scholarly journals Gastrointestinal Symptoms in Diabetes Occur Long Before Diabetic Complications

Author(s):  
Hwanseok Jung ◽  
Eun-Jung Rhee ◽  
Mi Yeon Lee ◽  
Jung Ho Park ◽  
Dong Il Park ◽  
...  

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

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Cristina Stasi ◽  
Cristiana Nisita ◽  
Sonia Cortopassi ◽  
Giorgio Corretti ◽  
Dario Gambaccini ◽  
...  

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.


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.


Author(s):  
Desiree F. Baaleman ◽  
Carlos A. Velasco-Benítez ◽  
Laura M. Méndez-Guzmán ◽  
Marc A. Benninga ◽  
Miguel Saps

AbstractTo evaluate the agreement between the Rome III and Rome IV criteria in diagnosing pediatric functional gastrointestinal disorders (FGIDs), we conducted a prospective cohort study in a public school in Cali, Colombia. Children and adolescents between 11 and 18 years of age were given the Spanish version of the Questionnaire on Pediatric Functional Gastrointestinal Disorders Rome III version on day 0 and Rome IV version on day 2 (48 h later). The study protocol was completed by 135 children. Thirty-nine (28.9%) children were excluded because of not following the instructions of the questionnaire. The final analysis included data of 96 children (mean 15.2 years old, SD ± 1.7, 54% girls). Less children fulfilled the criteria for an FGID according to Rome IV compared to Rome III (40.6% vs 29.2%, p=0.063) resulting in a minimal agreement between the two criteria in diagnosing an FGID (kappa 0.34, agreement of 70%). The prevalence of functional constipation according to Rome IV was significantly lower compared to Rome III (13.5% vs 31.3%, p<0.001), whereas functional dyspepsia had a higher prevalence according to Rome IV than Rome III (11.5% vs 0%).Conclusion: We found an overall minimal agreement in diagnosing FGIDs according to Rome III and Rome IV criteria. This may be partly explained by the differences in diagnostic criteria. However, limitations with the use of questionnaires to measure prevalence have to be taken into account. What is Known:• The Rome IV criteria replaced the previous Rome III criteria providing updated criteria to diagnose functional gastrointestinal disorders (FGIDs).• Differences found between Rome IV and historic Rome III FGID prevalence may have been affected by changes in prevalence over time or differences in sample characteristics. What is New:• We found a minimal agreement between Rome III and Rome IV FGID diagnosis, especially in the diagnoses of functional constipation, irritable bowel syndrome, and functional dyspepsia.• The minimal agreement may be partly explained by changes in diagnostic criteria, but limitations with the use of questionnaires to measure prevalence have to be taken into account.


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.


2021 ◽  
Vol 32 (120) ◽  
pp. 55-69
Author(s):  
Ruth Benasayag ◽  
Fermín Mearin ◽  
Mari Aguilera ◽  
Guillem Feixas

The importance of psychological factors in functional gastrointestinal disorders (FGID) is well-stablished in the literature; however, cognitive factors have hardly been researched and, in particular, cognitive conflicts have not been explored for these disorders. The aim of this study is to compare the cognitive and symptomatic characteristics of a group of 66 FGID patients (33 diagnosed with irritable bowel syndrome and 33 with functional dyspepsia) with a control group of participants without FGID or psychopathological symptoms. Both groups were matched by sex and age. The evaluation of the clinical sample was carried out following the criteria of the DSM-IV-TR. The SCL 90-R, and also the Repertory Grid for the identification of cognitive conflicts (implicative dilemmas) and self-ideal discrepancy, were administered to both the clinical sample and the control group. Results showed that 85% of FGID patients met the criteria for one axis I disorder of the DSM-IV-TR, mainly anxiety and somatization disorders. Regarding axis II, 23% presented at least one personality disorder, the most common ones being those of avoidance and dependence. Regarding axis IV, the patients reported a higher number of problems relative to the primary support group. FGID patients showed greater symptoms compared to the control group on various SCL 90-R scales. On the other hand, FGID patients presented more implicative dilemmas than healthy controls, as well as lower self-esteem. No significant differences were observed depending on the type of FGID (irritable bowel syndrome or functional dyspepsia).


2020 ◽  
Author(s):  
Monica Tosto ◽  
Paola D’Andrea ◽  
Ignazio Salamone ◽  
Salvatore Pellegrino ◽  
Stefano Costa ◽  
...  

Abstract Background Rome IV criteria for functional gastrointestinal disorders state that children suspected of having Irritable Bowel Syndrome (IBS) with Constipation (IBS-C) should be preliminarily treated for constipation. We aimed at verifying if functional constipation may indeed lead to an erroneous diagnosis of IBS with diarrhea (IBS-D) or IBS with mixed pattern of diarrhea and constipation (IBS-M).Methods We prospectively enrolled in an unblinded fashion 10 and 16 consecutive children referred to our center who met Rome IV criteria for a diagnosis of IBS-D and IBS-M, respectively. Patients who fulfilled criteria for suspect “occult constipation” were then given a bowel cleaning regimen with PEG 3350, re-evaluated at 2 months and followed up for at least 6 months. Sixteen additional patients with IBS with Constipation (IBS-C) referred in the same period served as control. The endpoints were: 1) a decrease of more than 50% in abdominal pain intensity and frequency scores; and 2) for patients with IBS-D and IBS-M: resolution of diarrhea.Results The endpoints were met by 8 (80%) and 14 (87%) of the patients with IBS-D and IBS-M, respectively, with decrease of abdominal pain and resolution of “diarrhea”. The response was not significantly different from that observed in 15 (93%) of the IBS-C control group.Conclusion acknowledging the limitations of the small number of patients and of the uncontrolled nature of the study, we suggest that a possibly large number of patients labeled as IBS-D or IBS-M may actually simply present functional constipation and should be managed as such.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1581-1581
Author(s):  
Nicole Roy ◽  
Phoebe Heenan ◽  
Catherine Wall ◽  
Wayne Young ◽  
Caterina Carco ◽  
...  

