scholarly journals Use of the Biphasic13C-Sucrose/Glucose Breath Test to Assess Sucrose Maldigestion in Adults with Functional Bowel Disorders

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Antone R. Opekun ◽  
Albert M. Balesh ◽  
Harold T. Shelby

Sucrase insufficiency has been observed in children with of functional bowel disorders (FBD) and symptoms of dietary carbohydrate intolerance may be indistinguishable from those of FBD. A two-phase13C-sucrose/13C-glucose breath test (13C-S/GBT) was used to assess sucrase activity because disaccharidase assays are seldom performed in adults. When13C-sucrose is hydrolyzed to liberate monosaccharides, oxidation to13CO2is a proportional indicator of sucrase activity. Subsequently,13C-glucose oxidation rate was determined after a secondary substrate ingestion (superdose) to adjust for individual habitus effects (Phase II).13CO2enrichment recovery ratio from13C-sucrose and secondary13C-glucose loads reflect the individualized sucrase activity [Coefficient of Glucose Oxidation for Sucrose(CGO-S)]. To determine if sucrase insufficiency could be a factor in FBD,13C-S/GBT was validated using subjects with known sucrase gene mutation status by comparing13CO2-breath enrichment with plasma13C-glucose enrichment.13C-S/GBT was used to assess sucrose digestion in FBD patients and asymptomatic controls.13CO2-breath enrichment correlated with the appearance of13C-sucrose-derived glucose in plasma (r2=0.80). Mean, control group CGO-S-enrichment outcomes were 1.01 at 60′, 0.92 at 75′, and 0.96 at mean 60′–75′ with normal CGO-S defined as >0.85 (95% C.I.). In contrast, FBD patients demonstrated lower CGO-S values of 0.77 at 60′, 0.77 at 75′, and 0.76 at mean 60′–75′ (Chi Square: 6.55;p<0.01), which points to sucrose maldigestion as a cause of FBD.

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1149-1149
Author(s):  
Abrar Turki ◽  
Sylvia Stockler ◽  
Sandra Sirrs ◽  
Ramona Salvarinova ◽  
Rajavel Elango

Abstract Objectives The objectives of the current study were: 1) to establish the use of ,13C-Glucose Breath Test (,13C-GBT) and its oxidation to ,13CO2 as a minimally invasive technique to examine in vivo glucose oxidation in healthy adults, and 2) to measure the utilization of uncooked cornstarch (UCCS) and Glycosade® in patients with glycogen storage disease type Ia (GSD-Ia) and healthy controls using ,13C-GBT, based on the natural enrichment of ,13C in UCCS and Glycosade®. Methods Experiment 1- Ten healthy adults (22 – 33y) underwent ,13C-GBT protocols twice as a proof-of-principle, once without oral isotope dose (only D-glucose 75 g/d) and once with isotope (D-glucose 75 g/d + U-,13C-glucose 75 mg/d). Breath samples were collected at baseline and every 20 min for 240 min to measure ,13CO2. Experiment 2- Two patients (12 and 28y) with GSD-Ia and five healthy controls (10 – 32y) underwent ,13C-GBT protocols twice. Subjects received UCCS or Glycosade® orally (based on their current prescribed dose 42 – 100 g) after a 4 hour fast according to GSD-Ia fasting tolerance. Breath samples were collected at baseline and every 30 min for 240 min. ,13CO2 oxidation of glucose from UCCS and Glycosade® were measured using an isotope ratio mass spectrometer and compared using a paired t-test. Blood glucose was measured using a glucometer hourly to test hypoglycemia (≤3.4 mmol/L). Results Results 1- The mean rate of ,13CO2 in all healthy adults from D-glucose without U-,13C-glucose 0.435 ± 0.162 was significantly lower than the mean rate of ,13CO2 in the same group with U-,13C-glucose 3.518 ± 0.988. The peak occurred at 200 minutes in all healthy adults without and with U-,13C-glucose. Results 2- Glucose oxidation from Glycosade® was lower than glucose oxidation from UCCS in the 12y GSD-Ia. Glucose oxidation from UCCS and Glycosade® remained the same in the 28y GSD-Ia. However, oxidation of glucose by the 28y GSD-Ia for both starches displayed a higher rate, compared to age matched controls. Conclusions Our results show that the minimally invasive,13C-GBT test over 4 hours can be useful to examine glucose metabolism from various exogenous carbohydrate sources in GSD. Future studies are needed to use ,13C-GBT in response to different doses to determine optimal glucose management in GSD patients. Funding Sources Saudi Arabian Cultural Bureau, Ottawa and BC Children's Hospital Research Institute.


