Prevalence Of Gastrointestinal Symptoms Research Articles

Whole blood transcriptome in long-COVID patients reveals association with lung function and immune response

BackgroundMonths after infection with SARS-CoV-2, at least 10% of patients still experience complaints. Long-COVID is a heterogeneous disease and clustering efforts revealed multiple phenotypes on a clinical level. However, the molecular pathways underlying long-COVID phenotypes are still poorly understood. ObjectivesThis study aims to cluster patients according to their blood transcriptomes and uncover the pathways underlying their disease. MethodsBlood was collected from 77 patients with long-COVID from the P4O2 COVID-19 study. Unsupervised hierarchical clustering was performed on the whole blood transcriptome. These clusters were analysed for differences in clinical features, pulmonary function tests and gene ontology (GO) term enrichment. ResultsClustering revealed two distinct clusters on a transcriptome level. Compared to cluster 2 (n=65), patients in cluster 1 (n=12) showed a higher rate of pre-existing cardiovascular disease (58% vs 22%), higher prevalence of gastrointestinal symptoms (58% vs 29%), shorter hospital duration during SARS-CoV-2 infection (median: 3 vs 8 days), lower Tiffeneau index (72% vs 81%) and lower diffusion capacity of the lung for carbon monoxide (DLCO) (68% vs 85% predicted). GO-term enrichment analysis revealed upregulation of genes involved in the antiviral innate immune response in cluster 1, while genes involved with the adaptive immune response were upregulated in cluster 2. ConclusionThis study provides a start in uncovering the pathophysiological mechanisms underlying long-COVID. Further research is required to unravel why the immune response is different in these clusters, and to identify potential therapeutic targets to create an optimized treatment or monitoring strategy for the individual long-COVID patient.

Assessment of Thyroid Carcinogenic Risk and Safety Profile of GLP1-RA Semaglutide (Ozempic) Therapy for Diabetes Mellitus and Obesity: A Systematic Literature Review.

The broadening application of glucagon-like peptide (GLP)-1 receptor agonists, specifically semaglutide (Ozempic) for the management of diabetes and obesity brings a critical need to evaluate its safety profile, considering estimates of up to 20 million prescriptions per year in the US until 2035. This systematic review aims to assess the incidence of thyroid cancer and detail the spectrum of adverse events associated with semaglutide, focusing on its implications for patient care. Through a systematic search of PubMed, Scopus, and Embase databases up to December 2023, ten randomized controlled trials (RCTs) involving 14,550 participants, with 7830 receiving semaglutide, were analyzed, with an additional number of 18 studies that were separately discussed because they reported data from the same RCTs. The review focused on thyroid cancer incidence, gastrointestinal symptoms, and other significant adverse events attributed to semaglutide. The incidence of thyroid cancer in semaglutide-treated patients was less than 1%, suggesting no significant risk. Adverse events were predominantly gastrointestinal, including nausea (2.05% to 19.95%) and diarrhea (1.4% to 13%). Nasopharyngitis and vomiting were also notable, with mean prevalences of 8.23% and 5.97%, respectively. Other adverse events included increased lipase levels (mean of 6.5%), headaches (mean prevalence of 7.92%), decreased appetite (reported consistently at 7%), influenza symptoms (mean prevalence of 5.23%), dyspepsia (mean prevalence of 5.18%), and constipation (mean prevalence of 6.91%). Serious adverse events varied from 7% to 25.2%, highlighting the need for vigilant patient monitoring. These findings underscore the gastrointestinal nature of semaglutide's adverse events, which, while prevalent, did not significantly deter from its clinical benefits in the treatment landscape. This systematic review provides a comprehensive assessment of semaglutide's safety profile, with a focus on gastrointestinal adverse events and a low incidence of thyroid cancer. Despite the prevalence of gastrointestinal symptoms, semaglutide remains an efficacious option for managing diabetes and obesity. The detailed characterization of adverse events underscores the importance of monitoring and managing these effects in clinical practice, excluding the hypothesis of carcinogenesis.

