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functional gastrointestinal disorders in inflammatory bowel disease: Time for a paradigm shift?

World Journal of Gastroenterology 2020年第26期26卷 3712-3719页

作者： Dipesh H Vasant Alexander C Ford Gastroenterology Manchester University NHS Foundation TrustWythenshawe HospitalManchester M239LTUnited Kingdom Division of Diabetes Endocrinology and GastroenterologyUniversity of ManchesterManchester M239LTUnited Kingdom Leeds Institute of Medical Research at St.James’s University of LeedsLeeds LS97TFUnited Kingdom Leeds Gastroenterology Institute Leeds Teaching Hospitals NHS TrustLeeds LS97TFUnited Kingdom

Recent advances in biological therapies have revolutionalised and redefined treatment targets in inflammatory bowel disease(IBD).There is now a stronger emphasis on achieving the more stringent therapeutic goals of mucosal and histological healing,rather than clinical remission ***,the treatment of refractory“functional”gastrointestinal symptoms,often attributed as the aftermath of previous inflammation,has recently become more prominent in quiescent *** further expected advances in anti-inflammatory treatments on the horizon,the burden of such symptoms in quiescent disease,which have been relatively neglected,is set to become an even bigger *** this article,we highlight the current state of research and understanding in this field,including recent developments and clinical practice guidelines on the diagnosis and management of functional gastrointestinal symptoms,such as irritable bowel syndrome and functional anorectal and pelvic floor disorders,in patients with quiescent *** disorders are not only highly prevalent in these patients,they are often misdiagnosed,and are difficult to treat,with very few evidence-based ***,they are associated with substantial impairment in quality-of-life,considerable morbidity,and psychological *** is therefore an urgent need for a change in emphasis towards earlier recognition,positive diagnosis,and targeted treatment for patients with ongoing functional gastrointestinal symptoms in the absence of active *** article also highlights the need for further research to develop much needed evidence-based therapies.

关键词： Irritable bowel syndrome Inflammatory bowel disease functional gastrointestinal disorders Faecal incontinence Pelvic floor dyssynergia

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functional gastrointestinal disorders,mental health,genetic susceptibility,and incident chronic kidney disease

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Chinese Medical Journal 2024年第9期137卷 1088-1094页

作者： Mengyi Liu Panpan He Ziliang Ye Sisi Yang Yanjun Zhang Qimeng Wu Chun Zhou Yuanyuan Zhang Fan Fan Hou Xianhui Qin Division of Nephrology Nanfang HospitalSouthern Medical UniversityNational Clinical Research Center for Kidney DiseaseState Key Laboratory of Organ Failure ResearchGuangdong Provincial Institute of NephrologyGuangdong Provincial Key Laboratory of Renal Failure ResearchGuangzhouGuangdong 510515China

Background:Whether functional gastrointestinal disorders(FGIDs)are associated with the long-term risk of chronic kidney disease(CKD)remains *** aimed to investigate the prospective association of FGIDs with CKD and examine whether mental health mediated the ***:About 416,258 participants without a prior CKD diagnosis enrolled in the UK Biobank between 2006 and 2010 were *** with FGIDs(including irritable bowel syndrome[IBS],dyspepsia,and other functional intestinal disorders[FIDs;mainly composed of constipation])were the exposure group,and non-FGID participants were the non-exposure *** primary outcome was incident CKD,ascertained from hospital admission and death registry records.A Cox proportional hazard regression model was used to investigate the association between FGIDs and CKD,and the mediation analysis was performed to investigate the mediation proportions of mental ***:At baseline,33,156(8.0%)participants were diagnosed with FGIDs,including 21,060(5.1%),8262(2.0%),and 6437(1.6%)cases of IBS,dyspepsia,and other FIDs,*** a mean follow-up period of 12.1 years,11,001(2.6%)participants developed *** were significantly associated with a higher risk of incident CKD compared to the absence of FGIDs(hazard ratio[HR],1.36;95%confidence interval[CI],1.28-1.44).Similar results were observed for IBS(HR,1.27;95%CI,1.17-1.38),dyspepsia(HR,1.30;95%CI,1.17-1.44),and other FIDs(HR,1.60;95%CI,1.43-1.79).Mediation analyses suggested that the mental health score significantly mediated 9.05%of the association of FGIDs with incident CKD and 5.63-13.97%of the associations of FGID subtypes with ***,the positive associations of FGIDs and FGID subtypes with CKD were more pronounced in participants with a high genetic risk of ***:Participants with FGIDs had a higher risk of incident CKD,which was partly explained by mental health scores and was more pronounced in those with high gen