Author(s):  
Anil Sarica ◽  
Serhat Bor ◽  
Mehmet Orman ◽  
Hector Barajas-Martinez ◽  
Jimmy Juang ◽  
...  

Introduction: Irritable bowel syndrome (IBS) is one of the most widely recognized functional bowel disorders (FBDs) with a genetic component. SCN5A gene and SCN1B loci have been identified in population-based IBS cohorts and proposed to have a mechanistic role in the pathophysiology of IBS. These same genes have been associated with Brugada syndrome (BrS). The present study examines the hypothesis that these two inherited syndromes are linked. Methods and Results: Prevalence of FBDs over a 12 months period were compared between probands with BrS/drug-induced type 1 Brugada pattern (DI-Type1 BrP) (n=148) and a control group (n=124) matched for age, female sex, presence of arrhythmia and co-morbid conditions. SCN5A/SCN1B genes were screened in 88 patients. Prevalence of IBS was 25% in patients with BrS/DI-Type1 BrP and 8.1% in the control group (p=2.34×10−4). On stepwise logistic regression analysis, presence of current and/or history of migraine (OR of 2.75; 95% CI: 1.08 to 6.98; p=0.033) was a predictor of underlying BrS/DI-Type1 BrP among patients with FBDs. We identified 8 putative SCN5A/SCN1B variants in 7 (12.3%) patients with BrS/DI-Type1 BrP and 1 (3.2%) patient in control group. Five out of 8 (62.5%) patients with SCN5A/SCN1B variants had FBDs. Conclusion: IBS is a common co-morbidity in patients with BrS/DI-Type1 BrP. Presence of current and/or history of migraine is a predictor of underlying BrS/DI-Type1 BrP among patients with FBDs. Frequent co-existence of IBS and BrS/DI-Type1 BrP necessitates cautious use of certain drugs among the therapeutic options for IBS that are known to exacerbate the Brugada phenotype.


2021 ◽  
Author(s):  
Nagisa Sugaya ◽  
Yoshitoshi Tomita ◽  
Misako Funaba ◽  
Hiroshi Iida ◽  
Kentaro Shirotsuki ◽  
...  

Abstract BackgroundThe Cognitive Scale for Functional Bowel Disorders (CS-FBD) is a useful measure to assess maladaptive cognition, and focuses on how functional bowel disorders relate to negative thoughts, perfectionism, and social desirability. This study aimed to confirm the reliability and validity of the Japanese version of the CS-FBD (CS-FBD-J). MethodsParticipants comprised 192 students (20.2±3.0 years) and 22 outpatients diagnosed with irritable bowel syndrome (IBS) (38.0±13.0 years). There were 76 students who met the diagnostic criteria for IBS, and two students who received treatment for IBS. Participants completed questionnaires containing the CS-FBD-J, IBS Severity Index (IBS-SI), Visceral Sensitivity Index (VSI), 24-item Dysfunctional Attitudes Scale (DAS-24), and Hospital Anxiety and Depression Scale (HADS).ResultsOur factor analysis revealed that the CS-FBD-J had a unidimensional factor structure, and that the factor loadings for 2 out of the 25 items were less than 0.4. After excluding the two items from the analysis, a single factor of the 23-item version accounted for 45.85% of the total variance. The CS-FBD-J scores had significant moderate correlations with the IBS-SI (r = 0.492~0.574) and VSI (r = 0.531~ 0.557) scores in the IBS group and the control group. Correlation between the DAS-24 and the CS-FBD-J was not significant (r = 0.179 ~ 0.191). Although the CS-FBD-J in the IBS group was significantly correlated with HADS-anxiety (r = 0.450) and depression scores (r = 0.357), their intercorrelations in the control group were not significant (r = 0.150 ~ 0.167). In the score comparison of the CS-FBD-J between the IBS patient group, non-patient IBS group (students with IBS except two who received treatment), and control group, there were significant group effects in the CS-FBD-J (IBS patient > non-patient IBS > control). The internal consistencies of the CS-FBD-J were high (α = 0.95). The item-total correlation analysis for the CS-FBD-J showed that the correlations between each item and the total score were significant.ConclusionThis study confirmed the reliability and validity of the 23-item version of the CS-FBS with the deletion of two items with low factor loadings.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Tarek M Youssef ◽  
Wael A Yousry ◽  
Mohamed M Salama ◽  
Ahmed E Ahmed ◽  
Islam A Awaad