Profile of adenoviral infection in hospitalized children

This single-center, retrospective study was conducted at Marengo Asia Hospital, Haryana from January 2023 to November 2023. Children aged 1 month to 16 years, admitted with a positive adenovirus polymerase chain reaction (nasopharyngeal swab) were included. Symptomatic management was provided to all children. The study focuses on discussing the demographic, clinical, laboratory and radiological profiles of hospitalized children with human adenovirus infection. Among the 25 children with a positive adenovirus polymerase chain reaction, 18 (72%) were males, 15 (60%) were within the age group of 1 month to 5 years. Furthermore, 13 (52%) children were hospitalized during summer season. The most prevalent symptoms observed in children admitted with adenovirus infection were high-grade persistent fever in 25 cases (100%), cough and cold in 15 cases (60%), 14 (56%) vomiting in 14 cases (56%), pain abdomen and loose stools in 10 cases (40%), conjunctivitis in 6 cases (24%), and adenoviral pneumonia in 4 cases (16%). Notably all children were discharged successfully without encountering any complications. HAdV infections are commonly associated with high- grade fever, challenging the conventional perception that respiratory infections are their predominant manifestation. Equally noteworthy is the prevalence of gastrointestinal symptoms in HAdV infections

Prevalence of Gastrointestinal Symptoms among Individuals with and without Diabetes: A Cross-Sectional Study from the PERSIAN Guilan Cohort Study

Prevalence of Gastrointestinal Symptoms among Individuals with and without Diabetes: A Cross-Sectional Study from the PERSIAN Guilan Cohort Study

Assessment of Gastrointestinal Adverse Effects during the First Six Months of "Biktarvy" Antiretroviral Therapy: Age-Related Patterns and Their Relation with Changes of 5 kg Weight Loss/Gain in the Initial Treatment Period.

The battle against HIV has led to the development of antiretroviral therapy (ART), including BIKTARVY®, which combines three potent agents. However, concerns about gastrointestinal side effects during the early phases of treatment have emerged, potentially impacting patient adherence and outcomes. This retrospective cohort study, conducted over four years in Romania, examined 222 patients initiated on BIKTARVY® therapy. Data were collected from electronic medical records, and stringent inclusion and exclusion criteria were applied to ensure data accuracy and relevance. Statistical analysis was performed to assess age-related patterns in gastrointestinal symptoms and their relation with significant weight loss. This study revealed significant differences in the prevalence of gastrointestinal symptoms between age groups, with older patients experiencing more symptoms. Notably, diarrhea did not exhibit a statistically significant age-related difference. Furthermore, weight loss exceeding 5 kg was more common in older patients. Of the patients who continued BIKTARVY® therapy, 84.9% showed an increase in CD4 cell counts, and most expressed satisfaction with treatment. Understanding age-related patterns and gastrointestinal side effects of BIKTARVY® is crucial for optimizing HIV patient care. Future research should aim to corroborate and expand upon these findings, potentially leading to improved therapeutic approaches in the ongoing fight against HIV.

The structure of gastrointestinal tract pathology in patients receiving hemodialysis treatment

BACKGROUND. Hemodialysis patients are characterized by a wide range of concomitant diseases, including cardiovascular, bone mineral, nutritional, cognitive, various metabolic disorders and anemia. Meanwhile, gastrointestinal tract disorders in these patients remains largely unexplored. Patients receiving treatment with programmed hemodialysis are characterized by a wide range of concomitant diseases, including cardiovascular, bone mineral, nutritional, cognitive, various metabolic disorders and anemia. Meanwhile, the pathology of the gastrointestinal tract in this category of patients remains largely unexplored.AIM: to investigate the structure of digestive diseases in patients receiving hemodialysis treatment.PATIENTS AND METHODS. This study included 180 hemodialysis patients. The median age was 60[47;68] years. Gastrointestinal Symptoms Questionnaire (GSQ) was used to evaluate gastrointestinal symptoms over the last month. The results of abdomen ultrasound, gastroscopy, colonoscopy, and complex laboratory examination were also analyzed.RESULTS. The overall prevalence of gastrointestinal symptoms was 77.2 % (139/180). The most frequent complaints were constipation (46.8 %) and abdominal pain (41 %). The most common stool frequency was one bowel action per day. The third, fourth, fifth type of stool according to the Bristol Stool Form Scale were noted by the majority of participants. Abdominal ultrasound revealed diffuse liver changes in 115 (63.9 %), signs of cirrhosis – in 7(3.9 %) patients. Ultrasound pathology of the gallbladder was represented by anomalies of its shape in 11.1 %, signs of chronic cholecystitis – in 10 %, stones (sludge) – in 7.2 %, polyps – in 2.2 % of patients. Diffuse changes in pancreatic parenchyma, steatosis, pseudocysts and dilatation of the main pancreatic duct were diagnosed respectively in 39(21,7 %), 21(11,7 %), 10(5,6 %) and 3(1.7 %) hemodialysis patients. According to 154 gastroscopies, the most common endoscopic finding in the stomach was chronic gastritis, detected in 86(55.8 %) of the subjects. Erosive gastritis was diagnosed in 22(14.3 %), gastric ulcer – in 3(2.0 %) patients. Endoscopic duodenal pathology was represented by erythematous duodenitis in 53(34.4 %), erosive duodenitis in 15(9.7 %), ulcer in 2(1.3 %), duodenal bulb abnormalities in 23(14.9 %) patients. Combined gastric and duodenal lesions were found in 88(57.1 %) patients. Сolonoscopy was performed in 56 patients, of whom 15 (26.8 %) had signs of colitis (mainly sigmoiditis), 2(3.6 %) – diverticulitis, 10(17.9 %) – diverticulosis, 12(21.4 %) – colon polyps, 8(14.3 %) – angiodysplasia mucosa, in 3(5.4 %) – dolichocolon. Despite the abundance of gastrointestinal symptoms and instrumental findings, no significant deviations in laboratory parameters (including an increase in AST, ALT, total bilirubin, amylase, lipase) were found.CONCLUSION. Hemodialysis patients are characterized by a high prevalence of gastrointestinal symptoms and various pathological changes in the gastrointestinal tract, the diagnosis and treatment of which require an individual multidisciplinary approach.

