scholarly journals Rebamipide increases the disaccharidases activity in patients with enteropathy with impaired membrane digestion. Pilot study

2019 ◽  
Vol 91 (2) ◽  
pp. 25-31 ◽  
Author(s):  
A I Parfenov ◽  
N I Belostotsky ◽  
S G Khomeriki ◽  
O V Akhmadullina ◽  
S V Bykova ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Functional Constipation ◽  
Duodenal Mucosa ◽  
Control Group ◽  
Activity Increase ◽  
Functional Diarrhea ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
Duodenal Biopsies ◽  
Rome Iv

Aim. To evaluate the effectiveness of enteroprotector Rebamipide in the treatment of enteropathy with impaired membrane digestion (EIMD). Materials and methods. We examined 102 patients aged 18 to 50 years (41 men and 61 women) with clinical signs of irritable bowel syndrome (n=65), functional diarrhea (n=33), and functional constipation (n=4) according to Rome IV criteria (2016). The activities of glucoamylase (GA), maltase, sucrase and lactase were determined by Dahlquist-Trinder method in duodenal biopsies obtained during esophagogastroduodenoscopy. The control group consisted of 20 healthy people aged 23-47. They showed following average enzyme activity: lactase - 42±13 ng glucose on 1 mg of tissue per minute, GA - 509±176, maltase - 1735±446, sucrase - 136±35 ng glucose on 1 mg of tissue per minute. These numbers were taken as the norm. Results and discussion. The activity of the disaccharidases was reduced in 89.2% out of 102 patients, and they were diagnosed with EIMD. Thirteen patients with EIMD were recommended to maintain the FODMAP diet and take enteroprotector Rebamipide 100 mg 3 times a day for 12 weeks. After 3 months 11 patients reported decreased or no flatulence, abdominal pain, stool disorder; 2 patients reported no change. The activity of GA increased to an average of 149±82 (by 78%, p=0.016), maltase - to 864±472 (by 131%, p=0.0019), sucrase - 63±35 (by 95%, p=0.0041) and lactase - 10±8 ng glucose on 1 mg of tissue per minute. The activity of lactase did not change. Conclusion. We discovered a previously unknown phenomenon of the disaccharidases activity increase in duodenal mucosa and improved carbohydrates tolerance in the patients with EIMD taking Rebamipide in the dose 300 mg/day for 12 weeks.

scholarly journals Functional constipation masked as irritable bowel syndrome

2020 ◽  
Author(s):  
Monica Tosto ◽  
Paola D’Andrea ◽  
Ignazio Salamone ◽  
Salvatore Pellegrino ◽  
Stefano Costa ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Functional Gastrointestinal Disorders ◽  
Functional Constipation ◽  
Control Group ◽  
Number Of Patients ◽  
Erroneous Diagnosis ◽  
Irritable Bowel ◽  
Mixed Pattern ◽  
Rome Iv

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 Polyethylene glycol 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.

scholarly journals Disaharidase deficiency – is one of the causes of functional disorders of intestine.

2018 ◽  
Vol 96 (4) ◽  
pp. 365-370
Author(s):  
Asfold I. Parfenov ◽  
O. V. Ahmadullina ◽  
N. I. Belostoskij ◽  
E. A. Sabelnikova ◽  
S. V. Bykova ◽  
...  
Keyword(s):  
Bowel Disease ◽  
Functional Constipation ◽  
Normal Activity ◽  
Functional Bowel Disease ◽  
Functional Diarrhea ◽  
Intestinal Infections ◽  
Bowel Diseases ◽  
Activity Of Enzymes ◽  
Irritable Bowel ◽  
Duodenal Biopsies

