ZNACZENIE KRENOTERAPII W REGULACJI PROCESÓW PRZEMIANY MATERII I PRACY UKŁADU POKARMOWEGO

Probiotics in irritable bowel syndrome: Has the time arrived?

Prokinetic drugs are being used with increasing frequency in the treatment of functional gastrointestinal disorders including functional dyspepsia (FD) and constipation-predominant Irritable Bowel Syndrome (IBS-C). Mosapride is a gastro-prokinetic agent that acts as a selective 5-HT4 agonist thereby accelerating gastric emptying. It has been used for the treatment of irritable bowel syndrome (IBS), functional dyspepsia (FD), and gastroesophageal reflux (GERD). Mosapride shares physiologic effects with previous 5-HT4 agonists, cisapride and tegaserod, but with a safer cardiac profile.

Angiotensin-Converting Enzyme Inhibitors and Risk of Esophageal and Gastric Cancer: A Nested Case-Control Study

Prevalence and Socioeconomic Impact of Upper Gastrointestinal Disorders in the United States: Results of the US Upper Gastrointestinal Study

Major depressive disorder (MDD) is clinically documented to co-occur with multiple gastrointestinal disorders (GID), but the potential causal relationship between them remains unclear. We aimed to evaluate the potential causal relationship of MDD with 4 GID [gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), peptic ulcer disease (PUD), and non-alcoholic fatty liver disease (NAFLD)] using a two-sample Mendelian randomization (MR) design. We obtained genome-wide association data for MDD from a meta-analysis (N = 480 359), and for GID from the UK Biobank (N ranges: 332 601-486 601) and FinnGen (N ranges: 187 028-218 792) among individuals of European ancestry. Our primary method was inverse-variance weighted (IVW) MR, with a series of sensitivity analyses to test the hypothesis of MR. Individual study estimates were pooled using fixed-effect meta-analysis. Meta-analyses IVW MR found evidence that genetically predicted MDD may increase the risk of GERD, IBS, PUD and NAFLD. Additionally, reverse MR found evidence of genetically predicted GERD or IBS may increase the risk of MDD. Genetically predicted MDD may increase the risk of GERD, IBS, PUD and NAFLD. Genetically predicted GERD or IBS may increase the risk of MDD. The findings may help elucidate the mechanisms underlying the co-morbidity of MDD and GID. Focusing on GID symptoms in patients with MDD and emotional problems in patients with GID is important for the clinical management.

Studies suggest links between diabetes and gastrointestinal (GI) traits; however, their underlying biological mechanisms remain unclear. Here, we comprehensively assess the genetic relationship between type 2 diabetes (T2D) and GI disorders. Our study demonstrates a significant positive global genetic correlation of T2D with peptic ulcer disease (PUD), irritable bowel syndrome (IBS), gastritis-duodenitis, gastroesophageal reflux disease (GERD), and diverticular disease, but not inflammatory bowel disease (IBD). We identify several positive local genetic correlations (negative for T2D – IBD) contributing to T2D’s relationship with GI disorders. Univariable and multivariable Mendelian randomisation analyses suggest causal effects of T2D on PUD and gastritis-duodenitis and bidirectionally with GERD. Gene-based analyses reveal a gene-level genetic overlap between T2D and GI disorders and identify several shared genes reaching genome-wide significance. Pathway-based study implicates leptin (T2D – IBD), thyroid, interferon, and notch signalling (T2D – IBS), abnormal circulating calcium (T2D – PUD), cardiovascular, viral, proinflammatory and (auto)immune-mediated mechanisms in T2D and GI disorders. These findings support a risk-increasing genetic overlap between T2D and GI disorders (except IBD), implicate shared biological pathways with putative causality for certain T2D – GI pairs, and identify targets for further investigation.

