scholarly journals Digestive symptoms in daily life of chronic adrenal insufficiency patients are similar to irritable bowel syndrome symptoms

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
L. Quénéhervé ◽  
D. Drui ◽  
J. Blin ◽  
M. Péré ◽  
E. Coron ◽  
...  

AbstractGastrointestinal symptoms are frequent in acute adrenal insufficiency. Although digestive symptoms can significantly reduce quality of life, they are rarely described in patients with treated chronic adrenal insufficiency (CAI). We aimed to characterize digestive symptoms in CAI patients. We used the section pertaining functional bowel disorders of the Rome IV questionnaire. A questionnaire was published on the website of the non-profit patient association “Adrenals” (NPPA of CAI patients) for five months. Information on demographics, characteristics of adrenal insufficiency, digestive symptoms and quality of life was collected. The relatives of CAI patients served as a control group. We analyzed responses of 33 control subjects and 119 patients (68 primary adrenal insufficiency (PAI), 30 secondary adrenal insufficiency (SAI) and 21 congenital adrenal hyperplasia (CAH)). Abdominal pain at least once a week over the past 3 months was reported by 40%, 47% and 33% of patients with PAI, SAI and CAH respectively versus 15% for the controls (p = 0.01). Symptoms were consistent with the Rome IV criteria for irritable bowel syndrome in 27%, 33% and 33% of patients respectively versus 6% for the controls (p < 0.0001). Quality of life was described as poor or very poor in 35%, 57% and 24% of patients respectively versus 5% for the controls (p < 0.0001). In conclusion, digestive symptoms are frequent and incapacitating in CAI patients and similar to symptoms of irritable bowel syndrome in 30% of CAI patients. Assessment and management of digestive symptoms should be considered a priority for physicians treating patients with CAI.

2012 ◽  
Vol 16 (1) ◽  
pp. 95-104 ◽  
Author(s):  
Sang-Eun Jun ◽  
Ruth Kohen ◽  
Kevin C. Cain ◽  
Monica E. Jarrett ◽  
Margaret M. Heitkemper

The aims of this exploratory study were to examine whether tryptophan hydroxylase ( TPH) gene polymorphisms are associated with psychosocial factors in women with irritable bowel syndrome (IBS). TPH is the rate-limiting enzyme in the biosynthesis of serotonin and has two isoforms, TPH1 and TPH2. Four single nucleotide polymorphisms (SNPs) in the TPH1 gene and one SNP in the TPH2 gene were selected based on previous studies investigating associations between these SNPs and psychiatric or behavioral disorders. One hundred ninety-nine Caucasian women with IBS were included. Results of univariate analysis showed no association between TPH1and TPH2 gene SNPs and current level of psychological distress or psychiatric illness. However, TPH1 gene SNPs were associated with IBS-related cognitions (rs4537731 and rs21105) and quality of life (rs684302 and rs1800532), in particular the mental health and energy subscales. These associations were independent of the subjects’ levels of gastrointestinal symptoms. These results suggest that patients’ perception of their illness, and of the impact it has on their lives, may be subject to genetic influences, in this case sequence variants in TPH1. However, caution should be used in interpreting these results given the large number of hypothesis tests performed in this exploratory hypothesis-generating study, and the results should be considered tentative until confirmed in an independent sample.