Tirzepatide-Induced Gastrointestinal Manifestations: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysisdetermine how frequently and how seriously gastrointestinal manifestations affect people with type 2 diabetes mellituson tirzepatide. Tirzepatide is a recently developed drug that attempts to enhance type 2 diabetics' ability to regulate their blood sugar levels and promote weight reduction. Despite its potential benefits, clinical trials have revealed that the medication may lead togastrointestinal side effects, including nausea, vomiting, decreased appetite, dyspepsia, constipation, and diarrhea. Theseside effectsmay negatively affect the drug's efficacy and patient tolerance. A comprehensive search of electronic databases such as PubMed, Web of Science, and Cochrane Library, was conducted to find pertinent studies reporting on the frequency and severity of gastrointestinal symptoms in type 2 diabetes patients receiving tirzepatide. This systematic review follows the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Study selection, data extraction, and quality assessment were performed. Six randomized controlled trials with a total of 4,586 patients were included. Most patients received tirzepatide to regulate their blood sugar levels and promote weight reduction, and the comparators were placebo, glucagon-like peptide one receptor agonistsdrugs, and insulin degludec. The dose of tirzepatide was 5mg, 10mg, and 15mgweekly. The incidence rate of nausea in patients who receive tirzepatide was 20.43%, while the incidence rate in the comparators was 10.47%, and it was significantly higher in the tirzepatide arm than in the comparators (RR, 2.90; 95% CI, 1.89 to 4.44; P≤0.00001). The incidence rate of vomiting in patients who receive tirzepatide was 9.05%, while the rate in the comparators was 4.86%, and it was significantly higher in the tirzepatide arm than in the comparators (RR, 2.69; 95% CI, 1.67 to 4.36; P≤0.0001). The incidence rate of constipation in patients who receive tirzepatide was 2.54%, while the rate in the comparators was 0.856%, and it was significantly higher in the tirzepatide arm than in the comparators (RR, 3.08; 95% CI, 1.83 to 5.20; P≤0.0001). The incidence rate of decreased appetite in patients who receive tirzepatide was 9.64%, while the rate in the comparators was 2.88%, and it was significantly higher in the tirzepatide arm than in the comparators (RR, 5.04; 95% CI, 3.01 to 8.45; P≤0.00001). The incidence rate of diarrhea in patients who receive tirzepatide was 16.24%, while the rate in the comparators was 8.63%, and it was significantly higher in the tirzepatide arm than in the comparators (RR, 2.07; 95% CI, 1.60 to 2.68; P≤0.00001). The incidence rate of dyspepsia in patients who receive tirzepatide was 7.13%, while the rate in the comparators was 3.31%, and it was significantly higher in the tirzepatide arm than in the comparators (RR, 2.52; 95% CI, 1.58 to 4.01; P≤0.0001). Tirzepatide usage is linked to a significant prevalence of gastrointestinal symptoms, including nausea, constipation, decreased appetite, dyspepsia, diarrhea, and vomiting, in people with type 2 diabetes. These findings may influence clinical decision-making and patient counseling on the use of tirzepatide and have significant implications for the medication's tolerance and efficacy. To find ways to reduce these negative effects and improve therapy for type 2 diabetes patients, more research is required.

