scholarly journals Faecal Inflammatory Biomarkers and Gastrointestinal Symptoms after Bariatric Surgery: A Longitudinal Study

2021 ◽  
pp. 1-8
Author(s):  
Floris Westerink ◽  
Inge Huibregtse ◽  
Marieke De Hoog ◽  
Sjoerd Bruin ◽  
Eelco Meesters ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Reference Values ◽  
Rating Scale ◽  
Gastrointestinal Symptoms ◽  
Reference Value ◽  
Inflammatory Biomarkers ◽  
Faecal Calprotectin ◽  
Inflammatory Biomarker ◽  
Gastrointestinal Symptom Rating Scale ◽  
Gi Inflammation

<b><i>Background:</i></b> Bariatric surgery induces various gastrointestinal (GI) modifications. We performed the first study longitudinally assessing the effect of bariatric surgery on faecal inflammatory biomarker levels and its relation with GI complaints. <b><i>Method:</i></b> Faecal calprotectin, lactoferrin, and calgranulin-C levels were determined in 41 patients (34 Roux-en-Y [RYGB], 7 sleeves) before and at 6–16 weeks, 6 months, and 1 year after surgery. Changes in biomarker levels and percentage of patients above reference value were determined. Gastrointestinal symptom rating scale (GSRS) was used to assess GI complaints at corresponding time points. The postoperative relation between GSRS score and biomarker levels above reference value was investigated. <b><i>Results:</i></b> After RYGB, median calprotectin levels are significantly higher (&#x3e;188, 104–415 μg/g) than before surgery (40, 19–78 μg/g; <i>p</i> &#x3c; 0.001), and over 90% of patients have levels above reference value 1 year after surgery. Median lactoferrin was 0.4 (0.2–1.6) μg/g before, and &#x3e;5.9 (1.8–13.6) μg/g after surgery (<i>p</i> &#x3c; 0.001). Median calgranulin-C levels remained far below the reference value and were 0.13 (0.05–0.24) μg/g before and &#x3c;0.23 (0.06–0.33) μg/g after surgery. Similar results were found after sleeve gastrectomy. No difference was seen in GSRS score for patients with calprotectin and lactoferrin levels above reference values. <b><i>Conclusion:</i></b> Faecal inflammatory biomarkers calprotectin and lactoferrin, but not calgranulin-C, rise above reference values shortly after bariatric surgery and remain elevated in the majority of patients. The discrepancy between calprotectin and calgranulin-C levels suggests no GI inflammation. Furthermore, patients after RYGB with biomarkers above the population reference value do not seem to have more GI complaints.

scholarly journals A Case Report on a Fibromyalgia Patient with Gastrointestinal Symptoms Treated with Odu-tang

2021 ◽  
Vol 42 (5) ◽  
pp. 863-871
Author(s):  
Hye-yeon Jang ◽  
Sang-gu Yu ◽  
Do-hyeong Kim ◽  
Young-su Lee
Keyword(s):  
Medical Treatment ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Gastrointestinal Symptoms ◽  
Herbal Medicines ◽  
Individual Characteristics ◽  
Fibromyalgia Patient ◽  
Gastrointestinal Symptom Rating Scale ◽  
Numerical Rating ◽  
Symptom Rating

Objective: The purpose of this study was to investigate the effects of Korean medical treatment on a fibromyalgia patient with gastrointestinal symptoms, using herbal medicines selected according to new rather than existing standards.Method: A 52-year-old female patient with fibromyalgia was treated with Odu-tang and acupuncture, cupping, and moxibustion for 22 days. To evaluate the treatment, we used the Numerical Rating Scale (NRS), American College of Rheumatology’s Preliminary Diagnostic Criteria (ACR), and Korean Gastrointestinal Symptom Rating Scale (KGSRS).Result: Following treatment, pantalgia diminished, NRS, and ACR scores improved, and the GSRS score decreased from 29 to 11.Conclusion: This study suggests that Korean medical treatment could effectively reduce pain and improve digestive symptoms in patients with fibromyalgia. It also presents a new method that considers individual characteristics when choosing herbal medicine.

