The role and therapeutic effectiveness of Plantago ovata seed husk (psyllium husk) in the prevention and non-pharmacological treatment of gastrointestinal diseases. Part 1. Clinical use of psyllium husk in the treatment of irritable bowel syndrome, ulcerative colitis, and colorectal cancer.

Plantago ovata is a common medicinal plant widely cultivated in tropical regions of the world. The outer seed coat of P. ovata, obtained by cleaning the seeds, contains soluble and insoluble fibre in a ratio of 7:3, making products containing P. ovata husk an ideal source of health-beneficial fibre. The results of clinical trials demonstrate the therapeutic efficacy of psyllium husk for various gastrointestinal disorders. It has also been documented that psyllium ingestion exhibits antioxidant, immunomodulatory, antiproliferative, anticancer, and antiviral effects. Such pleiotropic effects of P. ovata husk are related to the presence in its composition of arabinoxylan, which forms a gel in an aqueous environment, as well as bioactive compounds and their metabolites. This article presents the evidence available in the literature on the therapeutic potential and possible mechanisms of action of psyllium in the treatment of irritable bowel syndrome and ulcerative colitis, and prevention of colorectal cancer.

Application of Manuka honey in treatment patients with GERD.

Gastro-esophageal reflux disease has systematically increase in Western countries over recent years. Health benefits of Manuka honey allows to use it for medical purposes, for example reduction of inflammation of gastrointestinal mucosa. Thus, the aim of research was the application of Manuka honey in treatment patients with Gastro-esophageal reflux disease (GERD). The study was conducted on a group of 30 patients, which consumed Manuka honey or placebo for a period of 4 weeks. The gastroscopy and histology has been made twice, that is before and after experiment. Furthermore, the symptoms reports and nutritional interviews have been collected. The endoscopical examination showed that in Manuka group the improvement was 73.3%. In the sub-groups of esophagitis-A and esophagitis-B the improvement rate was 81.8%, and 50%, respectively. However, in the placebo group, the general improvement rate was much lower. The results have been confirmed in the histopathological examination. Moreover, it is worth noticing, that in sub-group declaring non-medication, the improvement was only for patients consuming Manuka honey. Changes of symptoms in subjective assessment of patients were evaluated after 2 and 4 weeks. The improvement rate in Manuka group was 86.7% and 100%, while in Placebo group it was only 26.7% and 40%, respectively. Manuka honey seems to be effective in GERD, which have been confirmed by subjective feelings of patients and by endoscopic and histopathologic examination. Our research is a pilot study before administration of Manuka honey to larger population. The results are promising and may facilitate the quality of life of patients with GERD.

Analysis of Aflatoxins, Fumonisins, Deoxynivalenol, Ochratoxin A, Zearalenone, HT-2, and T-2 Toxins in Animal Feed by LC-MS/MS Using Cleanup with a Multi-Antibody Immunoaffinity Column.

BACKGROUND: Regulations limiting aflatoxin levels in animal feed and guidance values for maximum levels for fumonisins (FB1 and FB2), deoxynivalenol (DON), ochratoxin A (OTA), zearalenone (ZON), HT-2, and T-2 toxins are in place both to protect animal health and to minimize potential transfer to animal products for human consumption. A multi-mycotoxin method which can handle complex feed matrices such as distillers dried grains with solubles (DDGS) is essential for analysis and accurate quantification without the need to revert to separately analyze individual mycotoxins. OBJECTIVE: The objective of this study is to generate single laboratory validation data for a method employing a multi-antibody immunoaffinity column (IAC) capable of providing cleanup for eleven mycotoxins, followed by LC-MS/MS quantification without the need for isotopic labelled and matrix-matched standards. The applicability of method is to be demonstrated for corn feed, pig feed, and DDGS by fortification and naturally occurring mycotoxins covering the range of regulated limits. METHODS: Feed sample (1 kg) ground by milling to approximately 1-2 mm particle size and sub-sample (5 g) extracted with acetonitrile-water-formic acid, passing through a multi-mycotoxin IAC, washing, and eluting prior to LC-MS/MS analysis monitoring selected ion transitions. RESULTS: Recoveries were in the range 74 to 117% (excluding five outliers) for aflatoxins, FB1, FB2, DON, OTA, ZON, HT-2, and T2- toxins spiked into three commercial animal feed matrixes (n = 84) and within-day RSDs averaged 1.7 to 10.3% (n = 99). CONCLUSION: Single laboratory validation of a multi-antibody IAC method coupled with LC-MS/MS has shown the method to be suitable for accurate quantification of eleven regulated mycotoxins in DDGS, pig feed, and poultry feed. HIGHLIGHTS: IAC method capable of accurately quantifying eleven regulated mycotoxins in complex feed matrices.