关键词： functional gastrointestinal disorders Chronic kidney diseases Genetic susceptibility Mental health

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Prevalence of functional gastrointestinal disorders in children with celiac disease on different types of gluten-free diets

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World Journal of Gastroenterology 2022年第46期28卷 6589-6598页

作者： Francesca Fiori Nastro Maria Rosaria Serra Sabrina Cenni Daniela Pacella Massimo Martinelli Erasmo Miele Annamaria Staiano Carlo Tolone Renata Auricchio Caterina Strisciuglio Department of Translational Medical Science Section of PediatricsUniversity of Naples“Federico Ⅱ”Naples 80100Italy Department of Experimental Medicine University of Campania“Luigi Vanvitelli”Naples 80100Italy Department of Public Health University of Naples“Federico Ⅱ”Naples 80100Italy Department of Woman Child and General and Specialistic SurgeryUniversity of Campania“Luigi Vanvitelli”Naples 80138Italy

BACKGROUND functional gastrointestinal disorders(FGIDs)are common during the pediatric *** are not related to biochemical or structural ***,since they have a high prevalence,several studies have evaluated an overlap between FGIDs and organic *** with celiac disease(CD)have been shown to be at an increased risk for functional abdominal pain,even if they adhere well to a gluten-free diet(GFD).Little information is available for the pediatric age *** aims of our study were to evaluate the prevalence of FGIDS in CD children 1 year after diagnosis and to compare the prevalence of FGIDs in CD children on a GFD with processed foods compared with those on a GFD with natural *** To assess the prevalence of FGIDs in children with CD after 1 year of follow-up and to compare the prevalence of FGIDs in children with CD on a GFD with processed foods and in children on a GFD with natural *** We recruited pediatric patients aged 1-18 years with a new CD *** were randomized to two groups:Group A on a GFD with processed foods(diet 1);and group B on a GFD with natural products(diet 2).Clinical monitoring,diet assessment and the questionnaire on pediatric gastrointestinal symptoms-Rome IV version were performed at diagnosis(T0)and after 12 mo of follow-up(T1).Dietary intake was assessed using a 3-d food diary *** from the diaries were evaluated using WinFood nutrient analysis *** assessed the prevalence of FGIDs at T1 and the correlation with the type of *** We registered 104 CD children,with 55 patients in group A(53.0%)and 49 patients in group B(47.0%).Initially,30 of the 55(54.5%)CD children were symptomatic in group A,while 25 of 49(51.0%)were symptomatic in group *** T1,in spite of a low or negative serology for CD,FGIDs prevalence was 10/55(18.0%)in group A and 8/49(16.3%)in group B,with no statistically significant difference between the two groups(P=0.780).At T1 the

关键词： functional gastrointestinal disorders Celiac disease Gluten free diet gastrointestinal symptoms Children

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Epidemiology of functional gastrointestinal disorders in children and adolescents: A systematic review

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World Journal of Gastroenterology 2017年第21期23卷 3915-3927页

作者： Alexandre Canon Boronat Ana Paula Ferreira-Maia Alicia Matijasevich Yuan-Pang Wang Institute&Department of Psychiatry(LIM-23) University of Sao Paulo Medical School Department of Preventive Medicine University of Sao Paulo Medical School

