Symptoms Of Gastrointestinal Disease Research Articles

Gastrointestinal quality of life index 10 (GIQLI-10) in Bahasa Indonesia: Translation and validation of a standardized questionnaire to assess patient symptoms

The Gastrointestinal Quality of Life Index (GIQLI-10) is a standardized measure of quality of life for gastrointestinal symptoms. Out purpose is translating and validating the GIQLI-10 to Bahasa Indonesia for use in the Indonesian population. Cases of gastrointestinal disease is rising in Indonesia, possibly due to changes in dietary patterns and infectious diseases. Therefore, it is necessary to adequately measure the symptoms of gastrointestinal diseases quantitatively and its impact on the quality of life of the patient. A simple and valid standardized questionnaire is necessary, which can be implemented in daily practice, requiring limited implementation time. GIQLI-10 is a tool to evaluate the quality of life of patients with gastrointestinal disorders, covering both their symptoms and overall well-being. However, as a closed-ended questionnaire, it may have limitations in capturing the full spectrum of individual patient symptoms and rely on subjective responses influenced by cultural factors. Despite these limitations, GIQLI-10 has been validated in various languages and populations, demonstrating its reliability and validity across different cultural backgrounds and diseases. The successful translation and validation of the GIQLI-10 into Bahasa Indonesia will facilitate its use in assessing the quality of life of Indonesian patients with gastrointestinal disorders, aiding diagnosis, treatment planning, and research. Our objective is to translate GIQLI-10 to Bahasa Indonesia and assess it’s reliability and validity. We used a standardized translation method recommended for medical questionnaires. The final version of the questionnaire was tested for its validity and reliability. Reliability was measured using Cronbach's alpha, which yielded a score of 0.714. Internal validity was assessed for each item using Pearson's correlations, which shows that the translated version is valid and reliable. This questionnaire can be implemented in a short duration, and applied to all patients with gastrointestinal symptoms.

Protozoan intestinal invasions in military personnel of the Northern region of Ukraine

Objective — to study the prevalence and spectrum of intestinal parasitic infestations (IPI) agents in groups of military personnel of the Northern region of Ukraine, which differed according to the criteria of having symptoms of gastrointestinal disorders and passing the serving in a combat zone. Materials and methods. From February to November 2023, the study covered 302 servicemen during inpatient medical care at the Military Medical Clinical Center of the Northern Region of Ukraine. Detection and identification of intestinal parasites in samples of feces (SF) was carried out by classical methods of microscopy using the enrichment procedure (formalin‑ethyl acetate sedimentation) and the preparation (from each enriched sediment) of four smears: two thick wet with 50% aqueous solution of glycerol and D’ Anthony iodine solution; two thin, fixed, permanently stained with Whitley’s modified trichrome (mWT) or Heidenhain’s iron hematoxylin (HIH) and the modified Ziehl‑Neelsen acid method (mZN). Smear microscopy results were evaluated according to the criteria of the US Clinical and Laboratory Standards Institute. Results. It was established that the level of prevalence of IPI among the examined servicemen reached 10.6% with variation in the value of this indicator in different groups of soldiers from 2.2% to 12.6%. A specific share of protozoan monoinvasions in soldiers reached 65.6%, and mixed invasions (with two parasites at the same time) — 34.4%. Soldiers with symptoms of gastrointestinal diseases had significantly higher rates of IPI than did asymptomatic. In addition, the infestation rates among soldiers were higher in the cold season (October‑February) with a seasonality index of 1.9. All cases of IPI in servicemen (n=32) were caused by protozoan parasites (n=39), in the etiological spectrum of which the vast majority (84.6%) were pathogenic species (Blastocystis sp., Dientamoeba fragilis, Giardia lamblia), and a smaller proportion (15.4%) were commensal species (Chilomastix mesnili, Iodamoeba butschliі). Among pathogenic protozoa (n=33), Blastocystis sp. (51.5%) and D. fragilis had the highest proportion (42.4%), G. lamblia (6.1%) had significantly less one. Conclusions. Optimizing the management tactics of military medicine to reduce the negative impact of IPI on the health and combat capacity of servicemen requires knowledge about the prevalence and spectrum of pathogens of invasions among specific groups of soldiers. A necessary condition for increasing the efficiency of microscopic detection/identification of protozoan parasites (primarily D. fragilis) in the SF is the production of permanently stained (mWT or HIH) smears. Microscopic examination of such smears at high resolution (100ґ objective, oil immersion) provides an increased incidence of detection/identification of Blastocystis sp. by 47.1% and D. fragilis by 100%.

