scholarly journals Daily Life Restrictions are Common and Associated with Health Concerns and Dietary Challenges in Adult Celiac Disease Patients Diagnosed in Childhood

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1718 ◽  
Author(s):  
Heini Leinonen ◽  
Laura Kivelä ◽  
Marja-Leena Lähdeaho ◽  
Heini Huhtala ◽  
Katri Kaukinen ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Rating Scale ◽  
Daily Life ◽  
Young Patients ◽  
Dietary Treatment ◽  
Well Being ◽  
Diagnostic Features ◽  
Health Concerns ◽  
Gastrointestinal Symptom Rating Scale ◽  
Adult Celiac Disease

The prevalence and associated factors of daily life restrictions due to a gluten-free diet in adult celiac disease patients diagnosed in childhood are poorly known. We investigated these issues by collecting the medical data of 955 pediatric patients and sending questionnaires evaluating various health outcomes to the 559 patients who had reached adulthood. Of the 231 respondents, 46% reported everyday life restrictions caused by dietary treatment. Compared with those without restrictions, they more often had anemia at diagnosis (37% vs. 22%, p = 0.014), but the groups were comparable in other diagnostic features. In adulthood, patients with restrictions reported more overall symptoms (32% vs. 17%, p = 0.006), although the symptoms measured with the Gastrointestinal Symptom Rating Scale questionnaire were comparable. Despite strict dietary adherence in both groups, the experience of restrictions was associated with dietary challenges (34% vs. 9%, p < 0.001), health concerns (22% vs. 13%, p = 0.050), and lower vitality scores in the Psychological General Well-Being questionnaire. The groups did not differ in their current age, socioeconomic status, family history of celiac disease, general health or health-related lifestyle, the presence of co-morbidities, or regular follow up. Our results encourage healthcare professionals to discuss the possible health concerns and dietary challenges with patients to avoid unnecessary daily life restrictions, especially when young patients start to take responsibility for their treatment.

scholarly journals Beneficial Effects of a Low-Nickel Diet on Relapsing IBS-Like and Extraintestinal Symptoms of Celiac Patients during a Proper Gluten-Free Diet: Nickel Allergic Contact Mucositis in Suspected Non-Responsive Celiac Disease

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2277 ◽  
Author(s):  
Raffaele Borghini ◽  
Natascia De Amicis ◽  
Antonino Bella ◽  
Nicoletta Greco ◽  
Giuseppe Donato ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Rating Scale ◽  
Gastrointestinal Symptoms ◽  
Gluten Free Diet ◽  
Rank Test ◽  
Gluten Free ◽  
Gastrointestinal Symptom Rating Scale ◽  
Histological Remission ◽  
Allergic Contact ◽  
Age Range

Background and Aim: Nickel (Ni)-rich foods can induce allergic contact mucositis (ACM) with irritable bowel syndrome (IBS)-like symptoms in predisposed subjects. Ni ACM has a high prevalence (>30%) in the general population and can be diagnosed by a Ni oral mucosa patch test (omPT). Many celiac disease (CD) patients on a gluten-free diet (GFD) often show a recrudescence of gastrointestinal and extraintestinal symptoms, although serological and histological remission has been achieved. Since a GFD often results in higher loads of ingested alimentary Ni (e.g., corn), we hypothesized that it would lead to a consequent intestinal sensitization to Ni in predisposed subjects. We wanted to (1) study Ni ACM prevalence in still symptomatic CD patients on a GFD and (2) study the effects of a low-Ni diet (LNiD) on their recurrent symptoms. Material and Methods: We recruited 102 consecutive CD patients (74 female, 28 male; age range 18–65 years, mean age 42.3 ± 7.4) on a GFD since at least 12 months, in current serological and histological remission (Marsh–Oberhuber type 0–I) who complained of relapsing gastrointestinal and/or extraintestinal symptoms. Inclusion criteria: presence of at least three gastrointestinal symptoms with a score ≥5 on the modified Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. Exclusion criteria: IgE-mediated food allergy; history of past or current cancer; inflammatory bowel diseases; infectious diseases including Helicobacter pylori; lactose intolerance. All patients enrolled underwent Ni omPT and followed a LNiD for 3 months. A 24 symptoms questionnaire (GSRS modified according to the Salerno Experts’ Criteria, with 15 gastrointestinal and 9 extraintestinal symptoms) was administered at T0 (free diet), T1 (GFD, CD remission), T2 (recurrence of symptoms despite GFD), and T3 (GFD + LNiD) for comparisons. Comparisons were performed using Wilcoxon signed-rank test. RESULTS: Twenty patients (all female, age range 23–65 years, mean age 39.1 ± 2.9) out of 102 (19.6%) were finally included. All 20 patients enrolled (100%) showed positive Ni omPT, confirming an Ni ACM diagnosis. A correct GFD (T0 vs. T1) induced the improvement of 19 out of the total 24 (79.2%) symptoms, and 14 out of 24 (58.3%) were statistically significant (p-value < 0.0083 according to Bonferroni correction). Prolonged GFD (T1 vs. T2) revealed the worsening of 20 out of the total 24 (83.3%) symptoms, and 10 out of 24 (41.7%) were statistically significant. LNiD (T2 vs. T3) determined an improvement of 20 out of the total 24 (83.4%) symptoms, and in 10 out of 24 (41.7%) symptoms the improvement was statistically significant. Conclusions: Our data suggest that the recrudescence of gastrointestinal and extraintestinal symptoms observed in CD subjects during GFD may be due to the increase in alimentary Ni intake, once gluten contamination and persisting villous atrophy are excluded. Ni overload can induce Ni ACM, which can be diagnosed by a specific Ni omPT. Improvement of symptoms occurs after a proper LNiD. These encouraging data should be confirmed with larger studies.