scholarly journals Health benefits and risks during 10 years after Roux-en-Y gastric bypass

2020 ◽  
Vol 34 (12) ◽  
pp. 5368-5376
Author(s):  
M. Chahal-Kummen ◽  
O. B. K. Salte ◽  
S. Hewitt ◽  
I. K. Blom-Høgestøl ◽  
H. Risstad ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Weight Regain ◽  
Rating Scale ◽  
Gastrointestinal Symptoms ◽  
Percent Excess Weight Loss ◽  
Gastrointestinal Symptom Rating Scale ◽  
Laparoscopic Rygb ◽  
Prospective Longitudinal

Abstract Background Long-term evaluations 10 years after Roux-en-Y gastric bypass (RYGB) are limited. We report the development in weight and cardiovascular risk factors during 10 years after laparoscopic RYGB, with evaluation of gastrointestinal symptoms and quality of life (QoL) at 10-year follow-up. Methods We performed a prospective longitudinal cohort study. Patients operated with laparoscopic RYGB from May 2004 to November 2006 were invited to 10-year follow-up consultations. Gastrointestinal Symptom Rating Scale (GSRS) questionnaire and two QoL questionnaires were used for analyses of gastrointestinal symptoms and QoL. Results A total of 203 patients were operated; nine (4.4%) died during follow-up. Of 194 eligible patients, 124 (63.9%) attended 10-year follow-up consultations. Percent excess weight loss (%EWL) and percent total weight loss (%TWL) at 10 years were 53.0% and 24.1%, respectively. %EWL > 50% was seen in 53.2%. Significant weight regain (≥15%) from 2 to 10 years was seen in 63.3%. Remission rates of type 2 diabetes, dyslipidemia, and hypertension were 56.8%, 46.0%, and 41.4%, respectively. Abdominal operations beyond 30 days after RYGB were reported in 33.9%. Internal hernia and ileus (13.7%) and gallstone-related disease (9.7%) were the most common causes. Vitamin D deficiency (<50nmol/L) was seen in 33.3%. At 10 years, bothersome abdominal pain and indigestion symptoms (GSRS scores ≥3) were reported in 42.9% and 54.0%, respectively, and were associated with low QoL. Conclusion We observed significant weight loss and remission of comorbidities 10 years after RYGB. Significant weight regain occurred in a substantial subset of patients. Gastrointestinal symptoms were common and negatively impacted QoL.

scholarly journals MO756MANAGEMENT OF CHRONIC HIPERKALAEMIA IN CLINICAL PRACTICE IN HAEMODIALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Vicent Esteve Simó ◽  
Irati Tapia González ◽  
Ursula Vadillo ◽  
Claudia Guzman ◽  
Miquel Fulquet Nicolás ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Treatment Adherence ◽  
Rating Scale ◽  
Phase 1 ◽  
Gastrointestinal Symptoms ◽  
Treatment Compliance ◽  
Dietary Advice ◽  
Phase 3 ◽  
Gastrointestinal Symptom Rating Scale ◽  
Increased Risk