Scintigraphy of Gastrointestinal Motility: Best Practices in Assessment of Gastric and Bowel Transit in Adults.

Various radiologic examinations and other diagnostic tools exist for evaluating gastrointestinal diseases. When symptoms of gastrointestinal disease persist and no underlying anatomic or structural abnormality is identified, the diagnosis of functional gastrointestinal disorder is frequently applied. Given its physiologic and quantitative nature, scintigraphy often plays a central role in the diagnosis and treatment of patients with suspected functional gastrointestinal disorder. Most frequently, after functional gallbladder disease is excluded, gastric emptying scintigraphy (GES) is considered the next step in evaluating patients with suspected gastric motility disorder who present with upper gastrointestinal symptoms such as dyspepsia or bloating. GES is the standard modality for detecting delayed gastric emptying (gastroparesis) and the less commonly encountered clinical entity, gastric dumping syndrome. Additionally, GES can be used to assess abnormalities of intragastric distribution, suggesting specific disorders such as impaired fundal accommodation or antral dysfunction, as well as to evaluate gastric emptying of liquid. More recently, scintigraphic examinations for evaluating small bowel and large bowel transit have been developed and validated for routine diagnostic use. These can be performed individually or as part of a comprehensive whole-gut transit evaluation. Such scintigraphic examinations are of particular importance because clinical assessment of suspected functional gastrointestinal disorder frequently fails to accurately localize the site of disease, and those patients may have motility disorders involving multiple portions of the gastrointestinal tract. The authors comprehensively review the current practice of gastrointestinal transit scintigraphy, with diseases and best imaging practices illustrated by means of case review. ©RSNA, 2024 See the invited commentary by Maurer and Parkman in this issue.

Assessing the impact of chlorella phenolic-rich extract on gastrointestinal health and function

Chlorella phenolic-rich extract has been studied due to its potential therapeutic effects on the gastrointestinal tract. In vivo and in vitro studies have demonstrated that consumption of Chlorella phenolic-rich extract can modulate gut microbiota, reducing inflammation and oxidative stress. Several studies have shown that Chlorella supplementation may improve symptoms of gastrointestinal diseases, such as ulcerative colitis and irritable bowel syndrome, as well as reducing liver enzyme levels in patients with metabolic dysfunction-associated steatotic liver disease and H. pylori infection rates in children. However, further research should be conducted to fully understand the mechanisms of action and potential therapeutic benefits of Chlorella phenolic-rich extract in the gastrointestinal tract. Patients should consult with experts before taking Chlorella, so that they can be made aware of the potential side effects and any relevant mediation interactions. Overall, the use of Chlorella phenolic-rich extract is an innovative subject where there is a need for researchers to examine the potential treatment of various gastrointestinal conditions. Additional researchers are needed to fully evaluate its effectiveness and safety.

Empiric anti-Giardia therapy in non-diarrheal protein-losing enteropathy: A focus on children with monogenic humoral immunodeficiency.

Background and Aim: Chronic giardia infection can lead to non-erosive gastrointestinal disorders, including protein-losing enteropathy (PLE). This report describes non-diarrheal PLE in chronic giardiasis in children with defective humoral immunity. Methods: The retrospective report is related to 2 children known to have a monogenic inborn error of immunity. The first patient is a 13-year-old boy with X-linked agammaglobulinemia (Patient-1), and the second is a 5-year-old boy with NF-kB inducing kinase (NIK) deficiency infection. Frequency, growth status, and serum immunoglobulin-G (IgG) trough and albumin levels were monitored (Patient-2). Results: Patient-1 had more frequency of pneumonia but reported no symptoms of gastrointestinal disease, including alteration of bowel habits, change in stool consistency, nausea, vomiting, fatigue, bloating, and abdominal pain. No clinical oedema on examination. His weight remains static at 19-20 kg for about 1.5 years. Simultaneously, hypoproteinaemia was noted (Figure-1). A trial of increasing IVIG (0.7 - 1 g/kg) and the use of subcutaneous immunoglobulin (0.2 g/kg) did not reverse the biochemical and clinical situation. Hypoproteinaemia workup revealed normal liver and kidney functions, normal cardiac function, and no proteinuria. Interestingly, his upper endoscopy showed mild duodenitis and the presence of giardia lamblia at the luminal surface (Figure-2). Following this, a 2-week course of oral metronidazole (7.5 mg/kg/dose BID) resulted in a restoration of therapeutic serum IgG trough and albumin levels. Additionally, the child's nutritional status improved, and the frequency of respiratory infections dropped. In Patient-2, progressive hypoproteinaemia was noted over nine months. Similarly, no gastrointestinal complaints; however, the family reported foul-smelling semisolid stools with regular consistency. His IgG trough level was 2 g/l, and his albumin level was 20 g/l. Despite maximizing IVIG, he developed two episodes of pneumonia and once otitis media. An empiric oral metronidazole course resulted in the amelioration of symptoms and restoration of proteinemia. Meanwhile, faeces microscopy confirmed the presence of Giardia lamblia. Conclusions: Progressive hypoproteinaemia in children with humoral immunodeficiency is a clinical concern. Routine stool microscopy can identify giardia infection despite the ambiguity of gastrointestinal symptoms in such patients. However, a trial of empiric metronidazole therapy should be considered.

