GSRS?A clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease

Backgrounds: Helicobacter Pylori is a common pathogen leading cause of peptic ulcer disease. Several studies linked Helicobacter Pylori infection and the development of irritable bowel syndrome. Aims: We investigated the effectiveness of standard triple therapy and the association between H.Pylori infection and the development of post infectious irritable bowel syndrome. Materials and methods: Prospective analytical study was conducted and we appointed 200 H.Pylori positive patients, they consented and subjected to structured questionnaire and received standard triple therapy (14 days course of proton pump inhibitor (PPI), clarithromycin and either amoxicillin or metronidazole). After three months all patients re-evaluated regarding their symptoms and tested for eradication. Additionally we evaluated the association between H.Pylori infection and irritable bowel syndrome

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SEVERITY OF IRRITABLE BOWEL SYNDROME SYMPTOMS AND FODMAPS INTAKE IN UNIVERSITY STUDENTS

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.202100000-84 ◽

2021 ◽

Vol 58 (4) ◽

pp. 461-467

Author(s):

Mariana Cerne AUFIERI ◽

Juliana Masami MORIMOTO ◽

Renata Furlan VIEBIG

Keyword(s):

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

University Students ◽

Rating Scale ◽

Adult Population ◽

Gastrointestinal Symptoms ◽

Severe Abdominal Pain ◽

Learning Ability ◽

Gastrointestinal Symptom Rating Scale ◽

Irritable Bowel

ABSTRACT BACKGROUND: Irritable bowel syndrome (IBS) symptoms such as diarrhea, bloating and abdominal pain can reduce University student’s productivity and learning ability. One of the possible treatments for IBS is the temporarily exclusion of foods that have a high content of short-chain fermentable carbohydrates, the fermentable, oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs). OBJECTIVE: This study aimed to assess University student’s intake of foods that are rich in FODMAPs, looking for possible associations with the severity of IBS symptoms. METHODS: A cross-sectional study was carried out, with undergraduate students from a private University in the city of São Paulo, Brazil, aged between 19 and 46 years old and that were enrolled in different courses and stages. Students were invited to participate and those who gave their formal consent were included in this research. A sociodemographic and lifestyle questionnaire was applied, in addition to the Gastrointestinal Symptom Rating Scale - GSRS. Students also responded a short Food Frequency Questionnaire, developed to investigate habitual FODMAPs intake of Brazilian adult population. Spearman’s correlation analysis between the student’s GSRS scores and the frequency of foods rich in FODMAPs intake were performed in SPSS v.21. RESULTS: Fifty-six students were interviewed, with mean age of 21.4 years old (SD=4.41), with a predominance of women (76.8%). The GSRS results showed that 58.9% of students felt minimal to moderate abdominal discomfort and 14.3% had moderately severe to very severe abdominal pain during the prior week to the interview. Besides abdominal pain, the gastrointestinal symptoms that were most reported by students were flatulence (98.2%), stomach rumbling (89.3%) and eructations (85.7%). Greater symptom severity was observed in women (P=0.004) and sedentary students (P=0.003). Regarding FODMAPs consumption, honey (P=0.04), chocolate (P=0.03) and milk table cream (P=0.001) intakes were positively correlated with the greater severity of symptoms. CONCLUSION: Although clinical diagnosis is necessary to establish IBS, 73.2% of the students presented minimal to very severe abdominal pain during the prior week. Female had sedentary students had greater severity of gastrointestinal symptoms. A low FODMAP diet, well oriented, could bring some symptoms relief to these University students.

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Therapeutic efficacy of duloxetine versus selective serotonin reuptake inhibitors in irritable bowel syndrome

European Psychiatry ◽

10.1016/s0924-9338(11)72996-0 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1291-1291

Author(s):

D. Vasile ◽

O. Vasiliu ◽

C. Tudor ◽

V. Bogdan ◽

A.G. Mangalagiu ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Rating Scale ◽