Author(s):  
Saeed Yazdani Ashtiani ◽  
Mersad Amery

Background: Irritable bowel syndrome (IBS) is a common, chronic and sometimes disabling functional disorder of the gastrointestinal system and its treatment remains as health problem. Thus the aim of this study was to evaluate the Effect of multispecies probiotic supplementation, as a novel and Controversial therapeutic method on Irritable bowel syndrome. Materials and Methods: In this randomized double blind Placebo-controlled clinical trial, 60 patients with IBS were enrolled. The patients were divided randomly into two groups. Patients in intervention group received two 500 mg probiotic capsules (Familact®) and in control group, received two 500 mg placebo capsules daily for 30 consecutive days. The symptoms and quality of life were measured and compared at the beginning and just after the end of study for each case. Results: Results showed the mean score of Abdominal pain after 1 month of treatment in the probiotic group was significantly lower than the control group (1.76 ± 2.04 vs. 2.88 ± 2.25, P=0.049, respectively). While, other symptoms and quality of life did not change significantly (P>0.05). Furthermore, defecation habit and global symptoms improvement was similar after intervention in both groups and we did not observe significant differences in these items (P>0.05). Conclusion: The results of this study showed the beneficial effects of multispecies probiotic supplementation in controlling IBS patients’ abdominal pain. thus it can be prescribed as a therapeutic option in addition to standard therapy and significantly lead to better control of this symptom in the short term.


2021 ◽  
Vol 6 (4) ◽  
pp. 129-136
Author(s):  
Noura Khosh Chin Gol ◽  
◽  
Bahman Akbari ◽  
Leila Moghtader ◽  
Iraj Shakerinia ◽  
...  

Background: Irritable Bowel Syndrome (IBS) is one of the most common gastrointestinal disorders and is usually associated with abdominal pain. This study aimed to compare the effectiveness of mindfulness and neurofeedback on quality of life in patients with irritable bowel syndrome. Materials & Methods: The present study was a pretest-posttest control group design with a two-month follow-up. The study population included all women with irritable bowel syndrome referred to gastroenterology centers and clinics of Qazvin city in 2019. Patients were selected by convenience sampling and randomly assigned into two experimental and one control groups (n=45). The experimental groups underwent Mindfulness-Based Cognitive Therapy (MBCT) and Neurofeedback (NFB). The Rome-III diagnostic criteria form and the WHOQOLBREF were administered. Data were analyzed using repeated measure analysis of variance. Results: There was significant difference between NFB and control group for total quality of life and all its components. The mean between-group difference (MD) of total quality of life score in NFB compared to control group was 21.2±2.58 in post-test and 15.4±2.35 in follow-up (P<0.05). MBCT group was significantly different with the control group in component of general health both in post-test (MD= 0.93±0.53) and follow-up (MD=0.73±0.53), (P<0.05). Conclusion: NFB therapy considerably improved the quality of life of patients with IBS that was remained after two months of follow-up, while MBCT was only effective on improvement of general health in comparison with the control group.


Author(s):  
Mihaela Fadgyas Stanculete ◽  
Dan Lucian Dumitrascu ◽  
Douglas Drossman

Irritable bowel syndrome (IBS) is a clinically well-defined chronic condition that is now understood as a disorder of gut-brain regulation, as established in the work of the Rome IV committees coordinated by Drossman, 2016. People with IBS often report high disability levels and poor health-related quality of life. Drug therapy focuses on reducing main symptoms and disability and improving health-related quality of life. Central neuromodulators reduce IBS symptoms by targeting dysregulated pain and motility related to gut-brain dysregulation. It can also treat associated mental health symptoms. Based on their multiple effects on central and peripheral mechanisms, neuromodulators have been used to treat IBS patients. This review presents the rationale supporting medication treatments for specific IBS symptoms, discusses evidence-based management of IBS with central neuromodulators, and reviews the progress in the research for new neuromodulators.


2020 ◽  
Vol 9 (1) ◽  
pp. 125 ◽  
Author(s):  
Maria Margarida Guerreiro ◽  
Zélia Santos ◽  
Elisabete Carolino ◽  
Julieta Correa ◽  
Marilia Cravo ◽  
...  