Influence of acupuncture on the clinical manifestations and gastrointestinal symptoms of children with autism spectrum disorder

To observe the effect of acupuncture therapy based on "gut-brain axis" on clinical manifestations and gastrointestinal symptoms of children with autism spectrum disorder (ASD). A total of 66 children with ASD were randomly divided into an observation group and a control group, 33 cases in each group. The control group was treated by routine rehabilitation training. On the basis of the control group, the observation group was treated with acupuncture based on "gut-brain axis", and the acupoints were Touwei (ST 8), Shenting (GV 24), Sishencong (EX-HN 1), Tianshu (ST 25), Zhongwan (CV 12), Zusanli (ST 36), etc. Both treatments were given once every other day, 3 times a week, 4 weeks as a course of treatment, consecutively for 3 courses. The scores of autism behavior checklist (ABC), TCM symptoms of gastrointestinal disease and childhood autism rating scale (CARS) were compared between the two groups before and after treatment, and the clinical efficacy was evaluated. After treatment, the scores of ABC, CARS and TCM symptoms of gastrointestinal disease in the two groups were lower than before treatment (P<0.05), and those in the observation group were lower than the control group (P<0.05). The total effective rate of the observation group was 90.9% (30/33), which was higher than 81.8% (27/33) in the control group (P<0.05). On the basis of routine rehabilitation training, acupuncture therapy based on "gut-brain axis" is effective in treating ASD, which can relieve the clinical manifestations and gastrointestinal symptoms.

The relationships between functional gastrointestinal diseases and psychological factors, diet and lifestyles: a network analysis

Objective: To investigate the relationship between common functional gastrointestinal diseases symptoms with psychological factors, diet and lifestyles by using the network analysis method which has achieved great success in the field of psychology in recent years. Method: A questionnaire survey was conducted in two military units using the cluster sampling method during July 2020, and a total of 1 805 subjects were included. Functional gastrointestinal disease symptoms were evaluated with the Gastrointestinal Symptom Rating Scale (GSRS). The state, trait anxiety scale and stress response scale were used to evaluate the mental and psychological state by self-evaluation. R was used to build the network and calculate statistical parameters. Results: 1 486 of the 1 805 subjects (82.3%) had experienced functional gastrointestinal diseases symptoms within 2 weeks, but most of them were mild. Network analysis shows that there was a strong interaction between digestive system symptoms with different clinical manifestations (Spearman coefficient ranges 0.31-0.56). There was a clear relationship between functional gastrointestinal symptoms and mental and psychological factors (Spearman coefficient ranges 0.16-0.27), but there was no clear interaction with diet, age, education level, body mass index, etc. Functional gastrointestinal diseases symptoms were connected with mental and psychological factors through two nodes: stress and indigestion. The stability coefficient of node strength correlation was 0.75, indicating that the network was stable. Conclusions: The current study revealed the network structure and features of functional gastrointestinal diseases symptoms with mental and psychological factors. The key linking nodes provided potential interfering target for controlling functional gastrointestinal symptoms related to mental and psychological factors.