Hemorrhagic Events in Adult Celiac Disease Patients. Case Report and Review of the Literature

2018 ◽  
Vol 27 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Alina Dima ◽  
Ciprian Jurcut ◽  
Anca Manolache ◽  
Daniel Vasile Balaban ◽  
Alina Popp ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Case Report ◽  
Wide Spectrum ◽  
Case Reports ◽  
Blood Coagulation Disorders ◽  
Review Of The Literature ◽  
Diagnostic Features ◽  
Mesh Terms ◽  
Adult Celiac Disease ◽  
Hemorrhagic Events

Background & Aims: Celiac disease (CD) presents with a wide spectrum of extra-digestive symptoms, including hemorrhagic manifestations. The aim of this review was to conduct an extensive analysis of the hemorrhagic events reported in adult CD patients.Methods: Case report and review of the literature. Pubmed (MEDLINE) database search from January 1970 onwards was performed using the medical subject headings [MeSH] terms “celiac disease” AND “blood coagulation disorders”, “hemorrhage”, “hematoma”, “hematuria”, “hemoptysis”, “epistaxis”, “hemosiderosis”.Only case reports were identified on the search theme. Information on patients’ characteristics, diagnostic features, coagulation parameters, symptomatology duration, and evolution under treatment were systematically collected and summarized.Results: We present the case of a 40-year-old man hospitalized for spontaneous muscular hematomas, in whom CD was diagnosed. We performed a review of the literature and summarized the published case reports of 46 CD patients, aged between 19 and 74 years, 64% of male gender. In 25% of cases, the symptomatology was present for more than 5 years prior to CD diagnosis. The clinical hemorrhagic events were as follows: 15 patients had gastrointestinal bleeding, 9 hemoptysis, 4 epistaxis, 6 hematuria, 8 cutaneous hematoma, petechia or ecchymoses, and only in 1 case hemarthrosis, hemorrhagic vesicular dermatitis, subcortical hemorrhage, or adrenal hemorrhage. Sixty percent of the patients had digestive symptoms, while the rest had only extradigestive CD involvement. The Lane Hamilton syndrome was defined in 15 patients. The evolution under a gluten-free diet was favorable in most cases.Conclusion: This review of case reports aims to increase awareness to hemorrhagic events, rare but possible life-threatening conditions, as part of the CD clinical spectrum. To the best of our knowledge, this is the first review of all types of hemorrhagic events in adult CD patients.

Efficacy of mebeverin in treatment of abdominal pain

2020 ◽  
Vol 1 (30) ◽  
pp. 24-28
Author(s):  
N. V. Baryshnikova
Keyword(s):  
Quality Of Life ◽  
Abdominal Pain ◽  
Rating Scale ◽  
Lifestyle Modification ◽  
Well Being ◽  
Life Assessment ◽  
Hypocaloric Diet ◽  
Complete Disappearance ◽  
Gastrointestinal Symptom Rating Scale

