Early Satiety Research Articles

DEATH DUE TO HEMORRAGIC SHOCK DUE TO RUPTURE ESOPHAGEAL VARICES: CLINICAL AND AUTOPSY BASED CASE REPORT

This is a case report of A 27 years old female was brought to the emergency department with the complaint of progressive abdominal distension with pain in abdomen and early satiety for last few months. On further clinical, radiological and laboratory evaluation, patient was diagnosed with portal hypertension with splenomegaly and got collapsed during the course of treatment. On autopsy examination, the cause of death was hemorrhagic shock due to rupture of esophageal varices.

A study to assess the effectiveness of ginger tea on symptoms of dyspepsia among adults

Introduction: Dyspepsia is a common gastrointestinal (GI) condition around the world. Dyspepsia is a symptom complex that includes a variety of upper GI symptoms such as epigastric pain or burning, early satiety, and post-prandial fullness. Treatment with complementary and alternative medicines, particularly herbal remedies, is one option for treating dyspepsia symptoms. Objectives: The objectives of the study were to evaluate the effectiveness of ginger tea on symptoms of dyspepsia among adults Methods: A one-group pre-test and post-test research design with 30 samples who met the inclusion criteria was used. Demographic and clinical data were collected using a self-structured questionnaire. During the pre-test, a questionnaire (LDQ) was used to assess the severity of dyspepsia symptoms using an interview method. Following the pre-test, 100ml of freshly prepared ginger tea was given once a day, seven days a week, in the morning before meals. The same tool was used for the post-test after seven days of ginger tea administration. Data has been subjected to descriptive and inferential statistics Result: During the pre-test, 13(43.33 %) of the 30 samples had moderate dyspepsia, 9(30%) had severe dyspepsia, and 8(26.67%) had mild dyspepsia, whereas in the post-test, 14(46.67%) had moderate dyspepsia, 12(40%) had mild dyspepsia, and 4(13.33%) had severe dyspepsia. Ginger tea is effective when the pre-test and post-test values are compared. At the p<0.001 level, the calculated paired ‘t’ test value of t = 9.104 was found to be statistically highly significant. Demographic variables such as marital status and clinical variables such as dyspepsia duration and smoking history show a significant association with post-test dyspepsia level at p<0.05. Conclusion: According to the study findings, the overall pre-test symptom score was mild to moderate. The post-test symptom score of dyspepsia patients who were given ginger tea showed a significant reduction in symptom severity. It was concluded that ginger had a greater impact on symptom relief in dyspepsia patients than other foods.

A study to assess the effectiveness of ginger tea on symptoms of dyspepsia among adults

Introduction: Dyspepsia is a common gastrointestinal (GI) condition around the world. Dyspepsia is a symptom complex that includes a variety of upper GI symptoms such as epigastric pain or burning, early satiety, and post-prandial fullness. Treatment with complementary and alternative medicines, particularly herbal remedies, is one option for treating dyspepsia symptoms. Objectives: The objectives of the study were to evaluate the effectiveness of ginger tea on symptoms of dyspepsia among adults Methods: A one-group pre-test and post-test research design with 30 samples who met the inclusion criteria was used. Demographic and clinical data were collected using a self-structured questionnaire.During the pre-test, a questionnaire (LDQ) was used to assess the severity of dyspepsia symptoms using an interview method. Following the pre-test, 100ml of freshly prepared ginger tea was given once a day, seven days a week, in the morning before meals. The same tool was used for the post-test after seven days of ginger tea administration. Data has been subjected to descriptive and inferential statistics Result: During the pre-test, 13(43.33 %) of the 30 samples had moderate dyspepsia, 9(30%) had severe dyspepsia, and 8 (26.67 %) had mild dyspepsia, whereas in the post-test, 14(46.67%) had moderate dyspepsia, 12(40%) had mild dyspepsia, and 4(13.33%) had severe dyspepsia. Ginger tea is effective when the pre-test and post-test values are compared. At the p<0.001 level, the calculated paired ‘t’ test value of t = 9.104 was found to be statistically highly significant. Demographic variables such as marital status and clinical variables such as dyspepsia duration and smoking history show a significant association with post-test dyspepsia level at p<0.05. Conclusion: According to the study findings, the overall pre-test symptom score was mild to moderate. The post-test symptom score of dyspepsia patients who were given ginger tea showed a significant reduction in symptom severity. It was concluded that ginger had a greater impact on symptom relief in dyspepsia patients than other foods.