Comparison of genome-derived and phenotypic antimicrobial resistance profiles of Shigella species isolated from patients with symptoms of gastrointestinal disease in England, 2015-2020

Increasing antimicrobial resistance (AMR) in Shigellaspecies is a global public health problem. We compared genotypic and phenotypic methods for the detection of AMR in Shigellaspecies to evaluate the use of genome data for surveillance and monitoring of emerging AMR. Whole genome sequencing (WGS) data from 388 isolates of all four Shigella species were analysed for the presence/absence of specific AMR determinants and selected accordingly. Phenotypic antimicrobial susceptibility testing was performed using in-agar dilution on all viable and pure isolates (n=358). The genotypic and phenotypic AMR profiles were then compared. There were 335 (93.6%) isolates resistant to at least one antimicrobial and 222 (62%) isolates were multi-drug resistant, of which the majority (77%) were associated with foreign travel. Out of a possible 2864 isolate/antimicrobial class combinations, we identified 119 unexpected results, giving an overall concordance of 96.8% between the two methods. There were 54 samples that had an AMR determinant expected to confer resistance that were phenotypically susceptible, of which 31/54 (57.4%) were associated with tetracycline resistance and trimethoprim-sulfamethoxazole resistance. There were 65 that were phenotypically resistant to a specific antimicrobial class, but no AMR determinant was detected, of which 32/65 (49.2%) were associated with isolates harbouring a single gyrA mutation and exhibiting an unexpectedly high minimum inhibitory concentration (MIC) to ciprofloxacin. Although comparisons between both methods showed good correlation between the genotypic and phenotypic AMR profiles, phenotypic monitoring is required to identify novel AMR mechanisms and to update reference database used for WGS analysis.

Analysis of Gastric Diseases and Their Symptoms Based on Indexes of Pepsinogen I (PGI) and Pepsinogen II (PGII): Take 1106 Patients as Samples

In this study, preoperative analysis of 1106 gastropathy patients with abdominal pain, vomiting, dyspepsia, and other symptoms was conducted. Independent sample t -test and correlation analysis and other ways were used for data cleansing and analysis. Findings were as follows: (1) Samples of different genders showed significance in PGI and PGII. The PGI and PGII values of women were significantly lower than those of men. (2) Age showed a significant positive correlation with PGI and PGII, which indicates that as the age increases, the PGI and PGII values become higher. (3) There was a significant negative correlation between age and abdominal pain. This signified that the younger the patient is, the more likely they will suffer abdominal pain. (4) PGI displayed a positive correlation with abdominal pain in the digestive tract (dyspepsia, gastrointestinal ulcers, gastrointestinal bleeding, etc.). It indicated that the higher the PGI value is, the more likely the patients will suffer abdominal pain and gastrointestinal diseases (dyspepsia, gastrointestinal ulcer, gastrointestinal hemorrhage, etc.). (5) PGII displayed a significant positive correlation with gastrointestinal diseases (dyspepsia, gastrointestinal ulcer, gastrointestinal hemorrhage, etc.) and a negative correlation with gastropathy (acute gastritis, chronic superficial gastritis, gastric ulcer, etc.). It indicated that the higher the value of PGII is, the more likely the patients will suffer symptoms of gastrointestinal diseases (dyspepsia, gastrointestinal ulcer, gastrointestinal hemorrhage, etc.), while less likely the patients will suffer gastropathy (acute gastritis, chronic superficial gastritis, gastric ulcer, etc.).

Effects of Cognitive-Behavioral Therapy on Pain Intensity and Stress Coping Styles in Patients With Gastric Wound

Background and Aim: Patients with the symptoms of gastrointestinal diseases and ulcers constitute a large number of patients referring to general and internal clinics. Furthermore, preliminary studies on gastric ulcers highlighted the role of psychological factors in the development of a susceptible gastric ulcer. The current study aimed to determine the effects of Cognitive-Behavioral Therapy (CBT) on pain intensity and stress coping styles in patients with gastric ulcers. Methods &amp; Materials: This was an experimental study with a pretest-posttest-follow-up and a control group design. The statistical population included all patients with a gastric ulcer who were referred to public health centers in Tehran City, Iran, in the winter of 2018. Among the volunteers participating in the study, 30 patients with gastric ulcers were selected by the convenience sampling method. Next, they were randomly assigned to the experimental and control groups (n=15/group). Measurement tools included the McGill Pain Questionnaire (MPQ) and the Coping Inventory for Stressful Situations (CISS; Endler &amp; Parker, 1990). The experimental group subjects participated in eight 90-minute sessions of CBT. However, the controls received no psychological treatment in this period. For data analysis, repeated-measures Analysis of Variance (ANOVA) and post-hoc tests were applied. Ethical Considerations: This study was approved by the Research Ethics Committee of the Islamic Azad University, Karaj Branch (Code: IR.IAU.K.REC.1397.85). Results: The present research results signified that CBT improved problem-oriented coping styles (P&lt;0.01) and decreased emotion-focused coping styles (P&lt;0.01) and avoidance (P&lt;0.01) in the test group. Besides, the mean scores of pain intensity decreased in the experimental group, compared to the controls (P&lt;0.01). Conclusion: The provided CBT was effective on pain intensity and stress coping styles in patients with gastric ulcers.

