfilled criteria for suspect “occult constipation” were then given a bowel cleaning regimen with PEG 3350, re-evaluated at 2 months and followed up for at least 6 months. Sixteen additional patients with IBS with Constipation (IBS-C) referred in the same period served as control. The endpoints were: 1) a decrease of more than 50% in abdominal pain intensity and frequency scores; and 2) for patients with IBS-D and IBS-M: resolution of diarrhea.Results The endpoints were met by 8 (80%) and 14 (87%) of the patients with IBS-D and IBS-M, respectively, with decrease of abdominal pain and resolution of “diarrhea”. The response was not significantly different from that observed in 15 (93%) of the IBS-C control group.Conclusion acknowledging the limitations of the small number of patients and of the uncontrolled nature of the study, we suggest that a possibly large number of patients labeled as IBS-D or IBS-M may actually simply present functional constipation and should be managed as such.


2020 ◽  
Vol 74 (6) ◽  
pp. 535-542
Author(s):  
Radek Kroupa ◽  
Jiří Jarkovský ◽  
Barbora Packová ◽  
Šárka Doležalová ◽  
Hana Junková ◽  
...  

Background: Supplementary dietary fiber and probiotics may improve bowel symptoms due to changes in microbiome and fermentation. The aim of the study was the evaluation of symbiotic with psyllium, ColonFit, in patients with functional colonic diseases. Patients and Methods: A prospective observational study in patients with irritable bowel syndrome, functional constipation and functional diarrhea for a 4-week intake of ColonFit 10 g daily. The type and severity of bowel symptoms (scale 1–5), number and consistency of stool and quality of life features were analyzed in subgroups according to dominant initial symptoms. Results: Complete data were available from 110 patients (mean age 49.9 ± 15.3 years, 58.2% females). Constipation related symptoms were predominant in 46 (41.8%) patients, diarrhea in 28 (25.5%) and mixed type in the rest. The symptoms in constipation predominant group were more severe than in others. The significant change in softening of stool consistency (from 1.9 to 3.8 in Bristol stool scale; p < 0.001), an increase in spontaneous bowel movements (from 3.1 to 5.6× weekly; p = 0,001) and reduction of incomplete bowel movements of 40% and abdominal pain of 42% were observed in constipated patients. The reduction in a number of bowel movement per week (from 17.8 to 13.6; p = 0.001) and improvement of abdominal cramps by 27% and reduction of dietary limitations by 30% were recorded in diarrhea subgroup. The beneficial effect lasted for a two-week follow up after the discontinuation of ColonFit use. Conclusion: The ColonFit use was most beneficial in constipated patients. The improvement of several symptoms was observed in other subtypes of irritable bowel syndrome without any worsening of troubles. The use of the combination of psyllium, inulin and probiotics may offer an effective alternative for the management of functional bowel diseases.


2017 ◽  
Vol 92 (4) ◽  
pp. 366-371 ◽  
Author(s):  
Hyun Jung Kim ◽  
Ra Ri Cha ◽  
Hyun Jin Kim

Author(s):  
Desiree F. Baaleman ◽  
Carlos A. Velasco-Benítez ◽  
Laura M. Méndez-Guzmán ◽  
Marc A. Benninga ◽  
Miguel Saps

AbstractTo evaluate the agreement between the Rome III and Rome IV criteria in diagnosing pediatric functional gastrointestinal disorders (FGIDs), we conducted a prospective cohort study in a public school in Cali, Colombia. Children and adolescents between 11 and 18 years of age were given the Spanish version of the Questionnaire on Pediatric Functional Gastrointestinal Disorders Rome III version on day 0 and Rome IV version on day 2 (48 h later). The study protocol was completed by 135 children. Thirty-nine (28.9%) children were excluded because of not following the instructions of the questionnaire. The final analysis included data of 96 children (mean 15.2 years old, SD ± 1.7, 54% girls). Less children fulfilled the criteria for an FGID according to Rome IV compared to Rome III (40.6% vs 29.2%, p=0.063) resulting in a minimal agreement between the two criteria in diagnosing an FGID (kappa 0.34, agreement of 70%). The prevalence of functional constipation according to Rome IV was significantly lower compared to Rome III (13.5% vs 31.3%, p<0.001), whereas functional dyspepsia had a higher prevalence according to Rome IV than Rome III (11.5% vs 0%).Conclusion: We found an overall minimal agreement in diagnosing FGIDs according to Rome III and Rome IV criteria. This may be partly explained by the differences in diagnostic criteria. However, limitations with the use of questionnaires to measure prevalence have to be taken into account. What is Known:• The Rome IV criteria replaced the previous Rome III criteria providing updated criteria to diagnose functional gastrointestinal disorders (FGIDs).• Differences found between Rome IV and historic Rome III FGID prevalence may have been affected by changes in prevalence over time or differences in sample characteristics. What is New:• We found a minimal agreement between Rome III and Rome IV FGID diagnosis, especially in the diagnoses of functional constipation, irritable bowel syndrome, and functional dyspepsia.• The minimal agreement may be partly explained by changes in diagnostic criteria, but limitations with the use of questionnaires to measure prevalence have to be taken into account.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
L. Quénéhervé ◽  
D. Drui ◽  
J. Blin ◽  
M. Péré ◽  
E. Coron ◽  
...  

AbstractGastrointestinal symptoms are frequent in acute adrenal insufficiency. Although digestive symptoms can significantly reduce quality of life, they are rarely described in patients with treated chronic adrenal insufficiency (CAI). We aimed to characterize digestive symptoms in CAI patients. We used the section pertaining functional bowel disorders of the Rome IV questionnaire. A questionnaire was published on the website of the non-profit patient association “Adrenals” (NPPA of CAI patients) for five months. Information on demographics, characteristics of adrenal insufficiency, digestive symptoms and quality of life was collected. The relatives of CAI patients served as a control group. We analyzed responses of 33 control subjects and 119 patients (68 primary adrenal insufficiency (PAI), 30 secondary adrenal insufficiency (SAI) and 21 congenital adrenal hyperplasia (CAH)). Abdominal pain at least once a week over the past 3 months was reported by 40%, 47% and 33% of patients with PAI, SAI and CAH respectively versus 15% for the controls (p = 0.01). Symptoms were consistent with the Rome IV criteria for irritable bowel syndrome in 27%, 33% and 33% of patients respectively versus 6% for the controls (p < 0.0001). Quality of life was described as poor or very poor in 35%, 57% and 24% of patients respectively versus 5% for the controls (p < 0.0001). In conclusion, digestive symptoms are frequent and incapacitating in CAI patients and similar to symptoms of irritable bowel syndrome in 30% of CAI patients. Assessment and management of digestive symptoms should be considered a priority for physicians treating patients with CAI.


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