The Efficacy of Persian Medicine Based Life Style Modification on Functional Bloating: A Randomized Controlled Clinical Trial

Functional bloating is one of the gastrointestinal diseases that impacts the quality of life and social activities of the patients. The present study aimed to evaluate the effectiveness of lifestyle modification based on Persian Medicine (PM) on functional bloating improvement. Fifty patients with functional bloating and ROME III confirmation criteria were enrolled in the study groups of control and intervention. The intervention group received lifestyle modification education based on PM perspectives, and the control group did not receive any training. The score of implementing PM recommendations by patients was evaluated by the questionnaire of “compliance with the PM principles effective on functional bloating” once every two weeks during the two months of the study. The severity of clinical Complications Associated with Functional Bloating (CAFB) was also evaluated before and after the study by visual analog scale. Primary and secondary outcomes were analyzed by t-test and ANCOVA in SPSS version 19. The qualitative data analysis was performed via Chi-square and Mann-Whitney tests. The severity of clinical CAFB was significantly higher in women at baseline (P = 0.027). Lifestyle modification of patients led to a gradual increase in compliance with the PM principles. By the end of the study, the mean score of compliance with the PM principles in the intervention group was significantly higher compared to the pre-intervention score (P<0.0001) and also compared to the control group (P < 0.0001). Besides, the educational intervention resulted in a significant decrease (51.8%) in the mean severity of all clinical CAFB in the intervention group before and after training (P < 0.0001) and between the control group and the intervention group (P < 0.0001). Therefore, Lifestyle modification based on PM probably can be effective in improving the clinical complications of functional bloating.

Symptom-based ordinal scale fuzzy clustering of functional gastrointestinal disorders

Background The validity of Rome III criteria for diagnosing functional gastrointestinal disorders (FGIDs) have been frequently questioned in the literature. In epidemiology, when a disease is diagnosed, the existence of a true cluster must be proven. Thus, clustering the common GI symptoms of individuals and comparing the clusters with FGIDs defined by the Rome III criteria could provide insights about the validity of FGIDs defined by those criteria. Well-separated compact clusters were detected in responses to questionnaires of the epidemiological features of different FGIDs in Iranian adults using fuzzy ordinal clustering. The representative sample from each cluster i.e. Cluster Representative (CR) was formed whose corresponding FGID was diagnosed with Rome III criteria. Then, FGID diagnosis was performed for all participants in each cluster and the percentage of cases whose FGID was the same as the cluster's identified FGID (agreement) was reported. Results Fourteen valid clusters were detected in 4763 people. The average membership of the objects in each cluster was 77.3%, indicating similarity of the objects in clusters to their corresponding CRs. Eight clusters were assigned to single FGIDs (irritable bowel syndromes: constipation IBS-C, diarrhea IBS-D and un-subtyped IBS-U; functional bloating FB; functional constipation FC; belching disorder BD. The agreement was higher than 50% in single FGID clusters except those whose diagnosis was IBS-U. Conclusions IBS-C, IBS-D, FC, BD, and FB defined with Rome III criteria exist in the population, which is not the case for IBS-U.

A systematic review of the association between fibromyalgia and functional gastrointestinal disorders

Background: Fibromyalgia and functional gastrointestinal disorders (FGID) including irritable bowel syndrome (IBS) are common conditions presenting in clinical settings and are more prevalent in women. While the relationship between IBS and fibromyalgia has been demonstrated, a review of the prevalence of the broader group of FGID in adults with fibromyalgia has not been undertaken. The aim of this review was to systematically review the published literature, identifying the comorbidity of FGID in people with fibromyalgia, and to discuss the clinical implications, limitations of current research and areas of interest for future research Methods: Medline, Embase, CINAHL and Web of Science were searched during June 2019. Results were screened for original research articles meeting established criteria for identification of FGID in adults diagnosed with fibromyalgia. Results: A total of 14 studies involving 1340 adults with fibromyalgia, 363 healthy controls and 441 adults with other pathologies were included in this review. Only 1 of the 14 studies included surveyed the full range of FGID . Functional gut disorders were matched to Rome II criteria for reporting and comparison. In addition to increased abdominal pain and functional bloating or gas, IBS of mixed-pattern and constipation-types appear to be more prevalent than diarrhoea-predominant IBS in adults with fibromyalgia. Conclusion: This review confirms previous reports that IBS is common in people living with fibromyalgia and suggests that IBS-mixed and constipation types predominate. An association with a range of FGID other than IBS is suggested, but data are limited. Research exploring the association between fibromyalgia and functional gastrointestinal dysfunction beyond IBS are warranted.