scholarly journals EOSINOPHILIC ESOPHAGITIS AND EOSINOPHILIC GASTROENTERITIS- NOT SO RARE?

2020 ◽  
pp. 1-2
Author(s):  
Suryawanshi Neha R ◽  
Redewad Nagnath K* ◽  
Pawar Sunil V ◽  
Mahajani Sheetal ◽  
Thorat Vinay K ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Eosinophilic Esophagitis ◽  
Food Allergen ◽  
Gastrointestinal Symptoms ◽  
Eosinophilic Gastroenteritis ◽  
Endoscopic Biopsy ◽  
Hypersensitivity Response ◽  
Early Satiety ◽  
Intestinal Symptoms ◽  
High Index Of Suspicion

Eosinophilic gastro-intestinal disorder is an uncommon disorder presenting with non-specic gastrointestinal symptoms. It is diagnosed by demonstrating eosinophilic inltration of gut wall after excluding other causes of eosinophilia. It is likely a hypersensitivity response to food allergen. The most common symptoms of patients are abdominal pain, nausea, vomiting, early satiety, and diarrhoea. It responds well to corticosteroids. We hereby present two cases – eosinophilic esophagitis and eosinophilic duodenitis- seen in a span of one month, presenting with vague gastro-intestinal symptoms for over a year. Their endoscopic biopsy showed eosinophilic inltration of mucosa. The aim of presenting the cases is to increase awareness of this disorder as high index of suspicion is necessary to diagnose these patients.

scholarly journals A123 GASTROINTESTINAL SYMPTOMS AND DISORDERS OF GUT BRAIN INTERACTION ARE COMMON IN PATIENTS WITH EHLERS-DANLOS SYNDROME (EDS) IN TERTIARY REFERRAL CENTER

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 143-144
Author(s):  
E Abu-Farhaneh ◽  
Y Tse ◽  
C H Parker ◽  
L W Liu
Keyword(s):  
Abdominal Pain ◽  
Fecal Incontinence ◽  
Gastrointestinal Symptoms ◽  
Retrospective Chart Review ◽  
Final Analysis ◽  
Ehlers Danlos Syndrome ◽  
Early Satiety ◽  
Tertiary Referral Center ◽  
Gi Symptoms ◽  
Danlos Syndrome

Abstract Background Ehlers Danlos Syndrome (EDS) is a group of rare connective tissue disorders. Gastrointestinal (GI) symptoms such as abdominal pain, nausea, vomiting, bloating and altered bowel habits are common in patients with EDS. Specifically, disorders of gut brain interaction (DGBI) appear to be more common in this patient population. The University Health Network (UHN) has the first and only multi-disciplinary clinic, including specialized gastroenterology services, in Canada for the management of EDS. Aims The aim of this study is to describe the GI symptoms and DGBI that are present in our cohort of EDS patients. Methods A retrospective chart review of all EDS who were seen in the gastroenterologist clinic of the GoodHope EDS clinic at UHN were reviewed from November 1, 2017 to September 26, 2019. Demographic information including age, sex and EDS subtype were collected. GI symptoms that were collected include constipation, diarrhea, fecal incontinence, nausea, vomiting, bloating, abdominal pain, early satiety, heart burn, dysphagia and regurgitation. A physician made diagnosis of irritable bowel syndrome (IBS) was recorded. Descriptive statistics were performed. Results The charts of 79 EDS patients were reviewed; 4 were excluded due to missing data. 75 patients were included in the final analysis. 93.3% of patients were female with a mean age of 36.4 +/- 12.5 years. Of these 75 patients, 43 (57.3%) had EDS-hypermobile subtype, 13 (17.3%) EDS-classic, 3 (4%) EDS-vascular, 3 (4%) unknown EDS subtype and 13 (17.3%) were categorized as having a hypermobile spectrum disorder. The most common GI symptoms observed in this patient group included abdominal pain in 85.5%, bloating in 64.4%, heartburn in 61.8%, constipation in 57.9%, nausea in 50%, diarrhea 43.4%, dysphagia in 43.4%, regurgitation in 34.2%, early satiety in 32.89%, vomiting in 30.2%,and fecal incontinence in 13.1%. It was also observed that 50.7% (n=38) had a physician made diagnosis of IBS. Of these patients with IBS, 16 (42.1%) had IBS constipation, 12 (31.5%) had IBS mixed, and 10 (26.3%) had IBS diarrhea. Conclusions Our study demonstrated that GI symptoms are common in patients with EDS. In our cohort, abdominal pain is the most commonly reported GI symptom, though other various GI symptoms are also reported in high numbers. DGBI are also common, with IBS being much more common than what has been reported in the general population. Further studies are needed to better understand the pathophysiology and impact of these GI symptoms and DGBI in patients with EDS. Funding Agencies UNH Foundation Goodhope Fund

scholarly journals Lactobacillus Reuteri DSM 17938 (Limosilactobacillus reuteri) in Diarrhea and Constipation: Two Sides of the Same Coin?

