scholarly journals “Ninjinto” (Ginseng Decoction), a Traditional Japanese Herbal Medicine, Improves Gastrointestinal Symptoms and Immune Competence in Patients with Chronic Intestinal Failure

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Shuichiro Uehara ◽  
Keiko Ogawa ◽  
Junsuke Arimitsu ◽  
Hiroomi Okuyama

Background. Treating functional gastrointestinal disorders is extremely difficult. We herein report the effect of the oral administration of Ninjinto (NJT, ginseng decoction), a traditional Japanese Kampo medicine, on chronic intestinal failure.Patients and Methods. Seven patients with chronic intestinal failure treated with NJT were evaluated in this study. The primary diseases included chronic intestinal pseudoobstruction (CIPO:n=4), short bowel syndrome (SBS:n=2), and intestinal atresian=1. All patients orally received NJT extract granules at a dose of 0.3 g/kg BW per day. The treatment outcomes were then assessed according to the patients’ symptoms and consecutive abdominal X-ray findings.Results. The targeted symptoms were abdominal distension in four patients, diarrhea in three patients, and frequent hospitalization due to infections in two patients. An improvement in the symptoms was observed in six of the seven patients, whereas one patient with SBS did not show any improvement. An improvement in an abdominal roentgenogram was observed in the four patients with remarkably dilated bowel loops due to CIPO.Conclusions. NJT may be effective in controlling functional gastrointestinal disorders associated with chronic intestinal failure. The use of Kampo medicine in the field of pediatric surgery may help to improve the quality of life in children suffering from such conditions.

1999 ◽  
Vol 4 (1) ◽  
pp. 45-46 ◽  
Author(s):  
Anita D Stuart ◽  
H Gertie Pretorius ◽  
Lynette Van der Merwe

Functional Gastrointestinal Disorders are defined as chronic or recurrent gastrointestinal symptoms characterized by abdominal pain, constipation and/or diarrhoea (Tally, 1994; University of North Carolina, 1998). These disorders are of concern because of their high incidence, associated morbidity, expense and the impact of these disorders on people's quality of life. Drossman (1993, in University of North Carolina (UNC), 1998) found that of 5 400 U.S. households, 69% of people met the criteria for at least one of the functional gastrointestinal disorders which represents a 59% increase in the incidence of functional gastrointestinal disorders since 1983 (Drossman, in UNC, 1998; Drossman, 1983). In particular, Irritable Bowel Syndrome (IBS) sufferers account for 2,4 - 3,5 million visits to doctors annually. Furthermore, IBS sufferers spend $40 million annually on treatment for their condition. They also tend to have 3 to 4 times more disability days than other workers, which illustrates the debilitating effect of this disorder (Drossman, in UNC, 1998). It is therefore necessary that the etiology of IBS be researched, as well as the course and management of this debilitating disease. The studies presented in this series aimed to improve the understanding of the multiple agents that influence the development and course of IBS.


2017 ◽  
Vol 4 (3) ◽  
pp. e32 ◽  
Author(s):  
Maria Lalouni ◽  
Brjánn Ljótsson ◽  
Marianne Bonnert ◽  
Erik Hedman-Lagerlöf ◽  
Jens Högström ◽  
...  