Abstract Objectives Dietary fibre supplementation is recognised as important for functional gastrointestinal disorders (FGID). The exact role of the microbiome in this relationship remains unclear. We explored differences in dietary fibre intake, GI symptoms and the fecal microbiome in those with FGID. Methods The COMFORT cohort is an observational case control study examining FGID, particularly irritable bowel syndrome (IBS) aetiology (Ethics 16/NTA/21). Participants prospectively completed a food and GI symptoms diary over 3 days. Severity of GI symptoms and mood disorders were assessed using clinical questionnaires; SAGIS and PROMIS for GI symptoms and HADS for anxiety and depression. Fecal samples were analysed by shotgun sequencing; 95 healthy controls (HC), 22 constipation IBS (IBS-C) and 50 diarrhea IBS (IBS-D). Taxonomic classifications were assigned by aligning sequences against the NCBI non-redundant database using DIAMOND. Results Diet diaries were completed by 292 participants (176 cases, 71.2% female). Average daily fibre intake was higher in HC compared to FGID (23.99g, 95% CI = –2.06-0.55; 20.28g, 95% CI = -1.96-0.45; P &lt; 0.05). Low fibre daily intake (&lt; 15g) was associated with higher depression scores (P &lt; 0.05) and increased anxiety in those with functional diarrhea (r2 = -0.554, P = 0.03). A negative association between fibre consumption and increased bloating in IBS (r2 = -0.19, P = 0.04) was also found. The GI microbiome in IBS was characterised by differences in Firmicutes belonging to the Lachnospiraceae family (e.g., Blautia and Ruminococcus, P &lt; 0.05). Other differentiating taxa included Bilophila (higher in IBS-D) and Methanobrevibacter (lower in IBS-D) (P &lt; 0.05). At the phylum level, bloating and constipation were correlated with Firmicutes relative abundance, and negatively correlated with Bacteroides (canonical r &gt; |0.5|). At the genus level, Blautia were correlated with diarrhea and faecal incontinence (canonical r &gt; 0.5). Conclusions Higher fibre consumption was associated with decreased bloating, anxiety and depression in different FGID subgroups. IBS was also associated with altered fecal microbiome composition including some taxa linked to carbohydrate and hydrogen metabolism. Funding Sources Funded by the Ministry of Business, Innovation and Employment through the High-Value Nutrition National Science Challenge.


2020 ◽  
Author(s):  
Marjan Mansourian ◽  
Hamid Reza Marateb ◽  
Ammar Hassanzadeh Keshteli ◽  
Hamed Daghagh Zadeh ◽  
Miquel Angel Mananas ◽  
...  

Background The validity of Rome III criteria for diagnosing functional gastrointestinal disorders (FGIDs) have been frequently questioned in the literature. In epidemiology, when a disease is diagnosed, the existence of a true cluster must be proven. Thus, clustering the common GI symptoms of individuals and comparing the clusters with FGIDs defined by the Rome III criteria could provide insights about the validity of FGIDs defined by those criteria. Well-separated compact clusters were detected in responses to questionnaires of the epidemiological features of different FGIDs in Iranian adults using fuzzy ordinal clustering. The representative sample from each cluster i.e. Cluster Representative (CR) was formed whose corresponding FGID was diagnosed with Rome III criteria. Then, FGID diagnosis was performed for all participants in each cluster and the percentage of cases whose FGID was the same as the cluster's identified FGID (agreement) was reported. Results Fourteen valid clusters were detected in 4763 people. The average membership of the objects in each cluster was 77.3%, indicating similarity of the objects in clusters to their corresponding CRs. Eight clusters were assigned to single FGIDs (irritable bowel syndromes: constipation IBS-C, diarrhea IBS-D and un-subtyped IBS-U; functional bloating FB; functional constipation FC; belching disorder BD. The agreement was higher than 50% in single FGID clusters except those whose diagnosis was IBS-U. Conclusions IBS-C, IBS-D, FC, BD, and FB defined with Rome III criteria exist in the population, which is not the case for IBS-U.


2019 ◽  
Vol 3 (20) ◽  
pp. 24-29
Author(s):  
Yu. P. Uspensky ◽  
A. A. Gnutov ◽  
Yu. A. Fominykh ◽  
O. S. Mirzoev

The article presents data on changes in the perception of functional gastrointestinal disorders introduced by the Rome IV criteria. Particular attention is paid to the functional dyspepsia, gallbladder and sphincter of Oddi disorders, the Rome IV criteria.


Sign in / Sign up

Export Citation Format

Share Document