Prevalence Of Gastrointestinal Disorders Research Articles

Constipation-associated factors in outpatients with schizophrenia: A multicenter questionnaire survey.

Constipation is a prevalent gastrointestinal disorder that affects people globally, decreasing their quality of life and life expectancy. Individuals with schizophrenia often suffer from constipation, which could be a result of the illness itself or the side effects of psychotropic medications. However, little research has been conducted on factors contributing to constipation in individuals with schizophrenia. To address this issue, we conducted a survey using self-administered questionnaires and medical records to identify factors associated with constipation in psychiatric outpatients. This study included 399 patients with schizophrenia, resulting in a high prevalence of constipation (43.4%). The analysis suggested that female gender, the doses of antiparkinsonian medications, and benzodiazepine sleeping pills may be associated with constipation.

Gut microbial signatures of patients with diarrhea-predominant irritable bowel syndrome and their healthy relatives

Abstract Aims Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder, encompassing diarrhea-predominant irritable bowel syndrome (IBS-D). Here, we utilized 16S rDNA gene sequencing to identify potential microbial drivers of IBS-D. Methods and Results A total of 30 healthy relatives and 27 patients with IBS-D were recruited. Clinical data and fecal samples were collected from patients and controls. 16S rDNA gene sequencing was performed to obtain fecal bacterial data. Differences in community composition were evaluated utilizing analysis of similarity (ANOSIM) using Bray–Curtis dissimilarity. The Wilcoxon rank sum test was used to compare differences in taxa and functional pathways. Finally, the key gut microbiota was identified using the random forest algorithm. Gut microbiota diversity, estimated through the Observe, Chao1, and abundance-based coverage estimator (ACE) indices, was significantly lower in the IBS-D patients than in the healthy relatives. ANOSIM analysis further confirmed significant differences in the composition of the gut microbiota between IBS-D patients and healthy relatives, with an R value of 0.106 and a P-value of 0.005. Notably, the IBS-D patients exhibited a significant enrichment of specific bacterial genera, including Fusicatenibacter, Streptococcus, and Klebsiella, which may possess potential pathogenic properties. In particular, the bacterial genus Klebsiella demonstrated a positive correlation with irritable bowel syndrome severity scoring system scores. Conversely, healthy subjects showed enrichment of bacterial genera such as Alistipes, Akkermansia, and Dialister, which may be beneficial bacteria in IBS-D. Utilizing the random forest model, we developed a discriminative model for IBS-D based on differential bacterial genera. This model exhibited impressive performance, with an area under the curve value of 0.90. Additionally, our analysis did not reveal any gender-specific differences in the microbiota community composition among IBS-D patients. Conclusions Our findings offer preliminary insights into the potential relationship between intestinal microbiota and IBS-D. The identification model for IBS-D, grounded in gut microbiota, holds promising prospects for improving early diagnosis of IBS-D.

Successful Treatment using OMT for Chronic GERD in a Pediatric Patient

Abstract Gastroesophageal Reflux Disease (GERD) is a highly prevalent gastrointestinal motility disorder affecting 10% to 20% of children in the United States. Many patients affected by this disorder are medically managed with proton pump inhibitors (PPI) and H2 receptor antagonists for prolonged durations. Here we present a pediatric patient with GERD refractory to chronic use of PPI. The patient received Osteopathic Manipulative Treatment (OMT) and had close follow-ups over 5 years. The patient reported significant relief in symptoms and improved daily performance within weeks of treatment. His symptoms are now being fully controlled by OMT without regular medication. This case report illustrates the advantages of utilizing OMT in the pediatric population.

Relationship between Gastroesophageal Reflux Disease (GERD) with Quality of Sleep

Background. Gastroesophageal Reflux Disease (GERD) is a common gastrointestinal disorder caused by reflux of stomach contents into the esophagus, as a result, it causes various symptoms or complications . GERD is a commonly prevalent gastrointestinal disorder in medical students. Based on data from the 2006 US National Health and Wellness survey observing respondents who experienced heartburn at least twice a month, 89% of respondents experiencing nightime GERD symptoms, it showed that the presence of nighttime GERD was associated with decrease quality of sleep. This study aimed to analyze the relationship between GERD and students’ sleep quality in Faculty of Medicine USU 2020-2022. Method. Cross sectional design with total sampling method. Data collection was carried out using an online questionnaire in the form of a google form. The questionnaires used were GERD-Q, FSSG, PSQI, and ISI. The analysis used was univariate and bivariate analysis with Chi-square. Results. This study involved 378 respondents, 114 people (30.2%) with GERD, 67 people (58.8%) with severe of GERD, 286 people (75.7%) had a bad quality of sleep, and 43 people (15%) with moderate and severe of insomnia. The results of statistical analysis showed an association between GERD and quality of sleep. Conclusion. There was a correlation between GERD and quality of sleep of USU Faculty of Medicine students class 2020-2022

