Selected personality traits and emotional disorders of women diagnosed with gastrointestinal disease - a pilot study.

Introduction: There are many studies on the influence of psychological factors in the appearance of symptoms and their treatment among gastroenterological patients. It is increasingly indicated that these factors are of great importance also for the quality of life of people struggling with a chronic disease. Aim: To evaluate personality traits and emotional disorders in female patients with gastrointestinal conditions such as functional dyspepsia (FD), irritable bowel syndrome (IBS), or inflammatory bowel disease (IBD). Material and methods: The sample of 28 patients was verified in terms of the disease using the GAST questionnaire and assessed by personality questionnaires and psychological tests: the Spielberger State-Trait Anxiety Inventory (STAI), EAS Temperament Survey, Eysenck Personality Inventory (EPQ-R), Coping Inventory for Stressful Situations (CISS); Beliefs about Pain Control Questionnaire (BPCQ), General Self-efficacy Scale (GSES), and Satisfaction with Life Scale (SWLS). Results: The control group was recruited from female university students declaring full health. The conducted statistical analysis showed that there is a significant relationship between personality traits, psychological predispositions, and both the experience of illness and satisfaction with life among this specific group of patients. Conclusions: This pilot study demonstrated the need for a personalized approach to gastroenterological patients, also based on their personality characteristics. Such an approach may increase the effectiveness of therapy and bring benefits in long-term treatment.

Evaluation of Subcortical Structure Volumes in Patients with Non-Specific Digestive Diseases.

(1) Background: To evaluate volume of subcortical structures such as hippocampus, globus pallidus, putamen, thalamus, nucleus accumbens, amygdala, caudate in patients with non-specific digestive diseases (functional dyspepsia-FD, irritable bowel syndrome-IBS) and non-specific inflammatory bowel diseases-IBD (colitis ulcerosa and Crohn's disease) in comparison to healthy control group (CON). (2) Material: The analysis included data obtained from 57 patients (FD-18, IBS-20, IBD-19) and 19 persons in control group. Both groups underwent examination in a 3T scanner (Achieva TX Philips Healthcare). (3) Results: Significant differences between the IBD group and Control group in volume of left thalamus and IBD group vs Control group in volume of right thalamus. (4) Conclusions: The brain-gut axis hypothesis explains connection between biological behavior, emotions and cognitive functions in patients with gastrointestinal disease. We found that there is a difference between volume of thalamus in IBD patients in comparison to both IBS and control group and it occurred to be smaller. Excess inflammation can be linked with psychological disorders like depressive symptoms, sleep difficulties and/or fatigue. Therefore, there is a need for using treatment both for depressive symptoms and IBD to reduce the causes and effects of inflammation.

Assessment of the usefulness of imaging studies and biomarkers in the activity of Crohn's disease.

AIM: The aim of the study was to determine the suitability of available diagnostic methods, by means of comparison, for predicting disease activity, based on cost efficiency and sensitivity criteria. MATERIAL AND METHODS: In this study, we conducted analyses of 37 patients with Crohn's disease (CD). CD was graded as "active" or "inactive" by adopting certain cut-off values for every marker. The main assumption was that methods used to grade CD severity do not give false positive results. The authors decided to measure the agreement between the methods by applying Cohen's κ coefficient. RESULTS: Endoscopy shows the highest sensitivity, negative predictive value, and accuracy in detecting CD. In the case of both intestines, the sensitivity of endoscopy reached 93.9% and the accuracy 94.6%, while the sensitivity and accuracy of enterography and calprotectin were 51.5% vs. 71,9% and 56.8% vs. 72.2%, respectively. For the large intestine, the sensitivity and accuracy of endoscopy reached 100%. For the small intestine, endoscopy had 55% sensitivity and 75% accuracy, while enterography showed only 66.7% and 81.1%, respectively. The best agreement (77.1%, p = 0.005) was seen between endoscopy and calprotectin for full intestines. However, the value of Cohen's κ suggests that this agreement is moderate. The optimal cut-off value for calprotectin was 43 µg/g, and the ROC curve (AUC = 0.871) was large enough to conclude that calprotectin is a statistically significant (p < 0.001) indicator of CD activity. CONCLUSIONS: Statistically significant compliance was shown only between colonoscopy and faecal calprotectin.

