scholarly journals Adding to the Burden: Gastrointestinal Symptoms and Syndromes in Multiple Sclerosis

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
David J. Levinthal ◽  
Ambreen Rahman ◽  
Salman Nusrat ◽  
Margie O’Leary ◽  
Rock Heyman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Fecal Incontinence ◽  
Functional Dyspepsia ◽  
Gastrointestinal Symptoms ◽  
Functional Constipation ◽  
Full Extent ◽  
Gi Symptoms ◽  
High Prevalence ◽  
Dyspeptic Symptoms ◽  
Routine Assessment

Background. Multiple sclerosis (MS) patients often suffer from gastrointestinal (GI) symptoms. However, the full extent and prevalence of such symptoms are not clearly established. Thus, we sought to define the prevalence of GI symptoms and syndromes in those with MS.Methods. 218 MS patients completed self-reported demographic and clinical data questionnaires as well as several standardized surveys probing MS severity and GI health.Results. Nearly two thirds (65.6%) of patients endorsed at least one persistent GI symptom. Constipation (36.6%), dysphagia (21.1%), and fecal incontinence (15.1%) were common. Surprisingly, nearly 30% (28.4%) of the patients reported dyspeptic symptoms. Using validated diagnostic algorithms, patients met criteria for functional dysphagia (14.7%), functional dyspepsia (16.5%), functional constipation (31.7%), and IBS (19.3%), among others. Functional dysphagia, functional dyspepsia, and IBS were significantly more common in those with self-identified mood disorders.Conclusions. Constipation, fecal incontinence, and dysphagia are indeed frequent symptoms seen in MS patients. We also noted a ~30% prevalence of dyspepsia in this population. The mechanisms driving this association are not clear and require further study. However, due to this high prevalence, dyspeptic symptoms should be incorporated into the routine assessment of MS patients and, if found, may warrant collaborative referral with a GI specialist.

scholarly journals Gastrointestinal Symptoms in Diabetes Occur Long Before Diabetic Complications

2021 ◽  
Author(s):  
Hwanseok Jung ◽  
Eun-Jung Rhee ◽  
Mi Yeon Lee ◽  
Jung Ho Park ◽  
Dong Il Park ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Functional Dyspepsia ◽  
Diabetes Complications ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Symptoms ◽  
Functional Constipation ◽  
Gastrointestinal Disorders ◽  
Gi Symptoms ◽  
Irritable Bowel ◽  
Diabetes Patients

Abstract Background: Gastrointestinal (GI) manifestations are common in patients with diabetes complications such as autonomic neuropathy. However, the prevalence of GI symptoms before the development of diabetes complications remains unclear.Method: We performed an interview survey of functional gastrointestinal disorders in diabetes patients who visited the endocrinology clinic of a general hospital using the ROME III criteria. The investigation consisted of various questions on functional dyspepsia, irritable bowel syndrome, and functional constipation including functional defecation disorder.Results: A total of 509 patients were included in this analysis. The patients were analyzed in three groups, prediabetes patients (n = 115), diabetes patients without neuropathy (n = 275), and diabetes patients with neuropathy (n = 119). The prevalence of gastrointestinal symptoms in prediabetes patients, diabetes patients without neuropathy, and diabetes patients with neuropathy was estimated at 16.52%, 27.27%, and 23.53% for functional dyspepsia; 8.7%, 11.68%, and 16.81% for irritable bowel syndrome; and 8.85%, 11.85%, and 15.25% for functional constipation. In the subgroup analysis, postprandial distress syndrome symptoms such as postprandial fullness and early satiation were more prevalent than epigastric pain symptoms. In the constipation group, pelvic outlet obstruction symptoms such as the sensation of anorectal obstruction or blockage and manual maneuvers to facilitate defecation were more frequently observed than slow transit constipation symptomsConclusions: The prevalence of functional gastrointestinal disorders increased with diabetes severity. Diabetes-related GI symptoms appeared long before the diabetes complications

scholarly journals High Prevalence of Strongyloides among South Asian Migrants in Primary Care―Associations with Eosinophilia and Gastrointestinal Symptoms