Prevalence and risk factors of gastro-esophageal reflux disease among college students at a public university in Riyadh, Saudi Arabia.

Gastroesophageal reflux disease (GERD) is one of the most prevalent gastrointestinal disorders worldwide. It manifests when the lower esophageal sphincter malfunctions, causing the stomach's contents to reflux into the esophagus, lead to discomforting symptoms. Heartburn and regurgitation are the typical symptoms of GERD. This study aims to determine the prevalence of GERD and assess its risk factors. This cross-sectional study was conducted at IMSIU, Saudi Arabia. An online survey was distributed to the students' email addresses to determine the prevalence of GERD, its related risk factors, and understanding of its symptoms. One thousand five hundred and thirty-three (1533) students participated in the survey. The prevalence of GERD was 34.6%. The majority (79.7%) of the respondent students had heard of GERD. Stress is believed to be a factor in developing GERD by 35.7% of students. Heartburn was the predominant symptom of GERD (76.2%). No association existed between the socio-demographic traits of those with GERD except for age and academic year. It is imperative to raise public awareness of the disorder's characteristics and its modifiable risk factors to prevent the emergence of GERD and its complications.

Diagnostic strategy of irritable bowel syndrome: a low- and middle-income country perspective.

Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder associated with substantial impairment which considerably burdens healthcare systems worldwide. Research on IBS has largely been conducted in high-income countries posing barriers to the application of diagnostic strategies in low- and middle-income countries (LMICs) due to differences in disease characteristics, healthcare resources, and socioeconomic factors. This review discusses the diagnostic issues associated with LMICs. We present a concise overview of the relevant approaches and propose a diagnostic strategy based on the latest evidence. A positive diagnostic strategy that relies on appropriate symptom-based criteria is crucial within the diagnostic framework. A combination of complete blood count, fecal occult blood test, and complete stool test may reliably identify individuals with suspected IBS who are more likely to have organic diseases, thus justifying the necessity for a colonoscopy. Eventually, we developed a diagnostic algorithm based on a limited setting perspective that summarizes the available evidence and may be applied in LMICs.

Real-world evidence of constipation and laxative use in the Korean population with chronic kidney disease from a common data model

Constipation is a highly prevalent gastrointestinal disorder in patients with chronic kidney disease (CKD). However, our understanding of its epidemiology and management in CKD is limited. We aimed to explore real-world data on constipation and laxative use in patients with CKD in a nationwide population-based cohort from the Korean Health Insurance Review and Assessment-National Patient Sample database. This study analyzed retrospective health claims data in Korea from 2012 to 2017 that were transformed into the Observational Medical Outcomes Partnership Common Data Model. The pooled proportion of constipation diagnoses was 30.5% in all patients with CKD and 15.9%, 16.5%, 17.4%, 29.9%, and 43.3% in patients with CKD stages 1–5, respectively, suggesting a higher prevalence in advanced CKD. Patients receiving peritoneal dialysis or hemodialysis had the highest prevalence of constipation, while transplant recipients showed a prevalence comparable to that of patients with early CKD. Patients with CKD had a significantly higher risk of constipation than age- and sex-matched non-CKD individuals (range of odds ratio [OR]:1.66–1.90). Laxative prescribing patterns differed by CKD severity. Osmotic agents were prescribed in more than half of patients with advanced CKD, while magnesium salts and bulking agents were prescribed less frequently. The CKD patients with constipation were more likely to be prescribed constipation-inducing medications, including antipsychotic and neurological medications. Our findings provide real-world constipation and laxative prescription status in the Korean CKD population, revealing a significantly higher risk of constipation and different laxative prescribing patterns in patients with CKD.

Paeoniflorin Alleviates Anxiety and Visceral Hypersensitivity via HPA Axis and BDNF/TrkB/PLCγ1 Pathway in Maternal Separation-induced IBS-like Rats.