To evaluate the effectiveness of a low FODMAP (fermentable oligosaccharides, monosaccharaides, disaccharides and polyols) diet in the relief of symptoms and an improvement of the quality of life in individuals with irritable bowel syndrome in comparison to a standard diet according to the British Dietetic Association’s guidelines. A non-randomized clinical trial of adult patients with IBS was compared two diet interventions. An assessment of symptoms, quality of life, and nutritional status was performed before and after the four-week mark of intervention. Individuals from the Low FODMAP Diet (LFD) group were evaluated on a third moment, after the controlled reintroduction of FODMAPs. A total of 70 individuals were divided in two groups: Low FODMAP Diet (LFD; n = 47) and Standard Diet (SD; n = 23). 57 individuals completed the four-week intervention (LFD; n = 39; SD; n = 18). At the completion of four weeks, the symptoms improved in both groups (LFD: p < 0.01; DC: p < 0.05) but LFD led to a higher relief (p < 0.05), primarily with respect to abdominal pain and diarrhoea. Quality of life improved significantly in both groups, with no significant differences between SD vs LFD (p > 0.05). In the LFD group, the relief of symptoms observed at the four-week mark remained constant after reintroduction of FODMAPs. Both interventions seem to be effective for the relief of symptoms and quality of life, however LFD had higher effectiveness in the former. The results with LFD suggest it can be a preferred approach in individuals with diarrhoeal profile.


2020 ◽  
pp. 90-95

Background and Objectives: Irritable bowel syndrome is the most common diagnosis among patients with gastrointestinal diseases and can adversely affect their quality of life. In this regard, the present study aimed to evaluate the effectiveness of self-efficacy-based training on depression, self-care behaviors, and the quality of life of patients with irritable bowel syndrome. Materials and Methods: This applied quasi-intervention study was conducted based on a pretest-posttest design with a control group and follow-up. The statistical population included all patients with irritable bowel syndrome who referred to Khorshid Hospital in Isfahan, Iran from September to November 2019. The samples were selected using the convenience sampling method. In total, 30 patients with irritable bowel syndrome were included in the study and randomly divided into two groups of intervention and control. The data were collected using Beck depression inventory, self-care questionnaire, and quality of life questionnaire. The intervention group received four sessions of self-efficacy training (one session per week for 90 min), while the control group did not receive any training. Two months later, the follow-up period was completed. The collected data were analyzed using repeated measures of analysis of variance in SPSS software (version 22). Results: The results showed that self-efficacy training was effective in decreasing depression (P<0.0001, F=35.39) and increasing quality of life (P<0.0001, F=120.30) and self-care behaviors (P<0.0001, F=70.50) in patients with irritable bowel syndrome. Conclusion: It can be concluded that training based on self-efficacy theory can effectively reduce depression and increase self-care behaviors and quality of life in patients with irritable bowel syndrome.


2021 ◽  
Vol 11 ◽  
Author(s):  
Esther Colomier ◽  
Joost Algera ◽  
Chloé Melchior

Irritable bowel syndrome (IBS) is one of the most common disorders of the gut-brain axis, which affects approximately 4% of the global population. The Rome IV criteria define IBS as chronic or recurrent abdominal pain associated with altered bowel habits. Patients can be categorized in four subtypes: IBS with predominant constipation (IBS-C), predominant diarrhea (IBS-D), mixed bowel habits (IBS-M), and unclassified (IBS-U). IBS is associated with a lower quality of life, reduced work productivity, and high healthcare costs. When comparing subtypes, patients with IBS-D report lower disease related quality of life. Due to the scope of this review, we have solely focused on patients with IBS-D. Choosing the right pharmacological treatment in these patients remains challenging due to the heterogeneous patient population, patients’ expectation of the treatment outcome, unavailability of efficacious drugs, and the multifactorial and incompletely understood underlying pathophysiology. Currently, pharmacological treatment options target individual symptoms, such as abdominal pain, altered bowel habits, and bloating. In this review, we aimed to summarize the current and recent pharmacological treatment options in IBS-D, targeting the predominant gastrointestinal symptoms. Additionally, we proposed a pharmacological treatment algorithm which healthcare professionals could use when treating individual patients with IBS-D.


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