Patients'perspectives on smoking and inflammatory bowel disease:An online survey in collaboration with European Federation of Crohn's and Ulcerative Colitis Associations

BACKGROUNDSmoking has detrimental effects on Crohn’s disease (CD) activity while data onulcerative colitis (UC) are conflicting. Little is known about the use and impact ofalternative smoking products in inflammatory bowel diseases (IBD).AIMTo understand the patients’ perceptions of the impact of smoking on their IBDand to assess differences between CD and UC patients.METHODSThe questionnaire was developed by Philip Morris Products SA in cooperationwith European Federation of Crohn's and Ulcerative Colitis Associations. Thefinal survey questionnaire consisted of 41 questions divided in 8 categories: (1)Subject screener;(2) Smoking history;(3) Background information;(4) IBD diseasebackground;(5) Current disease status;(6) Current therapeutics and medications;and (7) Current nicotine/cigarettes use and awareness of the impacts of smokingon IBD. The questionnaire was submitted online from 4th November 2019 to 11th March 2020 through the European Federation of Crohn's and Ulcerative ColitisAssociations website to IBD patients who were current smokers or had a historyof smoking.RESULTSIn total 1050 IBD patients speaking nine languages participated to the survey.Among them, 807 (76.9%) patients declared to have ever smoked or consumed analternative smoking product, with a higher proportion of current cigarettesmokers among CD patients (CD: 63.1% vs UC: 54.1%, P = 0.012). About twothirdsof the participants declared to have ever stopped cigarette smoking andrestarted (67.0%), with a significantly higher proportion among UC patientscompared to CD patients (73.1% vs 62.0%, P = 0.001). We also found significantdifferences between CD and UC patients in the awareness of the healthconsequences of smoking in their disease and in the perceived impact of smokingon disease activity, for both cigarettes and alternative smoking products.CONCLUSIONThis survey found significant differences between CD and UC patients in bothawareness and perception of the impact of smoking on their disease. Furtherefforts should be done to encourage smoking cessation for all IBD patients,including UC patients.

Rabeprazole test for the diagnosis of gastro-oesophageal reflux disease: Results of a study in a primary care setting

瞄准：为了决定病人的 rabeprazole 测试的诊断价值，由全科医生看。方法：有 GERD 暗示的症状的 83 个病人被全科医生在这个多中心注册，使随机化并且双窗帘学习。所有病人收到了 rabeprazole (20 mg 出价) 或安慰剂一个星期。GERD 的诊断在内视镜检查法或反常食道的 24-h pH 测试在粘膜裂缝的存在上被建立。如果病人们报导至少，“ 7 点 Likert 上的症状的清楚的改进”可伸缩，测试被认为阳性。结果：为 rabeprazole 和安慰剂的测试的敏感分别地是 83% 和 40% 。相应特性，积极、否定的预兆的价值是 45% 和 67% ， 71% 和 71% ，和 62% 和 35% 分别地。操作特征(巨鸟) 分析的接收装置证实最好差别对待截止对应于对“清楚的改进”的描述。结论：禁止者(PPI ) 测试的质子泵的差的特性不支持如此的一条途径在一个主要照顾背景建立 GERD 的诊断。

Saccharomyces cerevisiae I-3856 in irritable bowel syndrome with predominant constipation

BACKGROUND Probiotics are a promising solution for managing irritable bowel syndrome(IBS).Saccharomyces cerevisiae(S.cerevisiae)I-3856 has already demonstrated beneficial effects in IBS subjects,particularly in IBS with predominant constipation(IBS-C).AIM To confirm the efficacy of S.cerevisiae I-3856 in the management of gastrointestinal symptoms in IBS-C.METHODS A randomized,double-blind,placebo-controlled clinical study was performed in a total of 456 subjects.After a run-in period,subjects were randomly assigned to the group receiving S.cerevisiae I-3856(8×109 CFU daily)or the placebo for 8 wk,and they performed daily self-evaluations of gastrointestinal symptoms.The primary objective was to assess the effect of the probiotic on abdominal pain.The secondary objectives were the evaluation of other gastrointestinal symptoms,bowel movement frequency and consistency,and quality of life(QOL).RESULTS A significantly higher proportion of abdominal pain responders was reported in the Probiotic group(45.1%vs 33.9%,P=0.017).A nonsignificant difference in the area under the curve for abdominal pain over the second month of supplementation was observed in subjects receiving probiotic vs placebo[P=0.073,95%CI:-0.59(-1.23;0.05)].No statistically significant differences were reported in the evolution of bowel movement frequency and stool consistency between the groups.After 8 wk of supplementation,the overall QOL score was significantly higher in the Probiotic group than in the Placebo group[P=0.047,95%CI:3.86(0.52;7.20)].Furthermore,exploratory analyses showed statistically significant and clinically relevant improvements in QOL scores in abdominal pain responders vs nonresponders.CONCLUSION The results of this clinical study confirmed the abdominal pain alleviation properties of S.cerevisiae I-3856 in IBS-C.Abdominal pain relief was associated with improved QOL.ClinicalTrials.gov identifier:NCT03150212.