To assess the prevalence of functional gastrointestinal disorders (FGIDs) in children and ***, EMBASE, and Scopus databases were searched for original articles from inception to September 2016. The literature search was made in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. For inclusion, each study had to report epidemiological data on FGIDs in children between 4 and 18 years old and contain standardized outcome based on Rome II, III or IV criteria. The overall quality of included epidemiological studies was evaluated in accordance with Loney’s proposal for prevalence studies of health literature. Two reviewers assessed each study for data inclusion and extraction. Discrepancies were reconciled through discussion with *** total of 659 articles were identified from the databases and 16 through manual search. A total of 43 articles fulfilled the eligibility criteria for full-text reading, with 26 remaining to be included in the final analysis. All studies were written in English and published between 2005 and 2016. Eight (30.8%) articles were performed in North America, five (19.2%) in Latin America, five (19.2%) in Europe, seven (27%) in Asia, and one (3.8%) in Africa. Sample size varied between 114 and 99416 subjects, totaling 132600 individuals. Fourteen (53.9%) studies recruited their target samples from schools, 11 (42.3%) from healthcare settings and the remaining one (3.8%) from online panel community. The overall FGID prevalence rates for student samples ranged from 9.9% to 29% to as high as 87% in clinical samples. Cyclic vomiting, irritable bowel syndrome and functional constipation were the most researched conditions, with a prevalence ranging from 0.2% to 6.2%, 0% to 45.1% and 0.5% to 86.9%, respectively. The qualitative appraisal revealed that most of the studies showed average or below average *** heterogeneity of the studies o

关键词： functional gastrointestinal disorders Epidemiology Prevalence Children Adolescents

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A Breakthrough Point in Integrative Medical Research:Challenge of Treating Overlapping Symptoms in functional gastrointestinal disorders

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Chinese Journal of Integrative Medicine 2022年第6期28卷 554-559页

作者： TANG Xu-dong MA Xiang-xue Institute of Spleen and Stomach Diseases Xiyuan HospitalChina Academy of Chinese Medical SciencesBeijing100091China

functional gastrointestinal disorders(FGIDs)are common disorders that are characterized by persistent and recurring gastrointestinal *** patients with FGIDs have overlapping symptoms,which impaired the quality of life and ability to work of patients,and left a considerable impact on health-care systems and *** medicines(CMs)are commonly utilized by many patients with *** article discusses the current status of diagnosis and treatment of FGIDs,the advantages and characteristics of CM treatment,and how integrated medicine can make a breakthrough in FGIDs diagnosis and treatment.

关键词： functional gastrointestinal disorders overlapping symptoms integrative medicine

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Stress and sleep quality in doctors working on-call shifts are associated with functional gastrointestinal disorders

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World Journal of Gastroenterology 2017年第18期23卷 3330-3337页

作者： Soo-Kyung Lim Seung Jin Yoo Dae Lim Koo Chae A Park Han Jun Ryu Yong Jin Jung Ji Bong Jeong Byeong Gwan Kim Kook Lae Lee Seong-Joon Koh Department of Internal Medicine Seoul National University College of MedicineSeoul National University Boramae Hospital Department of Neurology Seoul National University Boramae HospitalSeoul National University College of Medicine

To investigate the role of sleep quality and psychosocial problems as predictors of functional gastrointestinal disorders (FGIDs) in doctors that work 24 hour-on-call *** this cross-sectional observation study, using the Rome III Questionnaire and Pittsburgh Sleep Quality Index (PSQI), we analyzed 170 doctors with 24 hour-on-call *** the participants that had experienced a 24 hour-on-call shift within the last 6 mo, 48 (28.2%) had FGIDs. Overall prevalence of irritable bowel syndrome (IBS) and functional dyspepsia (FD) were 16.5% and 17.1%, respectively, with 5.3% exhibiting both. Sleep scores (PSQI) (8.79 ± 2.71 vs 7.30 ± 3.43, P = 0.008), the presence of serious psychosocial alarm (83.3% vs 56.6%, P = 0.004), and the proportion of doctors who experienced over two months of recent on-call work (81.2% vs 68.9%, P = 0.044) were significantly different between individuals with or without FGIDs. Multivariate analysis revealed that presenting serious psychosocial alarm was an independent risk factor for prevalence of FD (OR = 5.47, 95%CI: 1.06-28.15, P = 0.042) and poor sleep quality (PSQI ≥ 6) was a predictor of IBS (OR = 4.17, 95%CI: 1.92-19.02, P = 0.016).CONCLUSIONPhysicians should recognize the role of sleep impairment and psychological stress in the development of FGIDs and a comprehensive approach should be considered to manage patients with FGIDs.

