Gastrointestinal(GI)ultrasound(GIUS)is valuable in the evaluation of GI diseases such as inflammatory bowel disease,but its use in functional GI disorders(FGIDs)is largely unknown although promising.In order to review...Gastrointestinal(GI)ultrasound(GIUS)is valuable in the evaluation of GI diseases such as inflammatory bowel disease,but its use in functional GI disorders(FGIDs)is largely unknown although promising.In order to review the current knowledge on current and potential uses of GIUS in FGIDs,information was obtained via a structured literature search through PubMed,EMBASE and Google Scholar databases with a combination of MESH and keyword search terms:“ultrasound”,“functional GI disorders”,“irritable bowel syndrome”,“functional dyspepsia”,“intestinal ultrasound”,“point of care ultrasonography”,“transabdominal sonography”,“motility”,“faecal loading”,“constipation”.GIUS is currently used for various settings involving upper and lower GI tracts,including excluding organic diseases,evaluating physiology,guiding treatment options and building rapport with patients.GIUS can be potentially used to correlate mechanisms with symptoms,evaluate mechanisms behind treatment efficacy,and investigate further the origin of symptoms in real-time.In conclusion,GIUS is unique in its real-time,interactive and non-invasive nature,with the ability of evaluating several physiological mechanisms with one test,thus making it attractive in the evaluation and management of FGIDs.However,there are still limitations and concerns of operator dependence and lack of validation data for widespread implementation of GIUS in FGIDs.展开更多
BACKGROUND Rumination syndrome (RS) is characterized by recurrent effortless postprandial regurgitation of recently ingested food from the stomach to the oral cavity and has been associated with quality of life impair...BACKGROUND Rumination syndrome (RS) is characterized by recurrent effortless postprandial regurgitation of recently ingested food from the stomach to the oral cavity and has been associated with quality of life impairment and malnutrition. There is a general lack of consensus on the most appropriate treatment options for RS. AIM To summarize the literature on treatment options for RS. METHODS We conducted a systematic review according to PRISMA guidelines. We searched Medline (1946 to February 2019), EMBASE (1947 to February 2019), PsycINFO (1806 to February 2019) and Cochrane central register of controlled trials for articles discussing treatment options for adult patients (> 18 years) with RS. All relevant articles were accessed in full text. We extracted data on study designs, patient profiles, duration of symptoms, follow up periods, date, diagnostic criteria, interventions and outcomes. Risk of bias assessment was carried out independently by 3 reviewers via Cochrane Risk of Bias tool and Newcastle Ottawa Scale for randomized controlled trials and Cohort studies respectively. RESULTS Twelve articles were identified. A total of 254 patients were included in the analysis, with a mean age of 36.1 (range 18-89). 185 patients (72.8%) were females. 5 studies looked into behavioral therapies, primarily diaphragmatic breathing (DB) 2 studies looked at baclofen, 1 fundoplication and 1 supportive lifestyle changes. 3 studies looked at a combination of therapies involving pharmacological, behavioral and psychotherapies. CONCLUSION Although evidence for treatment options is still limited, the strongest evidence point towards the use of DB and Baclofen, and both should be considered depending on their availabilities.展开更多
文摘Gastrointestinal(GI)ultrasound(GIUS)is valuable in the evaluation of GI diseases such as inflammatory bowel disease,but its use in functional GI disorders(FGIDs)is largely unknown although promising.In order to review the current knowledge on current and potential uses of GIUS in FGIDs,information was obtained via a structured literature search through PubMed,EMBASE and Google Scholar databases with a combination of MESH and keyword search terms:“ultrasound”,“functional GI disorders”,“irritable bowel syndrome”,“functional dyspepsia”,“intestinal ultrasound”,“point of care ultrasonography”,“transabdominal sonography”,“motility”,“faecal loading”,“constipation”.GIUS is currently used for various settings involving upper and lower GI tracts,including excluding organic diseases,evaluating physiology,guiding treatment options and building rapport with patients.GIUS can be potentially used to correlate mechanisms with symptoms,evaluate mechanisms behind treatment efficacy,and investigate further the origin of symptoms in real-time.In conclusion,GIUS is unique in its real-time,interactive and non-invasive nature,with the ability of evaluating several physiological mechanisms with one test,thus making it attractive in the evaluation and management of FGIDs.However,there are still limitations and concerns of operator dependence and lack of validation data for widespread implementation of GIUS in FGIDs.
文摘BACKGROUND Rumination syndrome (RS) is characterized by recurrent effortless postprandial regurgitation of recently ingested food from the stomach to the oral cavity and has been associated with quality of life impairment and malnutrition. There is a general lack of consensus on the most appropriate treatment options for RS. AIM To summarize the literature on treatment options for RS. METHODS We conducted a systematic review according to PRISMA guidelines. We searched Medline (1946 to February 2019), EMBASE (1947 to February 2019), PsycINFO (1806 to February 2019) and Cochrane central register of controlled trials for articles discussing treatment options for adult patients (> 18 years) with RS. All relevant articles were accessed in full text. We extracted data on study designs, patient profiles, duration of symptoms, follow up periods, date, diagnostic criteria, interventions and outcomes. Risk of bias assessment was carried out independently by 3 reviewers via Cochrane Risk of Bias tool and Newcastle Ottawa Scale for randomized controlled trials and Cohort studies respectively. RESULTS Twelve articles were identified. A total of 254 patients were included in the analysis, with a mean age of 36.1 (range 18-89). 185 patients (72.8%) were females. 5 studies looked into behavioral therapies, primarily diaphragmatic breathing (DB) 2 studies looked at baclofen, 1 fundoplication and 1 supportive lifestyle changes. 3 studies looked at a combination of therapies involving pharmacological, behavioral and psychotherapies. CONCLUSION Although evidence for treatment options is still limited, the strongest evidence point towards the use of DB and Baclofen, and both should be considered depending on their availabilities.
