The Relieving Effects of a Polyherb-Based Dietary Supplement ColonVita on Gastrointestinal Quality of Life Index (GIQLI) in Older Adults with Chronic Gastrointestinal Symptoms Are Influenced by Age and Cardiovascular Disease: A 12-Week Randomized Placebo-Controlled Trial

Chronic gastrointestinal symptoms (CGS) negatively affect the quality of life in about 15–30% of the population without effective drugs. Recent studies suggest that dietary supplement may improve CGS, but inconsistent results exist. The goal of this study is to evaluate the effect of a polyherbal-based supplement ColonVita on the gastrointestinal quality of life index (GIQLI) in 100 old adults with CGS (63.1 ± 9.6 years) who were randomly assigned to daily ColonVita or placebo tablets (n = 50/group) for 12 weeks in a double-blind, randomized controlled trial design. No significant fibrdifferences were found between ColonVita and placebo in the baseline total GIQLI score (101.12 ± 16.87 vs. 101.80 ± 16.48) ( P > 0.05 ) or postintervention total GIQLI score (114.78 ± 9.62 vs. 111.74 ± 13.01) ( P > 0.05 ). However, ColonVita significantly improved 16 scores of the 19 core GI symptoms compared with 10 items improved by placebo. The ColonVita group significantly improved the remission rate of 5 core GI symptoms compared to placebo and significantly improved the total GIQLI scores (118.09 ± 7.88 vs. 109.50 ± 16.71) ( P < 0.05 ) and core GI symptom scores (64.61 ± 3.99 vs. 60.00 ± 8.65) ( P < 0.05 ) in people ≥60 years of age (n = 49) but not in those under 60 y (n = 51). ColonVita significantly improved the total GIQLI scores and core GI symptom scores in people without cardiovascular diseases (CVD) (n = 56) (116.74 ± 9.38 vs. 110.10 ± 14.28) ( P < 0.05 ) and (63.11 ± 4.53 vs. 59.93 ± 8.03) ( P = 0.07 ), respectively, but not in those with CVD (n = 44). Thus, ColonVita was beneficial for old adults with CGS, especially those ≥60 years of age and without CVD. Because a heterogenous pathogenesis of CGS-like irritable bowel syndrome (IBS) and inflammatory bowel disease (ISD) is differentially associated with CVD, different comorbidities may have influenced the outcomes of different trials that should be controlled in further studies.

Clinical Outcome after Resection Rectopexy in patients with Constipation and Rectal Prolapse

Purpose Laparoscopic resection rectopexy (LRR) is an established procedure for the treatment of rectal prolapse. This study evaluated constipation and gastrointestinal quality of life in patients before and after LRR for rectal prolapse. Methods 30 patients (24 females, 6 males) underwent laparoscopic anterior (n = 14), posterior (n = 8) and suture resection rectopexy (n = 8) for rectal prolapse during 2010–2020. 25 were retrospectively evaluated for constipation and gastrointestinal quality of life using validated Cleveland Clinic Constipation Score (CCCS) and Gastrointestinal Quality of Life Index (GIQLI). Results Constipation score was significantly reduced from median 16.0 ± 6.4 to 6.0 ± 4.7 after 68.0 ± 42.8 months (p < 0.001). Constipation was improved in 20 patients (80.0%), unaltered in 2 patients and worse in 3 patients. Prior abdominal surgeries were associated with less improvement for constipation (p < 0,05). Significant improvement in GIQLI score was observed, with median total GIQLI score increasing from 95.0 ± 14.8 to 124.0 ± 18.2 (p < 0.001). Quality of life improved in 21 patients (84.0%). Positive changes were also observed in GIQLI subgroups of gastrointestinal symptoms, emotions, physical status, social dysfunction and effects of medical treatment (p < 0.001). There was no difference in outcome between the three procedures. Conclusion Laparoscopic resection rectopexy for rectal prolapse is safe, feasible, and very effective regarding both perioperative results and long-term functional outcome. Our results suggest that LRR significantly improves constipation in patients with outlet obstruction and clearly contributes to a higher quality of life.

Medium-term durability of giant hiatus hernia repair without mesh

Introduction This is the second report on objective review of 100 patients who underwent composite fundoplication-cardiopexy for repair of giant hiatus hernia (GHH) at a median of 24 months following surgery. Outcomes were objective follow-up by endoscopy and quality of life (QoL) by Gastrointestinal Quality of Life Index (GIQLI), modified Visick scores and dysphagia scores. The initial report for this cohort suggested a low objective recurrence rate (9%) and substantial improvements in QoL indices. Methods The rate of hernia recurrence was assessed with Kaplan–Meier analysis and covariates were analysed with the Cox proportional hazards model. Paired t-tests and related samples Wilcoxon signed-rank tests were used to compare QoL scores. Unpaired data were compared with the independent samples t-test and Mann–Whitney U test. Results Objective review was obtained in 97% of the patients. There were five recurrences of hernias that had a vertical height of >2cm from the diaphragmatic hiatus, with three patients requiring reoperation for severe dysphagia. Small recurrences (<2cm) occurred in 20 patients. The median time to recurrence was 40 months (95% confidence interval: 34–46 months). At two years, recurrence of any size had occurred in 24% of cases. At follow-up review (median: 27 months), the mean GIQLI score was 109 (p=0.279), the median modified Visick score was 2 (p=0.954) and the median dysphagia score was 41 (p=0.623). There was no evidence that the GIQLI score (p=0.089), the modified Visick score (p=0.339) or the dysphagia score (p=0.445) changed significantly after recurrence. Conclusions There was a sustained improvement in overall QoL and reflux scores after GHH repair. QoL scores showed persistent improvement in reflux and overall health, even in the subgroup with recurrence. The majority (80%) of recurrences were small and recurrent herniation did not appear to significantly change QoL. The rates of recurrence and QoL are comparable with those for other methods of repair.