Pathogens ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. 103 ◽  
Author(s):  
Elinor Chloe Baker ◽  
Damien K. Ming ◽  
Yasmin Choudhury ◽  
Shahedur Rahman ◽  
Philip J. Smith ◽  
...  
Keyword(s):  
Primary Care ◽  
South Asian ◽  
Eosinophil Count ◽  
Gastrointestinal Symptoms ◽  
Symptom Burden ◽  
Access To Treatment ◽  
Migrant Populations ◽  
Gi Symptoms ◽  
High Prevalence ◽  
Nested Case Control

Gastrointestinal (GI) symptoms are a frequent reason for primary care consultation, and common amongst patients with strongyloidiasis. We conducted a prospective cohort and nested case control study in East London to examine the predictive value of a raised eosinophil count or of GI symptoms, for Strongyloides infection in South Asian migrants. We included 503 patients in the final analyses and all underwent a standardised GI symptom questionnaire, eosinophil count and Strongyloides serology testing. Positive Strongyloides serology was found in 33.6% in the eosinophilia cohort against 12.5% in the phlebotomy controls, with adjusted odds ratio of 3.54 (95% CI 1.88–6.67). In the GI symptoms cohort, 16.4% were seropositive but this was not significantly different compared with controls, nor were there associations between particular symptoms and Strongyloidiasis. Almost a third (35/115) of patients with a positive Strongyloides serology did not have eosinophilia at time of testing. Median eosinophil count declined post-treatment from 0.5 cells × 109/L (IQR 0.3–0.7) to 0.3 (0.1–0.5), p < 0.001. We conclude Strongyloides infection is common in this setting, and the true symptom burden remains unclear. Availability of ivermectin in primary care would improve access to treatment. Further work should clarify cost-effectiveness of screening strategies for Strongyloides infection in UK migrant populations.

scholarly journals 452. Familial Cluster of COVID-19 Cases Associated with High Prevalence of Anosmia, Ageusia, and Gastrointestinal Symptoms

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S293-S293
Author(s):  
Bethany E Ho ◽  
Andrea P Ho ◽  
Michaela A Ho ◽  
Elizabeth C Ho
Keyword(s):  
Disease Transmission ◽  
Respiratory Symptoms ◽  
Index Case ◽  
Gastrointestinal Symptoms ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Familial Cluster ◽  
Gi Symptoms ◽  
High Prevalence ◽  
Polymerase Chain

Abstract Background Patients with COVID-19 most commonly report respiratory symptoms, with a minority reporting gastrointestinal (GI) symptoms in currently available reports. Additionally, little is known about the symptoms of anosmia/hyposmia, ageusia, and dysgeusia anecdotally seen in COVID-19 patients, which may be considered both GI and sensory/neurological manifestations of infection. Methods We interviewed 7 patients via oral inquiries and a questionnaire, collecting data on subject symptoms and their durations. Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to confirm 2 of these cases. Results We report a familial cluster of 7 COVID-19 cases, 5 of whom reported sensory symptoms of anosmia/hyposmia (5/7), ageusia/hypogeusia (5/7), and/or dysgeusia (3/7). All 7 cases reported GI involvement with one or more symptom of: nausea (5/7), diarrhea (4/7), abdominal pain (3/7), anorexia (3/7), and emesis (2/7). Figure 1. Timeline of Symptoms and Exposure to Index Case in Familial COVID-19 Cluster Conclusion This frequency of GI symptoms is high relative to currently available epidemiological reports, which also infrequently report on sensory symptoms. The mechanistic underpinnings of GI and sensory symptoms in COVID-19 warrant close consideration and analysis, especially as it relates to reducing disease transmission. COVID-19 exhibits wide variation in duration, severity, and progression of symptoms, even within a familial cluster. Disclosures All Authors: No reported disclosures

M1346 High Prevalence of Lower Gastrointestinal (GI) Symptoms in Functional Dyspepsia: A Factor and Cluster Analysis in the General Population

2010 ◽  
Vol 138 (5) ◽  
pp. S-385
Author(s):  
Hidekazu Suzuki ◽  
Juntaro Matsuzaki ◽  
Keiko Asakura ◽  
Yasushi Fukushima ◽  
Yoshimasa Saito ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
General Population ◽  
Functional Dyspepsia ◽  
Gi Symptoms ◽  
High Prevalence ◽  
Factor And Cluster Analysis ◽  
And Cluster Analysis

scholarly journals Subthreshold Psychiatric Psychopathology in Functional Gastrointestinal Disorders: Can It Be the Bridge between Gastroenterology and Psychiatry?