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 643
Author(s):  
Angela Saviano ◽  
Mattia Brigida ◽  
Alessio Migneco ◽  
Gayani Gunawardena ◽  
Christian Zanza ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Human Health ◽  
Bowel Disease ◽  
Chronic Constipation ◽  
Lactobacillus Reuteri ◽  
Current Knowledge ◽  
Gastrointestinal Symptoms ◽  
Inflammatory Bowel

Background and Objectives: Lactobacillus reuteri DSM 17938 (L. reuteri) is a probiotic that can colonize different human body sites, including primarily the gastrointestinal tract, but also the urinary tract, the skin, and breast milk. Literature data showed that the administration of L. reuteri can be beneficial to human health. The aim of this review was to summarize current knowledge on the role of L. reuteri in the management of gastrointestinal symptoms, abdominal pain, diarrhea and constipation, both in adults and children, which are frequent reasons for admission to the emergency department (ED), in order to promote the best selection of probiotic type in the treatment of these uncomfortable and common symptoms. Materials and Methods: We searched articles on PubMed® from January 2011 to January 2021. Results: Numerous clinical studies suggested that L. reuteri may be helpful in modulating gut microbiota, eliminating infections, and attenuating the gastrointestinal symptoms of enteric colitis, antibiotic-associated diarrhea (also related to the treatment of Helicobacter pylori (HP) infection), irritable bowel syndrome, inflammatory bowel disease, and chronic constipation. In both children and in adults, L. reuteri shortens the duration of acute infectious diarrhea and improves abdominal pain in patients with colitis or inflammatory bowel disease. It can ameliorate dyspepsia and symptoms of gastritis in patients with HP infection. Moreover, it improves gut motility and chronic constipation. Conclusion: Currently, probiotics are widely used to prevent and treat numerous gastrointestinal disorders. In our opinion, L. reuteri meets all the requirements to be considered a safe, well-tolerated, and efficacious probiotic that is able to contribute to the beneficial effects on gut-human health, preventing and treating many gastrointestinal symptoms, and speeding up the recovery and discharge of patients accessing the emergency department.

Coeliac disease presenting atypically: A much wider spectrum

2021 ◽  
pp. 004947552199134
Author(s):  
Avinash Lomash ◽  
Abhinaya Venkatakrishnan ◽  
Meenakshi Bothra ◽  
Bhavna Dhingra ◽  
Praveen Kumar ◽  
...  
Keyword(s):  
Coeliac Disease ◽  
Gestational Age ◽  
Dermatitis Herpetiformis ◽  
Mode Of Delivery ◽  
Gastrointestinal Symptoms ◽  
Stunted Growth ◽  
Significant Difference ◽  
High Index Of Suspicion ◽  
Gestational Age At Birth ◽  
Age At Birth

Atypical coeliac disease in young children is frequently missed when it presents atypically as non-gastrointestinal presentations to different specialties. There was a greater delay (54 months) in establishing the diagnosis in those with atypical coeliac disease (p < 0.001). No difference was observed in the mode of delivery or duration of breast feeding, but significant difference was observed between gestational age at birth (p < 0.001). Most cases showed stunted growth and underweight. Irritability, anaemia, rickets, dermatitis herpetiformis, alopecia and intussusception were other common predictors of atypical coeliac disease. Because of a myriad spectrum of non-gastrointestinal symptoms, at any age with diverse presentation, a high index of suspicion is therefore required.

scholarly journals COVID-19 and gastrointestinal symptoms in Mexico, a systematic review: does location matter?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Antonio Pizuorno ◽  
Nora A. Fierro ◽  
Edgar D. Copado-Villagrana ◽  
María E. Herrera-Solís ◽  
Gholamreza Oskrochi ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Mortality Rate ◽  
Clinical Symptoms ◽  
Descriptive Analysis ◽  
Gastrointestinal Symptoms ◽  
Northwest Mexico ◽  
Obesity And Diabetes ◽  
West Mexico ◽  
Southeast Mexico

