目的评价应用Bristol大便分型量表(BSFS)指导不同肠道准备方案后对提升整体人群肠道准备质量的效果,及2 L+2 L聚乙二醇电解质溶液(PEG-ES)作为Bristol大便性状1型及2型患者个性化方案的效果及耐受性。方法采用前瞻性研究方法,将拟行结...目的评价应用Bristol大便分型量表(BSFS)指导不同肠道准备方案后对提升整体人群肠道准备质量的效果,及2 L+2 L聚乙二醇电解质溶液(PEG-ES)作为Bristol大便性状1型及2型患者个性化方案的效果及耐受性。方法采用前瞻性研究方法,将拟行结肠镜检查的患者随机分为A、B两组,使用BSFS分辨出两组中Bristol大便性状1型、2型患者及3~7型患者并记录,其中A组中Bristol大便性状1型、2型患者肠道准备方案为2 L+2 L PEG-ES,3~7型患者为2 L PEG-ES方案;B组全部患者肠道准备方案均为2 L PEG-ES。结果本研究共纳入310例门诊患者,A组中肠道准备成功率、Boston肠道准备评分量表(BBPS)评分、息肉发现率、盲肠插管率均高于B组(P<0.05);A组中Bristol大便分型1型及2型患者的排便次数多于B组(P<0.05),但两组中该类人群的不良反应发生率及重复准备意愿无明显差异(P>0.05)。结论应用BSFS分辨出具有肠道准备不足风险的患者,通过指导个性化肠道准备方案,可使整体人群的肠道准备质量得到有效提升;同时,2 L+2 L PEG-ES方案作为该类患者的个性化肠道准备方案具有良好的清肠效果及耐受性。展开更多
BACKGROUND Amino-acid based medical foods have shown promise in alleviating symptoms of drug induced gastrointestinal side effects;particularly,diarrhea-predominant symptoms.Irritable bowel syndrome(IBS)is a gastroint...BACKGROUND Amino-acid based medical foods have shown promise in alleviating symptoms of drug induced gastrointestinal side effects;particularly,diarrhea-predominant symptoms.Irritable bowel syndrome(IBS)is a gastrointestinal disorder that affects up to 9% of people globally,with diarrhea predominant IBS(IBS-D)being the most prevalent subtype.Further trials are needed to explore potential added benefits when integrated into standard care for IBS-D.AIM To assess the effectiveness of an amino acid-based medical food as an adjunct to standard of care for adults with IBS-D.METHODS This is a pragmatic,real world,open label,single arm study comparing a 2-week baseline assessment to a 2-week intervention period.One hundred adults,aged 18 to 65 years,with IBS-D,according to Rome IV criteria,were enrolled after completing a 2-week baseline assessment period and received a 2-week supply of an amino acid based medical food which was consumed at home twice daily on top of their standard of care.The primary outcome was an assessment of tolerability after 2-weeks of consumption,while secondary outcomes included changes in stool consistency(Bristol Stool Form Scale),severity of abdominal pain&discomfort,symptoms of urgency,Global Improvement Survey(GIS),and the IBS severity scoring system(IBS-SSS).RESULTS The test product was well-tolerated as each participant successfully completed the full 14-day trial,and there were no instances of dropouts or discontinuation of the study product reported.Forty percent of participants achieved a 50% or more reduction in the number of days with type 6-7 bowel movements(IBS-D stool consistency responders).Fifty-three percent of participants achieved a clinically meaningful reduction of 30% in mean weekly pain scores,and 55%experienced the same for mean weekly discomfort scores(IBS-D pain and discomfort responders).Participants experienced a mean-109.4(95% confidence interval:-130.1,-88.8)point reduction on the IBS-SSS and 52% experienced a minimally clinically important difference of>95 points.An IBS-SSS category shift from severe to moderate or mild occurred in 69% of participants.For functional symptoms,76% of participants reported symptom relief on the GIS.CONCLUSION The amino acid-based medical food was well-tolerated,when added to the standard of care,and demonstrated improvements in both overall IBS symptom severity and IBS-D symptoms within just 2 wk.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
目的了解健康儿童粪便重量、长度及分型,探讨其临床意义.方法对60名(男34名,女26名)符合入选标准的3～5岁健康小儿所排新鲜粪便进行直接称重、测量长度,并按Bristol标准分型.结果1.健康小儿60名粪便重量(109.53±52.00)g,男(123.79&...目的了解健康儿童粪便重量、长度及分型,探讨其临床意义.方法对60名(男34名,女26名)符合入选标准的3～5岁健康小儿所排新鲜粪便进行直接称重、测量长度,并按Bristol标准分型.结果1.健康小儿60名粪便重量(109.53±52.00)g,男(123.79±55.869)g,女(90.12±39.66)g,男女比较有显著性差异(t=0.013 P＜0.05);2.粪便长度(17.98±6.98)cm,男(19.32±6.97)cm,女(16.25±6.37)cm,男女比较无显著差异(t=0.105 P ＞0.05);3.健康小儿60名粪便Bristol分型:1、2、3、4、5、6型分别占3.30%、5.10%、5.10%、64.40%、15.30%及6.80%,无7型粪便.结论健康小儿粪便重量、长度及分型,可作为判断被试小儿结肠运动及其他生理功能的参照指标,对患儿便秘及大便干燥的病因及选择基础治疗有指导意义.展开更多
