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1.
Mymensingh Med J ; 31(1): 161-164, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34999697

RESUMO

Helicobacter Pylori (H Pylori) that infects about 90% people of developing countries causes dyspepsia and upper gastrointestinal lesions. The aim of this study was to detect the trend of H Pylori active infection and to investigate the endoscopic findings of H Pylori infected dyspeptic patient of Bangladesh. In this prospective study, 360 dyspeptic patients (Male-251, Female-109) were recruited. Patients having alarm features, history of gastrectomy and malignancy were excluded from this study. Non-invasive fecal antigen test for H Pylori was done of all patients. All selected patients were sent for upper gastrointestinal endoscopy. Helicobacter Pylori fecal antigen was found positive in 134(37.2%) from 360 dyspeptic patients (age 14-80 years). Among 360 patients 303 (80.16%) had macroscopic endoscopic mucosal lesions. H Pylori infected 114 patients had endoscopic mucosal abnormality. H Pylori non-infected 189 patients also had mucosal lesion. Twenty patients (35.08%) had H Pylori infection among the 57 patients having endoscopic normal looking mucosa. This study revealed that active H Pylori infection rate is declining in Bangladesh. Risk of endoscopic mucosal lesion is more expected in H Pylori active infection.


Assuntos
Dispepsia , Infecções por Helicobacter , Helicobacter pylori , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Dispepsia/epidemiologia , Fezes , Feminino , Infecções por Helicobacter/complicações , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
2.
Saudi Med J ; 43(1): 75-80, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35022287

RESUMO

OBJECTIVES: To evaluate the hematological parameters in dyspepsia patients infected with Helicobacter pylori (H. pylori) infection from Al Qassim province of Kingdom of Saudi Arabia (KSA). METHODS: This retrospective study was carried out in Dr. Sulaiman Al-Habib Hospital, Al Qassim, KSA. The data of dyspepsia and epigastric pain patients were derived from the hospital based registration system between 2020-2021. Logistic regression models were used to investigate the correlation between the onset of H. pylori infection and anemia. RESULTS: Among 810 enrolled patients, there were 202 (24.9%) patients with H. pylori infection and 144 (17.8%) with anemia. The prevalence of anemia in the H. pylori (+) group was not statistically higher than the H. pylori (-) group after adjusting age, red blood cell count, serum ferritin, mean corpuscular volume, platelet count, and mean corpuscular hemoglobin (p>0.05). The level of hemoglobin was almost identical in both the H. pylori (+) group and the H. pylori (-) group (p>0.05). CONCLUSION: The findings show that H. pylori infection may not be related to anemia in dyspepsia patients from the Central region of KSA.


Assuntos
Dispepsia , Infecções por Helicobacter , Helicobacter pylori , Dispepsia/epidemiologia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/epidemiologia , Humanos , Estudos Retrospectivos , Arábia Saudita/epidemiologia
3.
BMC Gastroenterol ; 21(1): 441, 2021 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-34814828

RESUMO

BACKGROUND: Dyspepsia is a common cause of physician visits. If and when endoscopy should be performed depend on the regions and the populations. This study aimed to identify the current risk factors predictive of upper gastrointestinal malignancy or peptic ulcer in China with high prevalence of gastric cancer. METHODS: A questionnaire was conducted among consecutive outpatients undergoing their first esophagogastroduodenoscopy for dyspepsia. Symptoms other than alarm symptoms in this study were defined as uncomplicated dyspepsia. RESULTS: 4310 outpatients (mean age 44, median 42, range 14-86) were included in the final analyses. Significant pathology was found in 13.8% (595/4310) patients including peptic ulcer (12.3%) and upper gastrointestinal malignancy (1.5%). Age, male sex and alarm symptoms were significantly associated with malignancy. The age cut-off identified for upper gastrointestinal malignancy was 56 years among patients with uncomplicated dyspepsia, which was similar to the combined cutoff of age and gender. CONCLUSIONS: Age should be considered as the primary predictor for upper gastrointestinal malignancy in Chinese patients with uncomplicated dyspepsia. 56 could probably be the optimal age to identify those lesions in this population. TRIAL REGISTRATION: Chictr.org (ChiCTR2000040775).