Irritable Bowel Syndrome (IBS) is a prevalent gastrointestinal disorder that significantly diminishes the quality of life for affected individuals. The pathophysiology of IBS remains poorly understood, and available therapeutic options for IBS are limited. The crucial roles of brain-gut interaction, which is mediated by the Hypothalamic-Pituitary-Adrenocortical (HPA) axis and the autonomic nervous system in IBS, have attracted increasing attention. The objective of this study was to examine the impact of paeoniflorin (PF) on anxiety and visceral hypersensitivity in maternal separation-induced IBS-like rats. The IBS-like rat model was established through the implementation of Maternal Separation (MS) and subsequently subjected to various doses of PF administered via oral gavage for 14 days. Anxiety-like behavior was evaluated using the Open Field Test (OFT) and Elevated Plus Maze (EPM) test. The assessment of visceral sensitivity involved the utilization of the Abdominal Withdrawal Reflex (AWR) score and electromyographic (EMG) responses of the external oblique muscle in response to colorectal distention. The levels of adrenocorticotropic hormone (ACTH), corticosterone (CORT), and corticotrophin-releasing hormone (CRH) were examined by ELISA. Quantitative real-time PCR (qRT-PCR) and immunofluorescence were employed to detect the expressions of CRH receptors 1 (CRHR1) and 2 (CRHR2). Glucocorticoid receptors (GR), mineralocorticoid receptor (MR), brain-derived neurotrophic factor (BDNF), tyrosine receptor kinase B (TrkB), and phospholipase C γ1 (PLCγ1) were examined by Western blot. The results showed that MS induced anxiety-like behavior and visceral hypersensitivity, while PF treatment attenuated these changes. Furthermore, the HPA axis hyperactivity in MS rats was attenuated by PF treatment, indicated by reduced serum ACTH, CORT, and CRH levels and recovered hippocampal CRHR1 and GR expressions. In addition, PF inhibited BDNF/TrkB signaling by downregulating the protein levels of BDNF, TrkB, and phospho-PLCγ1 in the colon. These findings suggest that PF alleviated anxiety and visceral hypersensitivity in MS-induced IBS-like rats, which may be the modulation of HPA axis activity and BDNF/TrkB/PLCγ1 signaling pathway.

The Role of Diet in the Management of Irritable Bowel Syndrome: A Comprehensive Review.

Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder that has a significant impact on the general population. The suboptimal medical treatments available for IBS contribute to its large economic burden. The pathophysiology of IBS is complex, and treatments often focus on managing specific symptoms. Many individuals with IBS associate their symptoms with specific food intake, leading to increased scientific research on the role of diet in managing IBS. Dietary management has become a crucial aspect of IBS treatment, with initial recommendations focusing on adopting a healthy eating pattern and lifestyle. This comprehensive review aims to synthesise the current literature on the impact of diet on IBS, exploringvarious dietary approaches to managing IBS, including the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet, gluten-free diet, Mediterranean diet, and tritordeum-based diet. It presents evidence from both experimental and observational studies and summarises the underlying dietary triggers in IBS, including gut microbiota dysbiosis, visceral hypersensitivity, and immune activation. In addition, it explores the efficacy and limitations of the key diet and lifestyle recommendations provided by dietary guidelines and scientific literature, highlighting the importance of individualised dietary strategies tailored to the unique needs of different types of IBS patients. By elucidating the complex interplay between diet and IBS pathophysiology, this review provides valuable insights into optimising dietary management approaches for improving symptom control and enhancing the quality of life for individuals with IBS.

Causal Relationships of Chronic Constipation and Irritable Bowel Syndrome with Digestive Tract Cancers: A Mendelian Randomization Study.

