AIM To study if anxiety, depression and experience of stress are associated with gastrointestinal(GI) symptoms in patients with bipolar disorder.METHODS A total of 136 patients with bipolar disorder(mean age 49.9 year...AIM To study if anxiety, depression and experience of stress are associated with gastrointestinal(GI) symptoms in patients with bipolar disorder.METHODS A total of 136 patients with bipolar disorder(mean age 49.9 years; 61% women) and 136 controls from the general population(mean age 51.0 years; 60% women) were included in the study. GI symptoms were assessed with The Gastrointestinal Symptom Rating Scale-irritable bowel syndrome(GSRS-IBS), level of anxiety and depression with The Hospital Anxiety and Depression Scale(HADS) and stress-proneness with Perceived Stress Questionnaire. Over a ten year period, all visits in primary care were retrospectively recorded in order to identify functional GI disorders.RESULTS In subjects with low total HADS-score, there were no significant differences in GI-symptoms between patients and controls(GSRS-IBS 7.0 vs 6.5, P = 0.513). In the patients with bipolar disorder there were significant correlations between all GSRS and HADS subscores for all symptom clusters except for "constipation" and "reflux". Factors associated to GI symptoms in the patient group were female sex(adjusted OR = 2.37, 95%CI: 1.07-5.24) and high HADS-Depression score(adjusted OR = 3.64, 95%CI: 1.07-12.4). These patients had also significantly more visits for IBS than patients with low HADS-Depression scores(29% vs 8%, P = 0.008). However, there was no significant differences in consulting behaviour for functional GI disorders between patients and controls(25% vs 17%, P = 0.108).CONCLUSION Female patients and patients with high HADS depression score reported significantly more GI symptoms, whereas patients with low HADS scores did not differ from control subjects.展开更多
Background: The aim of this study was to verify the efficacy of lifestyle self-monitoring for the improvement of the IBS and reveal what has been changed due to the intervention. Methods: A total of 111 nursing school...Background: The aim of this study was to verify the efficacy of lifestyle self-monitoring for the improvement of the IBS and reveal what has been changed due to the intervention. Methods: A total of 111 nursing school students were randomized into three groups, two intervention groups (a two-month intervention group, n = 34, and a four-month intervention group, n = 35) and a control group (n = 34). The intervention groups conducted lifestyle self-monitoring in conjunction with a 15-minutes group work for either two or four months. The primary outcome measure was Rome II criteria for IBS. Other outcome measures were the Hospital Anxiety and Depression Scale (HADS) and the Gastrointestinal Symptom Rating Scale (GSRS). They were assessed at the baseline and the end of both of the intervention periods. Analysis was conducted as intention-to-treat. Results: The prevalence of IBS did not change significantly after the intervention in any of the groups. The HAD-A score, a subscale of the HADS score for anxiety, decreased 1.4 points in the two-month intervention group (p = 0.02) and 2.3 points in the four-month intervention group of (p = 0.01) after intervention. The average GSRS decreased 0.2 points in the control group (p = 0.05) and 0.3 points in the four-month intervention group (p < 0.01). Conclusions: Lifestyle self-monitoring for two or four months did not reduce the prevalence of the IBS significantly, but it did decrease anxiety and improved the QOL related to gastrointestinal symptoms in female nursing school students.展开更多