Abstract Background and Aims Patients with chronic kidney disease (CKD) on haemodialysis (HD) have an increased risk of hyperkalaemia, a serious and potentially fatal electrolyte disorder. New effective strategies for managing hyperkalaemia have recently become available. However, as yet, there is insufficient experience in routine clinical practice in HD. The aim of our study was to report the prevalence of chronic hyperkalaemia and analyse the effects of different treatment strategies on potassium management, ratio of adherence and gastrointestinal symptoms in our HD population. Method A 12-week, prospective, single-centre study in HD patients with chronic hyperkalaemia (&gt;5.5 mmol/l). Three study phases were established: Phase 1 — dietary advice (DA); Phase 2 — calcium polystyrene sulfonate resins (CPSRs); and Phase 3 — patiromer. In each phase, we analysed sociodemographic data, related biochemical data, treatment adherence and compliance (Simplified Medication Adherence Questionnaire [SMAQ]), gastrointestinal symptoms (Gastrointestinal Symptom Rating Scale [GSRS]), HD characteristics and usual medical treatment. Results 29.2% hyperkalaemia (46% mild); 13 patients (61.5% female); mean age 63.8 ± 14.1 years and 46.4 ± 41.6 months on HD. Serum K values decreased significantly (*p &lt;0.05) only in phase 3 (–0.75 mmol/l), with a higher percentage of patients reaching optimal K range. Compared with CPSRs, patiromer yielded significantly better overall GSRS scores: abdominal pain (3.7 versus 2.5), constipation (7.1 versus 5.3), indigestion (6.2 versus 5.6); and also better treatment compliance. No significant changes were found in any other biocbhemical data, HD characteristics or usual medication over the course of the study. Conclusion Chronic hyperkalaemia is a highly prevalent disorder on our HD unit. Compared to dietary advice and traditional potassium binders; patiromer was effective in managing chronic hyperkalaemia, leading to improvement in gastrointestinal symptoms and treatment adherence with no associated severe adverse effects. Thus, considering our results, we shall consider patiromer a first-line treatment for chronic hyperkalaemia in our patients with HD.

scholarly journals Beneficial Effects of a Low-Nickel Diet on Relapsing IBS-Like and Extraintestinal Symptoms of Celiac Patients during a Proper Gluten-Free Diet: Nickel Allergic Contact Mucositis in Suspected Non-Responsive Celiac Disease

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2277 ◽  
Author(s):  
Raffaele Borghini ◽  
Natascia De Amicis ◽  
Antonino Bella ◽  
Nicoletta Greco ◽  
Giuseppe Donato ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Rating Scale ◽  
Gastrointestinal Symptoms ◽  
Gluten Free Diet ◽  
Rank Test ◽  
Gluten Free ◽  
Gastrointestinal Symptom Rating Scale ◽  
Histological Remission ◽  
Allergic Contact ◽  
Age Range

Background and Aim: Nickel (Ni)-rich foods can induce allergic contact mucositis (ACM) with irritable bowel syndrome (IBS)-like symptoms in predisposed subjects. Ni ACM has a high prevalence (>30%) in the general population and can be diagnosed by a Ni oral mucosa patch test (omPT). Many celiac disease (CD) patients on a gluten-free diet (GFD) often show a recrudescence of gastrointestinal and extraintestinal symptoms, although serological and histological remission has been achieved. Since a GFD often results in higher loads of ingested alimentary Ni (e.g., corn), we hypothesized that it would lead to a consequent intestinal sensitization to Ni in predisposed subjects. We wanted to (1) study Ni ACM prevalence in still symptomatic CD patients on a GFD and (2) study the effects of a low-Ni diet (LNiD) on their recurrent symptoms. Material and Methods: We recruited 102 consecutive CD patients (74 female, 28 male; age range 18–65 years, mean age 42.3 ± 7.4) on a GFD since at least 12 months, in current serological and histological remission (Marsh–Oberhuber type 0–I) who complained of relapsing gastrointestinal and/or extraintestinal symptoms. Inclusion criteria: presence of at least three gastrointestinal symptoms with a score ≥5 on the modified Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. Exclusion criteria: IgE-mediated food allergy; history of past or current cancer; inflammatory bowel diseases; infectious diseases including Helicobacter pylori; lactose intolerance. All patients enrolled underwent Ni omPT and followed a LNiD for 3 months. A 24 symptoms questionnaire (GSRS modified according to the Salerno Experts’ Criteria, with 15 gastrointestinal and 9 extraintestinal symptoms) was administered at T0 (free diet), T1 (GFD, CD remission), T2 (recurrence of symptoms despite GFD), and T3 (GFD + LNiD) for comparisons. Comparisons were performed using Wilcoxon signed-rank test. RESULTS: Twenty patients (all female, age range 23–65 years, mean age 39.1 ± 2.9) out of 102 (19.6%) were finally included. All 20 patients enrolled (100%) showed positive Ni omPT, confirming an Ni ACM diagnosis. A correct GFD (T0 vs. T1) induced the improvement of 19 out of the total 24 (79.2%) symptoms, and 14 out of 24 (58.3%) were statistically significant (p-value < 0.0083 according to Bonferroni correction). Prolonged GFD (T1 vs. T2) revealed the worsening of 20 out of the total 24 (83.3%) symptoms, and 10 out of 24 (41.7%) were statistically significant. LNiD (T2 vs. T3) determined an improvement of 20 out of the total 24 (83.4%) symptoms, and in 10 out of 24 (41.7%) symptoms the improvement was statistically significant. Conclusions: Our data suggest that the recrudescence of gastrointestinal and extraintestinal symptoms observed in CD subjects during GFD may be due to the increase in alimentary Ni intake, once gluten contamination and persisting villous atrophy are excluded. Ni overload can induce Ni ACM, which can be diagnosed by a specific Ni omPT. Improvement of symptoms occurs after a proper LNiD. These encouraging data should be confirmed with larger studies.