Prevalence of Liver Injury, Gastrointestinal Tract Symptoms, and H. Pylori Infection in Patients of Coronavirus Disease 2019 (COVID-19)

Background COVID-19 most commonly presents with respiratory symptoms, including cough, shortness of breath, sore throat with characteristics of loss of smell and taste. However, digestive symptoms also occur in patients with COVID-19 and are often described in outpatients with less severe disease. Objective To estimate the rate of GI symptoms, liver enzyme levels outside reference ranges, and fecal tests for H. Pylori antigen among patients with the suspected or proven COVID-19. Patients and Methods The research performed on 70 Egyptian patients who have suspected COVID-19 symptoms included in this study. The patients are divided into four groups. Asymptomatic group, group with respiratory symptoms, group with digestive symptoms, and group with respiratory and digestive symptoms. Results The asymptomatic patient was 10%, gastrointestinal symptoms with or without respiratory symptoms 24.3%, digestive symptoms only 11.8% of COVID-19, and H. pylori present in 50% of the digestive group of COVID-19 patients. The use of corticosteroids in the low effective dose for ten days to 2 weeks and anticoagulant play an important role in the management of COVID-19, especially in moderate cases. Conclusion The prevalence of gastrointestinal symptoms in COVID-19 increase up to 24.3% and the prevalence of patients with digestive symptoms only was 11.4%. In some cases, the digestive symptoms, particularly diarrhea, can be the initial or only presentation of COVID-19.

COVID-19-induced gastrointestinal autonomic dysfunction: A systematic review.

It is common for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to occur in the gastrointestinal tract, which can present itself as an initial symptom. The severity of coronavirus disease 2019 (COVID-19) is often reflected in the prevalence of gastrointestinal symptoms. COVID-19 can damage the nerve supply to the digestive system, leading to gastrointestinal autonomic dysfunction. There is still much to learn about how COVID-19 affects the autonomic nervous system and the gastrointestinal tract. To thoroughly explore the epidemiology and clinical aspects of COVID-19-induced gastrointestinal autonomic dysfunction, including its manifestations, potential mechanisms, diagnosis, differential diagnosis, impact on quality of life, prognosis, and management and prevention strategies. We conducted a thorough systematic search across various databases and performed an extensive literature review. Our review encompassed 113 studies published in English from January 2000 to April 18, 2023. According to most of the literature, gastrointestinal autonomic dysfunction can seriously affect a patient's quality of life and ultimate prognosis. Numerous factors can influence gastrointestinal autonomic nervous functions. Studies have shown that SARS-CoV-2 has a well-documented affinity for both neural and gastrointestinal tissues, and the virus can produce various gastrointestinal symptoms by reaching neural tissues through different pathways. These symptoms include anorexia, dysgeusia, heartburn, belching, chest pain, regurgitation, vomiting, epigastric burn, diarrhea, abdominal pain, bloating, irregular bowel movements, and constipation. Diarrhea is the most prevalent symptom, followed by anorexia, nausea, vomiting, and abdominal pain. Although COVID-19 vaccination may rarely induce autonomic dysfunction and gastrointestinal symptoms, COVID-19-induced autonomic effects significantly impact the patient's condition, general health, prognosis, and quality of life. Early diagnosis and proper recognition are crucial for improving outcomes. It is important to consider the differential diagnosis, as these symptoms may be induced by diseases other than COVID-19-induced autonomic dysfunction. Treating this dysfunction can be a challenging task. To ensure the best possible outcomes for COVID-19 patients, it is essential to take a multidisciplinary approach involving providing supportive care, treating the underlying infection, managing dysfunction, monitoring for complications, and offering nutritional support. Close monitoring of the patient's condition is crucial, and prompt intervention should be taken if necessary. Furthermore, conducting thorough research on the gastrointestinal autonomic dysfunction caused by COVID-19 is vital to manage it effectively.

An Exploratory Study Investigating the Prevalence of Gastrointestinal Symptoms in Collegiate Division I American Football Athletes.