Effect of comorbid benign joint hypermobility and juvenile fibromyalgia syndromes on pediatric functional gastrointestinal disorders

ABSTRACT Objectives Musculoskeletal pain has a considerable frequency in pediatric outpatients. Benign joint hypermobility (BJHS) and juvenile fibromyalgia syndrome (JFMS) are non-inflammatory causes of musculoskeletal pain. In these syndromes, pain is often accompanied by various symptoms such as fatigue, sleep difficulties, mood disorders, cognitive dysfunction, dizziness, headaches, abdominal pain, irritable bowel syndrome, and restless legs syndrome. Functional dyspepsia, functional vomiting, functional abdominal pain, functional constipation, and irritable bowel syndrome all together are termed functional gastrointestinal (GI) disorders. We aimed to evaluate the functional gastrointestinal disorders association of BJHS and JFMS. Methods Patients aged 10–18 years who were diagnosed with functional GI disorder in the pediatric gastroenterology department were included in the study. The findings of BJHS and JFMS were evaluated by the pediatric rheumatology department. Scales for anxiety, somatization, and depression were administered by a child psychiatrist. COMPASS 31 scoring was used in autonomic dysfunction. Results The prevalence of JFMS and BJHS was 64% and 32%, respectively in children with a functional GI disorder. Retrosternal chest pain, dysphagia, early satiation, nausea, vomiting, and regurgitation were common in JFMS (p = 0.007; p = 0.005; p = 0.018; p = 0.002, p = 0.013; p = 0.014, respectively). Gastrointestinal symptoms did not differ with BJHS. One hundred six (88.3%) and 99 (82.5%) had orthostatic intolerance and reflex syncope, respectively. One hundred three (85.6%) had anxiety symptoms, 101 (84.2%) had somatization symptoms, and 102 (85%) had depression symptoms. Conclusions Functional GI disorders, JFMS, and BJHS are complex intertwined disorders influenced by emotional distress. Therefore, a multidisciplinary approach is necessary for the diagnosis and treatment process.

Aetiology and Pattern of Presentation of Upper Gastrointestinal Tract Ulcers among Patients Attending the Gastroenterology Department of BSMMU-A Tertiary Level Hospital

Background: Upper gastrointestinal endoscopy is the most common procedure performed in Gastroenterology department for numerous indications and ulceration of the upper GI tract is one of the major pathological findings during endoscopy. Early diagnosis of upper GI ulcers with definite cause is the mainstay of therapy for patient’s cure and prevention of complications. Different clinical features are observed in different types of ulcer. Objective: The objective of this study is to find out the causes of different types of ulceration in the upper gastrointestinal tract along with their clinical presentation. Methods: This cross-sectional study was conducted in the Department of Gastroenterology, BSMMU, Dhaka, Bangladesh during the period of July 2016 to April 2017. Patients referred for upper GI endoscopy for different indications were primarily selected. Consecutive 220 patients having ulcers anywhere in the upper GIT were finally included in the study. Ulcer diseases were diagnosed through analysis of morphology of the ulcers, histopathology of biopsy materials, relevant clinical history and further investigations if required. All the findings were documented in predesigned data collection sheet. Any association between various types of ulcers with age, gender, BMI, lifestyle, location of ulcer, different signs and symptoms was assessed. Results: Out of 220 patients duodenal ulcer was found in 45.9%, gastric ulcer in 30.0%, oesophageal ulcer in 7.7%, ulceration at multiple sites in 13.6%, and stomal ulcer in 2.7% cases. Among the aetiologies H. pylori infection (62.8%), NSAIDs (14.6%) and malignant ulcers (9.1%) were found in majority of cases. Less common causes were tubercular ulcer, lymphoma, GIST, Crohn’s disease and caustic injury. Aetiology could not be identified in 6.8% cases. Among various presenting complaints epigastric pain, early satiety, anorexia, vomiting and GI bleeding were the symptoms that differ significantly in patients with ulcers ...........