Gastrointestinal Symptoms ◽

Serotonin Reuptake Inhibitors ◽

Selective Serotonin ◽

Affective Symptoms ◽

Significant Difference ◽

Irritable Bowel

IntroductionSelective serotonin reuptake inhibitors (SSRIs) are frequently used for irritable bowel syndrome, while duloxetine was evaluated in other similar psycho-somatic syndromes.ObjectiveThis prospective, single-blind trial intends to compare the efficacy of SSRIs and duloxetine in the treatment of irritable bowel syndrome.MethodsA group of 22 patients, 15 female and 7 male, mean age 50.2, diagnosed with irritable bowel syndrome according to the Rome II Diagnostic Criteria (1992) were treated with either an SSRI (escitalopram 20 mg/day, n = 6 or fluoxetine 40 mg/day, n = 6) or duloxetine (90 mg/day, n = 10). Patients were evaluated initially and every 4 weeks, for 6 months, using Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale 17 items version (HAMD), Clinical Global Impressions -Severity/Improvement (CGI-I/S) and a 7-points Likert scale (LS) for self-evaluated severity.ResultsDuloxetine improved anxiety and depressive symptoms, as reflected by the significant decrease of HAMA (−17.6 points, p < 0.05) and HAMD scores (−18.2 points, p < 0.05) at week 12. SSRIs also reduced the affective symptoms, significantly to baseline (p < 0.05), but less than duloxetine (−14.3, −15.2) at week 12, with no significant difference at week 24 (p = 0.120). The CGI-I results paralleled the decrease of HAMD and HAMA, while the LS evaluation of gastrointestinal symptoms improved similarly in both groups, with no significant difference (p = 0.09).ConclusionDuloxetine is an efficient agent in the treatment of irritable bowel syndrome, because it decreases the mood symptoms more rapidly than SSRIs. The overall efficacy of SSRIs and duloxetine at 6 months is nevertheless similar.

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Peptic Ulcer Disease and Misuses of Ulcer Healing Drugs in a Tertiary Care Hospital in Dhaka City

Journal of Medicine ◽

10.3329/jom.v16i1.22386 ◽

2015 ◽

Vol 16 (1) ◽

pp. 27-34

Author(s):

Md. Hafiz Md. Hafiz Sardar ◽

Mohammad Murad Hossain ◽

Khan Abul Kalam Azad ◽

Md Uzzwal Mallik ◽

Moumita Chakraborty

Keyword(s):

Peptic Ulcer ◽

Abdominal Pain ◽

Peptic Ulcer Disease ◽

College Hospital ◽

Female Ratio ◽

Ulcer Disease ◽

Medical College ◽

Non Ulcer Dyspepsia ◽

Irritable Bowel ◽

Upper Abdominal

This prospective cross sectional study was conducted in Dhaka Medical College Hospital, Dhaka during July, 2013 to December, 2013. Hundred patients were included in this study. Peptic ulcer disease, presented as upper abdominal pain is one of the common disease with a number of underlying causes. Prospective analyses of 100 patients with upper abdominal pain were studied at medicine units of Dhaka Medical College Hospital, Dhaka. Of these 36 patients belonged to peptic ulcer, 20 patients to irritable bowel syndrome and 22 patients to non-ulcer dyspepsia. Next in order were helminthiasis (5 patients), cholelithiasis (4 patients), gastric carcinoma (4 patients), liver abscess (5 patients) chronic pancreatitis (3 patients) and acute pancreatitis (1 patient). Mean age incidence in this series was 39.47 years. Male and female ratio was 1.54:1. Forty patients were smoker with male and female ratio of 3.44:1.All patients had presenting feature of upper abdominal pain. Commonest site of pain was in the epigastrium in 48.08% of cases.Pain was burning in 43.27% cases, periodic pain in 24.03%, and nocturnal hunger pain in 33.65% of cases.Relief of pain after taking food were observed in 38.46%. Epigastric tenderness was present in 56.73% patients.The diagnosis of peptic ulcer disease, irritable bowel syndrome and non-ulcer dyspepsia, the three leading causes of upper abdominal pain, were suspected by history and physical examination but it was difficult to interpret these on clinical ground alone .Some routine and some selected investigation were done for confirmatory diagnosis.In this series, significant disparity detected between clinically diagnosed peptic ulcer diseases 90.38% and endoscopically confirmed peptic ulcer disease, 34.62% cases. As a consequence of wrong diagnosis of PUD, there are huge misuses of ulcer healing drugs and a great economic burden on patients (300 taka per month) and on the nation.DOI: http://dx.doi.org/10.3329/jom.v16i1.22386 J MEDICINE 2015; 16 : 27-34

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Subjective Taste and Smell Changes in Conjunction with Anxiety and Depression Are Associated with Symptoms in Patients with Functional Constipation and Irritable Bowel Syndrome

Gastroenterology Research and Practice ◽

10.1155/2021/5491188 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Jie Liu ◽

