Influence of dietary isoflavone intake on gastrointestinal symptoms in ulcerative colitis individuals in remission

AIM To analyse the association between isoflavone intake and ulcerative colitis motility symptoms in individuals in remission. METHODS Cross-sectional study was conducted in a group of ulcerative colitis remission individuals, in subgroups characterised by various intestinal motility and functioning characteristics(abdominal pain, flatulence, constipations, tenesmus). Total of 56 individuals with ulcerative colitis in remission(19 males and 37 females) were recruited for the study. Assessment of diet was based on self-reported data from each patient's dietary records taken over a period of three typical, random days(2 weekdays and 1 d of the weekend). The daily isoflavone intake(daidzein, genistein, glycitein and total isoflavones) and daily isoflavone intake per 1000 kcal of diet were assessed.RESULTS No correlations between isoflavone intake levels and number of bowel movements per day were observed both in the case of intake and intake per 1000 kcal of diet. In the group of individuals declaring lack of abdominal pain, the higher intakes of daidzein(P = 0.0075), daidzein per 1000 kcal of diet(P = 0.0358) and total isoflavone(P = 0.0358) were stated, than in the group of individuals declaring abdominal pain. In the group of individuals declaring lack of constipations, the lower intakes of glycitein(P = 0.0213) and glycitein per 1000 kcal of diet(P = 0.0213) were stated, than in the group of individuals declaring presence of constipations. No differences were observed in isoflavone intake between groups of ulcerative colitis individuals declaring lack of flatulence and declaring presence of flatulence, as well as between groups declaring lack of tenesmus and declaring presence of tenesmus.CONCLUSION The moderate dietary isoflavone intake may be beneficial for individuals with ulcerative colitis in remission, however, before including it into recommendations, further prospective studies are needed.

Saccharomyces cerevisiae CNCM I-3856 in irritable bowel syndrome: An individual subject meta-analysis

AIM To confirm previous conclusions on Saccharomyces cerevisiae(S. cerevisiae) CNCM I-3856 for irritable bowel syndrome(IBS) management.METHODS An individual patient data meta-analysis was performed on two randomized clinical trials studying the effect of S. cerevisiae CNCM I-3856 supplementation on gastrointestinal(GI) symptoms in IBS subjects. A total of 579 IBS subjects were included. Outcomes were the daily Likert scale scores of abdominal pain/discomfort and bloating [area under the curve(AUC) and weekly means], responder status, and bowel movements(stool frequency and consistency). Statistical analyses were conducted in Intent to Treat(ITT) population, IBS-C subjects and IBS-C subjects with an abdominal pain/discomfort score higher than or equal to 2 at baseline("IBS-C ≥ 2 subpopulation").RESULTS S. cerevisiae CNCM I-3856 significantly improved abdominal pain/discomfort and bloating during the second month of supplementation [AUC(W5-W8)]with improvement up to the minimal clinically relevant threshold of 10%: a 12.3% reduction of abdominal pain/discomfort in the ITT population compared to the Placebo group(P = 0.0134) has been observed. In the IBS-C ≥ 2 subpopulation, there were a 13.1% reduction of abdominal pain/discomfort and a 14.9% reduction of bloating compared to the Placebo group(P = 0.0194 and P = 0.0145, respectively). GI symptoms significantly decreased during supplementation but no statistical differences were reported between groups at the end of the supplementation period. Responder status was defined as a subject who experienced a decrease of 1 arbitrary unit(a.u.) or 50% of the abdominal discomfort score from baseline for at least 2 wk out of the last 4 wk of the study. A significant difference between groups was reported in the ITT population, when considering the first definition: subjects in the Active group had 1.510 higher odds to be a responder(reduction of 1 a.u. of abdominal pain/discomfort) compared with subjects in the Placebo group(P = 0.0240). At the end of supplementation period, stool consistency in the Active group of the ITT population was significantly improved and classified as "normal" compared to Placebo(respectively 3.13 ± 1.197 a.u. vs 2.58 ± 1.020 a.u., P = 0.0003). Similar results were seen in the IBS-C ≥ 2 subpopulation(Active group: 3.14 ± 1.219 a.u. vs Placebo group: 2.59 ± 1.017 a.u., P = 0.0009).CONCLUSION This meta-analysis supports previous data linking S. cerevisiae I-3856 and improvement of GI symptoms, in IBS overall population and in the IBS-C and IBS-C ≥ 2 subpopulations.