The aim of the study was to show the importance of intestinal carbohydrase (glucoamylase, maltase, sucrase and lactase) in the etiology and pathogenesis of functional bowel diseases. Material and methods. It was examined 74 patients with FBD in age from 18 to 50 years (36 men and 38 women.). According to Rome IV criteria (2016) 21 had irritable bowel syndrome (IBS) with predominance of diarrhea , 33 functional diarrhea, 6 - IBS with predominant constipation , 4 functional constipation and 10 IBS mixed type. Karbohidrase activity in mucosa of the small intestine was investigated by the method of Dahlquist modification Trinder in duodenal biopsies obtained during esophagogastroduodenoscopy. Results. Lactase deficiency identified in 87.8%, maltasa - 48.6 percent, saharasia - 51,3%, the lack of glucoamylase - in 85.1% of patients. The activity of all investigated enzymes was reduced in 23 (31.1%) patients with functional bowel disease. Normal activity of enzymes have 4 (5,4%) patients. Conclusion. In 70 of 74 patients with functional bowel disease violations of the chair, abdominal pain and flatulence due to the decrease in the activity of carbohydrase of mucosa. The reason of disaccharidase deficiency may be due to the acute intestinal infections, antibiotic and medicine (NSAIDs) treatment.

scholarly journals Functional gastrointestinal disorders in children: agreement between Rome III and Rome IV diagnoses

2021 ◽  
Author(s):  
Desiree F. Baaleman ◽  
Carlos A. Velasco-Benítez ◽  
Laura M. Méndez-Guzmán ◽  
Marc A. Benninga ◽  
Miguel Saps
Keyword(s):  
Diagnostic Criteria ◽  
Functional Dyspepsia ◽  
Functional Gastrointestinal Disorders ◽  
Functional Constipation ◽  
Final Analysis ◽  
Gastrointestinal Disorders ◽  
Rome Iii ◽  
Sample Characteristics ◽  
Irritable Bowel ◽  
Rome Iv

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.

scholarly journals Digestive symptoms in daily life of chronic adrenal insufficiency patients are similar to irritable bowel syndrome symptoms

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
L. Quénéhervé ◽  
D. Drui ◽  
J. Blin ◽  
M. Péré ◽  
E. Coron ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Adrenal Insufficiency ◽  
Gastrointestinal Symptoms ◽  
Control Group ◽  
Non Profit ◽  
Acute Adrenal Insufficiency ◽  
Irritable Bowel ◽  
Rome Iv

AbstractGastrointestinal symptoms are frequent in acute adrenal insufficiency. Although digestive symptoms can significantly reduce quality of life, they are rarely described in patients with treated chronic adrenal insufficiency (CAI). We aimed to characterize digestive symptoms in CAI patients. We used the section pertaining functional bowel disorders of the Rome IV questionnaire. A questionnaire was published on the website of the non-profit patient association “Adrenals” (NPPA of CAI patients) for five months. Information on demographics, characteristics of adrenal insufficiency, digestive symptoms and quality of life was collected. The relatives of CAI patients served as a control group. We analyzed responses of 33 control subjects and 119 patients (68 primary adrenal insufficiency (PAI), 30 secondary adrenal insufficiency (SAI) and 21 congenital adrenal hyperplasia (CAH)). Abdominal pain at least once a week over the past 3 months was reported by 40%, 47% and 33% of patients with PAI, SAI and CAH respectively versus 15% for the controls (p = 0.01). Symptoms were consistent with the Rome IV criteria for irritable bowel syndrome in 27%, 33% and 33% of patients respectively versus 6% for the controls (p < 0.0001). Quality of life was described as poor or very poor in 35%, 57% and 24% of patients respectively versus 5% for the controls (p < 0.0001). In conclusion, digestive symptoms are frequent and incapacitating in CAI patients and similar to symptoms of irritable bowel syndrome in 30% of CAI patients. Assessment and management of digestive symptoms should be considered a priority for physicians treating patients with CAI.

scholarly journals More fuel to the fire: some patients with non-celiac self-reported wheat sensitivity exhibit adaptive immunological responses in duodenal mucosa

