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Positive health:An integrated quantitative approach in patients with chronic gastrointestinal and hepato-pancreatico-biliary disorders

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World Journal of Gastroenterology 2024年第28期30卷 3418-3427页

作者： Anja H W M Lemlijn-Slenter Karolina AP Wijnands Gijs van der Hamsvoort Luuk P van Iperen Nico Wolter Angelique E de Rijk Ad AM Masclee Department of Social Medicine Faculty of HealthMedicine and Life sciencesCare and Public Health Research Institute Maastricht UniversityMaastricht 6200 MDLimburgNetherlands Division of Gastroenterology and Hepatology Department of Internal MedicineSchool of Nutrition and Translational Research in MetabolismMaastricht 6200 MDLimburgNetherlands Social Medical Affairs Employee Insurance Agency(UWV)Heerlen 6400 ACLimburgNetherlands Department of Research Academic Knowledge Center Work and Health South-East Netherlands(AKAG-ZON)Heerlen 6400 ACLimburgNetherlands

BACKGROUND The concept of positive health(PH)supports an integrated approach for patients by taking into account six dimensions of health.This approach is especially relevant for patients with chronic disorders.Chronic gastrointestinal and hepatopancreatico-biliary(GI-HPB)disorders are among the top-6 of the most prevalent chronically affected organ systems.The impact of chronic GI-HPB disorders on individuals may be disproportionally high because:(1)The affected organ system frequently contributes to a malnourished state;and(2)persons with chronic GIHPB disorders are often younger than persons with chronic diseases in other organ systems.AIM To describe and quantify the dimensions of PH in patients with chronic GI-HPB disorders.METHODS Prospective,observational questionnaire study performed between 2019 and 2021 in 235 patients with a chronic GIHPB disorder attending the Outpatient Department of the Maastricht University Medical Center.Validated questionnaires and data from patient files were used to quantify the six dimensions of PH.Internal consistency was tested with McDonald’s Omega.Zero-order Pearson correlations and t-tests were used to assess associations and differences.A P valuedisorders in other organ systems,but depressive symptoms(in 35%)and malnutrition(in 45%)were more frequent in patients with chronic GI-HPB disorders.Intercorrelation scores between the six dimensions were only very weak to weak,forcing us to quantify each domain separately.CONCLUSION All six dimensions of PH are impaired in the GI-HPB patients.Malnutrition and depressive symptoms are more prevalent compared to patients with chronic disorders in other organ systems.

关键词： Positive health Chronic gut disorders gastrointestinal disorders Hepato-pancreatico-biliary disorders Integrated care

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gastrointestinal disorders in children with autism:Could artificial intelligence help?

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Artificial Intelligence in Gastroenterology 2022年第1期3卷 1-12页

作者： Mohammed Al-Biltagi Nermin Kamal Saeed Samara Qaraghuli Department of Pediatrics Faculty of MedicineTanta UniversityTanta 31511AlghrabiaEgypt Department of Pediatrics University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityDr Sulaiman Al Habib Medical GroupManama 26671ManamaBahrain Medical Microbiology Section Pathology DepartmentSalmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 12ManamaBahrain Microbiology Section Pathology DepartmentIrish Royal College of SurgeonBahrainBusaiteen 15503MuharraqBahrain Department of Pharmacognosy and Medicinal Plant Faculty of PharmacyAl-Mustansiriya UniversityBaghdad 14022BaghdadIraq

Autism is one of the pervasive neurodevelopmental disorders usually associated with many medical comorbidities.gastrointestinal(GI)disorders are pervasive in children,with a 46%-84%prevalence rate.Children with Autism have an increased frequency of diarrhea,nausea and/or vomiting,gastroesophageal reflux and/or disease,abdominal pain,chronic flatulence due to various factors as food allergies,gastrointestinal dysmotility,irritable bowel syndrome(IBS),and inflammatory bowel diseases(IBD).These GI disorders have a significant negative impact on both the child and his/her family.Artificial intelligence(AI)could help diagnose and manage Autism by improving children's communication,social,and emotional skills for a long time.AI is an effective method to enhance early detection of GI disorders,including GI bleeding,gastroesophageal reflux disease,Coeliac disease,food allergies,IBS,IBD,and rectal polyps.AI can also help personalize the diet for children with Autism by microbiome modification.It can help to provide modified gluten without initiating an immune response.However,AI has many obstacles in treating digestive diseases,especially in children with Autism.We need to do more studies and adopt specific algorithms for children with Autism.In this article,we will highlight the role of AI in helping children with gastrointestinal disorders,with particular emphasis on children with Autism.