Chronic constipation and irritable bowel syndrome (IBS) manifest as prevalent gastrointestinal disorders, while digestive tract cancers (DTCs) present formidable challenges to global well-being. However, extant observational studies proffer uncertain insights into potential causal relationships of constipation and IBS with susceptibility to DTCs. We executed Mendelian randomization (MR) analysis to establish causal connections between these conditions and seven distinct categories of DTCs, including colorectal carcinoma (CRC), hepatocellular cancer (HCC), esophageal malignancy (ESCA), pancreatic adenocarcinoma (PAAD), biliary tract carcinoma (BTCs), gastric carcinoma (GC), and small intestine neoplasm (SIC). Leveraging instrumental variables (IVs) obtained from GWAS data of the FinnGen database, we employed a range of analytical methodologies, including inverse-variance weighting multiplicative random effects (IVW_MRE), inverse-variance weighting fixed effects (IVW_FE), maximum likelihood (ML), weighted median (WM), MR‒Egger regression, and the MR-PRESSO test. We observed a substantial linkage between genetically predicted constipation and increased vulnerability to PAAD (OR = 2.29, 95% CI: 1.422-3.69, P = 0.001) via the IVW method. Following the removal of outlier SNPs through MR-PRESSO, genetically predicted IBS was affiliated with an increased risk of CRC (OR = 1.17, 95% CI: 1-1.37, P = 0.05). Nonetheless, decisive causal correlations of constipation or IBS with other DTCs remain elusive. In summary, genetically predicted constipation was associated with an augmented PAAD risk, and IBS was associated with an increased CRC susceptibility within European cohorts, in agreement with some observational studies. Nevertheless, the causal associations of constipation and IBS with other DTCs remain inconclusive.

Association of body mass index and blood pressure with GERD severity

Background: Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal disorder characterized by the chronic reflux of stomach contents into the esophagus, leading to various symptoms and complications. Aims and Objectives: This study aims to investigate the association between body mass index (BMI), blood pressure, and GERD severity. Materials and Methods: A cross-sectional study was conducted involving 50 participants diagnosed with GERD, recruited from the Department of Medical Gastroenterology at King George’s Medical University in Lucknow, India. Data on BMI, blood pressure, and GERD severity were collected through standardized assessments. Results: It was observed that patients in the first tertile (T1) of the GERD score, as compared to their counterparts in the second and third tertiles (T2 and T3), were lower in age, smaller in height, and had lower body weight, BMI, systolic blood pressure, and diastolic blood pressure levels, but none of the associations were found to be significant statistically. Conclusion: There are significant clinical implications for knowing how blood pressure, GERD severity, and BMI relate to one another. To maximize treatment success and lower the risk of complications, health-care practitioners should think about evaluating and treating modifiable risk factors, such as obesity and hypertension, in patients with GERD. Pharmacological therapies may be used in conjunction with lifestyle adjustments such as blood pressure control, diet adjustments, and weight loss to help treat GERD symptoms and enhance overall patient health.

Antiulcer activity of ethanolic extract of Arctocarpus hirsutus Lam. leaves in albino Wistar rats

Peptic ulcers, a prevalent gastrointestinal disorder, remain a significant health concern. Artocarpus hirsutus Lam., a plant deeply rooted in traditional medicine, has been historically employed to address various health issues. Each component of this plant showcases diverse therapeutic activities, offering a holistic approach to health concerns. This study aimed to explore the gastroprotective and antiulcerogenic potential of the ethanol-based extract derived from Artocarpus hirsutus Lam leaves. Administered orally in 100, 200, and 400mg/kg doses, the extract's effects were compared with established medications - omeprazole (30mg/kg) and sucralfate (100mg/kg). Parameters such as gastric acid volume, gastric pH, ulcer index, total acidity, and free acidity were evaluated. The ethanol-based extract derived from Artocarpus hirsutus Lam. leaves demonstrated activity at doses of 200mg/kg and 400mg/kg, resulting in a marked decrease in free acidity, total acidity, gastric volume, ulcer index, and an increase in gastric pH compared to the ulcer control group. Notably, the ethanol-based extract of leaves of Artocarpus hirsutus Lam. exhibited significant gastroprotective and ant-ulcerogenic effects in both ethanol induced ulcer and pylorus ligated ulcer models. These findings underscore the potential therapeutic value of Artocarpus hirsutus Lam. as an effective agent against peptic ulcers, supporting its traditional use in holistic health practices.