scholarly journals SEVERITY OF IRRITABLE BOWEL SYNDROME SYMPTOMS AND FODMAPS INTAKE IN UNIVERSITY STUDENTS

2021 ◽  
Vol 58 (4) ◽  
pp. 461-467
Author(s):  
Mariana Cerne AUFIERI ◽  
Juliana Masami MORIMOTO ◽  
Renata Furlan VIEBIG
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
University Students ◽  
Rating Scale ◽  
Adult Population ◽  
Gastrointestinal Symptoms ◽  
Severe Abdominal Pain ◽  
Learning Ability ◽  
Gastrointestinal Symptom Rating Scale ◽  
Irritable Bowel

ABSTRACT BACKGROUND: Irritable bowel syndrome (IBS) symptoms such as diarrhea, bloating and abdominal pain can reduce University student’s productivity and learning ability. One of the possible treatments for IBS is the temporarily exclusion of foods that have a high content of short-chain fermentable carbohydrates, the fermentable, oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs). OBJECTIVE: This study aimed to assess University student’s intake of foods that are rich in FODMAPs, looking for possible associations with the severity of IBS symptoms. METHODS: A cross-sectional study was carried out, with undergraduate students from a private University in the city of São Paulo, Brazil, aged between 19 and 46 years old and that were enrolled in different courses and stages. Students were invited to participate and those who gave their formal consent were included in this research. A sociodemographic and lifestyle questionnaire was applied, in addition to the Gastrointestinal Symptom Rating Scale - GSRS. Students also responded a short Food Frequency Questionnaire, developed to investigate habitual FODMAPs intake of Brazilian adult population. Spearman’s correlation analysis between the student’s GSRS scores and the frequency of foods rich in FODMAPs intake were performed in SPSS v.21. RESULTS: Fifty-six students were interviewed, with mean age of 21.4 years old (SD=4.41), with a predominance of women (76.8%). The GSRS results showed that 58.9% of students felt minimal to moderate abdominal discomfort and 14.3% had moderately severe to very severe abdominal pain during the prior week to the interview. Besides abdominal pain, the gastrointestinal symptoms that were most reported by students were flatulence (98.2%), stomach rumbling (89.3%) and eructations (85.7%). Greater symptom severity was observed in women (P=0.004) and sedentary students (P=0.003). Regarding FODMAPs consumption, honey (P=0.04), chocolate (P=0.03) and milk table cream (P=0.001) intakes were positively correlated with the greater severity of symptoms. CONCLUSION: Although clinical diagnosis is necessary to establish IBS, 73.2% of the students presented minimal to very severe abdominal pain during the prior week. Female had sedentary students had greater severity of gastrointestinal symptoms. A low FODMAP diet, well oriented, could bring some symptoms relief to these University students.