An original study evaluating the effectiveness and safety of mebeverin in treatment of abdominal pain in patients with irritable bowel syndrome (IBS) are presented. Materials and methods: 40 patients diagnosed with IBS, according to the Rome Criteria IV, were monitored. Patients depending on the type of therapy were divided into two groups: 20 patients of the first group had recommendations for lifestyle modification, a hypocaloric diet and took mebeverin per os at a dose of 135 mg three times a day 20 minutes before meals for a month; 20 patients of the second group received only recommendations for lifestyle modification and a hypocaloric diet. All patients were evaluated before and after treatment using the Gastrointestinal Symptom Rating Scale (GSRS), Visual-Analog Pain Intensity Rating Scale (0–10 points), SF‑36 Quality of Life Assessment Question, adverse events assessment. Colonoscopy was performed before treatment to exclude organic pathology of the colon. Results. After treatment patients in the first group had a faster and more significant relief of complaints compared to the second group, a significant improvement in the quality of life on the scales of physical and mental functioning, as well as almost complete disappearance of pain on a visual-analog scale (7.1 out of 10 points before treatment and 0.4 points after). Conclusions. Mebeverin in a dosage of 135 mg three times a day during a month contributes to a significant improvement in well-being, optimizes the quality of life of this category of patients, is effective and safe, which allows us to recommend its use as a first-line spasmolytic drug in the complex therapy of IBS, as well as in various variants of visceral abdominal pain.

scholarly journals A Dose-Escalation Study Demonstrates the Safety and Tolerability of Cellobiose in Healthy Subjects

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 64
Author(s):  
Margret Irmgard Moré ◽  
Elisa Postrach ◽  
Gordana Bothe ◽  
Sonja Heinritz ◽  
Ralf Uebelhack
Keyword(s):  
Dose Escalation ◽  
Healthy Subjects ◽  
Large Scale ◽  
Rating Scale ◽  
Enzymatic Reaction ◽  
Well Being ◽  
Maximum Tolerated Dose ◽  
Scale Production ◽  
Dose Escalation Study ◽  
Gastrointestinal Symptom Rating Scale

The disaccharide and innovative ingredient cellobiose, consisting of two β-glucose molecules linked by a β(1→4) bond is the main component of cellulose. Cellobiose can be used within a wide variety of foodstuffs and functional foods as a low-caloric bulking agent or as a substitute for lactose. For purposes of industrial large-scale production, cellobiose is produced by an enzymatic reaction in which sucrose and glucose are converted to cellobiose and fructose. The goal of this single-arm, dose-escalation study was to evaluate the safety and tolerability of cellobiose and to determine the maximum tolerated dose of cellobiose in healthy subjects. Following a baseline period, consecutive cohorts of six subjects each consumed either single doses of 10, 15, 20 and 25 g, while 12 subjects each received multiple doses of 15 g or 20 g cellobiose (twice daily, 14 days). The main recorded parameters were stool consistency, gastrointestinal well-being (Gastrointestinal Symptom Rating Scale) and adverse events. In each highest single/multiple dosage group, some sensitive subjects experienced flatulence, borborygmus and/or transient diarrhoea. A 100% global tolerability rating makes 20 g cellobiose a tolerable dose for single use. For repeated consumption, we propose up to 15 g cellobiose twice daily (92.6% global tolerability rating). Cellobiose is a promising new ingredient with excellent tolerability.

Assessment of health related issues in individuals’, couples’, and families’ daily life

2008 ◽  
Vol 16 (3) ◽  
pp. 146-149 ◽  
Author(s):  
Meinrad Perrez ◽  
Michael Reicherts ◽  
Yves Hänggi ◽  
Andrea B. Horn ◽  
Gisela Michel ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
Daily Life ◽  
Ecological Validity ◽  
Reliability And Validity ◽  
Well Being ◽  
Computer Assisted ◽  
Emotional States ◽  
Self Reports ◽  
Health Related ◽  
Lower Variability

Abstract. Most research in health psychology is based on retrospective self reports, which are distorted by recall biases and have low ecological validity. To overcome such limitations we developed computer assisted diary approaches to assess health related behaviours in individuals’, couples’ and families’ daily life. The event- and time-sampling-based instruments serve to assess appraisals of the current situation, feelings of physical discomfort, current emotional states, conflict and emotion regulation in daily life. They have proved sufficient reliability and validity in the context of individual, couple and family research with respect to issues like emotion regulation and health. As examples: Regarding symptom reporting curvilinear pattern of frequencies over the day could be identified by parents and adolescents; or psychological well-being is associated with lower variability in basic affect dimensions. In addition, we report on preventive studies to improve parental skills and enhance their empathic competences towards their baby, and towards their partner.

