Burden of drug use for gastrointestinal symptoms and functional gastrointestinal disorders in France: a national study using reimbursement data for 57 million inhabitants

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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Prevalence of functional gastrointestinal disorders in infants and young children in China

BMC Pediatrics ◽

10.1186/s12887-021-02610-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ying Huang ◽

Serene Yaling Tan ◽

Panam Parikh ◽

Vanitha Buthmanaban ◽

Shaman Rajindrajith ◽

...

Keyword(s):

Young Children ◽

Maternal Education ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Symptoms ◽

Functional Constipation ◽

Gastrointestinal Disorders ◽

Cross Sectional ◽

Validated Questionnaire ◽

Rome Iv ◽

Infants And Young Children

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.

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117 The Effects of Probiotics on Inflammation, Uremic Toxins and Gastrointestinal Symptoms in Patients with End-Stage Renal Disease: A Meta-Analysis

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2018.02.123 ◽

2018 ◽

Vol 71 (4) ◽

pp. 544

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Meta Analysis ◽

Gastrointestinal Symptoms ◽

Uremic Toxins ◽

Stage Renal Disease ◽

End Stage

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Relationship between Nutritional Status and Gastrointestinal Symptoms in Geriatric Patients with End-Stage Renal Disease on Dialysis

Nutrients ◽

10.3390/nu10040425 ◽

2018 ◽

Vol 10 (4) ◽

pp. 425 ◽

Cited By ~ 3

Author(s):

Dinorah Carrera-Jiménez ◽

Paola Miranda-Alatriste ◽

Ximena Atilano-Carsi ◽

Ricardo Correa-Rotter ◽

Ángeles Espinosa-Cuevas

Keyword(s):

Nutritional Status ◽

Renal Disease ◽

End Stage Renal Disease ◽

Geriatric Patients ◽

Gastrointestinal Symptoms ◽

Stage Renal Disease ◽

End Stage

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The Association Between Inflammatory Markers and Hypertension. A Call for Anti-Inflammatory Strategies?

The Scientific World JOURNAL ◽

10.1100/tsw.2006.190 ◽

2006 ◽

Vol 6 ◽

pp. 1262-1273

Author(s):

Néstor H. García ◽

Luis I. Juncos

Keyword(s):

Blood Pressure ◽

Endothelial Dysfunction ◽

Beta Blockers ◽

Organ Damage ◽

Left Ventricular ◽

Cardiovascular Damage ◽

Inflammatory State ◽

Anti Inflammatory ◽

Stage Renal Disease ◽

End Stage

The most important goal of antihypertensive therapy is to prevent the complications associated with hypertension (stroke, myocardial infarction, end-stage renal disease, etc). For this, secondary targets such as left ventricular hypertrophy, proteinuria, dementia, and other signs of hypertension-induced organ damage help the physician to assess risks and monitor treatment efficacy. New treatment targets may be arising, however. One such target may be endothelial dysfunction. In effect, endothelial dysfunction not only may precede the elevation of blood pressure, but may also pave the way to conditions often associated with hypertension, such as diabetes, arteriosclerosis, microalbuminuria, congestive heart failure, and tissue hypertrophy. Because inflammation often accompanies endothelial dysfunction, approaches to counteract inflammation are now being evaluated. For this, antagonists of the renin-angiotensin-aldosterone system, statins, and beta blockers are all being tested. All of these agents seem to prevent or delay the induction of proinflammatory molecules aside from, and in addition to, their specific effects on blood pressure. The focus of this review is to update some of the animal and human research showing that hypertension sets off an inflammatory state and also to consider some of the anti-inflammatory approaches that may prevent the development of endothelial dysfunction, and the subsequent renal and cardiovascular damage.

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Case-control study of regular analgesic and nonsteroidal anti-inflammatory use and end-stage renal disease

Kidney International ◽

10.1111/j.1523-1755.2005.00346.x ◽

2005 ◽

Vol 67 (6) ◽

pp. 2393-2398 ◽

Cited By ~ 29

Author(s):

Luisa Ibeiez ◽

Merius Morlans ◽

Xavier Vidal ◽

Marea Jose Martanez ◽

Joan-Ramon Laporte

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Case Control Study ◽

Case Control ◽

Anti Inflammatory ◽

Stage Renal Disease ◽

End Stage ◽

Control Study

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Validation of the Pediatric Rome II Criteria for Functional Gastrointestinal Disorders Using the Questionnaire on Pediatric Gastrointestinal Symptoms

Journal of Pediatric Gastroenterology and Nutrition ◽

10.1097/01.mpg.0000172749.71726.13 ◽

2005 ◽

Vol 41 (3) ◽

pp. 305-316 ◽

Cited By ~ 100

Author(s):

Arlene Caplan ◽

Lynn Walker ◽

Andr??e Rasquin

Keyword(s):

Functional Gastrointestinal Disorders ◽

Gastrointestinal Symptoms ◽

Gastrointestinal Disorders ◽

Rome Ii Criteria

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No Correlation between Positive Fructose Hydrogen Breath Test and Clinical Symptoms in Children with Functional Gastrointestinal Disorders: A Retrospective Single-Centre Study

Nutrients ◽

10.3390/nu13082891 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2891

Author(s):

Jarosław Kwiecień ◽

Weronika Hajzler ◽

Klaudia Kosek ◽

Sylwia Balcerowicz ◽

Dominika Grzanka ◽

...

Keyword(s):

Clinical Features ◽

Clinical Symptoms ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Symptoms ◽

Clinical Importance ◽

Recurrent Abdominal Pain ◽

Clinical Feature ◽

Gastrointestinal Disorders ◽

Hydrogen Breath Test ◽

Fructose Malabsorption

Fructose malabsorption is regarded as one of the most common types of sugar intolerance. However, the correlation between gastrointestinal symptoms and positive results in fructose hydrogen breath tests (HBTs) remains unclear. The aim of this study was to assess the clinical importance of positive fructose HBT by correlating the HBT results with clinical features in children with various gastrointestinal symptoms. Clinical features and fructose HBT results were obtained from 323 consecutive children (2–18 years old, mean 10.7 ± 4.3 years) that were referred to the Tertiary Paediatric Gastroenterology Centre and diagnosed as having functional gastrointestinal disorders. A total of 114 out of 323 children (35.3%) had positive HBT results, of which 61 patients were females (53.5%) and 53 were males (46.5%). Children with positive HBT were significantly younger than children with negative HBT (9.0 vs. 11.6 years old; p < 0.001). The most frequent symptom among children with fructose malabsorption was recurrent abdominal pain (89.5%). Other important symptoms were diarrhoea, nausea, vomiting, and flatulence. However, no correlation between positive fructose HBT results and any of the reported symptoms or general clinical features was found. In conclusion, positive fructose HBT in children with functional gastrointestinal disorders can be attributed to their younger age but not to some peculiar clinical feature of the disease.

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