Antioxidant Properties and Fatty Acid Profile of Cretan Extra Virgin Bioolive Oils: A Pilot Study.

Olive oil is considered a valuable ingredient of human diet. It is a good source of mono- and polyunsaturated fatty acids, as well as other bioactive compounds, especially polyphenols. The composition of olive oil depends mainly on the variety of plant, cultivation practices, and manufacturing conditions. Traditional processing methods may ensure better quality and health benefits. Therefore, the aim of the study was the evaluation of antioxidant properties and fatty acid profile of Cretan extra virgin bioolive oils. These ones were compared with commercial Spanish, Italian, and Greek extra virgin olive oils. Obtained results showed that sample Cretan 1 had about 15% higher antioxidant capacity and about 60% higher total polyphenol content than commercial counterparts. This one had also a favorable profile of fatty acids, especially 20% more linoleic acid. We concluded that traditional production methods, using millstones, cold pressing, and without centrifugation and filtration ensure better olive oil quality and related health benefits.

Effects of Acute Consumption of Noni and Chokeberry Juices vs. Energy Drinks on Blood Pressure, Heart Rate, and Blood Glucose in Young Adults.

The purpose of this study has been to determine the effect of acute consumption of noni and chokeberry juices vs. energy drinks on blood pressure, heart rate, and blood glucose. The subjects divided into 4 groups, which consumed three portions of noni or chokeberry juices (30 mL or 200 mL, respectively) and energy drink (ED) or water (200 mL) at one-hour intervals. All participants had their blood pressure (BP), both systolic and diastolic BP (SBP and DBP), as well as heart rate (HR) and blood glucose (BG), measured. Consumption of noni juice caused a significant decrease in SBP and DBP of 5.0% and 7.5%, respectively, while, the consumption of chokeberry juice slightly decreased only DBP by 3.6%. On the contrary, consumption of three portions of EDs caused a significant increase in DBP by 14.7%. The BG of participants consuming noni juice decreased by 7.3%, while the consumption of EDs increased BG by as much as 15.8%. Acute consumption of noni juice contributed to a significantly decreased SBP, DBP, and HR as well as a mild reduction of BG. Consumption of chokeberry juice caused only a slight reduction of DBP. Contrary to juices, EDs consumption resulted in an increase of blood pressure (especially DBP) and blood glucose. The results of the study showed that noni juice may be effective in lowering blood pressure and blood sugar levels, but there is a need to continue research on the long-term effect of this juice.

Endoscopic removal of a battery that was lodged in the oesophagus of a two-year-old boy for an extremely long time.

In the present work we describe a 2-year-old boy whose battery ingestion was overlooked, and who had the battery endoscopically removed from the upper part of his oesophagus after several months. This is the only described case of such a long impaction of a lithium battery in the oesophagus, without development of severe complications. We stress the necessity to take into account ingestion of a dangerous foreign body by children demonstrating unspecific clinical signs.

Role of saliva in esophageal defense: implications in patients with nonerosive reflux disease.

BACKGROUND: It has been previously demonstrated that patients with reflux esophagitis exhibit a significant impairment in the secretion of salivary protective components versus controls. However, the secretion of salivary protective factors in patients with nonerosive reflux disease (NERD) is not explored. The authors therefore studied the secretion of salivary volume, pH, bicarbonate, nonbicarbonate glycoconjugate, protein, epidermal growth factor (EGF), transforming growth factor alpha (TGF-α) and prostaglandin E2 in patients with NERD and compared with the corresponding values in controls (CTRL). METHODS: Salivary secretion was collected during basal condition, mastication and intraesophageal mechanical (tubing, balloon) and chemical (initial saline, acid, acid/pepsin, final saline) stimulations, respectively, mimicking the natural gastroesophageal reflux. RESULTS: Salivary volume, protein and TGF-α outputs in patients with NERD were significantly higher than CTRL during intraesophageal mechanical (P < 0.05) and chemical stimulations (P < 0.05). Salivary bicarbonate was significantly higher in NERD than CTRL group during intraesophageal stimulation with both acid/pepsin (P < 0.05) and saline (P < 0.01). Salivary glycoconjugate secretion was significantly higher in the NERD group than the CTRL group during chewing (P < 0.05), mechanical (P < 0.05) and chemical stimulation (P < 0.01). Salivary EGF secretion was higher in patients with NERD during mechanical stimulation (P < 0.05). CONCLUSIONS: Patients with NERD demonstrated a significantly stronger salivary secretory response in terms of volume, bicarbonate, glycoconjugate, protein, EGF and TGF-α than asymptomatic controls. This enhanced salivary esophagoprotection is potentially mediating resistance to the development of endoscopic mucosal changes by gastroesophageal reflux.