Understanding the Multidimensional Nature of Illness Severity as Measured by Patient-Reported Outcome Measures in Irritable Bowel Syndrome

Some observational studies have suggested an association between insomnia and the risk of certain gastrointestinal disorders, such as gastroesophageal reflux, irritable bowel syndrome and peptic ulcers. However, the direction and magnitude of the causal relationship are difficult to determine due to confounding and reverse causation. The aim of this study is to explore the causal association between insomnia and a variety of gastrointestinal disorders from genetic level using Mendelian randomization. We used a two-sample, two-way MR to analyze the link between insomnia and several gastrointestinal disorders (nine in total). Genetic variants used as instrumental variables were obtained from genome-wide association study (GWAS) data in the Open GWAS database. Causal effects were primarily estimated using inverse variance weighted (IVW), weighted median (WM) and MR-Egger. Horizontal pleiotropy was tested using MR-PRESSO and MR-Egger regression. Heterogeneity and sensitivity were assessed using Cochran's Q and leave-one-out. The forward MR analysis demonstrated significant causal effects of insomnia on gastroesophageal reflux disease (GERD) (IVW: OR = 1.864, 95%CI: 1.16-2.98, P = 0.009) and irritable bowel syndrome(IBS) (IVW: OR = 2.401, 95%CI:1.06-5.44, P = 0.036; WM: OR = 3.381, 95%CI:1.12-10.22, P = 0.031). Conversely, reverse MR analyses indicated protective associations against insomnia development for chronic gastritis (IVW: OR = 0.98, 95%CI: 0.97-0.99, P = 0.027), while revealing risk-enhancing effects for acute gastritis (IVW: OR = 1.013, 95% CI: 1.006-1.019, P < 0.001). No causal associations were observed between insomnia and the remaining five gastrointestinal conditions. Through bidirectional MR analysis of nine gastrointestinal disorders, we provide genetic evidence for causal effects of insomnia on four conditions: gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), chronic gastritis, and acute gastritis.

Gastroesophageal reflux disease (GERD) is a common malady. It is a protean disease with many manifestations. Most patients seek medical attention due to symptoms. When a surgical remedy is contemplated, it is incumbent upon the surgeon to identify those patients in whom antireflux surgery (ARS) will lead to elimination of pathologic reflux and symptomatic improvement. There are many patient-related factors and technical factors which can predict success or failure of ARS. These predictors can be divided into proper diagnosis of GERD-like symptoms, GERD-related patient factors, non-GERD related patient factors, and operation-related factors. Proper diagnosis includes insuring that the GERD-like symptoms are in fact related to pathologic reflux and not some other disease or psychological process. GERD-related patient factors include differentiating between typical and atypical symptoms, as well as upright and supine reflux. This also includes assessing for reflux related complications, such as ulcers, strictures and neoplasia. Non-GERD-related patient factors include other gastrointestinal disorders such as irritable bowel syndrome (IBS), gastroparesis and peptic ulcer disease. Psychological disorders, such as anxiety and depression, can also affect the outcomes of ARS. Lastly, technical aspects, such as the type and geometry of the fundoplication, hiatal closure, division of the short gastric vessels and addition of a pyloroplasty can affect success. Attention to these details will place the surgeon in the best position to insure a favorable outcome of an antireflux operation.

Symptoms of 50 patients with the irritable bowel syndrome were compared with those of 49 with endoscopically proven peptic ulcer disease and 49 with radiologically or endoscopically proven inflammatory bowel disease using a questionnaire which was administered after the diagnosis was made. Symptoms of bowel dysfunction including pain related to bowel movements were more likely to occur in the irritable bowel syndrome than peptic ulcer disease. Only abdominal distension, straining at stool and scybala, however, were significantly more likely in the irritable bowel syndrome than inflammatory bowel disease. Four symptoms previously shown to be more common in irritable bowel syndrome than in organic abdominal disease were combined. The more of these symptoms that were present, the more likely were the patients to have the irritable bowel syndrome than peptic ulcer disease. Symptoms of gut dysfunction are highly discriminating between irritable bowel syndrome and peptic ulcer disease but less so between irritable bowel syndrome and inflammatory bowel disease.