Background Constipation is a common problem in children with spastic cerebral palsy(sCP)with a prevalence that reaches 75%.We hypothesized that treating constipation in those children will improve their health and sho...Background Constipation is a common problem in children with spastic cerebral palsy(sCP)with a prevalence that reaches 75%.We hypothesized that treating constipation in those children will improve their health and shorten time spent in daily care.Our aim was to evaluate the efficacy and safety of oral magnesium sulfate for treating chronic constipation in children with sCP.Methods A prospective,double-blinded randomized control trial was carried out involving 100 children aged 2-12 years with sCP(level Ⅲ-Ⅴ of the Gross Motor Functional Classification system)and chronic constipation.They were followed up in the Pediatric neurology clinic,Children's hospital,Ain Shams University,May 2017-January 2019.The intervention group(O-Mg)received oral magnesium sulfate 1 mL/kg/day daily for 1 month compared to the placebo.Outcome measures were constipation improvement and decrease in bowel evacuation time after 1 month.Results Initially,weekly bowel movements,constipation scores and stool consistency were comparable in both groups.After 1 month of regular administration of oral magnesium sulfate,the constipation score,stool frequency and consistency improved compared to the placebo group(P<0.001).Effective safe treatment was achieved in 31(68%)and 4(9.5%)patients in the O-Mg and placebo groups,respectively(RR,2.95;95%CI 2.0-4.5)(P<0.001).Painful bowel evacuation attempts spent by mothers decreased from 25(55.6%)of the cases initially to 10(22%)cases after one month in the O-Mg group(P=0.001).In contrast,in the placebo group,the decrease went from 21(50%)cases initially to 18(42.9%)after 1 month and was not significant(P=0.5).Conclusions Oral magnesium sulfate seems effective in alleviating chronic constipation and pain experience in children with sCP.Consequently,saving maternal time spent in daily bowel evacuation attempts.展开更多
Objective:To verify the effectiveness of acupuncture for diarrhea-predominant irritable bowel syndrome(IBS-D).Methods:Sixty-five patients with IBS-D were randomized into an acupuncture group(33 cases)and a sham-acupun...Objective:To verify the effectiveness of acupuncture for diarrhea-predominant irritable bowel syndrome(IBS-D).Methods:Sixty-five patients with IBS-D were randomized into an acupuncture group(33 cases)and a sham-acupuncture group(32 cases).In the acupuncture group,Tiānshū(天枢ST25),Zhōngwǎn(中脘CV12),Zúsānlǐ(足三里ST36),Shàngjùxū(上巨虚ST37),Gōngsūn(公孙SP4),Fēnglóng(丰隆ST40),Zhāngmén(章门LR13)and Yīnlíngquán(阴陵泉SP9)were selected and stimulated with routine acupuncture technique,once every two days,3 times weekly,for 8 weeks consecutively,24 times in total.In the shamacupuncture group,the sham-acupoints were selected,0.5 cun or 1 cun superior,inferior,lateral or medial to the corresponding points separately.The blunt-tip needles were used to stimulate only the skin surface of each point.The treatment frequency and courses were the same as the acupuncture group.Before treatment,in 4 weeks of treatment,after treatment and in follow-up,the changes in the score of IBS symptom severity scale(IBS-SSS),Bristol stool form scale and defecation satisfaction were observed in the patients of two groups.After treatment,the