Effectiveness of Abdominal Massage Versus Kinesio Taping in Women With Chronic Constipation: A Randomized Controlled Trial.

Background/Aims: Chronic constipation is an important public health problem and significantly affects women's lives. It is important to investigate non-pharmacological applications that can be used in the treatment of chronic constipation. The aim is to assess how abdominal massage and kinesio taping impact constipation severity, quality of life (QOL), and perception of subjective improvement in women with chronic constipation. Methods: Following Rome IV diagnostic criteria, women with constipation were randomly sorted into three distinct groups for study: massage group (lifestyle recommendations+abdominal massage, n:22), taping group (lifestyle recommendations+kinesio taping, n:22), and control group (lifestyle recommendations, n:22). Constipation Severity Instrument (CSI) (for constipation severity), 7 days bowel diary (for bowel function), Patient Assessment of Constipation QOL (PAC-QOL) questionnaire (for QOL), 4-item Likert-type scale (for perception of subjective improvement) was used. Results: The group x time interaction effect was significant in all CSI, bowel diary and PAC-QQL parameters, except for incomplete evacuation and PAC-QOL-worries/concerns, and a large effect size was found (Partial η2 > 0.14). Improvement scores of all parameters (except CSI-obstructive defecation, incomplete evacuation, PAC-QOL-worries/concerns) were similar in the massage and taping groups and were better than the control group. Noteworthy perceptions of subjective improvement and normalization of stool type predominantly manifested in the massage group (p<0.05). Conslusion: Abdominal massage and kinesio taping are recommended as initial conservative interventions for managing chronic constipation within the therapeutic spectrum.

Serum pepsinogen levels and OLGA/OLGIM staging in the assessment of atrophic gastritis types.

BACKGROUND: We assessed the validity of using serum pepsinogen tests (sPGTs) to differentiate autoimmune atrophic gastritis (AAG) from environmental atrophic gastritis (EAG). We also investigated the correlation and prognostic value between disease stage, according to Operative Link for Gastritis Assessment (OLGA)/Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM), and sPGT results in patients with gastric atrophy. METHODS: We enroled 115 patients in this prospective study: 95 with atrophic gastritis (16 with AAG and 79 with EAG) and 20 non-atrophic gastritis. These patients, along with 32 control patients, underwent esophagogastroduodenoscopy. Atrophy and intestinal metaplasia of the gastric biopsy specimens were staged according to the OLGA/OLGIM staging systems. RESULTS: The median (IQR) age of the patients (83 females (56.5%)) was 58 (46-67) years. Patients in the AAG group represented histologically advanced stages. The AAG group had lower pepsinogen (PG) I and II levels, as well as a lower PGI/PGII ratio, compared with the EAG group (p<0.01, p<0.05 and p<0.01, respectively). The optimal PGI/PGII ratio for predicting AAG was ≤1.9 (100% sensitivity and 100% specificity), and that for predicting EAG was ≤9.2 (47.5% sensitivity and 90.6% specificity). The OLGA/OLGIM stage was negatively correlated with the PGI level and PGI/PGII ratio. In the AAG group, four of five patients with low-grade dysplasia had OLGA/OLGIM stage III-IV disease. CONCLUSIONS: sPGT may provide valuable information for differentiating advanced-stage AAG from EAG, and in patients with atrophic gastritis, use of sPGTs and OLGA/OLGIM staging together may predict gastric cancer risk.

Evaluation of G-Protein-Coupled Bile Acid Receptor 1 (TGR5) Levels in Intrahepatic Cholestasis of Pregnancy.

Background and objective Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disease. G-protein-coupled bile acid receptor 1 (TGR5) agonists might be beneficial in ICP treatment. In this study, we aimed to investigate the relationship of serum TGR5 levels with ICP and associated itching. Methods Sixty-three pregnant women diagnosed with ICP based on a serum bile acid level of >10 µmol/L (patient group) and 47 healthy pregnant women as a control group were included in the study. In the patient group, ursodeoxycholic acid (UDCA) therapy was given at a dose of 15 mg/kg from the time of diagnosis until the termination of pregnancy. Serum transaminase levels were measured at the beginning and within 15 days after the onset of treatment, and the dose was increased in patients who were unresponsive to treatment. Results Bile acid level was found to be between 10-39 µmol/L in 61.9% of the ICP patients, and it was ≥40 µmol/L in 38.1% of the patients. The majority of the patients responded well to the treatment with UDCA. The mean TGR5 level was significantly higher in the patient group compared to the control group (0.98 ±0.95 ng/mL vs. 0.74 ±0.23 ng/mL, p=0.032). In the patient group, TGR5 level showed negative correlations with age and red cell distribution width and a positive correlation with lactate dehydrogenase level and lymphocyte count. Conclusions Based on our findings, it can be suggested that TGR5 may have a role in the pathogenesis but has no impact on the prognosis of the condition.

Severe jaundice due to coexistence of Dubin-Johnson syndrome and hereditary spherocytosis: a case report.

Dubin-Johnson syndrome is a chronic, benign, intermittent jaundice, mostly of conjugated hyperbilirubinemia. The level of bilirubin is not expected to be more than 20 mg/dl in this syndrome. In this article, we report a patient who was evaluated for hyperbilirubinemia and liver function test abnormalities and diagnosed with Dubin-Johnson syndrome coexisting with hereditary spherocytosis. We suggest that other diseases should be investigated if patients with Dubin-Johnson syndrome present with severe hyperbilirubinemia. Dubin-Johnson syndrome accompanied by hemolytic diseases might also have high coproporphyrin levels (as in Rotor's syndrome) than expected in pure Dubin-Johnson syndrome.