Histologic Features of Syphilitic Gastritis: A Rare but Resurging Imitator of Common Diseases.

The range of histopathologic features of gastric syphilis is not well described. Here we describe the clinicopathologic findings of eight patients with syphilitic gastritis. A search of our Pathology Data System (2003-2022) and multiple other institutions identified eight patients with syphilitic gastritis. Clinical information, pathology reports, and available slides were reviewed. Lesions predominated in middle-aged adults (mean age, 47.2 years; range, 23-61 years) with a propensity for men (n = 7). Three patients had a documented history of human immunodeficiency virus. Clinical presentations included weight loss, abdominal pain, hematochezia, fever, dyspepsia, nausea and vomiting, hematemesis, anemia, and early satiety. Endoscopic findings included ulcerations, erosions, abnormal mucosa, and nodularity. All specimens shared an active chronic gastritis pattern with intense lymphohistiocytic infiltrates, variable plasma cells, and gland loss. Prominent lymphoid aggregates were seen in four specimens. The diagnosis was confirmed either by immunostain for Treponema pallidum (n = 7) or by direct immunofluorescence staining and real-time polymerase chain reaction (n = 1). All patients with available follow-up data showed resolution of symptoms after antibiotic therapy (n = 4). Recognition of the histologic pattern of syphilitic gastritis facilitates timely treatment, prevents further transmission, and avoids unnecessarily aggressive treatment.

Combination of immunotherapy and Kampo medicines for a patient with autoimmune autonomic ganglionopathy

Combination of immunotherapy and Kampo medicines for a patient with autoimmune autonomic ganglionopathy

Evaluation of the dynamics of symptoms of dyspepsia after eradication therapy in patients with Helicobacter pylori-associated gastritis

The treatment of functional dyspepsia remains a complex and incompletely resolved issue of gastroenterology. Subjective sensations of the patient, described as a feeling of fullness in the epigastrium after eating, early satiety, pain in the epigastrium, may be a manifestation of dyspepsia associated with Helicobacter pylori (H. pylori) infection. Aim was evaluation of the effectiveness of standard triple eradication therapy enhanced with bismuth tripotassium dicitrate for the relief of symptoms of dyspepsia in patients with H. pylori-associated chronic gastritis. Materials and Methods. The study involved 38 patients with H. pylori-associated chronic gastritis with symptoms of dyspepsia. The Questionnaire “7 × 7” was used to describe the dynamics of symptoms of dyspepsia. Results. At the initial examination, dyspeptic disorders in most patients corresponded the criteria for mild and moderate severity, respectively - 44.7% and 28.9% of patients. The severity of pain in the stomach area on average corresponded to a moderate pain syndrome, and the burning sensation was of low intensity. A feeling of fullness in the stomach after eating and/or early satiety was experienced by 76.3% of patients, pain disorders were observed in 92.1% of individuals. Two months after successful eradication treatment, complete relief of dyspepsia symptoms was noted in 57.9% of patients, and significant relief of symptoms of the combined form of dyspepsia in 23.7% of individuals. Conclusions: Successful standard triple eradication therapy enhanced with bismuth tripotassium dicitrate is effective for the treatment of dyspeptic symptoms in patients with H. pylori-associated chronic gastritis.