Abstract Background Differentiating between functional bowel disorders and organic colonic disorders can often be difficult as they may be present with similar symptoms. Aim of the Work to evaluate the diagnostic value of plasma M2-pyruvate kinase level in differentiating functional colonic disorders (e.g: IBS) from organic colonic disorders (e.g: IBD, colorectal polyps and colorectal cancer) and to assess its use as screening tools for inflammatory bowel disease, premalignant and malignant colorectal lesions. Patients and Methods This study was conducted on 80 patients who divided into four groups: Group I included 20 patients, representing functional bowel disorders (as a control group). Group II included 20 patients with inflammatory bowel diseases; Group III included 20 patients with colorectal polyps; Group IV included 20 patients with colorectal cancer. Results The current study showed that plasma M2 - PK can be used to differentiate functional from organic colonic lesions at a cut-off point &gt; 3 U/mL, with 93.33% sensitivity, 100% specificity, 100% PPV and 83.3% NPV. Also, plasma M2-PK can be used to discriminate between benign (colorectal polyp) and malignant colonic lesions (CRC) with a cut-off level of &gt; 12 U/ml, with 100% sensitivity, 100% specificity, 100% PPV and 100% NPV. Also, In the present study there was a highly significant + ve correlations between Plasma M2 PK level and CEA as (r = 0.787, p value = 0.000) and their combination can give higher sensitivity and specificity. Conclusion Plasma M2-PK can differentiate between functional and organic colonic disorders as it is more elevated in organic than functional colonic disorders. Also, it is considered a promising rapid noninvasive biomarker for organic colonic disorders early detection and screening to reduce unnecessary endoscopic intervention.


1970 ◽  
Vol 2 (3) ◽  
Author(s):  
Ermiati E ◽  
Imas Rafiyah ◽  
Devi Kusnanti

Anemia merupakan salah satu penyebab terjadinya perdarahan dan bisa mengakibatkan kematian pada ibu hamil. Suplementasi besi merupakan program pemerintah dalam mengatasi anemia pada wanita hamil dan beberapa wanita hamil masih ada yang belum patuh dalam mengkonsumsi tablet besi. Oleh karena itu, diperlukan sebuah metode yang bisa meningkatkan kepatuhan wanita hamil dalam mengonsumsi tablet besi yaitu dengan short message service (SMS) reminder. Penelitian ini bertujuan untuk mengidentifikasi efektivitas SMS reminderterhadap kepatuhan konsumsi tablet besi pada ibu hamil di (unit pelayanan terpadu) UPT Puskesmas Cibuntu Kota Bandung. Rancangan penelitian quasi experimentaldengan desain posttest-only with control group designdengan teknik pengambilan sampel yang digunakan adalah purposive sampling. Penelitian ini dilaksanakan dari bulan April–Mei tahun 2014 di Puskesmas X Kota Bandung. Sampel berjumlah 40 orang wanita hamil yang tidak patuh dalam mengonsumsi tablet besi yang dibagi menjadi 20 kelompok intervensi dan 20 kelompok kontrol. Data diperoleh melalui kuesioner dalam bentuk self report.Analisis data yang digunakan adalah analisis deskriptif dan uji chi square. Hasil penelitian menunjukkan sebagian besar kelompok intervensi 17 orang (85%) patuh dan sebagian besar kelompok kontrol 16 orang (80%) tidak patuh. Hasil analisis dengan menggunakan chi squaredidapatkan p(0.000) dengan taraf signifikan <0.05 sehingga dapat disimpulkan bahwa SMS reminder efektif terhadap kepatuhan konsumsi tablet besi pada wanita hamil dan bisa dijadikan bahan pertimbangan bagi pihak Puskesmas untuk menjalin kerjasama dengan pihak provideratau mengajukan dana ke Dinas Kesehatan untuk mengaktifkan SMS reminderdi Puskesmas.Kata kunci: Kepatuhan, SMS reminder,tablet besi, wanita hamil AbstractAnemia is one of the leading causes of hemorrhage during pregnancy, and it can cause death to expectant mothers. Iron supplementation is a government program to overcome anemia among expectant mothers, and some of the expectant mothers still do not obediently consume iron tablets. Therefore, to increase the obedience of the expectant mothers on consuming the iron tablets, SMS reminder is the appropriate method needed. This research aims to identify the effectiveness of SMS reminder to the obedience of iron tablets consumption among expectant mothers at UPT Puskesmas Cibuntu , Bandung. The research employed quasi-experimental design with posttest-only control group design using purposive sampling technique. The research was held on April–May 2014 at UPT Puskesmas Cibuntu, Bandung. Forty expectant mothers consuming iron tablets disobediently divided into 20 intervention groups and 20 control groups were taken as the samples. Questionnaire in form of self report was used to obtain data. In addition, descriptive analysis and chi square test were applied to analyze the data. The result of the research showed that 17 persons (85%) of intervention groups were mostly obedient, and 16 persons (80%) of control groups were mostly disobedient. From the analysis using chi square, it was found the difference of the obedience of iron tablets consumption after SMS reminder (p=0.00) had been delivered with significant level <0.05. Based on the result of this research, SMS reminder had an effective impact toward the obedience of iron tablets consumption among the expectant mothers. The result will be a good consideration for Puskesmas to cooperate with provider or proposed some funds to Dinas Kesehatan to activate SMS reminder.Key words:Expectant mothers, obedience, SMS reminder, iron tablets