AIM: To determine the bowel symptoms associated with diabetes and diabetes-related factors after excluding gastrointestinal (GI) organic diseases.METHODS: Participants were 4738 (603 diabetic and 4135 non-diabetic) pa...AIM: To determine the bowel symptoms associated with diabetes and diabetes-related factors after excluding gastrointestinal (GI) organic diseases.METHODS: Participants were 4738 (603 diabetic and 4135 non-diabetic) patients who underwent colonoscopy and completed a questionnaire. On the day of pre-colonoscopy, 9 symptoms (borborygmus, abdominal distension, increased flatus, constipation, diarrhea, loose stools, hard stools, fecal urgency, and incomplete evacuation) were prospectively evaluated on a 7-point Likert scale. The test-retest reliability of the bowel symptom scores from the baseline and second questionnaires was analyzed using kappa statistics. Associations between bowel symptom scores and diabetes or diabetes-related factors were analyzed by a rank-ordered logistic model adjusted for related confounders, and odds ratios (ORs) were estimated.RESULTS: In multivariate analysis, constipation [adjusted odds ratio (AOR) = 1.57, CI: 1.33-1.85, P < 0.01] and hard stools (AOR = 1.56, CI: 1.33-1.84, P < 0.01) were associated with diabetes, and fecal urgency (AOR = 1.16, CI: 0.99-1.37, P = 0.07) and incomplete evacuation (AOR = 1.16, CI: 1.00-1.36, P = 0.06) were marginally associated with diabetes. These symptoms remained associated even after excluding organic GI diseases on colonoscopy. Test-retest reliability of symptom score with a mean duration of 3.2 mo was good (mean kappa, 0.69). Associations of symptoms with diabetes-related factors were found; constipation with HbA1c ≥ 8.0% (AOR = 2.11, CI: 1.19-3.73), body mass index (BMI) < 25 (AOR = 2.11, CI: 1.22-3.66), and insulin use (AOR = 1.90, CI: 1.08-3.36); hard stools with diabetes duration (AOR = 1.03, CI: 1.00-1.07); fecal urgency with BMI < 25 (AOR = 1.73, CI: 1.00-2.98); and incomplete evacuation with BMI < 25 (AOR = 2.60, CI: 1.52-4.43), serum creatinine level (AOR = 1.27, CI: 1.10-1.47), and insulin use (AOR = 1.92, CI: 1.09-3.38).CONCLUSION: Diabetes is associated with constipation, hard stools, fecal urgency, and incomplete evacuation, and poor glycemic control, duration, leanness, and nephropathy affect the risk of these symptoms.展开更多
BACKGROUND There are various studies showing the relationship between irritable bowel syndrome(IBS)and diet,and some dietary adjustments are recommended to reduce symptoms.In recent years,there is a growing number of ...BACKGROUND There are various studies showing the relationship between irritable bowel syndrome(IBS)and diet,and some dietary adjustments are recommended to reduce symptoms.In recent years,there is a growing number of studies that show a 4-8 wk low fermentable oligo,di-and mono-saccharides and polyols(FODMAP)diet has a 50%-80%significant effect on symptoms in IBS patients.There is strong evidence suggesting that changes in fecal microbiota have an impact on IBS pathogenesis.Based on this argument,probiotics have been used in IBS treatment for a long time.As is seen,the FODMAP diet and probiotics are used separately in IBS treatment.AIM To evaluate the effectiveness of adding probiotics to a low FODMAP diet to control the symptoms in patients with IBS.METHODS The patients who were admitted to the Gastroenterology Clinic of Dokuz Eylul University Hospital and diagnosed with IBS according to Rome IV criteria were enrolled into the study.They were randomized into 2 groups each of which consisted of 50 patients.All patients were referred to a dietitian to receive dietary recommendations for the low FODMAP diet with a daily intake of 9 g.The patients were asked to keep a diary of foods and beverages they consumed.The patients in Group 1 were given supplementary food containing probiotics(2 g)once a day in addition to their low FODMAP diet,while the patients in