Assuntos
Dispepsia , Neoplasias Gastrointestinais , Neoplasias Gástricas , Adulto , China/epidemiologia , Dispepsia/epidemiologia , Dispepsia/etiologia , Endoscopia Gastrointestinal , Neoplasias Gastrointestinais/complicações , Neoplasias Gastrointestinais/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Neoplasias Gástricas/complicações , Neoplasias Gástricas/epidemiologia
4.
Eur Rev Med Pharmacol Sci ; 25(18): 5836-5842, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34604975

RESUMO

OBJECTIVE: Functional gastrointestinal disorders are common gastrointestinal diseases. The pathophysiology is multifactorial and psychosocial distress worsens symptoms severity. Since the end of 2019 the world has been facing COVID-19 pandemic. The associated control measures have affected the psychological health of people. The aim of the present study is to evaluate the impact of the COVID-19 pandemic on the prevalence of functional gastrointestinal disorders among Italian children and adolescents. PATIENTS AND METHODS: The study sample is composed of 407 patients (187 males, 220 females), aged from 10 to 17 years. The mean age is 14.27 ± 2.24 years. The study was conducted through the Italian version of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III Version.  The prevalence of each disorder has been calculated as the ratio of affected subjects for each disease and the total number of effective cases for that specific disease. RESULTS: The study demonstrates that the prevalence of Functional Gastrointestinal Disorder in Italian children, during the COVD-19 pandemic, is higher, compared with the one reported in the previous studies. The most frequent disorders are Abdominal Migraine and Irritable Bowel Syndrome. CONCLUSIONS: Our study is the first one which provides data of the prevalence of Functional gastrointestinal disorders in sample of Italian adolescents, during the COVID-19 pandemic. The study underlines the need to focus on stress management, in order to reduce the effects of the lockdown on the psychological wellness of the youngest.


Assuntos
COVID-19/psicologia , Gastroenteropatias/etiologia , Gastroenteropatias/psicologia , Quarentena/psicologia , Isolamento Social/psicologia , Estresse Psicológico/complicações , Dor Abdominal/epidemiologia , Dor Abdominal/etiologia , Dor Abdominal/psicologia , Adolescente , Aerofagia/epidemiologia , Aerofagia/etiologia , Aerofagia/psicologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Criança , Constipação Intestinal/epidemiologia , Constipação Intestinal/etiologia , Constipação Intestinal/psicologia , Dispepsia/epidemiologia , Dispepsia/etiologia , Dispepsia/psicologia , Incontinência Fecal/epidemiologia , Incontinência Fecal/etiologia , Incontinência Fecal/psicologia , Feminino , Gastroenteropatias/diagnóstico , Gastroenteropatias/epidemiologia , Humanos , Síndrome do Intestino Irritável/epidemiologia , Síndrome do Intestino Irritável/etiologia , Síndrome do Intestino Irritável/psicologia , Itália , Masculino , Transtornos de Enxaqueca/epidemiologia , Transtornos de Enxaqueca/etiologia , Transtornos de Enxaqueca/psicologia , Prevalência , Síndrome da Ruminação/epidemiologia , Síndrome da Ruminação/etiologia , Síndrome da Ruminação/psicologia , Estresse Psicológico/diagnóstico , Inquéritos e Questionários , Vômito/epidemiologia , Vômito/etiologia , Vômito/psicologia
5.
J Med Life ; 14(4): 492-497, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34621372