Antimicrobial resistance profiles of diarrhoeagenic Escherichia coli isolated from travellers returning to the UK, 2015-2017.

Introduction. Diarrhoeagenic Escherichia coli (DEC) are difficult to distinguish from non-pathogenic commensal E. coli using traditional culture methods. The implementation of PCR targeting specific virulence genes characteristic of the five DEC pathotypes, has improved the detection of DEC in faecal specimens from patients with symptoms of gastrointestinal disease.Aim. Antimicrobial resistance (AMR) profiles of 660 strains of DEC isolated between 2015 and 2017 from UK travellers reporting symptoms of gastrointestinal disease were reviewed to look for evidence of emerging AMR associated with travellers' diarrhoea.Methodology. All isolates of DEC were sequenced, and sequence type, serotype, pathotype markers and AMR profiles were derived from the genome data.Results. A travel history was provided for 54.1 % (357/660) of cases, of which 77.0 % (275/357) reported travel outside the UK within 7 days of onset of symptoms, and 23.0 % (82/357) reported no travel in that time frame. Of the 660 strains of DEC in this study, 265 (40.2 %) samples were identified as EAEC, 48 (7.3 %) as EIEC, 61 (9.2 %) were ETEC and 286 (43.3 %) were EPEC. EPEC caused the highest percentage of infections in children (40.6 %) whilst the highest proportion of cases reporting recent travel were infected with ETEC (86.1 %). There were 390/660 (59.0 %) isolates resistant to at least one antimicrobial on the panel tested (EIEC, 81.3 %; ETEC, n=65.6 %; EAEC, n=73.2 %; EPEC, 40.9 %) and 265/660 (40.2 %) were multidrug-resistant (EIEC, 33.3 %; ETEC, 32.8 %; EAEC, 56.2 %; EPEC, 28.0 %). Genes conferring resistance to the beta-lactams and fluroquinolones were highest in the EAEC pathotype, 56.6 and 60.7%, respectively.Conclusions. Increasing MDR, along with resistance to the fluroquinolones and the third-generation cephalosporins, in DEC causing travellers' diarrhoea provides further evidence for the need to restrict the use of antimicrobial agents and continuous monitoring.

Paroxysmal Nocturnal Hemoglobinuria Presenting with Chronic Abdominal Pain and Iron Deficiency Anemia

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired disorder of hematopoietic stem cells characterized by chronic intravascular hemolysis, nocturnal hemoglobinuria, thromboembolic events and secondary bone marrow failure caused by uncontrolled complement activation. Generally, chronic abdominal pain and iron deficiency anemia are considered typical symptoms of gastrointestinal diseases, but are also common in PNH. We report a case of PNH presenting with chronic abdominal pain and iron deficiency anemia, along with a relevant literature review.

Clinicopathological profile of primary gastric lymphoma: A single-center experience of 45 patients in Benghazi, Libya

Background/Aim: Gastric lymphoma can be primary or secondary, and it comprises <5% of all patients with gastric primary neoplasms. The presenting symptoms of primary gastric lymphoma (PGL) are usually nonspecific and are similar to common upper gastrointestinal disease symptoms. Diffuse large B-cell lymphoma (DLBCL) is the most common subtype, followed by marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT). The present study aims to describe the clinicopathological characteristics of PGL. Patients and Methods: This was a cross-sectional and retrospective study of patients with PGL who were diagnosed in the Department of Oncology/Haematology, Benghazi Medical Centre, from January 2010 to December 2017. Results: A total of 45 cases of PGL were diagnosed. The mean age was 54 years, ranging from 17 to 83 years. The number of male and female patients was 26 (57.5%) and 19 (42.5%), respectively. Abdominal pain was the most common presenting symptom. The gastric antrum was the most common anatomical site of involvement (28 [62%]). DLBCL was the predominant histological subtype (28 [62%]). Serum Helicobacter pylori immunoglobulin G antibodies were raised in 19 (42.2%) patients. Half of the patients were in stage II1 at presentation (according to Lugano staging system). Conclusions: DLBCL and MALT lymphoma were the most common subtypes, and H. pylori infection was found in most of the patients with MALT lymphoma. Despite the clinical presentation being usually nonspecific, most of our patients were diagnosed with stage I or II disease.