Gastrointestinal (GI) symptoms may limit performance, but their prevalence and impact among team sports athletes is not well-documented. The objective of this study was to examine the prevalence of GI symptoms in a small sample of collegiate DI American football athletes, using a survey including the Gastrointestinal Symptoms Ratings Scale (GSRS). Forty-six athletes responded to the survey and reported scores for the 15-question GSRS with additional questions about dietary habits and supplement use. A total of 44 athletes were included in the study (45% of the current roster, age: 20.7 ± 1.7 years, 50% Afro-American or black, 39% skill position, 18% NSAIDs use, and 41% reporting protein supplement use); approximately half of the athletes (52%) reported experiencing GI complaints during exercise. Two-thirds of the athletes (61%) reported at least one or more GI symptoms in general, and 50% reported at least four moderate complaints. Seven athletes (16%) reported ≥2 severe GI symptoms with 5-13 moderate complaints. The most reported symptom was stomach pain (39%, n = 17), followed by hunger pain (36%, n = 16). Athletes reporting the use of protein supplements reported a higher GSRS score (22.0 and interquartile range (IQR) 17.0-31.8) vs. athletes not reporting protein use (15.0 and IQR 15.0-19.3), p = 0.001. Most athletes surveyed reported experiencing GI symptoms. A small group of these athletes reported multiple, varied, and severe symptoms that were associated with self-reported protein supplement use. In conclusion, the number of complaints varied among athletes, confirming the value of integrating the GSRS for screening purposes, and the expected need for individual dietary treatment approaches.

Prevalence of gastrointestinal symptoms in autism spectrum disorder: A meta-analysis

IntroductionA high prevalence of gastrointestinal (GI) symptoms has been described in children and adolescents with autism spectrum disorder (ASD). In addition, there is evidence that presence of GI symptoms is associated to greater severity of ASD. However, the frequency of GI symptoms in children and adolescents with ASD varies widely across studies, and their true prevalence is unknown. Therefore, the objective of this study was to estimate the prevalence of GI symptoms in children and adolescents with ASD. Material and methodWe conducted a meta-analysis following the PRISMA guidelines. We carried out a rapid systematic search for recent clinical and observational studies published from August 2012 in PubMed. The statistical analyses were performed with the software R. ResultsOf 91 potentially eligible articles, only 8 met our inclusion criteria. The prevalence of GI symptoms ranged between 0% and 69%, with an estimated general prevalence of 33% (95% CI, 13%–57%), higher than that reported by a previous meta-analysis for the general paediatric population. This difference is even greater in the specific comparison of studies that applied the paediatric version of the ROME III questionnaire (QPGS-ROME III). ConclusionsThe results confirmed the hypothesis that there is a higher prevalence of functional GI symptoms in paediatric patients with ASD compared to their neurotypical peers.

Prevalence of gastrointestinal symptoms among autistic individuals, with and without co-occurring intellectual disability.

Gastrointestinal symptoms (GI) are very common among individuals on the autism spectrum. Prior research reports mixed findings regarding whether individuals with autism and co-occurring intellectual disability (ID) have elevated risk of gastrointestinal symptoms relative to individuals with autism alone. GI symptoms can be challenging to assess in individuals with autism spectrum disorder (ASD) and/or ID given challenges with language, communication, and interoception. Prior research has tended to only include individuals with documented presence or absence of GI symptoms or conditions, that is, to exclude observations in which there is uncertainty regarding presence of GI symptoms. Therefore, none of the prior autism studies reported the association between ID and the certainty regarding presence or absence of GI symptoms. The objective of this study was to examine differences in parental certainty and odds of reporting gastrointestinal signs and symptoms among children on the autism spectrum, with and without intellectual disability. Participants were 308 children (36% ID) with a clinical diagnosis of autism spectrum disorder (6-17 years). Parents endorsed whether their child had experienced or displayed a range of signs or symptoms related to GI problems in the past 3 months. Parents of autistic children with ID were less certain about the presence of more subjective symptoms, including abdominal pain, nausea, and bloating. Conversely, certainty regarding more objective signs (e.g., constipation, diarrhea, spitting up, etc.) was not significantly different. More accurate measures for GI signs/symptoms are needed for this population.

Prevalence of gastro-intestinal symptoms among COVID-19 patients and the association with disease clinical outcomes.