关键词： Autism gastrointestinal disorders Artificial Intelligence Children

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Gut microbiota in various childhood disorders:Implication and indications

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World Journal of Gastroenterology 2022年第18期28卷 1875-1901页

作者： Nermin Kamal Saeed Mohammed Al-Beltagi Adel Salah Bediwy Yasser El-Sawaf Osama Toema Medical Microbiology Section Department of PathologySalmaniya Medical ComplexMinistry of HealthManama 12Bahrain Microbiology Section Department of PathologyIrish Royal College of SurgeonBusaiteen 15503Bahrain Department of Pediatrics University Medical CenterArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671Bahrain Department of Pediatrics Faculty of MedicineTanta UniversityTanta 31511Egypt Department of Chest Disease Faculty of MedicineTanta UniversityTanta 31527Egypt Department of Pulmonology University Medical CenterArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671Bahrain Department of Tropical Medicine Faculty of MedicineTanta UniversityTanta 31527Egypt Department of Gastroenterology University Medical CenterArabian Gulf UniversityDr.Sulaiman Al-Habib Medical GroupManama 26671Bahrain

Gut microbiota has a significant role in gut development,maturation,and immune system differentiation.It exerts considerable effects on the child's physical and mental development.The gut microbiota composition and structure depend on many host and microbial factors.The host factors include age,genetic pool,general health,dietary factors,medication use,the intestine's pH,peristalsis,and transit time,mucus secretions,mucous immunoglobulin,and tissue oxidation-reduction potentials.The microbial factors include nutrient availability,bacterial cooperation or antagonism,and bacterial adhesion.Each part of the gut has its microbiota due to its specific characteristics.The gut microbiota interacts with different body parts,affecting the pathogenesis of many local and systemic diseases.Dysbiosis is a common finding in many childhood disorders such as autism,failure to thrive,nutritional disorders,coeliac disease,Necrotizing Enterocolitis,helicobacter pylori infection,functional gastrointestinal disorders of childhood,inflammatory bowel diseases,and many other gastrointestinal disorders.Dysbiosis is also observed in allergic conditions like atopic dermatitis,allergic rhinitis,and asthma.Dysbiosis can also impact the development and the progression of immune disorders and cardiac disorders,including heart failure.Probiotic supplements could provide some help in managing these disorders.However,we are still in need of more studies.In this narrative review,we will shed some light on the role of microbiota in the development and management of common childhood disorders.

关键词： Gut microbiota Dysbiosis Children gastrointestinal disorders Immune disorders Allergic disorders Cardiac disorders

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Should gastroenterologists prescribe cannabis? The highs, the lows and the unknowns

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World Journal of Clinical Cases 2023年第18期11卷 4210-4230页

作者： Sonia Samuel Mark Michael Micheal Tadros Department of Internal Medicine Albany Medical CenterAlbanyNY 12208United States Department of Gastroenterology and Hepatology Albany Medical CenterAlbanyNY 12208United States

Cannabis,commonly known as marijuana,is a drug extracted from the Cannabis plant known for its psychotropic and medicinal properties.It has been used for healing purposes during ancient times,although its psychoactive components led to its restricted use in medicine.Nonetheless,cannabis is found to have modulatory effects on the endocannabinoid system exhibiting its medicinal role in the gastrointestinal(GI)system.Emerging animal and human studies demonstrate the influential effects of cannabis on a variety of GI diseases including inflammatory bowel disease,motility disorders and GI malignancies.It also has a regulatory role in GI symptoms including nausea and vomiting,anorexia,weight gain,abdominal pain,among others.However,both its acute and chronic use can lead to undesirable side effects such as dependency and addiction,cognitive impairment and cannabinoid hyperemesis syndrome.We will discuss the role of cannabis in the GI system as well as dosing strategies to help guide gastroenterologists to assess its efficacy and provide patient counseling before prescription of medical marijuana.

关键词： Marijuana cannabis Endocannabinoid system Side effects gastrointestinal disorders

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Role of gastrointestinal health in managing children with autism spectrum disorder

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世界临床儿科杂志 2023年第4期12卷 171-196页

作者： Mohammed Al-Beltagi Nermin Kamal Saeed Adel Salah Bediwy Reem Elbeltagi Rawan Alhawamdeh Pediatric Department Faculty of MedicineTanta UniversityAlgharbiaTanta 31511Egypt Pediatrics Univeristy Medical CenterKing Abdulla Medical CityArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManamaManama 26671Bahrain Medical Microbiology Section Pathology DepartmentSalmaniya Medical ComplexMinistry of HealthManamaManama 12Bahrain Medical Microbiology Section Pathology DepartmentIrish Royal College of SurgeonBahrainMuharraqBusaiteen 15503Bahrain Pulmonology Department Faculty of MedicineTanta UniversityAlgharbiaTanta 31527Egypt Pulmonology Department University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManamaManama 26671Bahrain Medicine The Royal College of Surgeons in Ireland-BahrainMuharraqBusiateen 15503Bahrain Pediatrics Research and Development DepartmentGenomics Creativity and Play CenterManamaManama 0000Bahrain Pediatrics Research and Development DepartmentSENSORYME Dubai 999041United Arab Emirates

Children with autism spectrum disorders(ASD)or autism are more prone to gastrointestinal(GI)disorders than the general population.These disorders can significantly affect their health,learning,and development due to various factors such as genetics,environment,and behavior.The causes of GI disorders in children with ASD can include gut dysbiosis,immune dysfunction,food sensitivities,digestive enzyme deficiencies,and sensory processing differences.Many studies suggest that numerous children with ASD experience GI problems,and effective management is crucial.Diagnosing autism is typically done through genetic,neurological,functional,and behavioral assessments and observations,while GI tests are not consistently reliable.Some GI tests may increase the risk of developing ASD or exacerbating symptoms.Addressing GI issues in individuals with ASD can improve their overall well-being,leading to better behavior,cognitive function,and educational abilities.Proper management can improve digestion,nutrient absorption,and appetite by relieving physical discomfort and pain.Alleviating GI symptoms can improve sleep patterns,increase energy levels,and contribute to a general sense of well-being,ultimately leading to a better quality of life for the individual and improved family dynamics.The primary goal of GI interventions is to improve nutritional status,reduce symptom severity,promote a balanced mood,and increase patient independence.

