Efficacy of a new nutraceutical formulation: L-tryptophan, probiotics, charcoal, chamomile, mint, and licorice (COLONIR®) in the improvement of gastrointestinal symptoms in subjects with irritable bowel syndrome.

BACKGROUND: Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders. IBS is characterized by recurrent chronic abdominal pain and altered bowel habits in the absence of organic damage. Although there are reviews and guidelines for treating IBS, the complexity and diversity of IBS presentation make treatment difficult. Treatment of IBS focuses on relieving symptoms as mild signs and symptoms can often be controlled by managing stress and by making changes in diet and lifestyle. The use of nutraceutical compounds has been advocated as a possible alternative treatment in patients with IBS. COLONIR® (Omega Pharma Srl, Milan, Italy) may be an alternative or adjuvant treatment in patients with gastrointestinal symptoms. This study aimed to evaluate the effect of this new nutraceutical formulation in inducing symptoms remission and improve gastrointestinal habits. METHODS: An initial cohort of 1004 consecutive patients referred to 25 different Units of Internal Medicine a/o Gastroenterology in Italy to perform colonoscopy for intestinal symptoms was asked to participate. Patients were treated for 2 months with two doses of nutraceuticals/day during meals namely COLONIR®. Patients were assessed at baseline and after 2 months to evaluate the frequency and severity of gastrointestinal symptoms in the past seven days with a questionnaire based on ROMA IV criteria. RESULTS: After 2 months, 899 patients completed the follow-up. COLONIR® achieved a statistically significant reduction of severity of symptoms in the study population without any documented side effects. CONCLUSIONS: These promising results, here reported, need to be confirmed, valuating the efficacy of COLONIR® in relieving gastrointestinal symptoms in IBS patients in further studies.

Endolaparoscopic treatment of cholecysto-choledochal lithiasis. Personal experience.

AIM OF THE STUDY: To demonstrate how, on the basis of the personal experience, the rendezvous technique, in the management of cholelithiasis associated with choledocolithiasis , whenever there is the indication, is better than the sequential treatment. METHODS: From January 2008 to May 2011, 48 patients with cholelithiasis and choledocolithiasis combined were treated with endolaparoscopic technique. Of these patients, 23 were treated with the sequential treatment and 25 with the rendezvous method. We attempted to define the indications for endolaparoscopic rendezvous: - cholelithiasis associated with choledocolithiasis or biliary sludge not bigger than 1 cm; - permeability of the colecystic duct; - a clinical picture of medium-low importance. CONCLUSIONS: The data of the study confirm the superiority of the rendezvous technique because it resolves cholelithiasis associated with choledocolithiasis in a single surgical act with greater acceptance of the patient who avoids a second invasive surgical act; moreover it requires shorter hospitalization and convalescence, resulting in reduced costs. Finally the data analyzed show a reduction in complications compared to sequential treatment.