Group 2 were given a placebo once a day in addition to their low FODMAP diet.Visual analogue scale(VAS),the Bristol Stool Scale and IBS Symptom Severity Scale(IBSSSS)scores were evaluated before and after the 21 d treatment.RESULTS The rate of adherence of 85 patients,who completed the study,to the FODMAP restricted diet was 92%,being 90%in Group 1 and 94%in Group 2.The mean scores of VAS and IBS-SSS of the patients in Group 1 before treatment were 4.6±2.7 and 310.0±78.4,respectively,and these scores decreased to 2.0±1.9 and 172.0±93.0 after treatment(both P<0.001).The mean VAS and IBS-SSS scores of the patients in Group 2 before treatment were 4.7±2.7 and 317.0±87.5,respectively,and these scores decreased to 1.8±2.0 and 175.0±97.7 after treatment(both P<0.001).The IBS-SSS score of 37 patients(86.04%)in Group 1 and 36 patients(85.71%)in Group 2 decreased by more than 50 points.Group 1 and Group 2 were similar in terms of differences in VAS and IBS-SSS scores before and after treatment.When changes in stool shape after treatment were compared using the Bristol Stool Scale,both groups showed significant change.CONCLUSION This study is the randomized controlled study to examine the efficiency of probiotic supplementation to a low FODMAP diet in all subtypes of IBS.The low FODMAP diet has highly positive effects on symptoms of all subtypes of IBS.It was seen that adding probiotics to a low FODMAP diet does not make an additional contribution to symptom response and adherence to the diet.展开更多
目的:探讨肠易激综合征(IBS)患儿实施集束化护理基础上配合应用艾箱灸的效果。方法:入选2019年7月—2020年9月佛山市高明区人民医院84例肠易激综合征患儿为研究对象,用随机数字表法分为对照组(予集束化护理)和试验组(予集束化护理配合...目的:探讨肠易激综合征(IBS)患儿实施集束化护理基础上配合应用艾箱灸的效果。方法:入选2019年7月—2020年9月佛山市高明区人民医院84例肠易激综合征患儿为研究对象,用随机数字表法分为对照组(予集束化护理)和试验组(予集束化护理配合应用艾箱灸),每组42例,比较两组患儿干预前和干预后30 d IBS症状尺度表(IBS-BSS)和专用生活质量量表(IBS-QOL)评分,比较两组患儿干预前后血清D-乳酸(D-LA)和乳脂球表皮生长因子-8(MFG-E8)含量,比较两组患儿干预效果及家属满意度。结果:干预后,对照组和试验组IBS-SSS评分、D-LA含量均较干预前下降,IBS-QOL评分升高、MFG-E8含量增加,差异均有统计学意义(P<0.01)。干预后,试验组IBS-SSS评分为(236.60±47.82)分,低于对照组的(304.08±51.36)分;IBS-QOL评分为(83.40±7.35)分,高于对照组的(75.12±6.11)分;试验组D-LA含量为(6.56±1.04)mg/L,低于对照组的(9.75±1.11)mg/L,MFG-E8含量高于对照组,组间比较差异均有统计学意义(P<0.01)。试验组干预有效率(97.62%)高于对照组(90.48%,P<0.01)。结论:对肠易激综合征患儿在集束化护理基础上联合应用艾箱灸治疗,能改善临床效果和生活质量、缓解症状,并促进患儿肠道屏障功能的逐步恢复。展开更多
OBJECTIVE:To evaluate the clinical effect of traditional Chinese spinal orthopedic manipulation(TCSOM) in treating irritable bowel syndrome(IBS) compared with pinaverium bromide Dicetel(PBD),and to assess a possible c...OBJECTIVE:To evaluate the clinical effect of traditional Chinese spinal orthopedic manipulation(TCSOM) in treating irritable bowel syndrome(IBS) compared with pinaverium bromide Dicetel(PBD),and to assess a possible cause for IBS.METHODS:Two hundred ten IBS patients were randomly divided into the TCSOM group and the PBD group.All patients in the TCSOM group were treated with spinal manipulations 5 times.Pain intensity was assessed on a visual analogue scale and symptoms were evaluated based on bowel symptom scale(BSS) scores before and after treatment.A symptom improvement rating(SIR) was implemented to evaluate the effects of treatment,and to statistically compare theTCSOM and PBD groups.RESULTS:Post-treatment subjective assessment for the TCSOM treatment group showed that 92 cases had excellent results,10 cases had good results,3 cases had fair results,and 0 cases had poor results.In the PBD group,30 cases had excellent results,41 cases had good results,12 cases had fair results,and 22 cases had poor results.According to the SIR,which was based on the BSS,the TCSOM group included 92 cases with excellent results,10 cases with good results and 3 cases with poor results.There were no adverse side effects from treatment.Based on the BSS,the PBD group had 30 cases with excellent results,41 cases with good results,and 34 cases with poor results.We found that the symptom rating in the BSS in the TCSOM group showed a more significant improvement,such as a reduction in the severity and frequency of symptoms,compared with that in the PBD group(P<0.001).CONCLUSION:Displacement of intervertebral discs and/or vertebra in the thoracic or lumbar region appears to be a contributing factor in the symptoms of IBS.Correcting this displacement of intervertebral discs and/or vertebra to resolve the stimuli caused by pressure exerted on the nerves and vessels around the spine is an effective treatment for IBS.