Diagnostic algorithm of centrally mediated abdominal pain syndrome — does it need changes? According to the materials of Rome IV Criteria

The article discusses the algorithm for diagnosing of centrally mediated abdominal pain syndrome (CAPS), formerly called functional abdominal pain syndrome, contained in the Rome Criteria of the IV revision (2016). Recommendations for the diagnosis of CAPS, mainly based on the compliance of the signs available in patients with the developed diagnostic criteria with a minimum of additional laboratory tests, are criticized, since such an approach is fraught with possible errors. The author considers the diagnosis of CAPS as a “diagnosis of exclusion”, which can be made only after a thorough examination of patients using laboratory and instrumental research methods (including ultrasound and endoscopic), confi rming the absence of organic diseases in patients.

Non-pharmacological therapy for infantile colic

Infant colic is an inconsolable cry of unknown cause in healthy babies. Observed in about 20% of infants, the most common reason for seeking medical attention at an early age. Colic is associated with maternal stress and the most significant risk factor for shaken baby syndrome, and can also cause premature breastfeeding termination. Informing and supporting parents with crying babies is increasingly important, and some guidelines recommend it as a cornerstone of intervention in families with a baby with colic. Because of the high quality randomized trials, none of the behavioral, dietary, pharmacological, or alternative interventions can be recommended as the only effective treatment. Unfortunately, many mothers around the world associate their child’s anxiety with “dietary mistakes” in their diets, leading to further dietary restrictions as a preventative measure. At the same time, according to the recommendations of the experts of the IV Rome Criteria, dietary restrictions for infant colic in breastfeeding mothers can be recommended only if there is a suspicion of suspicion of tolerance of cow’s milk protein. It is also possible for any type of feeding to prescribe fennel and chamomile preparations, in particular, in the form of aqueous infusions, and when breastfeeding it is desirable to use a bottle and excessively large volumes, which can reduce the amount of milk in a woman. It is desirable to exclude unreasonable dietary restrictions in breastfeeding mothers by excluding the so-called “gas-forming products” and ineffective therapy, in particular simethicone preparations.

Understanding of Irritable Bowel Syndrome among General practitioners in the Periphery of Lahore

Objective: To determine the understanding of irritable bowel syndrome among general practitioners in Lahore in terms of diagnosis and treatment. Study Design: Observational, cross sectional study. Place and Duration of Study: Department of Medicine, University of Lahore Teaching Hospital, Lahore from 1st October 2020 to 31st March 2021. Methodology: Two hundred and ninety eight patients from both urban and rural territory in Lahore were enrolled. Manning and Rome criteria were applied to establish diagnosis of irritable syndrome. Patient’s history, investigations and final diagnosis were recorded. After three months, patients were reassessed for final diagnosis and any alternative diagnosis if under consideration. Results: There were 180 (60.4%) females and 118 (39.6%) males with mean age of 34 years. About 70 patients presented with GIT complains were functional and 45 with organic problems. Out of 70 functional patients, 45 have irritable bowel syndrome. The condition was functional or organic quite inadequate and amounted to 56%. Conclusion: Majority of irritable bowel syndrome patients were either wrongly diagnosed by the general practitioners or inadequately treated. Key words: Irritable bowel syndrome (IBS), Functional and organic diarrhea

Consensus Meeting of European Society of Neurogastroenterology and Motility on Functional Dyspepsia (2020): Have We Dotted All the I’s?

Aim. A review of the agreement issued by the European Society of Neurogastroenterology and Motility consensus meeting on functional dyspepsia in 2020.Key points. Expert votes at the consensus meeting generally confirmed the main statements of the Rome Criteria Revision IV on the definition of functional dyspepsia, its aetiology and pathogenesis, diagnosis and treatment, as well as those of the Kyoto Consensus covering the possible association of dyspeptic complaints with H. pylori infection. An absent consensus on certain statements, especially in drug efficacy evaluation, demonstrates insufficient knowledge of many issues in disease.Conclusion. Functional dyspepsia demands further investigation.

Symptomatic Treatment of Pain-Related Pediatric Functional Gastrointestinal Disorders in a Biopsychosocial Construct, and a Validity Study of Rome III Criteria

Our study aims to assess improvement with symptomatic treatment of pain-related functional gastrointestinal disorders (FGIDs) in a biopsychosocial construct and evaluate validity of Rome III criteria. Children with chronic abdominal pain diagnosed with an FGID or organic disease were followed for 1 year: 256/334 were diagnosed with an FGID and 78/334 were diagnosed with a possible organic disease due to alarm signs or not meeting Rome III criteria. After 1 year, 251 had true FGID and 46 had organic diseases. Ninety percent of FGID patients improved with symptomatic treatment over an average of 5.4 months. With a 95% confidence interval, Rome criteria predicted FGIDs with sensitivity 0.89, specificity 0.90, positive predictive value 0.98, and negative predictive value 0.59. We conclude that symptomatic treatment of pain-related FGIDs results in clinical improvement and could reduce invasive/expensive testing. Rome III criteria’s high specificity and positive predictive value suggest they can rule in a diagnosis of FGID.

The case of Capogrossi in Rome: criteria and limits in the retouching process of a contemporary mural painting

This paper focuses on the reintegration treatments studied for a contemporary mural painting, which was designed and carried out by the Italian artist Giuseppe Capogrossi in 1954. This forgotten masterpiece is located on the ceilings of the main double staircase at the entrance of the Airone, an ex-cinema theatre in Rome, which was designed and planned during the Fifties by the famous architects Adalberto Libera, Eugenio Montuori and by the engineer Leo Calini. After a brief introduction based on the conservation history of the building and on the painting itself, it will be described criteria and limits in the reintegration process of a sample area of this highly degraded polyvinyl acetate (PVAc) based mural. The materials selected in the reintegration project, based on natural polymers and synthetic polymers, will be theoretically compared with one another and it will be explained why some of these could be appropriate and effective, while others could not chromatically work in this particular case.