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Antonia Isabel Castillo-Rodal ◽  
Janette Furuzawa-Carballeda ◽  
Mario Peláez-Luna ◽  
José Castro-Gómez ◽  
Yolanda López-Vidal ◽  
...  
Keyword(s):  
Duodenal Mucosa ◽  
Cross Sectional Study ◽  
Intraepithelial Lymphocytes ◽  
Control Group ◽  
Cross Sectional ◽  
Inflammatory Reactions ◽  
Immunological Responses ◽  
Clinical Scenarios ◽  
Wheat Sensitivity ◽  
Duodenal Biopsies

Abstract Background In contrast to the well-characterized Celiac Disease (CD), the clinical scenarios encompassed by the non-celiac self-reported wheat sensitivity (NCSRWS) might be related to different antigens that trigger distinct immune-inflammatory reactions. Although an increased number of intestinal intraepithelial lymphocytes is observed at the inception of both diseases, the subsequent immunopathogenic pathways seem to be different. We aimed to describe the cytokine profile observed in the duodenal mucosa of patients with NCSRWS. Methods In a blind, cross-sectional study, we included duodenal biopsies from 15 consecutive untreated patients with active CD, 9 individuals with NCSRWS and 10 subjects with dyspepsia without CD and food intolerances. Immunohistochemistry and flow-cytometry were used to determine the presence of pro-inflammatory cytokine expressing monocytes and monocyte-derived dendritic cells involved in innate immune activation, cytokine-driven polarization and maintenance of Th1 and Th17/Th 22, and anti-inflammatory/profibrogenic cytokines. Results The percentage of cells expressing all tested cytokines in the lamina propria and the epithelium was higher in CD patients than in the control group. Cytokines that induce and maintain Th1 and Th17 polarization were higher in CD than in NCSRWS and controls, also were higher in NCSRWS compared to controls. Similar differences were detected in the expression of IL-4 and TGF-1, while IL-10-expressing cells were lower in NCSRWS patients than in controls and CD subjects. Conclusions NCSRWS patients exhibit components of both, innate and adaptive immune mechanisms but to a lesser extent compared to CD.

scholarly journals Disaccharidase deficiency and functional bowel diseases

2017 ◽  
Vol 89 (4) ◽  
pp. 45-52 ◽  
Author(s):  
A I Parfenov ◽  
O V Akhmadullina ◽  
E A Sabelnikova ◽  
N I Belostotsky ◽  
M V Kirova ◽  
...  
Keyword(s):  
Functional Constipation ◽  
Biopsy Specimens ◽  
Functional Diarrhea ◽  
Intestinal Infections ◽  
Bowel Diseases ◽  
Precise Diagnosis ◽  
Intestine Mucosa ◽  
Inflammatory Drugs ◽  
Irritable Bowel

Aim. To elucidate the role of intestinal carbohydrases (glucoamylase, maltase, sucrose, and lactase) in the etiology and pathogenesis of functional bowel diseases (FBD). Subjects and methods. 74 patients (36 men and 38 women) aged 18 to 50 years with FBD were examined. According to Rome IV criteria (2016), there was diarrhea-predominant irritable bowel syndrome (IBS) in 21 patients, functional diarrhea (FD) in 33, constipation-predominant IBS in 6, functional constipation (FC) in 4, and mixed IBS in 10. The activity of carbohydrases in the small intestine mucosa (SIM) was investigated by the Dahlquist method modified by Trinder in the duodenal biopsy specimens obtained during esophagogastroduodenoscopy. Results. Lactase deficiency was identified in 87.8% of the patients; maltase deficiency in 48.6%; sucrose deficiency in 51.3%; and glucoamylase deficiency in 85.1%. The activity of all the investigated enzymes was reduced in 23 (31.1%) patients with FBD; deficiency of 1—3 carbohydrases was found in 47 (63.5%). Normal enzymatic activity was established in 4 (5.4%) patients. Conclusion. In the majority of patients with FBD, the intestinal symptoms are caused by the decreased activity of SIM carbohydrases. Therefore, disaccharidase deficiency associated with an established damaging agent (nonsteroidal anti-inflammatory drugs, antibiotics, acute intestinal infections, etc.) should be considered to be a more precise diagnosis.

scholarly journals More fuel to the fire: Some patients with non-celiac self-reported wheat sensitivity exhibit adaptive immunological responses in duodenal mucosa.