A COMPARATIVE EVALUATION OF EFFECTIVENESS OF ACOTIAMIDE WITH RABEPRAZOLE VS MOSAPRIDE WITH RABEPRAZOLE IN PATIENTS WITH FUNCTIONAL DYSPEPSIA POST H.PYLORI ERADICATION

Background: Functional Dyspepsia is well dened when a patient had one or more of these symptoms with duration of three months or longer like post-prandial fullness, early satiation, epigastric pain and burning, bloating, nausea, vomiting and belching. Functional dyspepsia, consisting of epigastric pain syndrome and postprandial distress syndrome, is a prevalent functional gastrointestinal disorder. To date, only limited treatment options are available and conicting results in terms of efcacy have been reported. This was a prospective, com Methods: parative study carried out for a period of six months. Patient data were extracted from their medical records. Treatment outcome was evaluated based on the resolving of Symptoms using Gastrointestinal Symptom Rating Scale (GSRS), and (Hospital anxiety and depression scale) HADS scales. Descriptive statistics were used to summarize patient characteristics. Unpaired t-test and Mann Whitney test were used wherever appropriate. A total of 100 patients with conrmed funct Results: ional dyspepsia after H. pylori eradication were included.They were randomized into two study Groups namely Group 1 & 2. Each Group consists of 50 patients. Patients in Group 1 treated with Acotiamide and Rabeprazole. Group 2 patients treated with Mosapride and Rabeprazole. Patients with two different treatments have shown signicant improvement in gastrointestinal symptoms. The major risk factors are consumption of junk food, tea and spicy food. Our study shows that FD is predominant in Females than Males. Minor ADRS were reported which includes Nausea, Headache, dizziness and Constipation. study till date revealed that effects of both gastroprokinetic drugs help in enhancing Gastric emptying Rate (GER) , Gastric Accommodation Rate (GAR) and helps in acceleration of intestinal transit which ultimately results in preventing relaxation peristaltic movements respectively. Our study demonstrated that Mosapride and Acotiamide were both effective and well t Conclusion: olerated in FD patients without serious side effects. We found that effectiveness of Mosapride is 86% and Acotiamide is 84% thus Mosapride offers good alternative to Acotiamide in treating post H.pylori FD patients. Further investigations with increased sample are required in order to conrm the results in depth

Operative outcomes for polycystic liver disease: results from a contemporary case series

Background: Persistent symptoms of pain, early satiety, dyspnea, and gastrointestinal reflux due to significant liver enlargement are an indication for operative debulking in patients with polycystic liver disease (PCLD) due to the lack of effective medical therapies. However, given the relative rarity of PCLD, current data on outcomes of surgical debulking for advanced PCLD are scarce, particularly within the realm of laparoscopic resection techniques.

Efficacy of prokinetic agents in diabetic gastroparesis comparing symptomatology and scintigraphy - An open-label trial.

It is pertinent to objectively assess the severity of diabetic gastroparesis and tailor treatment accordingly. The current study was planned to document gastroparesis by gastric emptying scintigraphy (GES) objectively and see the effect of medications and diet control on clinical and GES after four weeks. A prospective, open-label randomized trial was conducted in the Department of Internal Medicine at a tertiary care teaching hospital over twelve months. Type 2 diabetic patients aged 18-65 years diagnosed with a case of delayed gastric emptying by gastric scintigraphy were included. All baseline GSCI was recorded, and then they were allotted to 3 groups - Group-1 (Levosulpiride 25mg once daily), group-2 (Cinitapride 1mg thrice daily), and Group-3 (Waitlisted control) by block randomization and followed-up weekly till four weeks. After four weeks duration, if not improved clinically, then Group-3 on diet and diabetic control only, were randomized into Levosulpiride 25mg once daily (Group 1), and Cinitapride 1mg Thrice daily (Group 2) for the next four weeks. Forty confirmed cases with diabetic gastroparesis documented by Gastroparesis Symptom Cardinal Index (GCSI) scoring and later by Scintigraphy (GES) were included in this study. However, there was no statistically significant difference between the Levosulpiride and Cinitapride groups when all symptoms were taken into account. Levosulpiride was significantly more effective than Cinitapride in improving individual symptoms like nausea, vomiting, stomach fullness, and early satiety. Levosulpiride is better than Cinitapride in improving the symptoms of diabetic gastroparesis but no significant effect on gastric scintigraphy.