RESUMO

Recent data suggest that the prevalence of Helicobacter pylori (HP) infection in Romania has been declining in the last 30 years. However, there are no studies regarding HP prevalence among medical students. The objectives of this study were to estimate the prevalence of HP infection and assess the prevalence of dyspepsia in medical students and the relationship between dyspepsia and infection. We included 150 students from the Iuliu Hatieganu University of Medicine and Pharmacy of Cluj-Napoca, Romania (102 females and 48 males, mean age 21 years). Each student completed a lifestyle questionnaire, personal history, family history as well as the Rome IV questionnaire for functional dyspepsia. The status of HP infection was determined using the C13-urea respiratory test. The prevalence of HP infection was 25.33%, and 18% met the Rome IV criteria for functional dyspepsia. 37% of students with functional dyspepsia had a positive HP test. Of all students, 8% had a history of HP infection. Those with a history of HP infection had a 4.45% (95% CI 1.6 - 12.37) higher risk of having positive Rome IV criteria for functional dyspepsia than those with no previous history of infection (p=0.008). Thus, the present study adds to the body of evidence regarding HP prevalence among medical students, 25.33% being positive. We found no statistically significant correlation between HP infection and functional dyspepsia. Those with a history of HP infection had a higher risk of functional dyspepsia.


Assuntos
Dispepsia , Infecções por Helicobacter , Helicobacter pylori , Estudantes de Medicina , Adulto , Dispepsia/diagnóstico , Dispepsia/epidemiologia , Feminino , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/epidemiologia , Humanos , Masculino , Romênia/epidemiologia , Cidade de Roma , Adulto Jovem
6.
Aliment Pharmacol Ther ; 54(11-12): 1416-1431, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34626489

RESUMO

BACKGROUND: Rumination syndrome is a functional gastroduodenal disorder characterised by effortless regurgitation of recently ingested food. Emerging evidence reports duodenal eosinophilic inflammation in a subset, suggesting a shared pathophysiology with functional dyspepsia (FD). AIM: To assess the clinical features of rumination syndrome and FD in a community-based study. METHODS: We mailed a survey assessing gastrointestinal symptoms, diet and psychological symptoms to 9835 residents of Olmsted County, MN, USA in 2017-2018; diagnostic codes were obtained from linked clinical records. The two disorders were assessed as mutually exclusive in 'pure' forms with a separate overlap group, all compared to a control group not meeting criteria for either. Prevalence of associations, and univariate and independent associations with predictors were assessed by logistic regression. RESULTS: Prevalence of rumination syndrome and FD were 5.8% and 7.1%, respectively; the overlap was 3.83-times more likely than expected by chance. Independent predictors for rumination (odds ratio (OR), 95% confidence interval (CI)) were female gender (1.79, 1.21-2.63), smoking (1.89, 1.28-2.78), gluten-free diet (1.58, 1.14-2.19), allergic rhinitis (1.45, 1.01-2.08) and depression (1.10, 1.05-1.16). FD was independently associated with female gender, depression, non-coeliac wheat sensitivity, migraine, irritable bowel syndrome and somatic symptoms. A similar reported efficacy (≥54%) of low fat or dairy-free diets was found with both disorders (P = 0.53 and P = 1.00, respectively). The strongest independent associations with overlapping FD and rumination syndrome were a history of rheumatoid arthritis (3.93, 1.28-12.06) and asthma (3.02, 1.44-6.34). CONCLUSION: Rumination syndrome overlaps with FD with a shared risk factor profile, suggesting a common pathophysiology.


Assuntos
Dispepsia , Síndrome da Ruminação , Dieta Livre de Glúten , Dispepsia/epidemiologia , Feminino , Humanos , Prevalência , Fatores de Risco
7.
BMJ Open ; 11(10): e052522, 2021 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-34706958