2018 ◽  
Vol 3 (1) ◽  
pp. 1
Author(s):  
Sri Evi New Yearsi Pangadongan ◽  
Agustina Rahyu ◽  
Selvy Pasulu

Bronchial Asthma generally starts from childhood which is condition where respiration channel experiences constriction because of hyperactivity with some specific stimulation which cause inflammation. Some risk factors are smoking exposure of cigarette smoke, weather changes, mite on house dirt, pet and history of family sickness. The purpose of this research is to know Relation of mite on house dirt, exposure of cigarette smoke  and history of family sickness with bronchial asthma incident to child 5 – 10  years old on working area of Puskesmas Lempake Samarinda City in 2016. Method which used was analytic survey with Case Control approaching. The total sample was 36 children which consisted of 18 case group and 18 control group with matching by using age and gender which submitted with Purposive Sampling technique. Data Analysis used Chi Square with wrong degree α = 0,005. The result showed that there was relation of mite of house dirt (p = 0,006), history of family sickness (p = 0,001) and no relation with exposure of cigarette smoke (p = 0,370) with bronchial asthma incident to child 5 – 10 years old on working area of Puskesmas Lempake Samarinda City in 2016.


2017 ◽  
Vol 19 (2) ◽  
pp. 95
Author(s):  
Hetriana Leksananingsih ◽  
Slamet Iskandar ◽  
Tri Siswati

Background: Riskesdas in 2013 showed that Yogyakarta (DIY) had a prevalence of stunted new kid in school is less than the national average, which is 14.9% (MOH, 2013). Stunted or short, is a linear growth retardation has been widely used as an indicator to measure the nutritional status of individuals and community groups. Stunted can be influenced by several factors: birth weight, birth length match and genetic factors. Objective: To determine the weight, length of low birth weight and genetic factors as predictors of the occurrence of stunted on elementary school children. Methods: The study was a case control analytic. Research sites in SD Muhammadiyah Ngijon 1 Subdistrict Moyudan. The study was conducted in May and June 2015. The subjects were school children grade 1 to grade 5 the number of cases as many as 47 children and 94 control children. With the inclusion criteria of research subjects willing to become respondents, was present at the time of the study, they have a father and mother, and exclusion criteria have no data BB and PB birth, can not stand upright. The research variables are BBL, PBL, genetic factors and TB / U at this time. Data were analyzed by chi-square test and Odd Ratio (OR) calculation. Results: In case group as much as 91.5% of normal birth weight and length of 80.9% of normal birth weight, most of the height of a normal mother and father as many as 85.1%. In the control group as much as 78.7% of normal birth weight and 61.7% were born normal body length, height mostly normal mom and dad that 96.7% of women and 90.4% normal normal father. Statistical test result is no significant correlation between height mothers with stunted incidence in school children, and the results of chi-square test P = 0.026 with value Odd Ratio (OR) of 3.9 and a range of values from 1.091 to 14.214 Cl95%. Conclusion: High maternal body of mothers can be used as predictors of the occurrence of stunted school children and mothers with stunted nutritional status have 3.9 times the risk of having children with stunted nutritional status.


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