Imaging of Morphological Background in Selected Functional and Inflammatory Gastrointestinal Diseases in fMRI.

The study focuses on evaluation of the Default Mode Network (DMN) activity in functional magnetic resonance imaging (fMRI) in resting state in patients with functional dyspepsia (FD) and irritable bowel syndrome (IBS), Crohn's disease and colitis ulcerosa (IBD) in comparison to healthy volunteers. We assume that etiology of both functional and non-specific inflammatory bowel diseases is correlated with disrupted structure of axonal connections. We would like to identify the network of neuronal connections responsible for presentation of symptoms in these diseases. 56 patients (functional dyspepsia, 18; Crohn's disease and colitis ulcerosa, 18; irritable bowel syndrome, 20) and 18 healthy volunteers underwent examination in MRI of the brain with assessment of brain morphology and central nervous system activity in functional imaging in resting state performed in 3T scanner. Compared to healthy controls' DMN in patients with non-specific digestive tract diseases comprised additional areas in superior frontal gyrus of left hemisphere, in left cingulum and in the left supplementary motor area. Discovered differences in the DMNs can be interpreted as altered processing of homeostatic stimuli. Our study group involved patients suffering from both functional and non-specific inflammatory bowel diseases. Nevertheless a spectrum of changes in the study group (superior frontal gyrus of the left hemisphere, in the left cingulum and in the left supplementary motor area) we were able to find common features, differentiating the whole study group from the healthy controls.

Use of functional magnetic resonance imaging in patients with irritable bowel syndrome and functional dyspepsia.

Functional brain imaging (positron emission tomography - PET, functional magnetic resonance imaging - fMRI), allowing in vivo analysis of the brain-digestive tract interaction and the neurological mechanisms underlying visceral hypersensitivity, significantly advanced research and helped in the understanding of the interrelations in this field. Differences in this parameter can result from alterations in task-related cognitive states or from resting state processes. Nowadays, advanced imaging techniques such as fMRI are more frequently used and are acknowledged among both clinicians and radiologists in the diagnostic algorithm of digestive tract diseases. Functional dyspepsia is a condition in which neuroimaging allows for analysis of dysfunctions within the brain-gut axis (BGA) engaged in processing of visceral discomfort and pain. The results of studies in patient groups with irritable bowel syndrome prove that psychosocial factors significantly affect the mechanisms regulating visceral sensitivity within the brain. The BGA includes neuronal pathways (autonomic nervous system), neuroendocrine (hypothalamo-pituitary-adrenal axis), and neuroimmunological ones. Psychological processes affect the functioning of the digestive system and can cause dyspeptic symptoms. A patient's mental condition associated with stress can affect processes taking place in the central nervous system and trigger somatic reactions in the digestive tract through the autonomic visceral system.

The importance of cognitive flexibility and flexibility in coping with stress for the quality of life in inflammatory bowel disease patients during biological therapy. A preliminary report.

INTRODUCTION: There are studies demonstrating the relation between psychological factors and efficiency of treatment in the course of inflammatory bowel diseases (IBD). AIM: To investigate the relation between cognitive flexibility and flexibility in coping with stress and the quality of life, as well as the sense of satisfaction with life, in patients undergoing the biological treatment. MATERIAL AND METHODS: The study group consisted of 33 adults who were diagnosed with Crohn's disease (CD) or ulcerative colitis (UC). The Flexibility in Coping with Stress Questionnaire (FCSQ-14), the Cognitive Flexibility Inventory (CFI), the Quality of Life SF36v2 Questionnaire, the Satisfaction with Life Scale (SWLS), and the socio-demographic questionnaire were used to gather the data. RESULTS: A total of 14 females and 19 males were included in this analysis. The results did not prove that the disease diagnosis (UC or CD) differed the level of psychological resources. However, older respondents achieved lower results in cognitive flexibility. A positive correlation was observed between both cognitive flexibility and flexibility in coping with stress and different dimensions of quality of life and satisfaction with life. CONCLUSIONS: There is a relationship between both cognitive flexibility and flexibility in coping with stress and health-related quality of life. These factors can be considered to be a kind of resource that helps to cope with challenges posed by a chronic illness, including IBD. Therefore, it is significant to increase their level by applying tailored therapeutic methods.