关键词： Psychosocial stress Sleep 24 hour-on-call shift Doctors functional gastrointestinal disorders

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Rome Ⅲ:The functional gastrointestinal disorders, third edition, 2006

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World Journal of Gastroenterology 2008年第13期14卷 2124-2125页

作者： Randa Mostafa Department of Basic Medical Sciences Collegeof Medicine Sharjah University Sharjah United Arab Emirates

functional gastrointestinal disorders （FGIDs） represent a common and important class of disorders within gastroenterology. Rome Ⅰ, the first edition was published in 1994, with symptom-based diagnostic criteria for FGIDs. These criteria began to change the diagnostic approach to F-GIDs, and no longer considered ＂diagnoses of exclusion＂ but rather ＂diagnoses of inclusion＂. Rome Ⅱ, the second edition published in 2000, resulted from the continual process of analyzing new scientific and clinical evidence in the study of F-GIDs. Rome Ⅱ, diagnostic criteria for irritable bowel syndrome （IBS）, was extended with a focus on the frequency of symptoms occurring twelve weeks （not necessarily consecutive weeks） within twelve months. ROlE Ⅲ, the third edition, conservative one, was published in September 2006, with changes made only where there is good evidence to do so. Some of the differences between Rome Ⅱ and Rome Ⅲ criteria are highlighted in this issue.

关键词： Rome Ⅲ functional gastrointestinal disorders Diagnosis Classification

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Psycho-gastroenterological profile of an Italian population of children with disorders of gut-brain interaction:A case-control study

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World Journal of Clinical Pediatrics 2025年第1期14卷 69-77页

作者： Valentina Giorgio Ilaria Venezia Licia Pensabene Elisa Blasi Donato Rigante Paolo Mariotti Giuseppe Stella Gaia Margiotta Giovanna Quatrale Giuseppe Marano Marianna Mazza Antonio Gasbarrini Eleonora Gaetani Pediatric Unit Department of WomenChildren and Public Health SciencesFondazione Policlinico Universitario“A.Gemelli”IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy Child Neuropsychiatry Unit ASST Santi Paolo e CarloSan Paolo HospitalMilan 20142Italy Child Neuropsychiatry Unit Department of WomenChildren and Public Health SciencesFondazione Policlinico Universitario“A.Gemelli”IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy Department of Medical and Surgical Sciences Pediatric UnitUniversity Magna GraeciaCatanzaro 88100Italy Unit of Psychiatry Fondazione Policlinico Universitario“A.Gemelli”IRCCSRome 00168Italy Department of Neurosciences UniversitàCattolica del Sacro CuoreRome 00168Italy Department of Internal Medicine and Gastroenterology Fondazione Policlinico Universitario"A.Gemelli"IRCCSRome 00168Italy Department of Medical and Surgical Sciences Fondazione Policlinico Universitario"A.Gemelli"IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy

BACKGROUND disorders of gut-brain interaction(DGBI)are common,but knowledge about their physiopathology is still poor,nor valid tools have been used to evaluate them in *** To develop a psycho-gastroenterological questionnaire(PGQ)to assess the psycho-gastroenterological profile and social characteristics of a pediatric population with and without *** One hundred and nineteen Italian children(age 11-18)were included:28 outpatient patients with DGBI(Rome IV criteria)and 91 healthy *** filled the PGQ,faces pain scale revised(FPS-R),Bristol stool chart,ga-strointestinal symptoms rating scale,state-trait anxiety inventory,Toronto alexithymia scale 20,perceived self-efficacy in the management of negative emotions and expression of positive emotions(APEN-G,APEP-G),irritable bowel syndrome-quality of life questionnaire,school performances,tobacco use,early life events,degree of *** Compared to controls,patients had more medical examinations(35%of them went to the doctor more than five times),a higher school performance(23%vs 13%,P<0.05),didn’t use tobacco(never vs 16%,P<0.05),had early life events(28%vs 1%P<0.05)and a higher percentage of pain classified as 4 in the FPS-R during the examination(14%vs 7%,P<0.05).CONCLUSION Pediatric outpatients with DGBI had a higher prevalence of early life events,a lower quality of life,more medical examinations rising health care costs,lower anxiety levels.

