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World Journal of Gastroenterology 2016年第11期22卷 3252-3260页

作者： Noriko Ihana-Sugiyama Naoyoshi Nagata Ritsuko Yamamoto-Honda Eiko Izawa Hiroshi Kajio Takuro Shimbo Masafumi Kakei Naomi Uemura Junichi Akiyama Mitsuhiko Noda Department of Diabetes Endocrinology and Metabolism National Center for Global Health and Medicine Tokyo 162-8655 Japan Division of General Medicine Jichi Medical University Graduate School of Medicine Tochigi 329-0498 Japan Department of Gastroenterology and Hepatology National Center for Global Health and Medicine Tokyo 162-8655 Japan Department of Endocrinology and Metabolism Toranomon Hospital Tokyo 105-0001 Japan Diabetes Research Diabetes Research Center National Center for Global Health and Medicine Tokyo 162-8655 Japan Center for Clinical Sciences National Center for Global Health and Medicine Tokyo 162-8655 Japan Ohta Nishinouchi Hospital Fukushima 963-8022 Japan First Department of Comprehensive Medicine Saitama Medical Center Jichi Medical University School of Medicine Saitama 330-0834 Japan Department of Gastroenterology and Hepatology Kohnodai Hospital National Center for Global Health and Medicine Chiba 272-8516 Japan Department of Endocrinology and Diabetes Saitama Medical University Saitama 350-0495 Japan

AIM: To determine the bowel symptoms associated with diabetes and diabetes-related factors after excluding gastrointestinal (GI) organic ***: Participants were 4738 (603 diabetic and 4135 non-diabetic) patients who underwent colonoscopy and completed a questionnaire. On the day of pre-colonoscopy, 9 symptoms (borborygmus, abdominal distension, increased flatus, constipation, diarrhea, loose stools, hard stools, fecal urgency, and incomplete evacuation) were prospectively evaluated on a 7-point Likert scale. The test-retest reliability of the bowel symptom scores from the baseline and second questionnaires was analyzed using kappa statistics. Associations between bowel symptom scores and diabetes or diabetes-related factors were analyzed by a rank-ordered logistic model adjusted for related confounders, and odds ratios (ORs) were ***: In multivariate analysis, constipation [adjusted odds ratio (AOR) = 1.57, CI: 1.33-1.85, P diseases on colonoscopy. Test-retest reliability of symptom score with a mean duration of 3.2 mo was good (mean kappa, 0.69). Associations of symptoms with diabetes-related factors were found; constipation with HbA1c ≥ 8.0% (AOR = 2.11, CI: 1.19-3.73), body mass index (BMI) < 25 (AOR = 2.11, CI: 1.22-3.66), and insulin use (AOR = 1.90, CI: 1.08-3.36); hard stools with diabetes duration (AOR = 1.03, CI: 1.00-1.07); fecal urgency with BMI < 25 (AOR = 1.73, CI: 1.00-2.98); and incomplete evacuation with BMI < 25 (AOR = 2.60, CI: 1.52-4.43), serum creatinine level (AOR = 1.27, CI: 1.10-1.47), and insulin use (AOR = 1.92, CI: 1.09-3.38).CONCLUSION: Diabetes is as

关键词： functional bowel disease Gastrointestinal symptom rating scale Decreased passage of stools Diabetic complications

Irritable bowel syndrome and small intestinal bacterial overgrowth:Meaningful association or unnecessary hype

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World Journal of Gastroenterology 2014年第10期20卷 2482-2491页

作者： Uday C Ghoshal Deepakshi Srivastava Department of Gastroenterology Sanjay Gandhi Post Graduate Institute of Medical Sciences Lucknow 226104 India

Irritable bowel syndrome (IBS) is a common condition characterized by abdominal pain or discomfort, bloating, and altered stool form and passage. Small intestinal bacterial overgrowth (SIBO) is a condition in which there is overgrowth of bacteria in small bowel in excess of 105 colony forming units per milliliter on culture of the upper gut aspirate. Frequency of SIBO varied from 4%-78% among patients with IBS and from 1%-40% among controls. Higher frequency in some studies might be due to fallacious criteria [post-lactulose breath-hydrogen rise 20 PPM above basal within 90 min (early-peak)]. Glucose hydrogen breath test (GHBT) has a low sensitivity to diagnose SIBO. Hence, studies based on GHBT might have under-estimated frequency of SIBO. Therefore, it is important to analyze these studies carefully to evaluate whether the reported association between IBS and SIBO is over or under-projected. This review evaluates studies on association between SIBO and IBS, discordance between different studies, their strength and weakness including methodological issues and evidence on therapeutic manipulation of gut flora on symptoms of IBS.