Dyspepsia

Management and treatment of gastrointestinal disorders

Introduction: Acid peptic disorder (APD) is a condition which includes peptic ulcer and gastro esophageal reflux disease (GERD). The highest prevalence rate of gastric disorders had been found out between ages 45-50. Dyspepsia is a term used for reduced digestion or indigestion. GERD is referred to as condition where there is regurgitation of stomach contents to the esophagus. Around 58.7% of peoples are having acid regurgitation or heart burn yearly once and 19.8% weekly once. Worldwide functional gastrointestinal disorder are commonest now a days, Irritable Bowel Syndrome (IBS) is also one among them having frequent pain abdomen and altered bowel habits without any structural gut abnormalities. Homoeopathy is a system which is based on individualization, and has principles of “Like cures like” and law of nature. Materials and methods: A retrospective study had been conducted with those patients who had attended the gastroenterology OPD of NHRIMH, Kottayam, Kerala, for a period of 1 year (from January 2022 to December 2022). Data had been collected from the case records and it had been found that around 899 patients had visited for the symptoms like nausea, vomiting, abdominal pain, altered bowel movements (diarrhea and constipation), bleeding per rectum, dysuria and hesitancy in urination,etc for the past 1 year. Aim of the study is to find out the most frequent age group, diseases affected and to know the frequently indicated remedies in treating gastroenterology disorders. Results: 899 patients visited in the defined period with a highest number of patients (212) were from the age group of 51-60, female patients were more than male patients, 758 old patients and 141 new patients. 214 pateints had diagnosed as gastritis which is the highest frequency noted. The most frequently indicated remedies were Nuxvomica in 161 patients and Suphur in 118 patients. Conclusion:It is concluded from the study that gastritis is the most common condition among patients visiting the above OPD in the defined period and Nux vomica, Sulphur and Lycopodium were the most common indicated and prescribed remedies.

In spite of the fact that both laymen and clinicians have pointed out their relevance, the psychological aspects of gastrointestinal disorders, especially their influence on etiology and pathophysiology, have been a matter of controversy and challenge to researchers. Difficulties in this field arise from several sources, for instance, the sampling methodology in the selection of patients and the heterogeneity of the disorders studied. When the irritable bowel syndrome (IBS) is compared with peptic ulcer disease (PUD), the personality features of IBS have not been described with the same consistency as the dependency traits of PUD. Also, IBS patients have been regarded as more neurotic and depressed than PUD patients. In this study of 101 IBS and 103 PUD patients, our overall impression was that mental symptoms and personality profiles were essentially the same in IBS and PUD, but that both groups differed from a normal population. We conclude that from a psychosomatic point of view IBS and PUD may be looked upon as different facets of the same underlying psychogenic mechanism. Although conclusive evidence of how psychological factors affect physiological processes and contribute to the clinical picture in gastrointestinal disorders is still lacking, it seems reasonable to state that they are often significant and must be considered in treating individual IBS and PUD patients.

BackgroundThe question of whether asthma is causally related to gastrointestinal disorders remained unanswered so far. Thus, this study investigated whether there is such a relation and whether the time of onset of asthma plays a role in the occurrence of the following gastrointestinal disorders: peptic ulcer disease (PUD), gastroesophageal reflux disease (GORD), irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD) including the distinction between Crohn’s disease (CD) and ulcerative colitis (UC).MethodsUsing summary data of genome-wide association studies (GWASs), we ran Mendelian randomization analyses based on up to 456,327 European participants. Outlier assessment, a series of sensitivity analyses and validation of IBD results in a second GWAS were performed to confirm the results.ResultsPresented ORs represent the average change in the outcome per 2.72-fold increase in the prevalence of the exposure. Genetically predicted childhood-onset asthma was positively associated with PUD, GORD, and IBS with similar odds ratios near 1.003 and adjusted P-values from 0.007 (GORD) to 0.047 (PUD). Furthermore, it was inversely related to IBD (OR = 0.992, 95% CI: 0.986, 0.998, adjusted P = 0.023) and suggestively associated with its UC subtype (OR = 0.990, 95% CI: 0.982, 0.998, adjusted P = 0.059). There were no associations between genetically predicted adult-onset asthma and the mentioned gastrointestinal disorders.ConclusionsThis study provides evidence that the presence of asthma onset in childhood increases the risk for GORD, PUD, and IBS but decreases the risk for IBD in adults. The lower risk for IBD may be attributed to a lower risk primarily for UC.