Abstract Background Covid-19 in Mexico is on the rise in different parts of the country. We aimed to study the symptoms and comorbidities that associate with this pandemic in 3 different regions of Mexico. Methods We analyzed data from SARS-CoV-2 positive patients evaluated at healthcare centers and hospitals of Mexico (n = 1607) including Northwest Mexico (Sinaloa state), Southeast Mexico (Veracruz state) and West Mexico (Jalisco state) between March 1 and July 30, 2020. Mexico consists of a total population that exceeds 128 million. Demographics, comorbidities and clinical symptoms were collected. Statistical descriptive analysis and correlation analyses of symptoms, comorbidities and mortality were performed. Results A total of 1607 hospitalized patients positive for COVID-19 across all 3 regions of Mexico were included. The average age was 54.6 years and 60.4% were male. A mortality rate of 33.1% was observed. The most common comorbidities were hypertension (43.2%), obesity (30.3%) and diabetes (31.4%). Hypertension was more frequent in West (45%), followed by Northwest (37%) and Southeast Mexico (29%). Obesity was around 30% in Northwest and West whereas an 18% was reported in Southeast. Diabetes was most common in West (34%) followed by Northwest (22%) and Southeast (13%). This might be related to the highest mortality rate in Northwest (31%) and West (37%) when compared to Southeast. Most common symptoms in our overall cohort were fever (80.8%), cough (79.8%), headache (66%), dyspnea (71.1%), myalgia (53.8%), joints pain (50.8%) and odynophagia (34.8%). Diarrhea was the main gastrointestinal (GI) symptom (21.3%), followed by abdominal pain (18%), and nausea/ vomiting (4.5%). Diarrhea and abdominal pain were more common in West (23.1 and 21%), followed by Southeast (17.8, and 9.8%) and Northwest (11.4 and 3.1%). Conclusion Our study showed a high mortality rate likely related to high frequencies of comorbidities (hypertension, obesity and diabetes). Mortality was different across regions. These discrepancies might be related to the differences in the frequencies of comorbidities, and partially attributed to differences in socio-economic conditions and quality of care. Thus, our findings stress the need for improved strategies to get better outcomes in our population.

scholarly journals Seronegative Arthritis as a Complication of Whipple’s Disease

2021 ◽  
Vol 14 ◽  
pp. 117954762110177
Author(s):  
Rebecca DeBoer ◽  
Sahani Jayatilaka ◽  
Anthony Donato
Keyword(s):  
Rheumatoid Arthritis ◽  
Weight Loss ◽  
Abdominal Pain ◽  
Gastrointestinal Symptoms ◽  
Whipple’S Disease ◽  
Seronegative Arthritis ◽  
Whipple's Disease ◽  
Caucasian Male

Whipple’s disease (WD) is an uncommon cause of seronegative arthritis. WD is known for its gastrointestinal symptoms of diarrhea, weight loss, and abdominal pain. However, arthritis may precede gastrointestinal symptoms by 6 to 7 years. We describe a case of an 85-year-old Caucasian male with multiple joint complaints, not responsive to traditional treatments for conditions such as rheumatoid arthritis and osteoarthritis. We suggest that WD be considered for seronegative arthritis especially affecting large joints.

619 HIGH DISCOVERY RATE OF GASTRODUODENAL EOSINOPHILIA BUT NOT EOSINOPHILIC ESOPHAGITIS IN PATIENTS WITH CHRONIC GASTROINTESTINAL SYMPTOMS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Nicholas Talley ◽  
Amol Kamboj ◽  
William Chey ◽  
Henrik Rasmussen ◽  
Brian Lacy ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Gastrointestinal Symptoms ◽  
High Rate ◽  
Systematic Evaluation ◽  
Tissue Eosinophilia ◽  
Severity Scores ◽  
Gi Symptoms ◽  
Multi Center Study ◽  
Loss Of Appetite ◽  
Duodenal Biopsies