Functional dyspepsia : update 2023

Functional dyspepsia is defined by epigastric pain/burning, postprandial fullness and/or early satiety that have been present for at least six months before diagnosis, including three consecutive months, without evidence of an organic cause likely to explain these symptoms. The pathogenesis is complex and incompletely understood. The initial assessment includes a thorough history, physical examination, blood work, celiac disease serology and ruling out Helicobacter pylori infection. Most patients will undergo upper gastrointestinal endoscopy and abdominal ultrasound to exclude organic differential diagnoses. The therapy is multi-facetted and includes, among others, proton pump inhibitors, Helicobacter pylori eradication, herbal agents, and neuromodulators.

Splenic infarction as a first clinical manifestation of sickle cell/beta+ thalassemia: a case report

Background: An association between splenic infarction, high altitude, and different subtypes of sickle cell disease (SCD) has been reported in the literature, particularly sickle cell trait. However, none of these studies reported the possibility of splenic infarction as a presenting feature of sickle cell/beta+ thalassemia. Case Presentation: A 23-year-old male college student presented to the emergency department with dull pain in the left upper quadrant and without any known history of medical illness. The patient was originally from Qatif, the Eastern Province of Saudi Arabia, and was referred to the study hospital with an ultrasound report showing splenic infarction. Upon presentation to the study hospital, the patient still had mild abdominal pain and early satiety. Examination revealed tachycardia (128/minute), upper abdominal tenderness, and splenomegaly approximately 2-3 cm below the left costal margin, with thrombocytosis and high lactate dehydrogenase (LDH) levels. Hemoglobin (HGB) electrophoresis showed hemoglobin A (HbA) 19.3; HbA2 4.9; hemoglobin F 12.9 and hemoglobin S 62.9, confirming a diagnosis of sickle cell/beta+ thalassemia. The patient was started on IV hydration and therapeutic anticoagulation with enoxaparin 60 mg subcutaneously every 12 hours. The patient's symptoms improved. Therefore, the patient was discharged on life-long apixaban (5 mg PO Bid), with close follow-up at the hematology clinic. Conclusion: Splenic infarction could be manifested as an isolated feature in patients with SCD and its subtypes, such as sickle cell beta+ thalassemia. Therefore, physicians should pay careful attention to these complications and consider HGB electrophoresis as a part of the workup.

Isolation gastric sarcoidosis: a rare presentation

Background: Sarcoidosis is a multisystem inflammatory disease involving non necrotizing epithelioid granulomas with an unknown etiology. The presented case was interesting as presented with isolated gastric sarcoidosis without pulmonary involvement, which is exceedingly rare, and it is the first case detected in Aljouf region. Case Presentation: A 14-year-old Saudi girl not known to have any chronic medical illnesses presented to King Abdulaziz Specialist Hospital with a complained of 3 weeks duration of epigastric pain, anorexia, nausea, vomiting, loss of appetite, unintentional weight loss more than 5 kg over last 3 weeks, along with early satiety, inability to tolerate oral intake. Chest imaging including plain radiographs, and Computed tomography was normal and pulmonary function tests were also normal. An upper esophagogastroduodenoscopy was performed revealing a significant poor gastric insufflation and the wall of the stomach looked very rigid with circumferential diffuse erythema, friable mucosa, easy to bleed, edematous resembling lienitis plastic. Conclusion: This case represents a rare condition of isolated gastric sarcoidosis without pulmonary involvement. Understanding of these types of rare conditions could help in improvement of the diagnosis and management skills.