Galloyl flavonoids from Acacia farnesiana pods possess potent anthelmintic activity against Haemonchus contortus eggs and infective larvae.

Acacia farnesiana (L.) Willd is a shrub legume used as condiment, medicinal plant and bioactive herbage. This species is used in traditional medicine of several countries to relieve the symptoms of gastrointestinal diseases, diarrhoea, stomach pain and typhoid as well as astringent, antidysenteric and anthelmintic. Some studies have shown that this plant displayed anthelmintic activity against several gastrointestinal nematode parasites of livestock, and also against parasites of human beings, such as malaria. This work describes the isolation and chemical identification of the anthelmintic compounds of Acacia farnesiana pods against eggs and infective larvae of the sheep parasitic nematode Haemonchus contortus. The bio-guided chemical fractioning of A. farnesiana pods using ethyl acetate against H. contortus eggs and infective larvae allowed for the identification of naringenin 7-O-(6″-galloylglucoside) (flavonol group) as the compound responsible for the anthelmintic activity against this important parasitic nematode. Anthelmintic activity was assessed using the egg hatching inhibition assay (EHI) and mortality tests. A complete hydroalcoholic extract (HA-E) at 12.5-50mg/mL, an aqueous fraction (Aq-F) at 3.12-25mg/mL and an ethyl acetate fraction (EtOAc-F) at 3.12-25mg/mL were analysed in the first selection phase. The purification of compounds through the chromatographic separation of the organic fraction resulted in nine less complex mixtures (C1F1, C1F2, C1F3, C1F4, C2F1, C2F2, C2F3, C2F4 and C2F5) that were assessed at 0.62-5mg/mL concentrations. In addition, thiabendazole (0.6mg/mL) and ivermectin (5 mg/mL) were used as positive controls. Likewise, distilled water and 4% methanol were used as negative controls. The bioactive compounds of EtOAc-F were obtained and characterised through chromatographic processes like open column chromatography, thin layer chromatography (TLC), high performance liquid chromatography (HPLC), ultra-performance liquid chromatography (UPLC) and gass chromatography-mass detection (GC-MS). Bioactive compounds were identified by spectroscopy (1H and 13C NMR) and mass spectrometric analysis. Additionally, the H. contortus eggs and infective larvae exposed to the bioactive compounds were observed through environmental scanning electron microscopy (ESEM) and confocal laser scanning microscopy (CLSM). Data were analysed based on a completely randomised design using ANOVA through a general linear model. The EtOAc-F fraction showed the highest ovicidal and larvicidal activities, at close to 100% at 3.12 and 6.25mg/mL, respectively. The treatments C1F2, C1F3 and C2F3 displayed the main ovicidal activity (80-100%) at 2.5mg/mL. The major compounds found in these sub-fractions were identified as galloyl derivatives and flavanones, including gallic acid (1), methyl gallate (2), ethyl gallate (3), naringin (4), naringenin 7-O-(4″, 6″-digalloylglucoside) (5), naringenin 7-O-(6″-galloylglucoside) (6) and naringenin (7). Likewise, the ESEM and CLSM images showed that the assessed compounds adhered to the eggshell and the external cuticle of the larvae. These results indicate that A. farnesiana pods contain nematocidal compounds and might be promising natural anthelmintic agents against H. contortus. This leguminous plant could be used as a nutraceutical food source for the control of gastrointestinal nematodes in small ruminants.

The Signs and Symptoms Comparison of Gastrointestinal Diseases between Classic Medicine and Iranian Traditional Medicine: A Hybrid Qualitative Study