Risk factors for the development of digestive system diseases and prevalence of gastrointestinal symptoms in adolescents

2020 ◽  
pp. 41-47
Author(s):  
N. Komleva ◽  
V. Dolich ◽  
I. Zaikina ◽  
A. Danilov ◽  
A. Chekhonatskiy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Digestive System ◽  
Rating Scale ◽  
Gastrointestinal Symptoms ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Gastrointestinal Symptom Rating Scale ◽  
Digestive System Diseases

Digestive diseases are a very common pathology in children and adolescents. Analysis of risk factors for the development of diseases of the digestive system and prevalence of gastrointestinal symptoms in students of professional educational organizations are presented in the article. 265 students of vocational education organizations aged 15 to 18 years were examined. The study design was a one-time cross-sectional study (active screening). Standardized formalized maps were used (complaints, medical history, physical examination results, regime and nature of diets, lifestyle and social and economic aspects were studied) to assess frequency of gastrointestinal symptoms. Gastrointestinal Symptom Rating Scale (GSRS) – an internationally validated questionnaire for the study of quality of life developed by the Hassle Company (division of Astra) – was used to study gastrointestinal symptoms. Statistical data processing was carried out using «MS Excel 2002» program. The study was conducted in accordance with the requirements of bioethics, after receiving informed consent of adolescents and their parents. A number of adolescents who previously have been diagnosed with diseases of the digestive system are found; gastrointestinal symptoms are systematized and analyzed (symptom group according to the scales abdominal pain, reflux, dyspepsia diarrhoea, constipation) using the GSRS questionnaire; main risk factors for the development of digestive system diseases characteristic of adolescents are studied: (the nature and regime of diet, smoking, consumption of alcohol), awareness of students about the main factors of a healthy lifestyle were examined as results of the study. The results of the study must be taken into account when developing and implementing preventive and hygiene and educational measures that are aimed at maintaining health and improving the quality of life of the population and require an interdisciplinary approach.

Correlations Between Inflammatory Biomarkers and Activity in Inflammatory Bowel Diseases

2018 ◽  
Vol 69 (3) ◽  
pp. 710-713
Author(s):  
Catalina Mihai ◽  
Cristina Cijevschi Prelipcean ◽  
Mihaela Dranga ◽  
Otilia Gavrilescu ◽  
Anca Cardoneanu ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Inflammatory Biomarkers ◽  
Tertiary Referral Centre ◽  
Faecal Calprotectin ◽  
Inflammatory Biomarker ◽  
Reactive Protein ◽  
Non Invasive ◽  
North East ◽  
Bowel Diseases ◽  
Inflammatory Bowel

There is an increasing interest in non-invasive methods to assess gut inflammation. The data regarding the correlations between inflammatory markers and activity of inflammatory bowel disease (IBD) are still controversial. In the last years faecal calprotectin became the most widely used biomarker in diagnosis and monitoring the IBD activity. We prospectively studied the correlation between the serological inflammatory markers (platelets, erythrocyte sedimentation rate - ESR, fibrinogen, C Reactive Protein -CRP, ferritin, albumin), faecal calprotectin and severity of IBD in a tertiary referral centre in North-East Romania. Our study demonstrated that is a good correlation between serologic inflammatory markers (platelets, fibrinogen and ferritin, not ESR and albumin) and severity of IBD. CRP is a good marker in Crohn�s disease (CD) but not in ulcerative colitis (UC). Faecal calprotectin (FC) is the best inflammatory biomarker which correlates with activity both in UC and CD. Inflammatory biomarkers, especially FC are an important tool to evaluate patients with IBD.

scholarly journals Guidance on the interpretation of faecal calprotectin levels in children

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246091
Author(s):  
Martina Orfei ◽  
Marco Gasparetto ◽  
Kai O. Hensel ◽  
Florian Zellweger ◽  
Robert B. Heuschkel ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Catchment Area ◽  
Gastrointestinal Symptoms ◽  
Reference Value ◽  
Cost Effective ◽  
Diagnostic Value ◽  
Older Children ◽  
Faecal Calprotectin ◽  
Blood Tests ◽  
Inflammatory Bowel