Giant gastric bezoar: A case report and the review of literature

ABSTRACT A bezoar is a packed collection of undigested or partially digested food found in the gastrointestinal (GI) tract. The stomach is the most common site of bezoars and bezoars are most commonly found in the stomach and can affect people of any age or gender. Patients with behavioral disorders, abnormal gastric emptying, altered GI motility as in diabetes disorders are predisposed to the formation of gastric bezoars. The majority of gastric bezoars are asymptomatic, whereas others require treatment in the form of endoscopic or surgical removal. Gastric bezoar can occasionally result in serious complications such as gastric outlet obstruction, bleeding, and perforation. As a result, early detection and treatment are critical to avoid potentially serious complications. We report an extremely rare case of giant gastric trichobezoar in a young female that was timely and successfully managed surgically. A 25-year-old female presented with symptoms of repetitive nausea and vomiting, especially postmeals, early satiety, intermittent abdominal pain, weight loss, and abdominal lump. An abdomen examination revealed a mass in the epigastric region extending to the right hypochondrium of 20 cm × 14 cm, firm to hard in consistency with a palpable inferior margin. Ultrasonography and contrast-enhanced tomography scan abdomen confirmed the diagnosis of gastric bezoar. The patient was prepared and Elective OT was done with the removal of a large gastric trichobezoar measuring 24 cm × 16 cm and weighing 1865 g. Gastrostomy closure was done in two layers and the postoperative period was uneventful. The patient is doing well and is on regular follow-up.

A comparative study to evaluate the efficacy of Anacardium orientale and Bismuthum in management of non-ulcer dyspepsia by using gastrointestinal symptom (GIS) score

Non- ulcer dyspepsia (NUD) is a clinical syndrome which includes epigastric discomfort, bloating after meals, early Satiety, fullness, epigastric burning, flatulence, nausea and/ or vomiting. Although non-ulcer dyspepsia is not a life-threatening disease, there are a number of outpatient studies suggesting that it impairs health-related quality of life in patients on all major variables of quality of life, namely mental, social, and physical functioning, whose impact has received little attention. In light of the current situation, which sees an increase in cases of non-ulcer dyspepsia lowering quality of life related to health in patients and the much unexplored side of Anacardium orientale and Bismuthum, this clinical study was aimed to understand the potential of Anacardium orientale and Bismuthum in the management of non-ulcer dyspepsia by using GIS Score. The statistical results reveal that Bismuthum showed more efficacy than Anacardium orientale in the management of non-ulcer dyspepsia and improving the health-related quality of life (HRQOL) of patients.

Gastroparesis and Functional Dyspepsia: Spectrum of Gastroduodenal Neuromuscular Disorders or Unique Entities?

Gastroparesis is defined by delayed gastric emptying in the absence of mechanical obstruction of the stomach. Patients experience symptoms of nausea, vomiting, abdominal pain, fullness, and early satiety. The recognition of the disorder has progressed due to availability of gastric emptying scintigraphy and advancements made in understanding its pathophysiology and treatment options. The clinical presentation and treatment of gastroparesis overlap with a more commonly recognized disorder of gut-brain interaction, functional dyspepsia. Recent studies have reenergized the discussion whether these two are separate entities or perhaps reflect a spectrum of gastroduodenal neuromuscular disorders. The societal guidelines conflict on the utility of gastric emptying scintigraphy in assessment of patients with upper gastrointestinal symptoms. A better appraisal of similarities and differences between gastroparesis and functional dyspepsia will allow targeted treatment for these disorders. This is particularly important as specific pharmacological and endoscopic treatment options are being developed for gastroparesis which are unlikely to be helpful for functional dyspepsia. This review makes the case for considering these disorders in a spectrum where identification of both would most ideally position us toward providing the optimal clinical care.

Clinics in diagnostic imaging (216).

Clinics in diagnostic imaging (216).