[Hepatoxic effect of a noni juice consumption--a case report]. / Hepatoksyczny efekt spozywania soku noni--opis przypadku.

UNLABELLED: Noni juice of an Indian mulberry fruit has recently become a very popular remedy for several diseases. The paper presents the case of hepatotoxic action of Noni juice in a previously healthy 55-years old female patient. After symptomatic therapy and cessation of exposure to the juice all symptoms dissapeared. CONCLUSIONS: 1. Indian mulberry formulations may, in some cases, lead to liver toxicity. 2. Treatment consists of cessation of exposure to preparations containing Indian mulberry fruits and a symptomatic therapy. 3 There is an urgent need to examine the therapeutic and toxic effects of commonly used herbal specifics.

Socio-demographic characteristics of patients with diagnosed functional dyspepsia.

INTRODUCTION: The term "dyspepsia" comes from the Greek words "dys' and 'peptin", which maen "ill digestion" or indigestion, although this set of symptoms in the adult clinic has little to do with the digestion or absorption process, and refers more to ailments related to the upper section of the gastrointestinal tract. AIM: Assessment of the frequency of functional dyspepsia diagnosis, the characteristics of the group and an attempt to identify the accompanying symptoms, assessment of histological lesions and an attempt to answer question about the efficiency of anti-secretory and eradication therapy. MATERIAL AND METHODS: The study involved patients reporting for gastrofiberscopic examination due to dyspeptic ailments. A total of 230 patients were examined, including 140 women and 90 men, above 18 years of age. They underwent endoscopic examination, and a selected group with functional dyspepsia (FD), analysed using the 'Gast' questionnaire, underwent eradication therapy or proton pump inhibitors. Statistical analysis involved χ(2) and Fischer's test. RESULTS: The study involved 230 individuals with dyspeptic disorders. The largest age group was 46-60 years. These patients reported due to their ailments mostly in autumn and winter. The differentiated group with FD included 53 patients (23% of the clinical population). 69.8% of the FD group was infected with Helicobacter pylori (with 81.2% of the whole population, respectively). Individuals with FD reported improvement more often after being administered drugs to decrease gastric secretion, more often declared post-elementary education and suffered from non-gastric ailments yet still described their state of health as good. No positive therapeutic effect of eradication was noticed during the 6-month observation. CONCLUSIONS: Due to the very high ratio of subjects with functional dyspepsia, also observed in the study sample, and the influence of civilization progress, we should expect increasing frequency of occurrence of this problem.

[Characteristic and endoscopic evaluation of dyspeptic patients]. / Charakterystyka chorych na dyspepsje z uwzglednieniem roli badania endoskopowego.

UNLABELLED: Dyspeptic sypmtoms are common in our population and are typical for upper gastrointestinal tract disease. Endoscopy is commonly performed to evaluate symptoms of dyspepsia, especially in older patients after 45 years or with alarm symptoms. The aim of this study was to charaterize patients who receive endoscopy for dyspepsia and to analyse their endoscopic findings. MATERIAL AND METHODS: Endoscopic egzamination was performed first time in 230 patients without alarm symptoms, without history earlier history of gastrointestinal pathology, with normal abdomen ultrasonography. According to Rome II criteria (at least 12 months of symptoms) all patients were classified as dyspeptic. RESULTS: Only in 23% of this group no endoscopic changes were noticed. Functional dyspepsia was diagnosed mostly before 45 year, but organic changes mostly after 45 year, however in both groups (after and before 45 years) we found almost similar percent of serious organic changes (ulcers and neoplasm). Summarising, we found organic changes in 69% of patients before 45 years in comparison to 80% after 45 years (ns). CONCLUSION: We conclude that in the case of long lasting dyspeptic symptoms (at least 12 months), endoscopy should be performed to exclude organic pathology in all patients.