Background Pain-related functional gastrointestinal disorders (P-FGIDs; eg, irritable bowel syndrome) are highly prevalent in children and associated with low quality of life, anxiety, and school absence. Treatment options are scarce, and there is a need for effective and accessible treatments. Internet-delivered cognitive behavior therapy (Internet-CBT) based on exposure exercises is effective for adult and adolescent irritable bowel syndrome, but it has not been evaluated for younger children. Objective The objective of this study was to assess acceptability, feasibility, and potential clinical efficacy of Internet-CBT for children with P-FGIDs. Methods This was a feasibility study with a within-group design. We included 31 children aged 8-12 years and diagnosed with P-FGID, according to the ROME III criteria. Mean duration of abdominal symptoms at baseline was 3.8 years (standard deviation [SD] 2.6). The treatment was therapist-guided and consisted of 10 weekly modules of exposure-based Internet-CBT. The children were instructed to provoke abdominal symptoms in a graded manner and to engage in previously avoided activities. The parents were taught to decrease their attention to their children’s pain behaviors and to reinforce and support their work with the exposures. Assessments included treatment satisfaction, subjective treatment effect, gastrointestinal symptoms, quality of life, pain intensity, anxiety, depression, and school absence. Data were collected at pretreatment, posttreatment, and 6-month follow-up. Means, standard errors (SEs), and Cohen d effect sizes were estimated based on multi-level linear mixed models. Results Most children 25/31 (81%) completed 9 or 10 of the 10 treatment modules. Almost all children, 28/31 (90%), reported that the treatment had helped them to deal more effectively with their symptoms, and 27/31 (87%) children declared that their symptoms had improved during the treatment. Assessments from the parents were in accordance with the children’s reports. No child or parent reported that the symptoms had worsened. We observed a large within-group effect size on the primary outcome measure, child-rated gastrointestinal symptoms from pretreatment to posttreatment (Cohen d=1.14, P<.001, 95% CI 0.69-1.61), and this effect size was maintained at 6-month follow-up (Cohen d=1.40, P<.001, 95% CI 1.04-1.81). We also observed significant improvements from pretreatment to posttreatment on a wide range of child- and parent-rated measures including quality of life, pain intensity, anxiety, depression, and school absence. All results remained stable or were further improved at 6-month follow-up. Conclusions This study shows that children with longstanding P-FGIDs, and their parents, perceive exposure-based Internet-CBT as a helpful and feasible treatment. The included children improved significantly despite a long duration of abdominal symptoms before the intervention. The treatment shows potential to be highly effective for P-FGIDs. The results need to be confirmed in a randomized controlled trial (RCT).


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ying Huang ◽  
Serene Yaling Tan ◽  
Panam Parikh ◽  
Vanitha Buthmanaban ◽  
Shaman Rajindrajith ◽  
...  

Abstract Background The prevalence of functional gastrointestinal disorders (FGIDs) in children, particularly from Asia, is largely unknown. There are not many studies done in Asia especially using the Rome IV criteria. The aim of this study is to assess the prevalence of FGIDs in infants and young children in a representative sample in China. Methods A prospective, cross-sectional, community-based survey was conducted among healthy infants and young children between the ages of 0–4 years in Jinhua and Shanghai, China. A total of 2604 subjects (1300 subjects from Jinhua and 1304 subjects from Shanghai) completed a validated questionnaire on pediatric gastrointestinal symptoms. FGIDs in infants and young children were diagnosed using the Rome IV criteria. Results According to the Rome IV criteria, the prevalence of having a FGID in Chinese infants and young children is 27.3%. Infant regurgitation (33.9%) was the most common FGID among the 0–6 months old while functional constipation (7.0%) was the most common among the 1–4 years old. Risk factor analysis revealed that prevalence of infantile colic was higher with better maternal education and low birth weight. Prevalence of infantile regurgitation was significantly greater in males, living in a rural area, being exclusively breast fed at least up to 4 months and starting formula feeds within the first month. The risk of functional constipation was lower for infants who were delivered vaginally. Conclusions Infantile regurgitation was the most common FGID in Chinese infants while functional constipation was most prevalent among young Chinese children. Trial registration Netherlands Trial Registry Identifier: NL6973/NTR7161.


2020 ◽  
Vol 7 (10) ◽  
pp. 2015
Author(s):  
Shrish Bhatnagar ◽  
Roshan R. Mane ◽  
Irfan A. Shaikh ◽  
Ganesh Kadhe

Background: Functional gastrointestinal disorders (FGIDs) in infants and toddlers possess extensive burden to the parents and healthcare professionals. Guidelines addressing the practices in diagnosis and management of FGIDs in infants in Indian subcontinent is unavailable. Hence this study assessed current knowledge, attitude and practice of pediatricians in diagnosis and treatment of FGIDs.Methods: A cross-sectional survey based on a structured questionnaire assessed pediatrician’s knowledge about prevalence and profile of most common GI disorders in pediatric age groups (birth to 12 months), association of FGIDs with different feeding practices, impact of FGID on quality of life, various management options and physician preferred method of treatment.Results: Colic was rated as the most common GI disorder, followed by gassiness/fussiness, regurgitation and constipation. About 59% pediatricians come across FGIDs more in formula-fed infants compared to breastfed infants (4.2%) and 93.9% pediatricians affirm that FGIDs affect quality of life. Approximately 91% pediatricians believed reassurance and education was the best management option, which was also reported as the preferred mode of management by about 89% pediatricians, whereas pharmacological therapies were the least preferred (1.6%). For breastfed infants suffering with regurgitation, colic or constipation, majority pediatricians opted for switching to 100% whey partially hydrolysed protein formula; sequentially followed by use of pre/probiotics and switch to extensively hydrolyzed protein formula.Conclusions: Parental education and reassurance offer an ideal mode of management of FGIDs. Partially hydrolysed protein formula may be considered one of the best management options irrespective of the FGID condition in infants who are breastfeed.