Background: Iranian traditional medicine is the oldest form of medical structure and is, in fact, an inseparable part of the life of various Iranian societies. On the other hand, gastrointestinal and liver diseases are one of the most common causes of morbidity in the world, including in Iran. Such that 10% of diseases are allocated to them and their diseases are spreading increasingly.&#x0D; Objective: Considering the mentioned issues and the high prevalence of gastrointestinal symptoms, the aim of this study is to investigate the compliance of the symptoms of gastrointestinal diseases in classical medicine with Iranian traditional medicine from the viewpoint of Iranian traditional medicine experts.&#x0D; Methods: This is a hybrid qualitative study which was conducted in three phases, including 1- theoretical, 2- field and 3- combinational phases. In the theoretical phase, two types of medical textbooks i.e. Iranian traditional and classic medicine textbooks. In the field stage, 13 academic Iranian traditional medicine experts with at least 5 years of work experiences in Iranian traditional medicine were interviewed. Then, in the combinational phase, the results of two early phases have been summarized using descriptive statistics.&#x0D; Results: The results of the study show that 12 of the 40 symptoms in this study had a compliance of 100%. These 12 symptoms are Increase of Salivation, Pica, Borborygmi, Hiccups, Abdominal distention, Melena, Anal Fissure, Anal Stenosis, Cryptitis, Anal pruritus, Halitosis, Rectal pain; also, the results showed that 10 of the 40 symptoms in this study had over 70% compliance. These 10 symptoms are as Dysphagia, Belching, Regurgitation, Hematemesis, Flatulence, Increased Bowel sound, Abdominal pain, Diarrhea, Jaundice and Anal prolapse. Also, the percentage of compliance with the other 18 symptoms was less than 70%.&#x0D; Conclusion: Considering the results of this study and the capabilities of Iranian medicine in relation to symptoms of gastrointestinal diseases with classical medicine, it is possible to design appropriate patterns to expose it. Also, an integrated approach to clinical research is recommended to improve the efficacy and safety of gastrointestinal treatments.

Intravenous esomeprazole versus pantoprazole for heartburn

Heartburn is one of the most common symptoms of gastrointestinal diseases. Intravenous (IV) administration of pantoprazole, lansoprazole, and esomeprazole is recommended by the US Food and Drug Administration (FDA) for short-term acute treatment. Although there are many studies on these drugs in the literature, they are frequently related to long-term oral use and changes in intragastric pH. This study compared the effects of IV esomeprazole with those of IV pantoprazole in patients presenting to the emergency department with heartburn. For this randomized controlled double-blind trial, patients aged over 18 years presenting with gastritis-related heartburn were eligible. Study patients received 40 mg esomeprazole or pantoprazole in 100 ml normal saline. Pain intensity was measured on a visual analog scale (VAS) at 30, 60, and 120 min. Patients were randomized and assigned to either of the two study arms via closed envelopes. Finally, 205 patients were randomized (esomeprazole: 104; pantoprazole 101). Mean age was 39.1 ± 13.78 years and 48.8% were male. Both esomeprazole (median VAS: 26 mm, interquartile range [IQR]: 17–38 mm) and pantoprazole (median: 24 mm, IQR: 14.5–36 mm) effectively reduced heartburn at 30 min, 60 min (median: 59.5 mm, IQR: 48–73.5 mm vs. 55 mm, IQR: 33–68.5 mm), and 120 min (median: 80 mm, IQR: 66.5–89.8 mm vs. 77 mm, IQR: 56–85 mm). While there was no statistically significant difference between the two drugs at 30 min (p = 0.312), there was a statistically significant difference in pain intensity between the esomeprazole and pantoprazole groups at 60 and 120 min (p = 0.014, p = 0.02, respectively). Single-dose slow IV infusion of esomeprazole is faster and more effective in controlling heartburn than pantoprazole.

Factors influencing extent of nausea in the patients on oral iron therapy

Background/Aim. Nausea after oral administration of iron is frequent phenomenon (11% of patients) and it is believed to be consequence of accumulation of free radicals in mucosa of gastrointestinal tract. The aim of our study was to measure the extent of nausea in outpatients taking oral supplementation with iron, and to investigate possible factors that may have an influence on it. Methods. The study was of the cross-sectional type, and conducted on a sample of outpatients on oral iron supplementation. The sample was consecutive, including all patients coming to a community pharmacy for oral iron supply during the study period. Frequency and severity of nausea were measured by the 5- item Drug-Induced Nausea Scale (DINS). Results. The mean score of the DINS from the sample of 128 patients was 8.56 ? 5.07 (range from 5 to 25). Each additional cup of coffee per week increased the DINS score for 0.143 points, the history of gastrointestinal disease had protective effect and decreased the DINS score for 5.923 points. Conclusion. Frequency and severity of oral iron-induced nausea are not dependent on oral iron burden, but rather on coffee intake and previous experience of patients with symptoms of gastrointestinal diseases. Modification of diet and education about types and severity of symptoms of gastrointestinal diseases could be useful preventive measures to avoid or at least mitigate oral iron-induced nausea and/or vomiting.