INVESTIGATING THE THERAPEUTIC POTENTIAL OF BENIDIPINE IN INDO-METHACIN-INDUCED PEPTIC ULCERS: AN EXPERIMENTAL STUDY IN RATS

Objective: Peptic ulcer disease is a prevalent gastrointestinal disorder associated with escalating global mortality rates and a heightened risk of gastric cancer. This study investigates the therapeutic potential of Benidipine, an L-type calcium channel blocker known for its antioxidant properties, in an indomethacin-induced peptic ulcer model in rats. Methods: Thirty-six male albino Wistar rats were divided into six groups and subjected to various drug treatments, including Indomethacin, Famotidine, and Benidipine. Stomach tissue samples were collected for analysis. Results: Macroscopic examination revealed that indomethacin significantly increased ulcer areas in the stomach tissue, while Benidipine and Famotidine treatments effectively reduced these ulcer areas. Biochemical analysis indicated that Indomethacin-induced oxidative stress, as evidenced by elevated levels of malondialdehyde, a marker of lipid peroxidation, and decreased levels of total glutathione and superoxide dismutase, are crucial antioxidants. However, Benidipine treatment mitigated these changes, restoring antioxidant levels and reducing malondialdehyde levels. Conclusion: This study demonstrates that indomethacin induces gastric damage and oxidative stress, leading to ulcer formation, while Benidipine, with its antioxidant properties, effectively counteracts these effects and exhibits comparable efficacy to Famotidine in ulcer reduction. These findings suggest that Benidipine may hold promise as a therapeutic agent for mitigating peptic ulcers induced by nonsteroidal anti-inflammatory drugs like Indomethacin, warranting further exploration in clinical settings.

Impact of IDO activation and alterations in the kynurenine pathway on hyperserotonemia, NAD+ production, and AhR activation in autism spectrum disorder

Hyperserotonemia is the most replicated biochemical anomaly associated with autism spectrum disorder (ASD) and has been reported in 35–46% of individuals with ASD. Serotonin is synthesised from the essential amino acid tryptophan (TRP). However, the main catabolic route of TRP is the kynurenine pathway (KP), which competes with serotonin synthesis when indoleamine dioxygenase (IDO) is activated. Using the same cohort of individuals with ASD, we used to report extensive studies of the serotonin/melatonin pathway, and found increased kynurenine (KYN), suggesting IDO activation in 58.7% of individuals with ASD (159/271), supported by a strong negative correlation between KYN/TRP ratio and miR-153-3p plasma levels, which negatively regulates IDO. IDO activation was associated with normoserotonemia, suggesting that IDO activation could mask hyperserotonemia which meant that hyperserotonemia, if not masked by IDO activation, could be present in ~94% of individuals with ASD. We also identified several KP alterations, independent of IDO status. We observed a decrease in the activity of 3-hydroxyanthranilate dioxygenase which translated into the accumulation of the aryl hydrocarbon receptor (AhR) selective ligand cinnabarinic acid, itself strongly positively correlated with the AhR target stanniocalcin 2. We also found a deficit in NAD+ production, the end-product of the KP, which was strongly correlated with plasma levels of oxytocin used as a stereotypical neuropeptide, indicating that regulated neuropeptide secretion could be limiting. These results strongly suggest that individuals with ASD exhibit low-grade chronic inflammation that is mediated in most cases by chronic AhR activation that could be associated with the highly prevalent gastrointestinal disorders observed in ASD, and explained IDO activation in ~58% of the cases. Taken together, these results extend biochemical anomalies of TRP catabolism to KP and posit TRP catabolism as a possible major component of ASD pathophysiology.

Network pharmacology combined with an animal model to reveal the material basis and mechanism of Amomum villosum in alleviating constipation in mice

Constipation is a prevalent gastrointestinal disorder, with its prevalence showing an annual upward trend. There are many factors involved in the occurrence of constipation, such as abnormal smooth muscle contraction and disorders of gastrointestinal hormone secretion. Amomum villosum (A. villosum) has been proven to be effective in improving digestive system diseases, but there is no report on improving constipation. Therefore, we used network pharmacology prediction combined with animal experiments to explore the key active components of A. villosum and their pharmacological mechanisms. The results of network pharmacological prediction showed that β-sitosterol was the key laxative compound of A. villosum, which may play a laxative role by activating the adrenoceptor alpha 1 A-myosin light chain (ADRA1A-MLC) pathway. Further animal experiments showed that β-sitosterol could significantly shorten the time to first black stool; increase faecal weight, faecal number, and faecal water content; and promote gastrointestinal motility. β-sitosterol may promote intestinal motility by upregulating the expression of ADRA1A and myosin light chain 9 (Myl9) mRNA and protein in the colon, thereby activating the ADRA1A-MLC signalling pathway. In addition, it is possible to improve constipation symptoms by regulating serum neurotransmitters and gastrointestinal motility-related factors, such as the serum content of 5-hydroxytryptamine (5-HT) and acetylcholinesterase (AchE) and the mRNA expression of 5-hydroxytryptamine receptor 4 (5-HT4), stem cell factor (SCF), stem cell factor receptor (c-Kit) and smooth muscle myosin light chain kinase (smMLCK) in the colon. These results lay a foundation for the application of A. villosum and β-sitosterol in constipation.