effectiveness was assessed in the two groups.Results:In 4 weeks of treatment,after treatment and in follow-up,IBS-SSS score,Bristol stool form scale and defecation satisfaction were all lower than those before treatment in either group(all P<0.01).Bristol stool form scale in the acupuncture group was lower than that in the sham-acupuncture group in4 weeks of treatment,after treatment and in follow-up,while,IBS-SSS score and defecation satisfaction were lower than the sham-acupuncture group in follow-up(all P<0.05).Conclusion:Acupuncture can effectively relieve diarrhea and improves defecation satisfaction in the patients with IBS-D.展开更多
文摘目的评价应用Bristol大便分型量表(BSFS)指导不同肠道准备方案后对提升整体人群肠道准备质量的效果,及2 L+2 L聚乙二醇电解质溶液(PEG-ES)作为Bristol大便性状1型及2型患者个性化方案的效果及耐受性。方法采用前瞻性研究方法,将拟行结肠镜检查的患者随机分为A、B两组,使用BSFS分辨出两组中Bristol大便性状1型、2型患者及3~7型患者并记录,其中A组中Bristol大便性状1型、2型患者肠道准备方案为2 L+2 L PEG-ES,3~7型患者为2 L PEG-ES方案;B组全部患者肠道准备方案均为2 L PEG-ES。结果本研究共纳入310例门诊患者,A组中肠道准备成功率、Boston肠道准备评分量表(BBPS)评分、息肉发现率、盲肠插管率均高于B组(P<0.05);A组中Bristol大便分型1型及2型患者的排便次数多于B组(P<0.05),但两组中该类人群的不良反应发生率及重复准备意愿无明显差异(P>0.05)。结论应用BSFS分辨出具有肠道准备不足风险的患者,通过指导个性化肠道准备方案,可使整体人群的肠道准备质量得到有效提升;同时,2 L+2 L PEG-ES方案作为该类患者的个性化肠道准备方案具有良好的清肠效果及耐受性。
文摘BACKGROUND Amino-acid based medical foods have shown promise in alleviating symptoms of drug induced gastrointestinal side effects;particularly,diarrhea-predominant symptoms.Irritable bowel syndrome(IBS)is a gastrointestinal disorder that affects up to 9% of people globally,with diarrhea predominant IBS(IBS-D)being the most prevalent subtype.Further trials are needed to explore potential added benefits when integrated into standard care for IBS-D.AIM To assess the effectiveness of an amino acid-based medical food as an adjunct to standard of care for adults with IBS-D.METHODS This is a pragmatic,real world,open label,single arm study comparing a 2-week baseline assessment to a 2-week intervention period.One hundred adults,aged 18 to 65 years,with IBS-D,according to Rome IV criteria,were enrolled after completing a 2-week baseline assessment period and received a 2-week supply of an amino acid based medical food which was consumed at home twice daily on top of their standard of care.The primary outcome was an assessment of tolerability after 2-weeks of consumption,while secondary outcomes included changes in stool consistency(Bristol Stool Form Scale),severity of abdominal pain&discomfort,symptoms of urgency,Global Improvement Survey(GIS),and the IBS severity scoring system(IBS-SSS).RESULTS The test product was well-tolerated as each participant successfully completed the full 14-day trial,and there were no instances of dropouts or discontinuation of the study product reported.Forty percent of participants achieved a 50% or more reduction in the number of days with type 6-7 bowel movements(IBS-D stool consistency responders).Fifty-three percent of participants achieved a clinically meaningful reduction of 30% in mean weekly pain scores,and 55%experienced the same for mean weekly discomfort scores(IBS-D pain and discomfort responders).Participants experienced a mean-109.4(95% confidence interval:-130.1,-88.8)point reduction on the IBS-SSS and 52% experienced a minimally clinically important difference of>95 points.An IBS-SSS category shift from severe to moderate or mild occurred in 69% of participants.For functional symptoms,76% of participants reported symptom relief on the GIS.CONCLUSION The amino acid-based medical food was well-tolerated,when added to the standard of care,and demonstrated improvements in both overall IBS symptom severity and IBS-D symptoms within just 2 wk.
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.