scholarly journals Somatization in patients with predominant diarrhoea irritable bowel syndrome: the role of the intestinal barrier function and integrity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Laura Prospero ◽  
Giuseppe Riezzo ◽  
Michele Linsalata ◽  
Antonella Orlando ◽  
Benedetta D’Attoma ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Barrier Function ◽  
Rating Scale ◽  
Psychological Symptoms ◽  
Intestinal Barrier ◽  
Intestinal Barrier Function ◽  
Fatty Acid Binding ◽  
Gastrointestinal Symptom Rating Scale ◽  
Gi Symptoms ◽  
Irritable Bowel

Abstract Background Irritable bowel syndrome (IBS) is characterised by gastrointestinal (GI) and psychological symptoms (e.g., depression, anxiety, and somatization). Depression and anxiety, but not somatization, have already been associated with altered intestinal barrier function, increased LPS, and dysbiosis. The study aimed to investigate the possible link between somatization and intestinal barrier in IBS with diarrhoea (IBS-D) patients. Methods Forty-seven IBS-D patients were classified as having low somatization (LS = 19) or high somatization (HS = 28) according to the Symptom Checklist-90-Revised (SCL-90-R), (cut-off score = 63). The IBS Severity Scoring System (IBS-SSS) and the Gastrointestinal Symptom Rating Scale (GSRS) questionnaires were administered to evaluate GI symptoms. The intestinal barrier function was studied by the lactulose/mannitol absorption test, faecal and serum zonulin, serum intestinal fatty-acid binding protein, and diamine oxidase. Inflammation was assessed by assaying serum Interleukins (IL-6, IL-8, IL-10), and tumour necrosis factor-α. Dysbiosis was assessed by the urinary concentrations of indole and skatole and serum lipopolysaccharide (LPS). All data were analysed using a non-parametric test. Results The GI symptoms profiles were significantly more severe, both as a single symptom and as clusters of IBS-SSS and GSRS, in HS than LS patients. This finding was associated with impaired small intestinal permeability and increased faecal zonulin levels. Besides, HS patients showed significantly higher IL-8 and lowered IL-10 concentrations than LS patients. Lastly, circulating LPS levels and the urinary concentrations of indole were higher in HS than LS ones, suggesting a more pronounced imbalance of the small intestine in the former patients. Conclusions IBS is a multifactorial disorder needing complete clinical, psychological, and biochemical evaluations. Trial registration: https://clinicaltrials.gov/ct2/show/NCT03423069.

Frequency, severity, and impact on daily life of delayed and intercycle chemotherapy-induced nausea, vomiting, and retching

2021 ◽  
pp. 030089162199043
Author(s):  
Silvia Gonella ◽  
Dino S. Di Massimo ◽  
Marinella Mistrangelo ◽  
Gianmauro Numico ◽  
Paola Berchialla ◽  
...  
Keyword(s):  
Rating Scale ◽  
Daily Life ◽  
Numeric Rating Scale ◽  
Cross Sectional Study ◽  
Common Side Effect ◽  
Cross Sectional ◽  
Chemotherapy Administration ◽  
Effect Of Treatment ◽  
Numeric Rating ◽  
Observation Period

Introduction: Chemotherapy-induced nausea, vomiting, and retching (CINVR) remains a common side effect of treatment. Most previous studies have focused on vomiting control; nausea and retching have been less explored. This study aimed at describing the incidence, severity, and impact on daily life (IDL) of CINVR in the acute (0–24 hours), delayed (>24–120 hours), and overall (0–120 hours) postchemotherapy periods and beyond 120 hours (until next chemotherapy administration); and the pharmacologic and nonpharmacologic strategies adopted by patients to relieve symptoms. Methods: This was a single-center, cross-sectional study of 60 patients undergoing chemotherapy. Participants reported the frequency, severity, and IDL of CINVR from the day of chemotherapy administration up to 120 hours thereafter and nausea and vomiting that occurred beyond 120 hours, as well as pharmacologic and nonpharmacologic remedies used. Results: Forty-seven (78.3%, 95% confidence interval [CI] 66.4–86.9), 37 (61.7%, 95% CI 49.0–72.9), and 35 (58.3%, 95% CI 45.7–69.9) patients reported no nausea (Numeric Rating Scale ⩽1), vomiting, or retching in the acute, delayed, and overall periods, respectively. Nausea was more frequent, more severe, and had a greater IDL than did vomiting and retching across the overall observation period; beyond 120 hours, 11 (18.3%, 95% CI 10.6–29.9) patients reported nausea and none reported vomiting, with a median IDL of 1/10 (interquartile range: 0.75–5.00; 95% CI 0–7.6). Metoclopramide (n = 57 administrations), dexamethasone (n = 28), eating small servings of food (n = 13), and aloe (n = 11) were the most commonly used rescue therapies. Conclusions: Future studies should set hard outcomes, such as the absence of any symptoms, as a primary end point, and these should be assessed across and beyond the 120-hour period.