关键词： gastrointestinal disorders Autism spectrum disorders,Children Gut microbiota Ketogenic diet Gluten-free casein-free diet,Dietary management

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Perioperative transcutaneous electrical acupoint stimulation for improving postoperative gastrointestinal function:A randomized controlled trial

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Journal of Integrative Medicine 2021年第3期19卷 211-218页

作者： Wen-jing Li Chao Gao Li-xin An Yu-wei Ji Fu-shan Xue Yi Du Department of Anesthesiology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China Department of Anesthesiology Beijing Hui-Min HospitalBeijing 100053China Department of Traditional Chinese Medicine Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China

Background:Postoperative gastrointestinal dysfunction(PGD)is one of the most common complications in patients undergoing major abdominal surgery.Acupuncture has been used widely in gastrointestinal diseases due to its effectiveness and minimally invasive nature.Objective:This study evaluated the efficacy of using transcutaneous electrical acupoint stimulation(TEAS)during the surgery and postoperative recovery in patients with gastric and colorectal surgery for improving postoperative gastrointestinal function.Design,setting,participants and interventions:A total of 280 patients undergoing abdominal surgery were stratified by type of surgery(i.e.,gastric or colorectal surgery)and randomly allocated into the TEAS group(group T)or the sham group(group S).Patients in group T received TEAS at LI4,PC6,ST36 and ST37.Patients in group S received pseudo-TEAS at sham acupoints.The stimulation was given from 30 min before anesthesia until the end of surgery.The same treatment was performed at 9 am on the 1st,2nd and 3rd days after surgery,until the recovery of flatus in patients.Main outcome measures:The primary outcome was the time to the first bowel motion,as detected by auscultation.The secondary outcomes included the first flatus and ambulation time,changes of perioperative substance P(SP),incidence of PGD,postoperative pain,postoperative nausea and vomiting(PONV)and some economic indicators.Results:The time to first bowel motion,first flatus and first ambulation in group T was much shorter than that in group S(P<0.01).In patients undergoing colorectal surgery,the concentration of SP was lower in group T than in group S on the third day after the operation(P<0.05).The average incidence of PGD in all patients was 25%,and the frequency of PGD was significantly lower in group T than in group S(18.6%vs.31.4%,respectively;P<0.05).TEAS treatment(odds ratio=0.498;95%confidence interval:0.232–0.786)and type of surgery were relevant factors for the development of PGD.Postoperative pain score and PONV occurrence were significantl

关键词： Transcutaneous electrical acupoint stimulation Postoperative period gastrointestinal disorders Substance P

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Electro-acupuncture to prevent prolonged postoperative ileus:A randomized clinical trial

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World Journal of Gastroenterology 2010年第1期16卷 104-111页

作者： M Kay Garcia Joseph S Chiang Bob Thornton J Lynn Palmer Jennifer McQuade Lorenzo Cohen Department of Anesthesiology and Pain Medicine/Integrative Medicine M.D.Anderson Cancer CenterThe University of Texas Department of Anesthesiology and Pain Medicine M.D.Anderson Cancer CenterThe University of Texas Department of Palliative Care and Rehabilitation Medicine M.D.Anderson Cancer CenterThe University of Texas Department of Behavioral Science M.D.Anderson Cancer CenterThe University of Texas Department of GI Medical Oncology M.D. Anderson Cancer CenterThe University of Texas

AIM:To examine whether acupuncture can prevent prolonged postoperative ileus(PPOI)after intraperitoneal surgery for colon cancer. METHODS:Ninety patients were recruited from the Fudan University Cancer Hospital,Shanghai,China. After surgery,patients were randomized to receive acupuncture(once daily,starting on postoperative day 1, for up to six consecutive days)or usual care.PPOI was defined as an inability to pass flatus or have a bowel movement by 96 h after surgery.The main outcomes were time to first flatus,time to first bowel movement, and electrogastroenterography.Secondary outcomes were quality of life(QOL)measures,including pain, nausea,insomnia,abdominal distension/fullness,and sense of well-being. RESULTS:No significant differences in PPOI on day 4 (P=0.71)or QOL measures were found between the groups.There were also no group differences when the data were analyzed by examining those whose PPOI had resolved by day 5(P=0.69)or day 6(P= 0.88).No adverse events related to acupuncture were reported. CONCLUSION:Acupuncture did not prevent PPOI andwas not useful for treating PPOI once it had developed in this population.

关键词： Acupuncture gastrointestinal motility gastrointestinal disorders gastrointestinal neoplasms

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