Profiling of the fecal microbiota and circulating microRNA-16 in IBS subjects with Blastocystis infection : a case–control study

Irritable bowel syndrome (IBS) is a prevalent gastrointestinal (GI) tract disorder. Although the main reason for IBS is not clear, the interaction between intestinal microorganisms and the gut barrier seems to play an important role in pathogenesis of IBS. The current study aimed to investigate the effect of Blastocystis on the gut microbiota profile and the circulation levels of microRNA (mir)-16 of IBS patients compared to healthy subjects. Stool and blood samples were collected from 80 participants including 40 samples from each IBS and healthy group. Upon DNA extraction from stool samples, barcoding region and quantitative real-time PCR were analyzed to investigate Blastocystis and the microbiota profile, respectively. RNA was extracted from serum samples of included subjects and the expression of mir-16 was evaluated using stem-loop protocol and qreal-time PCR. Significant changes between IBS patients and healthy controls was observed in Firmicutes, Actinobacteria, Faecalibacterium, and Alistipes. In IBS patients, the relative abundance of Bifidobacteria was directly correlated with the presence of Blastocystis, while Alistipes was decreased with Blastocystis. Lactobacillus was significantly increased in Blastocystis carriers. In healthy subjects, the relative abundance of Bifidobacteria was decreased, but Alistipes was increased in Blastocystis carriers. The changes in the Firmicutes/Bacteroidetes ratio was not significant in different groups. The relative expression of mir-16 in Blastocystis-negative IBS patients and healthy carriers was significantly overexpressed compared to control group. The presence of Blastocystis, decreased the relative expression of mir-16 in IBS patients compared to Blastocystis-negative IBS patients. The present study revealed that Blastocystis has the ability to change the abundance of some phyla/genera of bacteria in IBS and healthy subjects. Moreover, Blastocystis seems to modulate the relative expression of microRNAs to control the gut atmosphere, apply its pathogenicity, and provide a favor niche for its colonization.

The Antioxidant and anti-inflammatory Activity of Selenium and Lecithin Combination Against ethanol-induced Gastric Ulcer in mice via Modulating IGF-1/PTEN/Akt/FoxO3a Signaling.

Gastric ulcers are one of the most prevalent gastrointestinal disorders. The current study investigated the antioxidant and anti-inflammatory effects of selenium (Se) and lecithin (Lec) alone and in combination against ethanol-induced gastric ulcers in mice, and their ability to modulate insulin-like growth factor-1 (IGF-1)/ Phosphatase and tensin homologue deleted on chromosome 10 (PTEN)/ Protein kinase B (Akt)/ Forkhead box O3a (FoxO3a) signaling. The mice were divided into normal, ethanol, Se + ethanol, Lec + ethanol, Se + Lec + ethanol, and omeprazole + ethanol groups. Treatment with the selected doses was continued for 14 days before a single dose of absolute ethanol (5 ml/kg body weight) was administered to induce gastric ulcers in mice. The results showed that pretreatment with Se and Lec combination effectively decreased both the macro- and microscopic gastric lesions and increased the protection index compared to the ethanol group. Remarkably, the Se and Lec combination decreased the levels of reactive oxygen species, malondialdehyde, and cytochrome c and increased glutathione, glutathione peroxidase, and thioredoxin reductase activities in gastric tissues. The Se and Lec combination increased prostaglandin E2 and interleukin-10 levels but decreased tumor necrosis factor-α, interleukin-6 and interleukin-1β levels compared to either treatment alone. Interestingly, this combination decreased the expression of IGF-1, p-Akt, and FoxO3a proteins and increased PTEN expression in gastric tissues. The gastric tissues examination by hematoxylin and eosin staining confirmed these results. Therefore, the Se and Lec combination showed superior protective effects against ethanol-induced gastric ulcers in mice, compared to either treatment alone, through antioxidant, and anti-inflammatory activities, in addition to modulating IGF-1/PTEN/Akt/FoxO3a pathway signaling.