文摘目的了解健康儿童粪便重量、长度及分型,探讨其临床意义.方法对60名(男34名,女26名)符合入选标准的3～5岁健康小儿所排新鲜粪便进行直接称重、测量长度,并按Bristol标准分型.结果1.健康小儿60名粪便重量(109.53±52.00)g,男(123.79±55.869)g,女(90.12±39.66)g,男女比较有显著性差异(t=0.013 P＜0.05);2.粪便长度(17.98±6.98)cm,男(19.32±6.97)cm,女(16.25±6.37)cm,男女比较无显著差异(t=0.105 P ＞0.05);3.健康小儿60名粪便Bristol分型:1、2、3、4、5、6型分别占3.30%、5.10%、5.10%、64.40%、15.30%及6.80%,无7型粪便.结论健康小儿粪便重量、长度及分型,可作为判断被试小儿结肠运动及其他生理功能的参照指标,对患儿便秘及大便干燥的病因及选择基础治疗有指导意义.
文摘Background Constipation is a common problem in children with spastic cerebral palsy(sCP)with a prevalence that reaches 75%.We hypothesized that treating constipation in those children will improve their health and shorten time spent in daily care.Our aim was to evaluate the efficacy and safety of oral magnesium sulfate for treating chronic constipation in children with sCP.Methods A prospective,double-blinded randomized control trial was carried out involving 100 children aged 2-12 years with sCP(level Ⅲ-Ⅴ of the Gross Motor Functional Classification system)and chronic constipation.They were followed up in the Pediatric neurology clinic,Children's hospital,Ain Shams University,May 2017-January 2019.The intervention group(O-Mg)received oral magnesium sulfate 1 mL/kg/day daily for 1 month compared to the placebo.Outcome measures were constipation improvement and decrease in bowel evacuation time after 1 month.Results Initially,weekly bowel movements,constipation scores and stool consistency were comparable in both groups.After 1 month of regular administration of oral magnesium sulfate,the constipation score,stool frequency and consistency improved compared to the placebo group(P<0.001).Effective safe treatment was achieved in 31(68%)and 4(9.5%)patients in the O-Mg and placebo groups,respectively(RR,2.95;95%CI 2.0-4.5)(P<0.001).Painful bowel evacuation attempts spent by mothers decreased from 25(55.6%)of the cases initially to 10(22%)cases after one month in the O-Mg group(P=0.001).In contrast,in the placebo group,the decrease went from 21(50%)cases initially to 18(42.9%)after 1 month and was not significant(P=0.5).Conclusions Oral magnesium sulfate seems effective in alleviating chronic constipation and pain experience in children with sCP.Consequently,saving maternal time spent in daily bowel evacuation attempts.
基金Supported by Evaluation of the clinical effect of acupuncture on diarrhea-type irritable bowel syndrome:2017S382。
文摘Objective:To verify the effectiveness of acupuncture for diarrhea-predominant irritable bowel syndrome(IBS-D).Methods:Sixty-five patients with IBS-D were randomized into an acupuncture group(33 cases)and a sham-acupuncture group(32 cases).In the acupuncture group,Tiānshū(天枢ST25),Zhōngwǎn(中脘CV12),Zúsānlǐ(足三里ST36),Shàngjùxū(上巨虚ST37),Gōngsūn(公孙SP4),Fēnglóng(丰隆ST40),Zhāngmén(章门LR13)and Yīnlíngquán(阴陵泉SP9)were selected and stimulated with routine acupuncture technique,once every two days,3 times weekly,for 8 weeks consecutively,24 times in total.In the shamacupuncture group,the sham-acupoints were selected,0.5 cun or 1 cun superior,inferior,lateral or medial to the corresponding points separately.The blunt-tip needles were used to stimulate only the skin surface of each point.The treatment frequency and courses were the same as the acupuncture group.Before treatment,in 4 weeks of treatment,after treatment and in follow-up,the changes in the score of IBS symptom severity scale(IBS-SSS),Bristol stool form scale and defecation satisfaction were observed in the patients of two groups.After treatment,the effectiveness was assessed in the two groups.Results:In 4 weeks of treatment,after treatment and in follow-up,IBS-SSS score,Bristol stool form scale and defecation satisfaction were all lower than those before treatment in either group(all P<0.01).Bristol stool form scale in the acupuncture group was lower than that in the sham-acupuncture group in4 weeks of treatment,after treatment and in follow-up,while,IBS-SSS score and defecation satisfaction were lower than the sham-acupuncture group in follow-up(all P<0.05).Conclusion:Acupuncture can effectively relieve diarrhea and improves defecation satisfaction in the patients with IBS-D.