This study examined the various manifestations of COVID-19 in people's gastro-intestinal system and how gastro-intestinal involvement relates to the progression and outcome of the disease. A questionnaire survey was used to collect data from 561 COVID-19 patients between February 6 and 6April2022. Laboratory data and clinical outcomes were obtained from the patients' medical records. 39.9% of patients presented gastro-intestinal symptoms, mainly loss of appetite, nausea, vomiting and diarrhea. Gastro-intestinal symptoms were not linked to poorer outcomes such as mortality, ICU admission or length of hospital stays. gastro-intestinal symptoms were common among patients and may manifest with respiratory symptoms. We recommended clinicians to watch out for gastro-intestinal symptoms as related to COVID-19 infection.

Comparing Hemodialysis and Peritoneal Dialysis Patients for Gastrointestinal Symptoms

Objective: The purpose of this research was to compare gastrointestinal (GI) symptoms in ESRD patients receiving PD and HD to see whether there were any significant changes. Methods: After the ethical approval from the institute review board, this crossectional study was conducted at shahida Islam medical complex ,lodhran. From 01/01/22 to 30/06/22. A modified 15-item gastrointestinal symptom rating scale (GSRS) questionnaire was used to assess GI symptoms; this questionnaire included questions on eating dysfunction. Age, a etiology of ESRD, and most recent adequacy evaluation of dialysis were collected through the follow-up database, patient interviews, and chart reviews. Results: Total seventy patients were included in the present study, N=35 was on hemodialysis and N=35 on peritoneal dialysis. HD and PD patients were similar with respect to age, sex, the occurrence of diabetes mellitus, and average dialysis duration. In ESRD patients’ overall prevalence of GI symptoms (GSRS >1) was 68.5% (48/70 patients). Patients with a GSRS > 1 were more common among those with HD group (28/35; 80%) than those with PD (57%; 20/35) (P 0.058*). In the HD group, more patients suffered from abdominal pain, constipation, and diarrhea (74%, 60% and 68.5%, respectively), compared with those in the PD group (34%, 28.5% and 32%, respectively; P value is 0.003, 0.001, and 0.008 respectively) Conclusion: Gastrointestinal (GI) symptoms vary in frequency, intensity, and variety across HD and PD individuals. Keywords: Gastrointestinal symptom, Hemodialysis, Peritoneal dialysis, End-stage renal disease

Comparison of Hospitalized COVID-19 Patients in Terms of Disease Course According to the Presence of Gastrointestinal Symptoms Before and After Admission.

This study aimed to find the prevalence of gastrointestinal symptoms in hospitalized COVID-19 patients and to investigate the effects of gastrointestinal symptoms on the course of the disease during hospitalization. Patients who were hospitalized due to COVID-19 were included in this retrospective study. The diagnostic method of COVID-19 was either a positive reverse transcription polymerase chain reaction test or a typical finding in chest computed tomography. This study was conducted by contacting patients by phone 1 month after they were discharged from hospital to investigate gastrointestinal symptoms. Patients' laboratory findings at the time of admission, medications they used, and clinical findings were obtained from hospital records retrospectively. Patients with gastrointestinal symptoms were divided into 2 groups according to the start of treatment: pre-treatment and post-treatment groups. At least 1 gastrointestinal symptom (anorexia, weight loss, diarrhea, nausea, vomiting, and abdominal pain) was present in 67.5% of 435 patients (55.6% male, mean age 52.8). If anorexia and weight loss are excluded, the rate of the presence of at least 1 gastrointestinal symptom is 54%. Gastrointestinal symptoms were present in 48.9% before the initiation of COVID-19 treatment. The most prevalent 3 symptoms were anorexia, weight loss, and diarrhea (56%, 52%, and 35.6%, respectively). Presence of pre-treatment gastrointestinal symptoms was associated with elevated C-reactive protein levels. Pre-treatment gastrointestinal symptoms were more common in those who received oxygen supply and who were intubated. Resolution of gastrointestinal symptoms takes longer time in those who were admitted to intensive care unit. Weight loss and diarrhea were more common in COVID-19 patients with gastrointestinal symptoms who were intubated than who were not intubated. Abdominal pain was not found to be a significant predictor of disease severity. The prevalence of at least 1 gastrointestinal symptom in hospitalized COVID-19 patients was 67%. The most prevalent symptoms were anorexia, weight loss, and diarrhea. Presence of pre-treatment gastrointestinal symptoms was associated with elevated C-reactive protein levels, use of oxygen supply, and intubation. Gastrointestinal symptoms persist longer in those admitted to intensive care unit.

Gastrointestinal Symptoms of Monkeypox Infection: A systematic review and meta-analysis.