A distinct salivary secretory response mediated by the esophago-salivary reflex in patients with Barrett's esophagus: its potential pathogenetic implications.

PURPOSE: A significantly compromised epidermal growth factor (EGF) secretion by basal parotid saliva may contribute to the development of Barrett's esophagus (BE). The rate of secretion of EGF as well as a wide spectrum of protective factors in total basal and stimulated saliva in BE patients remains to be explored. We therefore studied the rate of secretion of salivary buffers, glycoconjugate, protein, EGF, transforming growth factor α (TGFα) and prostaglandin E2 (PGE2), evoked by esophago-salivary reflex, in patients with BE and controls (CTRL). MATERIAL/METHODS: Salivary secretion was collected during basal condition, mastication, and intraesophageal mechanical and chemical stimulations respectively, mimicking the natural gastroesophageal reflux scenario. RESULTS: Salivary pH in BE was significantly lower than in controls during mechanical (p<0.001) and chemical stimulations (p<0.001). Bicarbonate and protein outputs in BE were significantly lower during mechanical (p<0.05) and chemical stimulations (p<0.01). The non-bicarbonate and glycoconjugate outputs in BE were lower during chemical stimulation (p<0.05) and during mechanical (p<0.05) and chemical stimulations (p<0.05) respectively. The rate of salivary EGF output in BE was significantly lower during mechanical stimulation (p<0.05). We observed a higher TGFα output during mastication (p<0.05) and PGE2 secretion during basal and masticatory condition (p<0.05) in BE. CONCLUSIONS: Patients with BE demonstrated significantly compromised salivary pH and rate of secretion of bicarbonate, non-bicarbonate, glycoconjugate, protein and EGF. This impairment could potentially predispose to the development of accelerated esophageal mucosal injury. Potential restoration of this impairment by masticatory stimulation of salivary secretion using sugarless chewing gum justifies further clinical exploration.

Salivary bicarbonate as a major factor in the prevention of upper esophageal mucosal injury in gastroesophageal reflux disease.

BACKGROUND: It has been previously demonstrated that the exposure of the lower esophageal mucosa to acid and pepsin results in significant increase in salivary protective factors secretion, mediated by the esophago-salivary reflex. The impact of the upper esophageal mucosal exposure to acid and pepsin on salivary secretory response remains unknown. AIMS: To investigate the rate of salivary protective factors secretion during the upper esophageal mucosal exposure to acid and pepsin and to compare with the corresponding results recorded during the lower esophageal mucosal exposure, in the same group of asymptomatic volunteers. METHODS: The study was conducted in 10 asymptomatic volunteers. Salivary samples were collected during the esophageal mucosal exposure to saline, followed by acid/pepsin and the final saline, using the esophageal perfusion catheter. Salivary bicarbonate and non-bicarbonate buffers were analyzed using TitraLab. Salivary mucin and protein were quantified through PAS and Lowry methodologies, respectively, whereas PE2 using radioimmunoassay. Statistical analysis was performed using Σ-Stat software. RESULTS: The rate of salivary bicarbonate secretion was significantly higher (3.1-fold) during the upper versus the lower esophageal mucosal exposure to acid and pepsin (87.5 ± 14.4 vs. 28.0 ± 7.70 µEq/min, p < 0.05). The volumes of saliva, pH, salivary protein, mucin and PE2 were similar in both esophageal perfusions. CONCLUSIONS: Threefold stronger secretion of salivary bicarbonate could be a major factor protecting the upper esophageal mucosa. This phenomenon may represent an ultimate defense mechanism potentially preventing further complications within the upper esophageal mucosa; however, it needs to be confirmed in patients of gastroesophageal reflux disease.