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Cristina Stasi ◽  
Cristiana Nisita ◽  
Sonia Cortopassi ◽  
Giorgio Corretti ◽  
Dario Gambaccini ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Functional Dyspepsia ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Symptoms ◽  
Functional Constipation ◽  
Psychiatric Evaluation ◽  
Gastrointestinal Disorders ◽  
Axis I ◽  
Spectrum Disorders ◽  
Irritable Bowel

Background and Aims. Functional gastrointestinal disorders (FGDs) are multifactorial disorders of the gut-brain interaction. This study investigated the prevalence of Axis I and spectrum disorders in patients with FGD and established the link between FGDs and psychopathological dimensions.Methods. A total of 135 consecutive patients with FGD were enrolled. The symptoms’ severity was evaluated using questionnaires, while the psychiatric evaluation by clinical interviews established the presence/absence of mental (Diagnostic and Statistical Manual—4th edition, Axis I Diagnosis) or spectrum disorders.Results. Of the 135 patients, 42 (32.3%) had functional dyspepsia, 52 (40.0%) had irritable bowel syndrome, 21 (16.2%) had functional bloating, and 20 (15.4%) had functional constipation. At least one psychiatric disorder was present in 46.9% of the patients, while a suprathreshold panic spectrum was present in 26.2%. Functional constipation was associated with depressive disorders (p<0.05), while functional dyspepsia was related to the current major depressive episode (p<0.05). Obsessive-compulsive spectrum was correlated with the presence of functional constipation and irritable bowel syndrome (p<0.05).Conclusion. The high prevalence of subthreshold psychiatric symptomatology in patients with FGD, which is likely to influence the expression of gastrointestinal symptoms, suggested the usefulness of psychological evaluation in patients with FGDs.

The Association Between Gastrointestinal Symptoms and Transvaginal Ultrasound Findings in Women Referred for Endometriosis Evaluation: A Prospective Pilot Study

2020 ◽  
Author(s):  
Lee Cohen Ben-Meir ◽  
David Soriano ◽  
Michal Zajicek ◽  
Vered Yulzari ◽  
Jerome Bouaziz ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Transvaginal Ultrasound ◽  
Gastrointestinal Symptoms ◽  
Fold Increase ◽  
Uterosacral Ligament ◽  
Peritoneal Adhesions ◽  
Gi Symptoms ◽  
High Prevalence ◽  
Rome Iii ◽  
And Performance

Abstract Purpose To evaluate the relationship between gastrointestinal (GI) symptoms and transvaginal ultrasound (TVUS) findings suggestive of endometriosis. Materials and Methods A prospective design. Women referred for a diagnostic ultrasound due to suspicion of endometriosis completed a Rome III and Pelvic Floor Distress Inventory (PFDI-20) questionnaire for clinical, GI symptoms, before undergoing TVUS. Endometriosis was diagnosed in the presence of endometriomas and/or deeply infiltrative endometriotic (DIE) lesions. Association between lesion sites and GI symptoms was evaluated by univariate and multivariate analysis. Results The study included 241 women who presented with: dysmenorrhea (89.6 %), dyspareunia (76.3 %), chronic pelvic pain (77.2 %), dyschezia (66 %), hematochezia (15.4 %), subfertility (24.5 %). GI symptoms were present in 25.3–76.8 % and 5.4–55.6 % of Rome III and PFDI-20 questionnaire responses, respectively. TVUS findings were endometriomas (23.2 %), peritoneal adhesions (46.5 %), uterosacral ligament (26.7 %), retrocervical (11.2 %), rectosigmoid (11.2 %), intestinal (4.6 %), and bladder (0.8 %) involvement, and pouch of Douglas (POD) obliteration (15.4 %). There was a high prevalence of peritoneal adhesions, uterosacral ligament involvement, and rectosigmoid and intestinal nodules on TVUS in women with GI symptoms, up to Chi2 = 9.639 (p = 0.013) on univariate and Chi2 = 8.102 (p = 0.005) on multivariate analysis. Conclusion We observed an almost 10-fold increase in DIE lesions in women with GI symptoms. We suggest that the presence of GI symptoms should prompt a referral for endometriosis evaluation and performance of a dedicated TVUS before invasive gastrointestinal procedures.