High risk of temporomandibular disorder in irritable bowel syndrome: Is there a correlation with greater illness severity?

AIM To investigate the prevalence and the risk of temporomandibular disorders(TMDs)in patients with irritable bowel syndrome(IBS)(including each subtype:constipation,diarrhoea,and mixed)compared to the general population.METHODS Between January 2014 and December 2015 we enrolled consecutively adult patients diagnosed with IBS at the outpatient clinic of the University of Salerno and healthy controls(HC)without IBS.At enrollment,we analyzed all patients for the presence of TMDs according to the Research Diagnostic Criteria for TMD.RESULTS We enrolled 91 IBS patients(23 IBS-D,30 IBS-C and38 IBS-M)and 57 HC in the study.We found a higher risk of having TMD(OR=3.41,95%CI:1.66-7.01)compared to the HC.The risk of having TMD was independent of IBS-subtype.Multiple regression analysis showed that facial pain was positively related to abdominal pain and higher level of depression.CONCLUSION IBS patients had a more than three times greater risk of TMD compared to HC.The risk of having TMDwas similar in different IBS subtypes.IBS patients that also fulfilled criteria for TMD seem to share along with chronic facial and abdominal pain a significant co-occurrence with psychiatric disorders and female preponderance.Key words:Temporomandibular disorders;Irritable bowel syndrome;Chronic pain;Facial pain;Abdominal pain;Irritable bowel syndrome severity score symptoms;Irritable bowel syndrome predominant diarrhea;Irritable bowel syndrome predominant constipation;Irritable bowel syndrome mixed?The Author(s)2017.Published by Baishideng Publishing Group Inc.All rights reserved.

Non-invasive stimulation techniques to relieve abdominal/pelvic pain: Is more always better?

Chronic abdominal and pelvic pain is a common condition that has significant impact on quality of life,and causes billions of dollars in direct and indirect costs.Emerging data suggest that transcranial direct current stimulation(t DCS),alone or in combination with transcutaneous electrical nerve stimulation(TENS),could be a promising therapeutic avenue to reduce chronic pain.The encouraging results coming from these studies prompted us to try combining TENS and t DCS in 4 of our patients who suffered from chronic abdominal/pelvic pain and to compare the effect with 5other patients who received TENS alone.Pain intensity was assessed with a visual analog scale before,during and after the stimulation.We observed that there was a slight decrease in pain which was similar in both patient groups(TENS alone and TENS combined with t DCS).These observations suggest that combining TENS and t DCS in patients suffering from chronic pelvic and/or abdominal pain produces no additional benefit,compared to TENS alone.Future studies,looking at the effect of several/consecutive TENS and t DCS sessions should be conducted.

Effect of Gan Fu Le on24 Cases of Primary Hepatocarcinoma

Since 1994 we have treated 24 cases of primary hepatocarcinoma with a novel preparation Gan Fu Le (肝复乐). The effect was definite as reported in the following. Subjects and method A total of 24 cases of primary hepatocarcinoma (21 males and 3 females) aged 42-73 (mean 57) years old were enrolled in the treatment group and treated only with Gan Fu Le, 10 tablets, t.i.d. for 2 months as one therapeutic course.

Clinical Study on Acupuncture plus Medication for Chronic Atrophic Gastritis Due to Spleen-stomach Deficiency

Objective: To observe the clinical efficacy of combining acupuncture and medication in treating chronic atrophic gastritis(CAG) due to spleen-stomach deficiency. Methods: Totally 176 patients with CAG were randomized into two groups by the random number table. The 91 subjects in the treatment group were intervened by acupuncture and oral Chinese patent medication; the other 85 subjects were by oral Chinese patent medication alone. The clinical efficacies were compared at the end of intervention. Results: After a treatment course, the total effective rate was 87.9% in the treatment group versus 75.3% in the control group; according to the gastroscopy and pathological biopsy examinations, the total effective rate was 85.7% in the treatment group versus 74.1% in the control group. There were significant differences in comparing the clinical efficacy, gastroscopy and pathological examinations between the two groups(P<0.05). Conclusion: Combining acupuncture and medication can produce a better therapeutic efficacy than medication alone in treating CAG due to spleen-stomach deficiency.