Intragastric Balloon (BIB system) in the treatment of obesity and preparation of patients for surgery - own experience and literature review.

UNLABELLED: Despite the recognition of bariatric surgery as the only effective method of weight reduction, we remain in search of minimally invasive methods, both for the treatment of obesity and preparation of patients for surgical procedures. The aim of the study was to determine intragastric balloon (Allergan) implantation results as the only method of treating obesity, and patient preparation for further stages of abdominal hernia operations, as well as other surgical procedures. MATERIAL AND METHODS: The study presented own results considering the use of Bioenteric Intragastric Balloons (BIB system) in the treatment of pathological obesity, and preparation of patients for bariatric surgery and abdominal hernia operations. The study group comprised 18 female and 7 male patients. Average patient age amounted to 50.6 and 54 years, respectively. Indications for intragastric balloon insertion were as follows: preparation for hernia (10 cases) and bariatric (5 patients) operations, and weight reduction management (8 patients). In two cases the implantation of the intragastric balloon served the preparation for gynecological and orthopedic (vertebral column) operations. One female patient was prepared for both bariatric and hernial surgery. The procedure was performed under general anesthesia. Statistical analysis considered 22 patients (one female patient was excluded from analysis, due to death, two other were excluded because of lack of sufficient data).Results. In case of two patients the intragastric balloon system was removed before 6 months had elapsed because of intolerance. One female patient died during the observation period for reasons not related to the procedure. The obtained BMI reduction ranged between 2 and 6 kg/m2, which amounted to a maximum weight loss of 24 kg. In one patient a weight gain of 2 kg was observed. Considering patients prepared for abdominal hernia operations weight reduction was greater and better maintained after the removal of the BIB system. CONCLUSIONS: According to the authors of the presented study the intragastric balloon serves its role as a bridge to bariatric procedures and weight reduction, before planned extensive postoperative hernia operations. The use of the intragastric balloon only to reduce weight has no medical and economic justification.

Gastric juice prostaglandins and peptide growth factors as potential markers of chronic atrophic gastritis, intestinal metaplasia and gastric cancer: their potential clinical implications based on this pilot study.

BACKGROUND: Gastric secretion can provide valuable information especially when Helicobacter pylori (Hp) infection results in chronic atrophic gastritis (CAG) and intestinal metaplasia (IM) preceding adenocarcinoma (AdCa). AIMS: Looking for a potential biomarker of malignant transformation in the setting of chronic inflammation we studied the levels of prostaglandin E2 (PGE(2)), as well as peptide growth factors [epidermal growth factor (EGF) and transforming growth factor α (TGFα)], harbingers of injury and repair, in gastric juice aspirated at endoscopy from patients with CAG, CAG/IM, AdCa, and controls. METHODS: The PGE(2), EGF and TGFα concentrations in the gastric juice were measured using radioimmunoassays (RIAs). RESULTS: In patients with AdCa gastric juice PGE(2) increased fivefold versus controls (P < 0.01) and almost threefold versus patients with CAG (P < 0.05). The EGF levels in patients with AdCa were fourfold higher versus controls (P < 0.001) and almost threefold higher versus CAG (P < 0.05). In patients with CAG/IM the EGF levels were also almost 3 times higher versus controls. The TGFα levels in patients with AdCa were half the value of controls and CAG (P < 0.05). In patients with CAG/IM the levels were as low as 1/5 of controls or CAG (P < 0.05). CONCLUSIONS: Testing the gastric juice for PGE(2), EGF, and TGFα in patients with endoscopy and biopsy proven CAG, may be helpful in follow up of patients who may potentially progress to IM and ultimately AdCa. This could be considered as an adjunct to histologic assessment especially that even the best surveillance biopsy specimen regimens are inherited with sampling errors.

[Adventitious diagnosis of coeliac disease in three family members]. / Przypadkowe rozpoznanie celiakii u trzech czlonków rodziny.