Since early May 2022, outbreaks of Monkeypox (Mpox) cases have emerged and become a global concern. Studies exploring the gastrointestinal symptoms and/or liver injury of Mpox are still very limited. This systematic review and meta-analysis is the first to summarize the gastrointestinal symptoms reported by Mpox patients. We searched for Mpox studies published until October 21, 2022, in MEDLINE, EMBASE, SCOPUS, and organization websites. Mpox studies were observational studies that reported at least one of either gastrointestinal symptoms and/or liver injury in Mpox patients. Meta-analysis was done to obtain the pooled prevalence of gastrointestinal symptoms in Mpox patients. Subgroup analyses were done based on the study location, age groups, and MpoxClades. The quality of included studies was assessed using the NIH Quality Assessment Tool. Overall, 31 studies that reported gastrointestinal symptoms and/or liver injury in Mpox patients were included. The reported gastrointestinal symptoms were abdominal pain, anorexia, diarrhea, nausea, and vomiting. There is a lack of reporting for liver injury. The most prevalent gastrointestinal symptoms in Mpox patients were anorexia (47%; 95% confidence interval [CI] 41%-53%), followed by vomiting (12%; 95%CI 11%-13%), nausea (10%; 95%CI 9%-11%), abdominal pain (9%; 95%CI 8%-10%), and diarrhea (5%; 95%CI 4%-6%). Additionally, the prevalence of proctitis, rectal/anal pain, and rectal bleeding were 11% (95%CI 11%-12%), 25% (95%CI 24%-27%), and 12% (95%CI 11%-13%), respectively. Anorexia was the most frequently reported gastrointestinal symptom in Mpox patients, followed by vomiting, nausea, abdominal pain, and diarrhea. Proctitis is a novel presentation of Mpox in the 2022 outbreak.

Sociodemographic Factors, Nutritional Status, and Inflammatory Markers in Patients with Postural Orthostatic Tachycardia Syndrome

Objectives. Postural orthostatic tachycardia syndrome (POTS) is characterized by cardiovascular autonomic dysfunction of unknown etiology with high a prevalence of gastrointestinal symptoms. The aim of the present study was to examine sociodemographic, lifestyle, and nutritional factors as well as inflammatory markers in patients with POTS. Materials and Methods. Forty-three patients with POTS and 61 healthy controls completed questionnaires about sociodemographic factors, lifestyle habits, and gastrointestinal symptoms. Blood samples were analyzed for serum levels of cobalamins, folic acid, iron, total iron-binding capacity (TIBC), ferritin, sodium, potassium, magnesium, phosphorus, albumin, high-sensitive C-reactive protein (CRP), and 25-hydroxyvitamin D (25-OH vitamin D). Results. POTS patients were predominantly women with a lower education level and were more often working part-time, on sick leave, and living alone compared with healthy controls. They reported lower alcohol intake and physical activity levels than controls. The nutrient intake was in general similar in both groups, but POTS patients had a higher intake of different drinks and reported more gastrointestinal symptoms than controls. POTS was associated with higher CRP levels (β: 1.370; 95% CI: 0.004–2.737; p = 0.049 ), lower albumin levels (β: -1.443; 95% CI: -2.648–(-0.238); p = 0.019 ), and higher sodium levels (β: 1.392; 95% CI: 0.559–2.225; p = 0.001 ). Abdominal pain ( p = 0.004 ) and intestinal symptoms’ influence on daily life ( p = 0.025 ) were negatively associated with albumin levels. Abdominal pain ( p = 0.011 ), vomiting and nausea ( p = 0.003 ), and intestinal symptoms’ influence on daily life ( p = 0.026 ) were associated with higher sodium levels. Serum levels representing iron and vitamin metabolism were equal between groups. Conclusions. POTS is associated with poorer sociodemographic status, but malnutrition cannot explain POTS or related gastrointestinal symptoms. Higher CRP and lower albumin levels suggest low-grade inflammation as one possible etiological factor.

Prevalence of gastrointestinal symptoms and their association with psychological problems in youths.

