P347 PPI refractory ‘reflux’ symptoms are associated with bowel symptom severity in patients with Cystic Fibrosis

Objective: The irritable bowel syndrome (IBS) is a chronic and often disabling functional bowel disorder. Psychological treatments, in particular cognitive and behavioural interventions, have been shown to be effective for this disorder. The aim of this study was to test the efficacy of a cognitive-behaviour program. Method: Eight participants (seven female, one male) aged between 24 and 71 years, with a diagnosis of IBS according to the Rome criteria, were recruited from among the gastroenterology outpatients at Nepean Hospital, in Sydney, Australia. Participants were administered pretreatment on measures of psychological function and bowel symptom severity. Following a 2-week baseline period, participants began a structured psychological treatment comprising eight sessions of cognitive-behaviour therapy. Throughout treatment, participants maintained daily records of symptom severity and completed homework assignments to ensure treatment compliance. The pretreatment assessment measures were repeated 1 week post-treatment. Results: After treatment, five of the eight patients no longer met the Rome diagnostic criteria for IBS. There was no significant reduction in bowel symptom frequency. There were, however, significant improvements in the distress and disability associated with bowel symptoms. Anxiety and depression were also significantly reduced. Conclusions: Cognitive-behaviour therapy reduced the distress and disability associated with IBS, but not the frequency of bowel symptoms. This supports the proposed cognitive model for IBS, and cognitive-behaviour therapy appears to have its effect by altering the cognitive response to visceral hypersensitivity.

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S58 Triple CFTR modulators improve sino-nasal and laryngopharyngeal reflux symptoms in people with advanced cystic fibrosis lung disease

10.1136/thorax-2021-btsabstracts.64 ◽

2021 ◽

Author(s):

S Shakir ◽

C Echevarria ◽

S Doe ◽

M Brodlie ◽

C Ward ◽

...

Keyword(s):

Cystic Fibrosis ◽

Lung Disease ◽

Laryngopharyngeal Reflux ◽

Cystic Fibrosis Lung ◽

Reflux Symptoms ◽

Cystic Fibrosis Lung Disease ◽

Cftr Modulators

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300 Frequency of laryngopharyngeal reflux symptoms in patients with cystic fibrosis

Journal of Cystic Fibrosis ◽

10.1016/s1569-1993(05)80267-x ◽

2005 ◽

Vol 4 ◽

pp. S78

Keyword(s):

Cystic Fibrosis ◽

Laryngopharyngeal Reflux ◽

Reflux Symptoms

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M1779 Both Bowel Symptom Severity and Visceral Anxiety Are Major Determinants of the Quality of Life Impact of Constipation

Gastroenterology ◽

10.1016/s0016-5085(08)61950-2 ◽

2008 ◽

Vol 134 (4) ◽

pp. A-416-A-417

Author(s):

Olafur S. Palsson ◽

Bruce D. Naliboff ◽

Marsha J. Turner ◽

Rona L. Levy ◽

Andrew D. Feld ◽

...

Keyword(s):

Quality Of Life ◽

Symptom Severity ◽

Bowel Symptom ◽

Life Impact

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Illness perceptions mediate the relationship between bowel symptom severity and health-related quality of life in IBS patients

Quality of Life Research ◽

10.1007/s11136-015-0932-8 ◽

2015 ◽

Vol 24 (8) ◽

pp. 1845-1856 ◽

Cited By ~ 26

Author(s):

Véronique De Gucht

Keyword(s):

Quality Of Life ◽

Symptom Severity ◽

Illness Perceptions ◽

Health Related Quality ◽

Bowel Symptom ◽

Related Quality ◽

Health Related ◽

The Relationship

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Pregnancy in cystic fibrosis of the pancreas

JAMA ◽

10.1001/jama.195.12.993 ◽

1966 ◽

Vol 195 (12) ◽

pp. 993-1000 ◽

Cited By ~ 9

Author(s):

R. J. Grand

Keyword(s):

Cystic Fibrosis

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Freeze-Fracture Examination of Tight Junctions of Human Eccrine Sweat Glands