展开更多
文摘AIM To study if anxiety, depression and experience of stress are associated with gastrointestinal(GI) symptoms in patients with bipolar disorder.METHODS A total of 136 patients with bipolar disorder(mean age 49.9 years; 61% women) and 136 controls from the general population(mean age 51.0 years; 60% women) were included in the study. GI symptoms were assessed with The Gastrointestinal Symptom Rating Scale-irritable bowel syndrome(GSRS-IBS), level of anxiety and depression with The Hospital Anxiety and Depression Scale(HADS) and stress-proneness with Perceived Stress Questionnaire. Over a ten year period, all visits in primary care were retrospectively recorded in order to identify functional GI disorders.RESULTS In subjects with low total HADS-score, there were no significant differences in GI-symptoms between patients and controls(GSRS-IBS 7.0 vs 6.5, P = 0.513). In the patients with bipolar disorder there were significant correlations between all GSRS and HADS subscores for all symptom clusters except for "constipation" and "reflux". Factors associated to GI symptoms in the patient group were female sex(adjusted OR = 2.37, 95%CI: 1.07-5.24) and high HADS-Depression score(adjusted OR = 3.64, 95%CI: 1.07-12.4). These patients had also significantly more visits for IBS than patients with low HADS-Depression scores(29% vs 8%, P = 0.008). However, there was no significant differences in consulting behaviour for functional GI disorders between patients and controls(25% vs 17%, P = 0.108).CONCLUSION Female patients and patients with high HADS depression score reported significantly more GI symptoms, whereas patients with low HADS scores did not differ from control subjects.
文摘Background: The aim of this study was to verify the efficacy of lifestyle self-monitoring for the improvement of the IBS and reveal what has been changed due to the intervention. Methods: A total of 111 nursing school students were randomized into three groups, two intervention groups (a two-month intervention group, n = 34, and a four-month intervention group, n = 35) and a control group (n = 34). The intervention groups conducted lifestyle self-monitoring in conjunction with a 15-minutes group work for either two or four months. The primary outcome measure was Rome II criteria for IBS. Other outcome measures were the Hospital Anxiety and Depression Scale (HADS) and the Gastrointestinal Symptom Rating Scale (GSRS). They were assessed at the baseline and the end of both of the intervention periods. Analysis was conducted as intention-to-treat. Results: The prevalence of IBS did not change significantly after the intervention in any of the groups. The HAD-A score, a subscale of the HADS score for anxiety, decreased 1.4 points in the two-month intervention group (p = 0.02) and 2.3 points in the four-month intervention group of (p = 0.01) after intervention. The average GSRS decreased 0.2 points in the control group (p = 0.05) and 0.3 points in the four-month intervention group (p < 0.01). Conclusions: Lifestyle self-monitoring for two or four months did not reduce the prevalence of the IBS significantly, but it did decrease anxiety and improved the QOL related to gastrointestinal symptoms in female nursing school students.