Gastrointestinal symptoms and psychological problems are common in youths, which can negatively affect their lives on physical, mental, and social levels. This cross-sectional study aimed to determine the prevalence of gastrointestinal symptoms in youths and further explore their association with psychological problems. Self-reported data on gastrointestinal symptoms and psychological problems in 692 sophomores who majored in education in a high vocational school and 310 recruits who were undergoing basic training in an army in China were retrospectively collected. The self-reported data included demographics, gastrointestinal symptoms, and Symptom Checklist 90 (SCL-90) used for the assessment of psychological problems. Gastrointestinal symptoms surveyed included nausea, emesis, abdominal pain, acid regurgitation, eructation, heartburn, anorexia, abdominal bloating, diarrhea, constipation, hematemesis, and hematochezia. Logistic regression analysis was performed to identify the independent risk factors associated with gastrointestinal symptoms. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated. The prevalence of gastrointestinal symptoms was 36.7% (n=254) and 15.5% (n=48) in the sophomores and recruits, respectively. Participants with gastrointestinal symptoms had a significantly higher prevalence of total SCL-90 score beyond 160 than those without gastrointestinal symptoms in both sophomores (19.7% vs. 3.2%, P<0.001) and recruits (10.4% vs. 1.1%, P<0.001). Total SCL-90 score beyond 160 was independently associated with gastrointestinal symptoms in both sophomores (OR =5.467; 95% CI: 2.855-10.470; P<0.001) and recruits (OR =6.734; 95% CI: 1.226-36.999; P=0.028). Gastrointestinal symptoms may be common and strongly associated with psychological problems in youths. Prospective studies should be required to explore the impact of the correction of psychological problems on the improvement of gastrointestinal symptoms.

The prevalence of gastrointestinal symptoms and cobalamin deficiency in patients with chronic urticaria

BackgroundThere is a paucity of studies reporting the presence of systemic symptoms and micronutrient deficiency in patients with chronic urticaria, and these data are lacking in a Canadian population.ObjectiveTo report the prevalence of gastrointestinal symptoms and vitamin B12 (cobalamin) deficiency in a Canadian patient population diagnosed with chronic urticaria.MethodsA retrospective chart review of 100 adult patients with chronic urticaria was conducted. Demographic characteristics, medications, presence of gastrointestinal symptoms, and laboratory findings were abstracted from electronic medical records.ResultsSeventy percent of patients with chronic urticaria reported experiencing gastrointestinal symptoms. The most common symptom identified was gastroesophageal reflux (42%). Vitamin B12 (cobalamin) deficiency, defined as serum vitamin B12 level ≤ 250 pmol/L, was identified in 31.7% of the patients. Among those patients with urticaria and vitamin B12, 68% reported gastrointestinal symptoms.ConclusionsThis is the first study to provide data on the high prevalence of gastrointestinal symptoms and vitamin B12 (cobalamin) deficiency in a Canadian population diagnosed with chronic urticaria. Early recognition and management of systemic symptoms and micronutrient deficiency may lead to a more comprehensive approach to management of these patients.Trial registration Not applicable

Beyond shallow feelings of complex affect: Non-motor correlates of subjective emotional experience in Parkinson's disease.

Affective disorders in Parkinson's disease (PD) concern several components of emotion. However, research on subjective feeling in PD is scarce and has produced overall varying results. Therefore, in this study, we aimed to evaluate the subjective emotional experience and its relationship with autonomic symptoms and other non-motor features in PD patients. We used a battery of film excerpts to elicit Amusement, Anger, Disgust, Fear, Sadness, Tenderness, and Neutral State, in 28 PD patients and 17 healthy controls. Self-report scores of emotion category, intensity, and valence were analyzed. In the PD group, we explored the association between emotional self-reported scores and clinical scales assessing autonomic dysregulation, depression, REM sleep behavior disorder, and cognitive impairment. Patient clustering was assessed by considering relevant associations. Tenderness occurrence and intensity of Tenderness and Amusement were reduced in the PD patients. Tenderness occurrence was mainly associated with the overall cognitive status and the prevalence of gastrointestinal symptoms. In contrast, the intensity and valence reported for the experience of Amusement correlated with the prevalence of urinary symptoms. We identified five patient clusters, which differed significantly in their profile of non-motor symptoms and subjective feeling. Our findings further suggest the possible existence of a PD phenotype with more significant changes in subjective emotional experience. We concluded that the subjective experience of complex emotions is impaired in PD. Non-motor feature grouping suggests the existence of disease phenotypes profiled according to specific deficits in subjective emotional experience, with potential clinical implications for the adoption of precision medicine in PD. Further research on larger sample sizes, combining subjective and physiological measures of emotion with additional clinical features, is needed to extend our findings.