关键词： disorders of gut-brain interaction functional gastrointestinal disorders Psycho-gastroenterological profile Gut-brain axis Rome IV criteria Pediatric patients

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Cow’s milk-induced gastrointestinal disorders:From infancy to adulthood

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World Journal of Clinical Pediatrics 2022年第6期11卷 437-454页

作者： Mohammed Al-Beltagi Nermin Kamal Saeed Adel Salah Bediwy Reem Elbeltagi Department of Pediatrics Faculty of MedicineTanta UniversityTanta 31511AlgharbiaEgypt Department of Pediatrics University Medical CenterArabian Gulf UniversityManama 26671Bahrain Department of Pathology Microbiology SectionSalmaniya Medical ComplexManama 26671Bahrain Department of Pathology Microbiology SectionRoyal College of Surgeons in Ireland-BahrainBusaiteen 15503MuharraqBahrain Department of Chest Diseases Faculty of MedicineTanta UniversityTanta 31527AlgharbiaEgypt Department of Chest Diseases University Medical CenterArabian Gulf UniversityManama 26671Bahrain Department of Medicine The Royal College of Surgeons in Ireland-BahrainBusiateen 15503MuharraqBahrain

Milk is related to many gastrointestinal disorders from the cradle to the grave due to the many milk ingredients that can trigger gastrointestinal discomfort and ***’s milk protein allergy(CMPA)is the most common food allergy,especially in infancy and childhood,which may persist into *** are three main types of CMPA;immunoglobulin E(IgE)-mediated CMPA,non-IgEmediated CMPA,and mixed *** appears before the first birthday in almost all *** may start even during the neonatal period and can be severe enough to simulate neonatal ***(often non-IgE mediated)can present with symptoms of gastroesophageal reflux,eosinophilic esophagitis,hemorrhagic gastritis,food protein-induced protein-losing enteropathy,and food protein-induced enterocolitis *** CMPAs are benign and outgrown during *** is not as common in adults as in children,but when present,it is usually severe with a protracted *** intolerance is a prevalent condition characterized by the development of many symptoms related to the consumption of foods containing *** intolerance has four typical types:Developmental,congenital,primary,and *** intolerance and CMPA may be the underlying pathophysiologic mechanisms for many functional gastrointestinal disorders in children and *** are also common in inflammatory bowel *** consumption may have preventive or promoter effects on cancer *** may also become a source of microbial infection in humans,causing a wide array of diseases,and may help increase the prevalence of antimicrobial *** editorial summarizes the common milk-related disorders and their symptoms from childhood to adulthood.

关键词： Cow’s milk Adults Children functional gastrointestinal disorders Cow’s milk protein allergy Lactose intolerance,Inflammatory bowel disease Zoonosis

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Fructose-sorbitol ingestion provokes gastrointestinal symptoms in patients with eating disorders

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World Journal of Gastroenterology 2009年第42期15卷 5295-5299页

作者： Noel Friesen Ross D Hansen Suzanne F Abraham John E Kellow Department of Obstetrics and Gynaecology Royal North Shore HospitalUniversity of SydneySydney 2065Australia Department of Gastroenterology Royal North Shore HospitalUniversity of SydneySydney 2065Australia

AIM:To evaluate gastrointestinal(GI) symptoms and breath hydrogen responses to oral fructose-sorbitol(F-S) and glucose challenges in eating disorder(ED) ***:GI symptoms and hydrogen breath concentration were monitored in 26 female ED inpatients for 3 h,following ingestion of 50 g glucose on one day,and 25 g fructose/5 g sorbitol on the next day,after an overnight fast on each *** to F-S were compared to those of 20 asymptomatic healthy ***:F-S provoked GI symptoms in 15 ED patients and one healthy control(P 17.5 kg/m 2(P functional GI disorders or breath hydrogen responses between patients with and without an F-S ***:F-S,but not glucose,provokes GI symptoms in ED patients,predominantly those with low *** findings are important in the dietary management of ED patients.

关键词： Fructose Sorbitol Malabsorption syndromes functional gastrointestinal disorders Eating disorders Underweight

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