2020 ◽  
Author(s):  
Antonia Isabel Castillo-Rodal ◽  
Janette Furuzawa-Carballeda ◽  
Mario Pelaez-Luna ◽  
Jose Castro-Gomez ◽  
Yolanda Lopez-Vidal ◽  
...  
Keyword(s):  
Duodenal Mucosa ◽  
Cross Sectional Study ◽  
Intraepithelial Lymphocytes ◽  
Control Group ◽  
Cross Sectional ◽  
Inflammatory Reactions ◽  
Immunological Responses ◽  
Clinical Scenarios ◽  
Wheat Sensitivity ◽  
Duodenal Biopsies

Abstract Background: In contrast to the well-characterized Celiac Disease (CD), the clinical scenarios encompassed by the non-celiac self-reported wheat sensitivity (NCSRWS) might be related to different antigens that trigger distinct immune-inflammatory reactions. Although an increased number of intestinal intraepithelial lymphocytes (IEL) is observed at the inception of both diseases, the subsequent immunopathogenic pathways seem to be different. We aimed to describe the cytokine profile observed in the duodenal mucosa of patients with NCSRWS.Methods: In a blind, cross-sectional study, we included duodenal biopsies from 15 consecutive untreated patients with active CD, 9 individuals with NCSRWS and 10 subjects with dyspepsia without CD and food intolerances. Immunohistochemistry and flow-cytometry were used to determine the presence of pro-inflammatory cytokine expressing monocytes and monocyte-derived dendritic cells involved in innate immune activation, cytokine-driven polarization and maintenance of Th1 and Th17/Th 22, and anti-inflammatory/profibrogenic cytokines.Results: The percentage of cells expressing all tested cytokines in the lamina propria and the epithelium was higher in CD patients than in the control group. Cytokines that induce and maintain Th1 and Th17 polarization were higher in CD than in NCSRWS and controls, also were higher in NCSRWS compared to controls. Similar differences were detected in the expression of IL-4 and TGF-1, while IL-10-expressing cells were lower in NCSRWS patients than in controls and CD subjects.Conclusions: NCSRWS patients exhibit components of both, innate and adaptive immune mechanisms but to a lesser extent compared to CD.

scholarly journals Possibilities of sodium picosulfate application in constipation pharmacotherapy in functional intestinal disorders

2019 ◽  
pp. 92-97
Author(s):  
V. N. Drozdov ◽  
K. I. Karnouh ◽  
S. Y. Serebrova ◽  
I. A. Komissarenko ◽  
A. K. Starodubtsev
Keyword(s):  
Clinical Trials ◽  
Functional Constipation ◽  
Efficacy And Safety ◽  
Functional Disorders ◽  
Controlled Clinical Trials ◽  
Global Problems ◽  
Mucous Membranes ◽  
Sodium Picosulfate ◽  
Irritable Bowel ◽  
Rome Iv

Constipation, which is currently one of the global problems of mankind, requires modern approaches to its pharmacological correction. Constipation that occurs in the absence of organic digestive pathology is in most cases considered a symptom of functional constipation or irritable bowel syndrome, the diagnosis of which is based on the compliance of the patient’s complaints and anamnestic data with the Rome IV criteria for the diagnosis of these functional disorders. Regulax Picosulphate, an intravenous droplet, is a modern laxative drug with a possibility of precise and easy dosing that does not have a local irritant effect on the gastric and duodenal mucous membranes; the efficacy and safety of this drug has been proven in controlled clinical trials.

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