scholarly journals Investigation of oral, gastric, and duodenal microbiota in patients with upper gastrointestinal symptoms

2020 ◽  
Vol 69 (4) ◽  
pp. 870-877
Author(s):  
Jorge Cervantes ◽  
Majd Michael ◽  
Bo-Young Hong ◽  
Aden Springer ◽  
Hua Guo ◽  
...  
Keyword(s):  
Gastrointestinal Symptoms ◽  
Microbiota Composition ◽  
Gi Tract ◽  
Upper Gi ◽  
Functional Gi Disorders ◽  
Gi Symptoms ◽  
Dyspeptic Symptoms ◽  
Upper Gastrointestinal Symptoms ◽  
Upper Gastrointestinal ◽  
Gastric Microbiota

Disease-associated alterations of the intestinal microbiota composition, known as dysbiosis, have been well described in several functional gastrointestinal (GI) disorders. Several studies have described alterations in the gastric microbiota in functional dyspepsia, but very few have looked at the duodenum.Here, we explored the upper GI tract microbiota of inpatients with upper GI dyspeptic symptoms, and compared them to achalasia controls, as there is no indication for an esophagogastroduodenoscopy in healthy individuals.We found differences in the microbiota composition at the three sites evaluated (ie, saliva, stomach and duodenum). Changes observed in patients with dyspepsia included an increase in Veillonella in saliva, an oral shift in the composition of the gastric microbiota, and to some degree in the duodenum as well, where an important abundance of anaerobes was observed. Metabolic function prediction identified greater anaerobic metabolism in the stomach microbial community of patients with dyspepsia. Proton pump inhibitor use was not associated with any particular genus. Co-abundance analysis revealed Rothia as the main hub in the duodenum, a genus that significantly correlated with the relative abundance of Clostridium, Haemophilus, and Actinobacillus.We conclude that patients with upper GI symptoms consistent with dyspepsia have alterations in the microbiota of saliva, the stomach, and duodenum, which could contribute to symptoms of functional GI disorders.

scholarly journals A123 GASTROINTESTINAL SYMPTOMS AND DISORDERS OF GUT BRAIN INTERACTION ARE COMMON IN PATIENTS WITH EHLERS-DANLOS SYNDROME (EDS) IN TERTIARY REFERRAL CENTER

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 143-144
Author(s):  
E Abu-Farhaneh ◽  
Y Tse ◽  
C H Parker ◽  
L W Liu
Keyword(s):  
Abdominal Pain ◽  
Fecal Incontinence ◽  
Gastrointestinal Symptoms ◽  
Retrospective Chart Review ◽  
Final Analysis ◽  
Ehlers Danlos Syndrome ◽  
Early Satiety ◽  
Tertiary Referral Center ◽  
Gi Symptoms ◽  
Danlos Syndrome

Abstract Background Ehlers Danlos Syndrome (EDS) is a group of rare connective tissue disorders. Gastrointestinal (GI) symptoms such as abdominal pain, nausea, vomiting, bloating and altered bowel habits are common in patients with EDS. Specifically, disorders of gut brain interaction (DGBI) appear to be more common in this patient population. The University Health Network (UHN) has the first and only multi-disciplinary clinic, including specialized gastroenterology services, in Canada for the management of EDS. Aims The aim of this study is to describe the GI symptoms and DGBI that are present in our cohort of EDS patients. Methods A retrospective chart review of all EDS who were seen in the gastroenterologist clinic of the GoodHope EDS clinic at UHN were reviewed from November 1, 2017 to September 26, 2019. Demographic information including age, sex and EDS subtype were collected. GI symptoms that were collected include constipation, diarrhea, fecal incontinence, nausea, vomiting, bloating, abdominal pain, early satiety, heart burn, dysphagia and regurgitation. A physician made diagnosis of irritable bowel syndrome (IBS) was recorded. Descriptive statistics were performed. Results The charts of 79 EDS patients were reviewed; 4 were excluded due to missing data. 75 patients were included in the final analysis. 93.3% of patients were female with a mean age of 36.4 +/- 12.5 years. Of these 75 patients, 43 (57.3%) had EDS-hypermobile subtype, 13 (17.3%) EDS-classic, 3 (4%) EDS-vascular, 3 (4%) unknown EDS subtype and 13 (17.3%) were categorized as having a hypermobile spectrum disorder. The most common GI symptoms observed in this patient group included abdominal pain in 85.5%, bloating in 64.4%, heartburn in 61.8%, constipation in 57.9%, nausea in 50%, diarrhea 43.4%, dysphagia in 43.4%, regurgitation in 34.2%, early satiety in 32.89%, vomiting in 30.2%,and fecal incontinence in 13.1%. It was also observed that 50.7% (n=38) had a physician made diagnosis of IBS. Of these patients with IBS, 16 (42.1%) had IBS constipation, 12 (31.5%) had IBS mixed, and 10 (26.3%) had IBS diarrhea. Conclusions Our study demonstrated that GI symptoms are common in patients with EDS. In our cohort, abdominal pain is the most commonly reported GI symptom, though other various GI symptoms are also reported in high numbers. DGBI are also common, with IBS being much more common than what has been reported in the general population. Further studies are needed to better understand the pathophysiology and impact of these GI symptoms and DGBI in patients with EDS. Funding Agencies UNH Foundation Goodhope Fund