scholarly journals Validation of questionnaire-reported chest wall abnormalities with a telephone interview in Swiss childhood cancer survivors

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rahel Kasteler ◽  
Christa Lichtensteiger ◽  
Christina Schindera ◽  
Marc Ansari ◽  
Claudia E. Kuehni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Chest Wall ◽  
Daily Life ◽  
Well Being ◽  
Childhood Cancer Survivors ◽  
Thoracic Wall ◽  
Medical Attention ◽  
The Impact

Abstract Background Chest wall abnormalities are a poorly studied complication after treatment for childhood cancer. Chest wall abnormalities are not well-described in the literature, and little is known on the impact on daily life of survivors. Methods We investigated prevalence and risk factors of chest wall abnormalities in childhood cancer survivors in a nationwide, population-based cohort study (Swiss Childhood Cancer Survivor Study) with a questionnaire survey. We then interviewed a nested sample of survivors to validate types of chest wall abnormalities and understand their impact on the daily life of survivors. Results Forty-eight of 2382 (95%CI 2–3%) survivors reported a chest wall abnormality. Risk factors were older age at cancer diagnosis (16–20 years; OR 2.5, 95%CI 1.0–6.1), lymphoma (OR 3.8, 95%CI 1.2–11.4), and central nervous system tumors (OR 9.5, 95%CI 3.0–30.1) as underlying disease, and treatment with thoracic radiotherapy (OR 2.0, 95%CI 1.0–4.2), surgery to the chest (OR 4.5, 95%CI 1.8–11.5), or chemotherapy (OR 2.9, 95%CI 1.0–8.1). The nature of the chest wall abnormalities varied and included thoracic wall deformities (30%), deformations of the spine (5%) or both (55%), and scars (10%). Chest wall abnormalities affected daily life in two thirds (13/20) of those who reported these problems and necessitated medical attention for 15 (75%) survivors. Conclusion It is important that, during follow-up care, physicians pay attention to chest wall abnormalities, which are rare late effects of cancer treatment, but can considerably affect the well-being of cancer survivors.

scholarly journals Intracortical and Intercortical Motor Disinhibition to Transcranial Magnetic Stimulation in Newly Diagnosed Celiac Disease Patients

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1530
Author(s):  
Francesco Fisicaro ◽  
Giuseppe Lanza ◽  
Carmela Cinzia D’Agate ◽  
Raffaele Ferri ◽  
Mariagiovanna Cantone ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
De Novo ◽  
Motor Evoked Potentials ◽  
Silent Period ◽  
Cross Sectional ◽  
Transcallosal Inhibition ◽  
Resting Motor Threshold

Background: Celiac disease (CD) may present or be complicated by neurological and neuropsychiatric manifestations. Transcranial magnetic stimulation (TMS) probes brain excitability non-invasively, also preclinically. We previously demonstrated an intracortical motor disinhibition and hyperfacilitation in de novo CD patients, which revert back after a long-term gluten-free diet (GFD). In this cross-sectional study, we explored the interhemispheric excitability by transcallosal inhibition, which has never been investigated in CD. Methods: A total of 15 right-handed de novo, neurologically asymptomatic, CD patients and 15 age-matched healthy controls were screened for cognitive and depressive symptoms to the Montreal Cognitive Assessment (MoCA) and the 17-item Hamilton Depression Rating Scale (HDRS), respectively. TMS consisted of resting motor threshold, amplitude, latency, and duration of the motor evoked potentials, duration and latency of the contralateral silent period (cSP). Transcallosal inhibition was evaluated as duration and latency of the ipsilateral silent period (iSP). Results: MoCA and HDRS scored significantly worse in patients. The iSP and cSP were significantly shorter in duration in patients, with a positive correlation between the MoCA and iSP. Conclusions: An intracortical and interhemispheric motor disinhibition was observed in CD, suggesting the involvement of GABA-mediated cortical and callosal circuitries. Further studies correlating clinical, TMS, and neuroimaging data are needed.

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