Chaolan Lv ◽

Dandan Wu ◽

Ying Wang ◽

Chenyu Sun ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Rating Scale ◽

Gastrointestinal Symptoms ◽

Functional Constipation ◽

Anxiety And Depression ◽

Hamilton Depression Scale ◽

Healthy Controls ◽

Irritable Bowel ◽

The Impact ◽

Taste And Smell

Background. Patients with functional constipation (FC) and irritable bowel syndrome (IBS) often report psychological abnormalities and decreased eating enjoyment. Several patients also complain of changes in the sense of smell and taste, but these are often disregarded clinically. Aims. Therefore, there is a need to determine whether taste/smell disturbances and psychological abnormalities are present in patients with FC or IBS and whether these are related to the severity of lower gastrointestinal symptoms. Methods. A total of 337 subjects were recruited, including FC ( n = 115 ), IBS ( n = 126 ), and healthy controls ( n = 96 ). All participants completed questionnaires evaluating taste and smell (taste and smell survey (TSS)), Lower Gastrointestinal Symptoms Rating Scale (LGSRS), Hamilton anxiety scale (HAMA), and Hamilton depression scale (HAMD). TSS recorded information on the nature of taste and smell changes (TSCs) and the impact of these changes on the quality of life. LGSRS was used to assess the severity of lower gastrointestinal symptoms; HAMA and HAMD scales were used to reflect the psychosocial state. This study protocol was registered on the Chinese Clinical Trial Registry (No. ChiCTR-2100044643). Results. Firstly, we found that taste and smell scores were higher in patients with IBS than in healthy controls. Secondly, for FC and IBS patients, LGSRS was significantly correlated with the taste score ( Spearma n ’ s rho = 0.832 , P < 0.001 ). LGSRS was also significantly correlated with HAMA ( Spearma n ’ s rho = 0.357 , P = 0.017 ) and HAMD ( Spearma n ’ s rho = 0.377 , P = 0.012 ). In addition, the taste score was significantly correlated with HAMD ( Spearma n ’ s rho = 0.479 , P = 0.001 ), while the smell score was also significantly correlated with HAMD ( Spearma n ’ s rho = 0.325 , P = 0.031 ). Thirdly, 60.87% and 71.43% of patients complained of taste abnormality, while 65.22% and 71.43% had smell abnormality in the FC and IBS groups, respectively. Meanwhile, 47.83% and 47.62% of patients suffered from anxiety, while 43.48% and 57.14% suffered from depression in the FC and IBS groups, respectively. Finally, we found significant differences in the taste, smell, HAMD, and LGSRS scores between the female and male IBS groups ( P < 0.050 ). Conclusions. TSCs and psychological disorders are prominent in FC and IBS patients. Taste abnormalities, as well as anxiety and depression, are significantly correlated with LGSRS. Awareness of this high prevalence of taste/smell abnormalities and the psychological changes among patients with FC and IBS may help better predict and understand the severity of symptoms.

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GWAS of peptic ulcer disease implicates Helicobacter pylori infection, other gastrointestinal disorders and depression

Nature Communications ◽

10.1038/s41467-021-21280-7 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Yeda Wu ◽

Graham K. Murray ◽

Enda M. Byrne ◽

Julia Sidorenko ◽

Peter M. Visscher ◽

...

Keyword(s):

Helicobacter Pylori ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Genome Wide Association Study ◽

Gastrointestinal Diseases ◽

Ulcer Disease ◽

Susceptibility To Infection ◽

Genome Wide ◽

Host Genetic ◽

Irritable Bowel

AbstractGenetic factors are recognized to contribute to peptic ulcer disease (PUD) and other gastrointestinal diseases, such as gastro-oesophageal reflux disease (GORD), irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Here, genome-wide association study (GWAS) analyses based on 456,327 UK Biobank (UKB) individuals identify 8 independent and significant loci for PUD at, or near, genes MUC1, MUC6, FUT2, PSCA, ABO, CDX2, GAST and CCKBR. There are previously established roles in susceptibility to Helicobacter pylori infection, response to counteract infection-related damage, gastric acid secretion or gastrointestinal motility for these genes. Only two associations have been previously reported for duodenal ulcer, here replicated trans-ancestrally. The results highlight the role of host genetic susceptibility to infection. Post-GWAS analyses for PUD, GORD, IBS and IBD add insights into relationships between these gastrointestinal diseases and their relationships with depression, a commonly comorbid disorder.

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