scholarly journals Does Diabetic Microvascular Complications Affect Gastrointestinal Symptoms?

2019 ◽  
Author(s):  
Akram Ghadiri-Anari ◽  
Somayeh Gholami ◽  
Elham Sheyda ◽  
Shadab Kharazmi ◽  
Nasim Namiranian
Keyword(s):  
Microvascular Complications ◽  
Gastrointestinal Symptoms ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Gi Symptoms ◽  
High Prevalence ◽  
Rome Iii ◽  
Diabetic Microvascular Complications ◽  
Sample Method

Abstract- Due to high prevalence of diabetes in our region (16.3%) and no data on the frequency of gastrointestinal (GI) symptoms in this population, we performed a cross-sectional study to evaluate the frequency of GIsymptoms in diabetic patients and its association between microvascular complications (retinopathy and nephropathy) and gastrointestinal symptoms in diabetic subjects.This analytical crosssectional study was conducted from 2014 to 2016 on 233 patients with type 2 diabetes mellitus (T2DM), 3065-year, referred to Yazd diabetic research center. They were selected by convenient sample method. A questionnaire according to Rome III Criteria was used to collect digestive information related to diabetes. Last HbA1c (Since 2-3 months ago) was available in the patient's medical folder. Diabetic nephropathy defines to increased excretion rate of albumin in the urine in the range of above 30 mg/g creatinine. Diabetic retinopathy was examined by an expert ophthalmologist (retinal specialist). For the current study, 233 patients (age 30-65 years with mean age of 57.43±10.49 years, 102 (43.8%) males and 131 (56.2%) females) were included. Among 233 patients, 91 cases (39.1%) had nephropathy,and 111(47.6%) subjects had different degrees of retinopathy. Bloating and early satiety and upper GI symptoms were higher in the subjects with retinopathy than another group. In summary, this study provides evidence that GI symptoms in diabetic subjects are independently linked to diabetic complications, particularly to retinopathy.

Excessive Belching: a Separate Syndrome or Another Symptom of Functional Dyspepsia?

2020 ◽  
Vol 30 (3) ◽  
pp. 55-60 ◽  
Author(s):  
A. A. Sheptulin ◽  
O. A. Storonova
Keyword(s):  
Functional Dyspepsia ◽  
Functional Gastrointestinal Disorders ◽  
High Resolution Manometry ◽  
Published Evidence ◽  
Key Points ◽  
Dyspeptic Symptoms ◽  
The Relationship ◽  
Rome Iv ◽  
Selection Of ◽  
Optimal Treatment Strategy

Aim of review. Interpretation of published evidence on the relationship between the excessive belching syndrome and functional dyspepsia (FD) and their management in patient care.Key points. According to the Rome IV criteria of functional gastrointestinal disorders (FGID), excessive belching in the absence of other dyspeptic symptoms is to be considered a manifestation of the excessive belching syndrome, which can be of gastric or supragastric nature. Combination of high-resolution manometry and impedancemetry allows an accurate diagnosis of belching and selection of optimal treatment strategy. Belching complicated by other symptoms of dyspepsia is to be considered yet another FD symptom according to the Rome IV criteria of FGID. Prokinetics are recommended to relieve belching in such cases.Conclusion. Understanding the relationship between the excessive belching syndrome and FD requires further research.

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