Abstract   Although the prevalence of eosinophilic gastrointestinal disorders (EGIDs) is increasing, there is evidence that eosinophilic gastritis and/or duodenitis (EG/EoD) are underdiagnosed. Patients with EG/EoD often present with chronic, non-specific gastrointestinal (GI) symptoms, similar to patients with functional GI disorders. We hypothesized that systematic evaluation, including multiple esophageal, gastric and duodenal biopsies, of patients with chronic GI symptoms might reveal a high rate of gastroduodenal eosinophila, with or without eosinophilic esophagitis (EoE). Methods We performed a prospective multi-center study of patients with non-specific GI symptoms for ≥6 months, from 20 sites. Patients completed a questionnaire assessing abdominal pain, abdominal cramping, early satiety, bloating, nausea, vomiting, diarrhea, and loss of appetite. Those with daily average symptom severity scores ≥3/10 for any single symptom underwent esophagogastroduodenoscopy (EGD) with collection of 4 esophageal (EoE), 8 gastric, and 4 duodenal biopsies, analyzed by central pathologists. Histologic criteria for EoE was ≥15eos/hpf in ≥1 esophageal site and for EG/EoD was peak eosinophil counts ≥30/hpf in ≥5 gastric hpfs and/or 3 duodenal hpfs—criteria used in randomized trials. Results Of 556 patients screened, 405 (73%) met symptom criteria and underwent EGD; 181 patients (45%, mean age 45, 73% female) who underwent EGD met the histologic criteria for EG/EoD, and of these, 7% also had EoE diagnosed. Overall 2% met histologic criteria for EoE alone. Of patients who met the histologic criteria for EG/EoD, 93% were previously diagnosed with gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), or functional dyspepsia (FD) (Figure 1). The average duration of GI symptoms in the screened population as well as those that met histologic criteria for EG/EoD was 11 years. Conclusion Forty-five percent of patients with moderate-to-severe GI symptoms who underwent EGD met histologic criteria for EG/EoD. Over 90% of these patients had previously been diagnosed with GERD, IBS, and/or FD, and had minimal overlap with EoE. EGD with systematic gastroduodenal biopsies, and intentional evaluation for tissue eosinophilia, should be performed in patients with chronic GI symptoms. Accurate diagnosis of EG/EoD is required for appropriate, targeted treatment and improved outcomes of patients with moderate-to-severe GI symptoms.

620 GASTRODUODENAL EOSINOPHILIA IS UNDER-APPRECIATED IN EOSINOPHILIC ESOPHAGITIS (EOE) PATIENTS WITH FUNCTIONAL BOWEL SYMPTOMS: A REAL LIFE EXPERIENCE

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Kathryn Peterson ◽  
Robert Genta ◽  
Henrik Rasmussen ◽  
Bradford Youngblood ◽  
Amol Kamboj
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Eosinophilic Esophagitis ◽  
Life Experience ◽  
Real Life ◽  
Gastrointestinal Disorder ◽  
Control Group ◽  
Abdominal Symptoms ◽  
Gi Symptoms ◽  
Initial Work

Abstract   Eosinophilic esophagitis (EoE) is currently thought to be the most common Eosinophilic Gastrointestinal Disorder. EoE patients often present with non-esophageal GI symptoms. Presence of EoE increases one’s risk of developing distal eosinophilia, including eosinophilic gastritis (EG) and duodenitis (EoD). A diagnosis of EG/EoD often takes years due to lack of provider awareness and absence of consensus diagnostic guidelines. The aim was to evaluate the prevalence of EG/EoD in patients with EoE and functional abdominal symptoms. Methods 52 EoE patients with extra-esophageal GI symptoms (i.e. abdominal pain, nausea, bloating, irritable bowel) who had stomach and small bowel biopsies interpreted as non-specific inflammation or normal were identified (‘EoE + S’). 15 EoE patients without extra-esophageal complaints who had routine screening stomach and small bowel biopsies at their initial endoscopies were included as a control group (‘EoE-S’). Biopsies taken at initial work up were identified and blocks were cut for H&E staining and assessment by an independent, blinded GI pathologist skilled in eosinophil (eos) assessment. Results 45 EoE + S and 12 EoE-S patients were evaluated (Table 1). Common symptoms were abdominal pain, bloating and nausea. All prior pathology reports were consistent with non-specific inflammation or normal tissue. Upon blinded re-assessment, 8/45 (17.8%) EoE + S patients met criteria for EG (≥30 eos/hpf in ≥5 gastric hpfs). None of the EoE-S patients met criteria for EG. 24/45 (53%) EoE + S patients met criteria for EoD (≥30 eos/hpf in ≥3 duodenal hpfs). 7 patients had concomitant EG + EoD. 3/12 EoE-S patients met criteria for EoD. Peak gastric and duodenal eos counts for the EoE + S group were higher than for the EoE-S group. Conclusion In patients with EoE and extra-esophageal GI complaints, review of gastric and duodenal biopsies previously reported as normal or ‘non-specific inflammation’ demonstrated a high discovery rate of gastroduodenal eosinophilia. These findings suggest that intentional evaluation of gastric and duodenal eos is indicated in patients with EoE and persistent non-esophageal GI symptoms. Increased awareness of EG/EoD and consensus diagnostic criteria may lead to the identification of currently undiagnosed patients with EG/EoD.