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s1431927600002786 ◽

1980 ◽

Vol 38 ◽

pp. 634-635

Author(s):

J. V. Briggman ◽

J. Bigelow ◽

H. Bank ◽

S. S. Spicer

Keyword(s):

Cystic Fibrosis ◽

Freeze Fracture ◽

Sweat Glands ◽

Hypertonic Solution ◽

Dark Cells ◽

Clear Cells ◽

Junctional Complexes ◽

Secretory Coil ◽

Eccrine Sweat Glands ◽

Eccrine Sweat

The prevalence of strands shown by freeze-fracture in the zonula occludens of junctional complexes is thought to correspond closely with the transepi-thelial electrical resistance and with the tightness of the junction and its obstruction to paracellular flow.1 The complexity of the network of junc¬tional complex strands does not appear invariably related to the degree of tightness of the junction, however, as rabbit ileal junctions have a complex network of strands and are permeable to lanthanum. In human eccrine sweat glands the extent of paracellular relative to transcellular flow remains unknown, both for secretion of the isotonic precursor fluid by the coil and for resorption of a hypertonic solution by the duct. The studies reported here undertook, therefore, to determine with the freeze-fracture technique the complexity of the network of ridges in the junctional complexes between cells in the secretory coil and the sweat ducts. Glands from a patient with cystic fibrosis were also examined because an alteration in junctional strands could underlie the decreased Na+ resorption by sweat ducts in this disease. Freeze-fracture replicas were prepared by standard procedures on isolated coil and duct segments of human sweat glands. Junctional complexes between clear cells, between dark cells and between clear and dark cells on the main lumen, and between clear cells on intercellular canaliculi of the coil con¬tained abundant anastomosing closely spaced strands averaging 6.4 + 0.7 (mean + SE) and 9.0 +0.5 (Fig. 1) per complex, respectively. Thus, the junctions in the intercellular canaliculi of the coil appeared comparable in complexity to those of tight epithlia. Occasional junctions exhibited, in addition, 2 to 5 widely spaced anastomosing strands in a very close network basal to the compact network. The fewer junctional complexes observed thus far between the superficial duct cells consisted on the average of 6 strands arranged in a close network and 1 to 4 underlying strands that lay widely separated from one another (Fig. 2). The duct epitelium would, thus, be judged slightly more "leaky" than the coil. Infrequent junctional complexes observed to date in the secretory coil segment of a cystic fibrosis specimen disclosed rela¬tively few closely crowded strands.

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Hormone Replacement Therapy and Voice

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig3-2018-0007 ◽

2019 ◽

Vol 4 (4) ◽

pp. 607-614

Author(s):

Jean Abitbol

Keyword(s):

Replacement Therapy ◽

Symptom Severity ◽

Low Dose ◽

Hormone Replacement ◽

Clinical Signs ◽

Female Voice ◽

Fat Cells ◽

High Pitch ◽

Endocrine Effects ◽

The Voice

The purpose of this article is to update the management of the treatment of the female voice at perimenopause and menopause. Voice and hormones—these are 2 words that clash, meet, and harmonize. If we are to solve this inquiry, we shall inevitably have to understand the hormones, their impact, and the scars of time. The endocrine effects on laryngeal structures are numerous: The actions of estrogens and progesterone produce modification of glandular secretions. Low dose of androgens are secreted principally by the adrenal cortex, but they are also secreted by the ovaries. Their effect may increase the low pitch and decease the high pitch of the voice at menopause due to important diminution of estrogens and the privation of progesterone. The menopausal voice syndrome presents clinical signs, which we will describe. I consider menopausal patients to fit into 2 broad types: the “Modigliani” types, rather thin and slender with little adipose tissue, and the “Rubens” types, with a rounded figure with more fat cells. Androgen derivatives are transformed to estrogens in fat cells. Hormonal replacement therapy should be carefully considered in the context of premenopausal symptom severity as alternative medicine. Hippocrates: “Your diet is your first medicine.”

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