2020 ◽  
Vol 11 ◽  
Author(s):  
Chloé Melchior ◽  
Charlotte Desprez ◽  
Fabien Wuestenberghs ◽  
Anne-Marie Leroi ◽  
Antoine Lemaire ◽  
...  

Objective: We aimed to determine the burden of opioid consumption in a cohort of patients with functional gastrointestinal disorders.Methods: All patients diagnosed with functional gastrointestinal disorders and referred to our university hospital were evaluated from 2013 to the beginning of 2019. Irritable bowel syndrome and functional dyspepsia diagnoses were determined according to Rome criteria and severity according to irritable bowel syndrome severity scoring system. Vomiting was quantified using a 5-point Likert scale, and constipation severity was measured using the Knowles-Eccersley-Scott-Symptom questionnaires. Quality of life was quantified by the GastroIntestinal Quality of Life Index. Patients were categorized as being treated on a chronic basis with either tramadol, step II opioids, step III opioids or as being opioid-free.Results: 2933 consecutive patients were included. In our cohort, 12.5% had only irritable bowel syndrome, 39.3% had only functional dyspepsia, 24.9% had a combination of both, and 23.4% had other functional gastrointestinal disorders. Among them, the consumption of tramadol, step II (tramadol excluded) and step III opioids was 1.8, 1.3 and 0.3 % respectively in 2013 and 4.3, 3.4 and 1.9% in 2018 (p &lt; 0.03). Opioid consumption was associated with increased vomiting (p = 0.0168), constipation (p &lt; 0.0001), symptom severity (p &lt; 0.001), more altered quality of life (p &lt; 0.0001) and higher depression score (p = 0.0045).Conclusion: In functional gastrointestinal disorders, opioid consumption has increased in the last years and is associated with more GI symptoms (vomiting, constipation and GI severity), higher depression and more altered quality of life.


2019 ◽  
Vol 12 ◽  
pp. 175628481985379 ◽  
Author(s):  
Philippe Tuppin ◽  
Sébastien Rivière ◽  
David Deutsch ◽  
Christelle Gastaldi-Menager ◽  
Jean-Marc Sabaté

Background: Gastrointestinal therapeutic drugs (GTDs) are extensively prescribed. The aim of this study was to investigate the characteristics of GTD use in a large population: the French general health scheme beneficiaries (87% of the 66 million inhabitants) in 2016. Methods: The national health data system was used to identify individual characteristics, diseases and GTD classes reimbursed, together with the costs, using anatomical therapeutic chemical class. Results: Among the 57.5 million individuals included, 45% received at least one reimbursement among the 130 million prescriptions reimbursed (90% prescribed by a general practitioner): proton-pump inhibitors (PPI; A02BC: 24%), drugs for functional gastrointestinal disorders (A03: 20%), drugs for constipation (A06: 10%), antidiarrheals, intestinal anti-inflammatory/anti-infective agents (A07: 10%), antiemetics and antinauseants (A04: 7%), other drugs for acid-related disorders (A02X: 6%), other drugs for peptic ulcer and gastro-oesophageal reflux disease (A02BX: 4.5%), antacids (A02A: 1.5%). The overall cost of reimbursed GTDs was €707 million and the mean cost per user was €28. Marked variations were observed according to age, sex, and disease. The rates of at least one reimbursement among infants were A07: 28%, A03: 17%, A02BX: 9%, A02X: 7%, A02BC: 6% and A06: 5%. Women more frequently received a reimbursement than men for each GTD class. Reimbursement rates also varied according to health status (end-stage renal disease A02BC: 66%, pregnancy A03: 53%, A04: 11%), treatments (people with at least six reimbursements for nonsteroidal anti-inflammatory drugs in 2016 A02BC: 62%). Chronic GTD use (>10 reimbursements/year) was observed in 19% of people with at least one A02BC reimbursement, A02BX: 11%, A03: 7%, A04: 2%, A06: 17% and A07: 3%. Conclusions: This study demonstrates extensive and chronic use of GTD in France, raising the question of their relevance according to current guidelines. They must be disseminated to general practitioners, who are the main prescribers of these drugs.


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