Frecuencia de autoanticuerpos y síntomas sugestivos de enfermedad gastrointestinal en un grupo de pacientes con psoriasis

IntroductionPsoriasis is a chronic disease associated with multiple comorbidities including inflammatory intestinal disease. There are no previous studies in Colombia regarding the relationship of gastrointestinal symptoms in patients with psoriasis. ObjectiveTo determine the frequency of symptoms and autoantibodies suggestive of gastrointestinal disease in patients with psoriasis, and to compare the results with healthy controls, as well as their relationship with disease activity. Materials and methodsCross-sectional study with an analytical component, including a questionnaire on symptoms and serum analysis of antibodies suggestive of gastrointestinal disease in cases and controls. ResultsThe analysis included 84 individuals, separated into groups of 44 cases and 40 controls. Mild psoriasis was observed in 64% of cases, and the remaining 36% had moderate to severe psoriasis. Topical treatments were given to 71% of cases, with another 16% using oral treatments, and 14% received biological treatment. The main symptoms of gastrointestinal disease were, abdominal distention (45%), constipation (39%), and fatigue (34%). A comparison showed a higher prevalence of gastrointestinal symptoms in cases vs. controls, and fatigue was statistically significant (P=.04). Only the antinuclear autoantibodies in the serum analysis were statistically significant (0 vs. 43%; P=.01). ConclusionsThe prevalence of symptoms and autoantibodies suggestive of gastrointestinal disease in patients with psoriasis is considered important, even although there are no significant differences when compared with healthy controls. Some patients with gastrointestinal symptoms had positive autoantibodies. This suggests that an adequate clinical follow-up should be carried out. Dermatologists have a decisive role in the integral management of patients.

Frequency of autoantibodies and symptoms suggestive of gastrointestinal disease in a group of patients with psoriasis

IntroductionPsoriasis is a chronic disease associated with multiple comorbidities including inflammatory intestinal disease. There are no previous studies in Colombia regarding the relationship of gastrointestinal symptoms in patients with psoriasis. ObjectiveTo determine the frequency of symptoms and autoantibodies suggestive of gastrointestinal disease in patients with psoriasis, and to compare the results with healthy controls, as well as their relationship with disease activity. Materials and methodsCross-sectional study with an analytical component, including a questionnaire on symptoms and serum analysis of antibodies suggestive of gastrointestinal disease in cases and controls. ResultsThe analysis included 84 individuals, separated into groups of 44 cases and 40 controls. Mild psoriasis was observed in 64% of cases, and the remaining 36% had moderate to severe psoriasis. Topical treatments were given to 71% of cases, with another 16% using oral treatments, and 14% received biological treatment. The main symptoms of gastrointestinal disease were, abdominal distention (45%), constipation (39%), and fatigue (34%). A comparison showed a higher prevalence of gastrointestinal symptoms in cases vs. controls, and fatigue was statistically significant (p=0.04). Only the antinuclear autoantibodies in the serum analysis were statistically significant (0 vs. 43%; p=0.01). ConclusionsThe prevalence of symptoms and autoantibodies suggestive of gastrointestinal disease in patients with psoriasis is considered important, even although there are no significant differences when compared with healthy controls. Some patients with gastrointestinal symptoms had positive autoantibodies. This suggests that an adequate clinical follow-up should be carried out. Dermatologists have a decisive role in the integral management of patients.

Neuroimmunophysiology of the gut: advances and emerging concepts focusing on the epithelium.

The epithelial lining of the gastrointestinal tract serves as the interface for digestion and absorption of nutrients and water and as a defensive barrier. The defensive functions of the intestinal epithelium are remarkable considering that the gut lumen is home to trillions of resident bacteria, fungi and protozoa (collectively, the intestinal microbiota) that must be prevented from translocation across the epithelial barrier. Imbalances in the relationship between the intestinal microbiota and the host lead to the manifestation of diseases that range from disorders of motility and sensation (IBS) and intestinal inflammation (IBD) to behavioural and metabolic disorders, including autism and obesity. The latest discoveries shed light on the sophisticated intracellular, intercellular and interkingdom signalling mechanisms of host defence that involve epithelial and enteroendocrine cells, the enteric nervous system and the immune system. Together, they maintain homeostasis by integrating luminal signals, including those derived from the microbiota, to regulate the physiology of the gastrointestinal tract in health and disease. Therapeutic strategies are being developed that target these signalling systems to improve the resilience of the gut and treat the symptoms of gastrointestinal disease.