Dispepsija u primarnoj zdravstvenoj zaštiti - prikaz slučaja

Dyspepsia is a term originated from the Greek prefix dys-(bad) and the word pepsis (digestion) and it means indigestion. Dyspepsia is a symptom which indicates occasional or constant pain in the region of the upper abdomen or discomfort which is described in the form of early satiety or a feeling of fullness in the stomach. Sometimes it can be accompanied by nausea, vomiting and heartburn. The symptoms of dyspepsia are not specific enough to indicate a particular disease. And if indicated, additional diagnostics are performed in order to prove or rule out a physical disorder. Dyspepsia is a frequent reason for visiting the doctor. About 40% of the world's population has symptoms of dyspepsia, most often the working population aged between 20-40 years, equally in both sexes. About 25% of patients seek doctor's help, while the rest seek help for their problems at a pharmacy. Dyspepsia is the reason for 40% of performed gastroenterology consultations. This article presents the clinical picture, therapeutic and diagnostic course, as well as the outcome of the treatment of a 53-year-old patient who came to the doctor with symptoms of dyspepsia. The symptoms of dyspepsia had lasted for several years before coming to the doctor. During the first examination, an anamnesis was taken, the review of systems was performed, and a basic blood test done in the local Health center. Given that there was no data on the existence of alarming symptoms in this patient, symptomatic therapy and advised change of habits were included, as well as a planned checkup in one month. At the checkup, the patient reported a decrease in frequency and intensity of abdominal pain, so it was decided to perform additional diagnostics: test for Helicobacter pylori, fecal occult blood test, and ultrasound examination of the abdomen. Requested result of FOBT was negative, but the test for Helicobacter pylori was positive. Ultrasound examination revealed the presence of small calculi in the gallbladder, but there were no other significant clinical findings. Eradication therapy for helicobacter infection was included, and an examination by a gastroenterologist for further diagnostics (esophagogastroduodenoscopy) was planned. Gastroscopy findings were described as chronic non-atrophic gastritis, predominantly antral. A follow-up gastroscopy was planned in five-year interval, the patient was given the proton pump inhibitors therapy, as well as dietary instructions. Given that dyspepsia often occurs in clinical practice, it was necessary to make a proper assessment regarding further diagnostics, on the one hand for economic reasons and on the other hand for medical reasons. Here, the decision was made to carry out further diagnostics considering the duration of the health problems, the presence of the problems during symptomatic therapy, the age of the patient and his concerns. Given the absence of alarming symptoms, appointments were scheduled for all examinations, so a complete diagnosis of organic dyspepsia was reached after 13 months.

Evaluation and comparison of therapeutic effects of probiotics and colloidal bismuth subcitrate on abdominal bloating.

Functional abdominal bloating is one of the functional gastrointestinal disorders (FGIDs). Here, we aimed to investigate and compare the effects of probiotics and colloidal bismuth subcitrate on abdominal bloating. This was a double-blinded randomized clinical trial performed on 125 patients with functional abdominal bloating in Isfahan in 2020-2021. At the beginning of the study, information on the frequency of abdominal bloating, its severity, the occurrence of early satiety, frequency of borborygmus, frequency of belching, and the frequency of defecation per week was collected. Patients were divided into 3 groups receiving familact probiotic pills that contained 7 bacterial strains, colloidal bismuth subcitrate tablets, and placebo pills for 4 weeks. Afterwards, the frequency and severity of abdominal bloating and other symptoms were compared. After 2 weeks, patients in the probiotic group had a significantly lower frequency of abdominal bloating compared to other groups (P= 0.006). After 4 and 8 weeks, patients in the probiotic group and bismuth group had a lower frequency of bloating )3.18±3.02, 4.11±3.34) compared to placebo (5.10±3.54) (P= 0.001 and P= 0.037, respectively). During the study, patients in the probiotic group had a significantly lower bloating severity (41.90% had no symptom) compared to bismuth and placebo groups (12.50 ,12.00% had no symptom) (p< 0.05). The frequency of borborygmus was significantly lower in the probiotic group after 2 and 4 weeks during the study compared to other groups (1.62±0.2 Vs 2.69±0.3, 2.45±0.3 ) (P= 0.010 and P= 0.013, respectively). According to our data, consumption of probiotics improves the frequency and severity of abdominal bloating and reduces borborygmus. Colloidal bismuth subcitrate also has significant effects.