scholarly journals Longer colonic transit time is associated with laxative and drug use, lifestyle factors, and symptoms of constipation

2018 ◽  
Vol 7 (10) ◽  
pp. 205846011880723 ◽  
Author(s):  
Johan Bohlin ◽  
Erik Dahlin ◽  
Julia Dreja ◽  
Bodil Roth ◽  
Olle Ekberg ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Drug Use ◽  
Transit Time ◽  
Gastrointestinal Symptoms ◽  
Coffee Consumption ◽  
Lifestyle Factors ◽  
Colonic Transit ◽  
Stool Frequency ◽  
Colonic Transit Time ◽  
Female Sex

Background Gastrointestinal symptoms and changes in colonic transit time (CTT) are common in the population. Purpose To evaluate consecutive patients who had been examined for CTT, along with completion of a diary about laxative and drug use, lifestyle factors, and gastrointestinal symptoms, to identify possible associations with longer or prolonged CTT. Material and Methods A total of 610 consecutive patients had undergone the radiopaque marker method with an abdominal X-ray for clinical purposes. The patients had completed a diary regarding medical treatment, lifestyle factors, stool habits, and their perceived constipation and abdominal pain during the examination period. The associations between CTT and laxative use, lifestyle factors, stool habits, and symptoms were calculated by logistic regression. Results Women had longer CTT (2.5 [1.6–3.9] vs. 1.7 [1.1–3.0] days, P < 0.001), lower weekly stool frequency (6 [3–10] vs. 8 [5–12], P = 0.001), and perceived more constipation ( P = 0.025) and abdominal pain ( P = 0.001) than men. High coffee consumption ( P = 0.045), bulk-forming ( P = 0.007) and osmotic ( P = 0.001) laxatives, and lower stool frequency, shaped stool, and perceived constipation ( P for trend < 0.001) were associated with longer CTT. In total, 382 patients (63%) were treated with drugs affecting motility. In the 228 patients without drug treatment, longer CTT was associated with female sex and smoking, and lower frequency of symptoms and prolonged CTT were observed compared to patients using drugs. Tea, alcohol, and abdominal pain did not associate with CTT. Conclusions Female sex, coffee, smoking, drug use, infrequent stools, shaped stool, and perception of constipation are associated with longer or prolonged CTT.

scholarly journals Eosinophilic Esophagitis in Brazilian Pediatric Patients

2013 ◽  
Vol 7 ◽  
pp. CMPed.S12733 ◽  
Author(s):  
Mayra Isabel Correia Pinheiro ◽  
Luciano Pamplona De Góes Cavalcanti ◽  
Rodrigo Schuler Honório ◽  
Luïs Hélder De Alencar Moreno ◽  
Mayara Carvalho Fortes ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Topical Corticosteroid ◽  
Eosinophilic Esophagitis ◽  
Pediatric Patients ◽  
Erosive Esophagitis ◽  
Normal Mucosa ◽  
Patient Treatment ◽  
Therapeutic Approaches ◽  
Endoscopic Findings ◽  
The Mean

We examined 11 pediatric patients with eosinophilic esophagitis with a tardy diagnosis. The symptoms were initially thought to be related to other diseases, leading to the use of inadequate therapeutic approaches. The patients were between 3 and 17 years old (mean 7.8 ± 3.8 years), and 8 of the patients were male. Common symptoms included abdominal pain, regurgitation, difficulty in gaining weight, vomiting, dysphagia, and coughing. The mean age for the onset of symptoms was 4.3 ± 2.9 years. Endoscopic findings included normal mucosa in five (45%) patients, thickening of the mucosa with longitudinal grooves in three (27%), erosive esophagitis in two (18%), and a whitish stippling in one (9%) patient. Treatment included the use of a topical corticosteroid for 10 patients. In eight (73%) cases, the treatment made the symptoms disappear. Ten patients underwent histopathological management after treatment, with a decrease in the number of eosinophils.

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