基金Supported by Health Sciences Research Grants(Comprehensive Research on Life-Style Related Diseases including Cardiovascular Diseases and Diabetes Mellitus No.H25-016)from the Ministry of HealthLabour and Welfare of Japanand supported in part by Grants-in-Aid for Research from the National Center for Global Health and Medicine No.26A-201
文摘AIM: To determine the bowel symptoms associated with diabetes and diabetes-related factors after excluding gastrointestinal (GI) organic diseases.METHODS: Participants were 4738 (603 diabetic and 4135 non-diabetic) patients who underwent colonoscopy and completed a questionnaire. On the day of pre-colonoscopy, 9 symptoms (borborygmus, abdominal distension, increased flatus, constipation, diarrhea, loose stools, hard stools, fecal urgency, and incomplete evacuation) were prospectively evaluated on a 7-point Likert scale. The test-retest reliability of the bowel symptom scores from the baseline and second questionnaires was analyzed using kappa statistics. Associations between bowel symptom scores and diabetes or diabetes-related factors were analyzed by a rank-ordered logistic model adjusted for related confounders, and odds ratios (ORs) were estimated.RESULTS: In multivariate analysis, constipation [adjusted odds ratio (AOR) = 1.57, CI: 1.33-1.85, P < 0.01] and hard stools (AOR = 1.56, CI: 1.33-1.84, P < 0.01) were associated with diabetes, and fecal urgency (AOR = 1.16, CI: 0.99-1.37, P = 0.07) and incomplete evacuation (AOR = 1.16, CI: 1.00-1.36, P = 0.06) were marginally associated with diabetes. These symptoms remained associated even after excluding organic GI diseases on colonoscopy. Test-retest reliability of symptom score with a mean duration of 3.2 mo was good (mean kappa, 0.69). Associations of symptoms with diabetes-related factors were found; constipation with HbA1c ≥ 8.0% (AOR = 2.11, CI: 1.19-3.73), body mass index (BMI) < 25 (AOR = 2.11, CI: 1.22-3.66), and insulin use (AOR = 1.90, CI: 1.08-3.36); hard stools with diabetes duration (AOR = 1.03, CI: 1.00-1.07); fecal urgency with BMI < 25 (AOR = 1.73, CI: 1.00-2.98); and incomplete evacuation with BMI < 25 (AOR = 2.60, CI: 1.52-4.43), serum creatinine level (AOR = 1.27, CI: 1.10-1.47), and insulin use (AOR = 1.92, CI: 1.09-3.38).CONCLUSION: Diabetes is associated with constipation, hard stools, fecal urgency, and incomplete evacuation, and poor glycemic control, duration, leanness, and nephropathy affect the risk of these symptoms.
文摘BACKGROUND There are various studies showing the relationship between irritable bowel syndrome(IBS)and diet,and some dietary adjustments are recommended to reduce symptoms.In recent years,there is a growing number of studies that show a 4-8 wk low fermentable oligo,di-and mono-saccharides and polyols(FODMAP)diet has a 50%-80%significant effect on symptoms in IBS patients.There is strong evidence suggesting that changes in fecal microbiota have an impact on IBS pathogenesis.Based on this argument,probiotics have been used in IBS treatment for a long time.As is seen,the FODMAP diet and probiotics are used separately in IBS treatment.AIM To evaluate the effectiveness of adding probiotics to a low FODMAP diet to control the symptoms in patients with IBS.METHODS The patients who were admitted to the Gastroenterology Clinic of Dokuz Eylul University Hospital and diagnosed with IBS according to Rome IV criteria were enrolled into the study.They were randomized into 2 groups each of which consisted of 50 patients.All patients were referred to a dietitian to receive dietary recommendations for the low FODMAP diet with a daily intake of 9 g.The patients were asked to keep a diary of foods and beverages they consumed.The patients in Group 1 were given supplementary food containing probiotics(2 g)once a day in addition to their low FODMAP diet,while the patients in Group 2 were given a placebo once a day in addition to their low FODMAP diet.Visual analogue scale(VAS),the Bristol Stool Scale and IBS Symptom Severity Scale(IBSSSS)scores were evaluated before and after the 21 d treatment.RESULTS The rate of adherence of 85 patients,who completed the study,to the FODMAP restricted diet was 92%,being 90%in Group 1 and 94%in Group 2.The mean scores of VAS and IBS-SSS of the patients in Group 1 before treatment were 4.6±2.7 and 310.0±78.4,respectively,and these scores decreased to 2.0±1.9 and 172.0±93.0 after treatment(both P<0.001).The mean VAS and IBS-SSS scores of the patients in Group 2 before treatment were 4.7±2.7 and 317.0±87.5,respectively,and these scores decreased to 1.8±2.0 and 175.0±97.7 after treatment(both P<0.001).The IBS-SSS score of 37 patients(86.04%)in Group 1 and 36 patients(85.71%)in Group 2 decreased by more than 50 points.Group 1 and Group 2 were similar in terms of differences in VAS and IBS-SSS scores before and after treatment.When changes in stool shape after treatment were compared using the Bristol Stool Scale,both groups showed significant change.CONCLUSION This study is the randomized controlled study to examine the efficiency of probiotic supplementation to a low FODMAP diet in all subtypes of IBS.The low FODMAP diet has highly positive effects on symptoms of all subtypes of IBS.It was seen that adding probiotics to a low FODMAP diet does not make an additional contribution to symptom response and adherence to the diet.