This report presents family that among three of four family members (father, daughter, son) coeliac disease was diagnosed. The first diagnosed person was 11-year-old girl who was included into population screening tests for coeliac disease. Father has been presented chronic diarrhoea since childhood. Son has been suffering from recurrent aphthous stomatitis for many years. The girl was completely asymptomatic. The serum antiendomysial antibodies were positive in a high titre in all three patients. They all also presented macroscopic markers of coeliac disease in form of loss of folds, scalloping or mosaic pattern in the descending part of the duodenum and typical histopathological lesions graded as 3b or 3c according to Marsh classification.

[Twenty-two months old girl with haemorrhagic gastritis as a complication after the nonsteroid anti-inflammatory drugs application--case report]. / Krwotoczne zapalenie blony sluzowej zoladka u 22-miesiecznej dziewczynki jako powiklanie zastosowania niesterydowych leków przeciwzapalnych--opis przypadku.

The aim of case report was to pay attention for possibility of side effects of nonsteroid anti-inflammatory drugs. Child of young and healthy parents was born after normal pregnancy, natural delivery. The disease started in two days before the admission, child had fever, cough and sneezing. Mother gave her two doses of ibuprofen. On the time of admission general state of patient was moderate; girl was apathic. In physical examination features of upper respiratory tract infection were shown. In the course of treatment antibiotic and symptomatic drugs including paracetamol (3x5 ml) were delivered. During the second day of treatment child had no appetite, started to vomit with fresh and haemolized blood. Parenteral hydratation was started. Emergency gastroscopy was done and features of haemorrhagic gastritis were shown. Anti-inflammatory drugs were no more used and delivery of omeprazole was started. Parenteral hydratation was continued. General state of patient was better. In the sixth day after bleeding child was excripted in good general state with order of use of omeprazole. Parents were informed about the restriction of anti-inflammatory drugs use. The aim of case report was to pay attention that haemorrhagic gastritis may be one of side effects of nonsteroid anti-inflammatory drugs used accordingly to actual standards.

[Impedance-pH analysis in gastroesophageal reflux monitoring]. / Zastosowanie metody pH-impedancji w monitorowaniu refluksu zoladkowo-przelykowego.

Gastroesophageal reflux is defined as regurgitation of the stomach contents into the esophagus due to transient or persistent failure of the lower esophageal sphincter. The measurement of impedance is a new technique used to diagnose gastroesophageal reflux. This technique is devoid of restrictions connected with classical esophageal pH-metry. Multichannel intraluminal impedance depends on changes in resistance to alternating current between two metal ring electrodes (impedance measuring segment) generated by the presence of bolus within that segment. The impedance measuring segments are located at 3, 5, 7, 9 cm (distal esophagus) and at 15 and 17 cm (proximal esophagus) over the proximal margin of the lower esophageal sphincter. The technique allows for classification of gastroesophageal reflux incidents as acid, weakly acidic and non-acid, assessment of reflux contents as liquid, gas or gas-liquid and the height of reflux regurgitation into the esophagus. The usefulness of pH-impedance analysis is still difficult due to the lack of normal values in children.

Beneficial effect of iloprost on the course of acute taurocholate pancreatitis in rats and its limitation by antecedent acute ethanol intake.

The effects of stable prostacyclin analogue iloprost on the trypsinogen activation, labilization of lysosomal membranes, lipolytic enzymes activities, histopathological and ultrastructural changes in the pancreas of rats with severe, taurocholate acute pancreatitis (AP), preceded for 6 h by acute ethanol intake have been investigated. Iloprost (1 microg/kg b.w., i.p.) was applied every 6 hours after inducing of taurocholate AP. The antecedent intragastric 40% ethanol intake (5 g/kg b.w.) increased an index of trypsinogen activation in AP lasting 18 h. Treatment with iloprost prevented this increase in the rats with AP given earlier alcohol, and limited the labilization of lysosomal membranes in nonalcoholized rats with AP. Phospholipase A2 and lipase activities were reduced by iloprost only in the rats not given ethanol. The additional damaging effect of acute ethanol abuse prior to AP could be dependent on augmented activation of trypsinogen. The protective effect of iloprost in AP seems to be dependent on the attenuation of trypsinogen activation, decrease of total potential trypsin and the decrease of lysosomal membranes labilization. Its protective effect could be limited in taurocholate acute pancreatitis preceded by acute ethanol intake as evidenced by the differences in the cathepsin B, phospholipase A2 and lipase activities and by histopathological and ultrastructural examination.