Effectiveness of Rifaximin on the Outcomes of Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder that impacts the lives of many individuals worldwide. We conducted a systemic review and meta-analysis of randomized controlled trials (RCTs) to assess both the effectiveness of rifaximin in alleviating IBS symptoms and its potential adverse effects. PubMed, Web of Science, Embase, the Cochrane Library, Scopus, and Google Scholar were searched from inception until August 20, 2023, for studies comparing rifaximin with placebo in the resolution of symptoms among IBS patients. Risk ratios (RRs) and their corresponding 95% confidence intervals (CIs) were derived for all the outcomes of interest. Six RCTs were pooled in this analysis. The results showed improved abdominal distension with rifaximin over the control group. Overall symptom relief at the end of the treatment period and follow-up period was also observed in the patients receiving rifaximin. However, no significant differences were found between the rifaximin group and the control group for the outcomes of abdominal pain, nausea, headache, vomiting, diarrhea, sinusitis, bronchitis, and upper respiratory tract infection. The results of our meta-analysis support the use of rifaximin in the treatment of IBS, owing to its safety and effectiveness. Future RCTs should be conducted to assess this topic of interest more extensively.

OPEN VERSUS LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS: A SYSTEMATIC REVIEW

Background: Acute cholecystitis is an inflammatory disease caused by gallstones that can range from mild to severe, with septic sepsis as a complication. It is the sixth most prevalent gastrointestinal disorder and is responsible for 0.2% to 0.5% of all fatalities. 16% of men and 50% of women in their 70s have gallbladder disease, which is a risk factor. Various treatment modalities, such as open or laparoscopic cholecystectomy, are available.
 Aim: The purpose of this review is to compare the advantages and disadvantages of open cholecystectomy and laparoscopic cholecystectomy in the acute management of cholestitis.
 Methods: We conducted a comprehensive search of multiple electronic reference databases (PubMed, ScienceDirect, Web of Science, and Cochrane). The inclusion criteria were English-language articles with full-text availability and articles published between 2018 and 2023. The studies analyzed complications and a variety of other parameters to determine the benefits and drawbacks of each method.
 Results : A total of 5 studies were included. Various complications can be used as parameters to determine the superiority of each method. Four out of 5 studies found that laparoscopic was superior to open cholecystectomy. The hospitalization time of laparoscopic patients was lower (LC 1.67±0.9 days; OC 3.2±1.8) with a lower amount of bleeding during surgery >100 ml compared to open laparoscopic (Intra operative bleeding (OC (n=8) vs LC (n=0)).
 Conclusion: Considering the advantages and disadvantages of the described complication parameters, laparoscopic procedures are superior and preferable to the use of open cholesistectomy in cases of acute cholesystitis.

Alterations of the salivary microbiota in gastroesophageal reflux disease

ObjectivesGastroesophageal reflux disease (GERD) is among the most prevalent gastrointestinal disorders. The oral microbiota plays an important role in human health and may be altered by the presence of GERD. Here, we aimed to investigate the alterations of salivary microbiota in GERD patients. MethodsWe collected clinical information and salivary samples from 60 individuals. All participants underwent combined pH/impedance monitoring measurement and submitted samples for salivary microbiota sequencing. According to acid exposure time and DeMeester score, participants were divided into two groups: GERD + (Group G) and GERD – (Group C). ResultsThere was no significant difference in alpha diversity between study groups. Regarding beta diversity, principal coordinate analysis plots indicated that the microbiota composition data of the participants were grouped within partial overlapping clusters. The statistical analysis of the distance matrices was performed using the Adonis test (p = 0.017). Based on linear discriminant analysis effect size, the relative abundances of the phylum Bacteroidetes, class Bacteroidia, order Bacteroidales, family Prevotellaceae, and genus unidentified_Prevotellaceae were enriched in Group G. Compared with Group C, the phylum Actinobacteria, classes unidentified_Actinobacteria and Bacilli, orders Micrococcales and Lactobacillales, families Micrococcaceae and Streptococcaceae, and genuses Rothia and Streptococcus were decreased in Group G. At the genus level, the abundances of Streptococcus and Rothia were negatively correlated with DeMeester score and acid exposure time. ConclusionsThis study revealed alterations of the salivary microbiota in GERD patients, suggesting that acid reflux changes the oral ecosystem.