Background Faecal calprotectin (FCP) is a powerful tool to predict inflammatory bowel disease (IBD) in patients with gastrointestinal symptoms. In the paediatric patient population, the reference value of < 50 μg/g and the influence of age on FCP levels result in a high number of redundant investigations and specialist referrals. We assessed paediatric FCP levels, their diagnostic value and corresponding referral pathways from primary and secondary care. Methods We analysed two cohorts from a precisely defined catchment area: one consisted of all FCPs measured in this area (n = 2788). The second cohort—a subset of the first cohort—consisted of FCP values and corresponding clinical data from children who were referred for possible IBD to our department (n = 373). Results In the first cohort, 47% of FCP levels were > 50 μg/g, 15% were ≥ 250 μg/g. Children < 1y had significantly (p < 0.001) higher FCP than older children. In the second cohort, 6.7% of children with an FCP of < 250 μg/g (or 8.6% with an FCP of < 600 μg/g) had IBD–all featured symptoms suggestive of IBD (e.g. bloody diarrhoea, nocturnal abdominal pain, weight loss) or abnormal blood tests. 76% of patients in whom raised FCP (> 50 μg/g) was the sole reason for being referred for suspected IBD did not have IBD. Conclusion Children with an FCP < 600 μg/g and without matching symptoms suggestive of IBD are unlikely to have IBD. A higher FCP reference value may provide cost-effective improvement that could avoid redundant investigations and specialist referrals. A guideline for specialist referrals is proposed.

scholarly journals Gastrointestinal Tolerance and Microbiome Response to Snacks Fortified with Pea Hull Fiber: A Randomized Trial in Older Adults

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Zainab Alyousif ◽  
Daniela Rivero Mendoza ◽  
Jérémie Auger ◽  
Vanessa De Carvalho ◽  
Samantha Amos ◽  
...  
Keyword(s):  
Older Adults ◽  
Gastrointestinal Symptom ◽  
Rating Scale ◽  
Gastrointestinal Symptoms ◽  
Baseline Period ◽  
Stool Frequency ◽  
Nutritional Risk ◽  
Gastrointestinal Symptom Rating Scale ◽  
Stool Form ◽  
Hull Fiber

ABSTRACT Background Consuming foods with added fiber may help older adults achieve fiber recommendations; however, many high-fiber ingredients have little effect on laxation and may contribute to unpleasant gastrointestinal side effects. Objectives The aim of the study was to determine the effects of consuming snacks fortified with pea hull fiber (PHF) on stool frequency and form, gastrointestinal symptoms, and appetite in older adults. An exploratory aim was to determine if PHF altered the microbiota profile. Methods A 10-wk, randomized, blinded, crossover study was carried out. Following a 2-wk baseline period, participants [aged (mean ± SD) 69.7 ± 6.5 y; n = 31; 14 men, 17 women] consumed snacks providing 10 g/d of PHF or a control, each for 2-wk periods followed by 2-wk washouts. Participants used the Bristol Stool Form Scale (BSFS) to record daily stool frequency and gastrointestinal symptoms, and completed the Gastrointestinal Symptom Rating Scale (GSRS) and Simplified Nutritional Appetite Questionnaire (SNAQ) biweekly. One stool was collected per period for 16S ribosomal RNA high-throughput amplicon sequencing of the fecal microbiota profile. Results Participants reported 1.63 ± 0.05 stools/d and 76.6% normal transit stool form at baseline and no change with PHF. GSRS syndrome scores were similarly unchanged. Daily abdominal noises and bloating were higher for PHF versus control, and flatulence was higher for PHF versus baseline, suggesting fermentation in some individuals. There was no evidence to suggest a common PHF-induced microbiome response for the group as a whole; however, a subgroup of participants (n = 7) who responded with increased flatulence (fermenters), harbored many different taxa than nonfermenters, and demonstrated lower abundance of Clostridiales with PHF. Appetite was unchanged with PHF. Conclusions PHF did not modulate stool form or frequency in older adults with normal bowel habits. Because snacks fortified with PHF did not suppress appetite, PHF may be an appropriate fiber source for older adults at nutritional risk. Microbiome profile may be predictive of gastrointestinal symptom response to PHF. This trial was registered at www.clinicaltrials.gov as NCT02778230.

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