文摘目的:探讨肠易激综合征(IBS)患儿实施集束化护理基础上配合应用艾箱灸的效果。方法:入选2019年7月—2020年9月佛山市高明区人民医院84例肠易激综合征患儿为研究对象,用随机数字表法分为对照组(予集束化护理)和试验组(予集束化护理配合应用艾箱灸),每组42例,比较两组患儿干预前和干预后30 d IBS症状尺度表(IBS-BSS)和专用生活质量量表(IBS-QOL)评分,比较两组患儿干预前后血清D-乳酸(D-LA)和乳脂球表皮生长因子-8(MFG-E8)含量,比较两组患儿干预效果及家属满意度。结果:干预后,对照组和试验组IBS-SSS评分、D-LA含量均较干预前下降,IBS-QOL评分升高、MFG-E8含量增加,差异均有统计学意义(P<0.01)。干预后,试验组IBS-SSS评分为(236.60±47.82)分,低于对照组的(304.08±51.36)分;IBS-QOL评分为(83.40±7.35)分,高于对照组的(75.12±6.11)分;试验组D-LA含量为(6.56±1.04)mg/L,低于对照组的(9.75±1.11)mg/L,MFG-E8含量高于对照组,组间比较差异均有统计学意义(P<0.01)。试验组干预有效率(97.62%)高于对照组(90.48%,P<0.01)。结论:对肠易激综合征患儿在集束化护理基础上联合应用艾箱灸治疗,能改善临床效果和生活质量、缓解症状,并促进患儿肠道屏障功能的逐步恢复。
基金Supported by the Scientific and Technologic Project of Jiangsu Administration of TCM(NO.LZ09085)
文摘OBJECTIVE:To evaluate the clinical effect of traditional Chinese spinal orthopedic manipulation(TCSOM) in treating irritable bowel syndrome(IBS) compared with pinaverium bromide Dicetel(PBD),and to assess a possible cause for IBS.METHODS:Two hundred ten IBS patients were randomly divided into the TCSOM group and the PBD group.All patients in the TCSOM group were treated with spinal manipulations 5 times.Pain intensity was assessed on a visual analogue scale and symptoms were evaluated based on bowel symptom scale(BSS) scores before and after treatment.A symptom improvement rating(SIR) was implemented to evaluate the effects of treatment,and to statistically compare theTCSOM and PBD groups.RESULTS:Post-treatment subjective assessment for the TCSOM treatment group showed that 92 cases had excellent results,10 cases had good results,3 cases had fair results,and 0 cases had poor results.In the PBD group,30 cases had excellent results,41 cases had good results,12 cases had fair results,and 22 cases had poor results.According to the SIR,which was based on the BSS,the TCSOM group included 92 cases with excellent results,10 cases with good results and 3 cases with poor results.There were no adverse side effects from treatment.Based on the BSS,the PBD group had 30 cases with excellent results,41 cases with good results,and 34 cases with poor results.We found that the symptom rating in the BSS in the TCSOM group showed a more significant improvement,such as a reduction in the severity and frequency of symptoms,compared with that in the PBD group(P<0.001).CONCLUSION:Displacement of intervertebral discs and/or vertebra in the thoracic or lumbar region appears to be a contributing factor in the symptoms of IBS.Correcting this displacement of intervertebral discs and/or vertebra to resolve the stimuli caused by pressure exerted on the nerves and vessels around the spine is an effective treatment for IBS.