关键词： Glucose hydrogen breath test Lactulose hydrogen breath test functional bowel disease Dysbiosis Gut flora

Can probiotics benefit children with autism spectrum disorders?

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World Journal of Gastroenterology 2016年第46期22卷 10093-10102页

作者： fernando Navarro Yuying Liu Jon Marc Rhoads Department of Pediatrics Division of Gastroenterology the University of Texas Health Science Center at Houston Mc Govern Medical School

Children with autism are commonly affected by gastrointestinal problems such as abdominal pain, constipation and diarrhea. In recent years, there has been a growing interest in the use of probiotics in this population, as it hypothetically may help to improve bowel habits and the behavioral and social functioning of these individuals. The gut microbiome plays an important role in the pathophysiology of organic as well as functional gastrointestinal disorders. Microbial modification with the use of antibiotics, probiotics, and fecal transplantation have been effective in the treatment of conditions such as recurrent Clostridium difficile infection, pouchitis, and irritable bowel syndrome. The present review presents a number of reported clinical, immunological and microbiomerelated changes seen in children with autism compared to normally developed children. It also discusses gut inflammation, permeability concerns, and absorption abnormalities that may contribute to these problems. Most importantly, it discusses evidence, from human and animal studies, of a potential role of probiotics in the treatment of gastrointestinal symptoms in children with autism.

关键词： Microbiome gastrointestinal Inflammation functional bowel disease probiotics autism

Increased colon transit time and faecal load in irritable bowel syndrome

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2021年第1期12卷 13-20页

作者： Dennis Raahave Andreas K Jensen Department of Gastroenterology and Surgery Copenhagen University North Sealand HospitalHilleroed 3400Denmark Faculty of Health Sciences Section of BiostatisticsUniversity of CopenhagenHilleroed 3400Denmark

BACKGROUND Irritable bowel syndrome(IBS)is a bowel disorder involving abdominal pain or discomfort along with irregularity of stool form and passage *** pathophysiology is poorly understood and seems to be *** of possible causes of IBS have included only a few colonic transit studies and no simultaneous determination of the colonic faecal *** To compare colon transit time and faecal load between IBS-patients and healthy control *** The study included 140 patients with IBS,with a mean age of 50.0 *** control group comprised 44 healthy persons with a mean age of 43.4 years,who were selected at random from the National Civil *** the patient group and the control group underwent a marker study to measure colon transit time(CTT)and to calculate a faecal loading *** patient group underwent treatment with a combined prokinetic regime,after which their CTT and faecal loading were *** were performed to compare measurements between the control group and the patient group before and after *** Compared to healthy controls,IBS-patients exhibited a significantly prolonged mean CTT(45.48 h vs 24.75 h,P=0.0002)and significantly greater mean faecal loading scores in all colonic segments(P<0.001).Among IBS patients,we found no significant differences between the 48 h and 96 h *** patients exhibiting increased CTT and faecal loading,approximately half exhibited a palpable mass in the right iliac *** intervention with a prokinetic treatment,the mean CTT among IBS patients was reduced from 45.48 h to 34.50 h(P=0.091),with the post-treatment CTT not significantly differing from the CTT among control subjects(P=0.095).The faecal loading score among IBS patients did not significantly differ before and after treatment(P=0.442).The posttreatment faecal loading score in IBS patients remained significantly higher compared to that in controls(5.3 vs 4.3,P=0.014).Aft

关键词： Irritable bowel syndrome functional bowel disease Faecal retention Colon transit time Faecal load