RESUMO

OBJECTIVE: Age and alarm features are commonly used as indicators for endoscopy in dyspeptic patients; however, the age cut-off and the predictive value of these parameters for identifying upper gastrointestinal (UGI) malignancies are uncertain. DESIGN: Cross-sectional study. SETTING: Data were extracted from the Gastrointestinal Endoscopy Centre of Siriraj Hospital, Thailand, during 2005-2011. PARTICIPANTS: Consecutive patients underwent a first-time upper endoscopy for dyspepsia. Patients with previous surgery, suspected UGI malignancy by imaging, or indefinite biopsy results on prior examination were excluded. MAIN OUTCOME MEASURES: Alarm features included dysphagia, unintentional weight loss, GI bleeding/anaemia, and persistent vomiting. The diagnostic performance of each alarm feature and different age cut-off values were evaluated. RESULTS: A total of 4664 patients (mean age: 52.0±14.4 years, 66% female) were included. Alarm symptoms were presented in 21.6%. The prevalence of active Helicobacter pylori infection was 26.3%. Fifty-eight (1.2%) patients had UGI malignancy. The prevalence of malignancy significantly increased with increasing age (0.6% in patients aged <50 years, and 1.8% in patients aged >60 years (p<0.001)). Cancer was found in two patients aged <50 years who did not have alarm features. Patients with alarm features had a higher prevalence of malignancy (OR 22.3, 95% CI 10.5 to 47.4; p<0.001) than those without. The pooled sensitivity, specificity, positive predictive value and negative predictive value of alarm features for UGI malignancy were 87.0%, 79.1%, 4.7% and 99.8%, respectively. Among all age groups, persistent vomiting had a positive likelihood ratio (PLR) >10, while dysphagia and GI bleeding/anaemia had a PLR >10 in patients <50 years old. CONCLUSION: Despite the overall limited value of age and alarm features, persistent vomiting, dysphagia, and GI bleeding/anaemia are strong predictors for malignancy in patients aged <50 years. Without these symptoms, cancer prevalence is negligible; thus, they are worthy guidance for endoscopic evaluation in this age group.


Assuntos
Dispepsia , Neoplasias Gastrointestinais , Infecções por Helicobacter , Helicobacter pylori , Adulto , Idoso , Estudos Transversais , Dispepsia/diagnóstico , Dispepsia/epidemiologia , Dispepsia/etiologia , Endoscopia Gastrointestinal , Feminino , Neoplasias Gastrointestinais/complicações , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Gastrointestinais/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Tailândia
8.
West Afr J Med ; 38(8): 775-784, 2021 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-34504383

RESUMO

BACKGROUND: Helicobacter pylori is common in developing countries like Nigeria with significant morbidity and risk of mortality. With rising antimicrobial resistance, risk factors of infection should be explored to develop prevention strategies and improve the health of developing communities. OBJECTIVE: To identify determinants and clinical correlates of H. pylori among study participants. METHODS: We conducted a hospital-based cross-sectional study between May and July 2017 of 280 dyspeptic adults in Garki Hospital Abuja. They were tested using serum H. pylori Immunoglobulin G antibody test kits. Data on patient characteristics were collected using pre-tested interviewer administered questionnaires. The data were analysed using SPSS version 25. Logistic regression and odds ratios with 95% confidence intervals were computed to identify risk factors and clinical features associated with H. pylori infection. RESULTS: The overall prevalence of H. pylori infection was 53.6%. H. pylori was positively associated with age and monthly income. Family history of dyspepsia (OR = 0.32: 95% CI = 0.13 to 0.78), regular consumption of fruits and vegetables (OR = 0.11: 95% CI = 0.046 - 0.281) and regular handwashing with soap and water (OR = 0.02: 95% CI = 0.006 -0.040) were found to be protective against H. pylori infection. CONCLUSION: There is a high H. pylori prevalence amongst patients with dyspepsia in Garki Hospital Abuja. Interventions to reduce the incidence of H. pylori infection should emphasise regular handwashing with soap and water and regular fruit and vegetable consumption.


Assuntos
Dispepsia , Infecções por Helicobacter , Helicobacter pylori , Adulto , Estudos Transversais , Dispepsia/epidemiologia , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/epidemiologia , Humanos , Nigéria/epidemiologia , Prevalência
9.
BMC Gastroenterol ; 21(1): 355, 2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34579657

RESUMO

BACKGROUND: Helicobacter pylori (H. pylori) infection is the most important risk factor for gastritis and peptic ulcer. However, factors other than H. pylori are involved in its pathogenesis. In the current study, we aimed to compare the clinical manifestations and endoscopic and histopathological findings of patients with and without H. pylori infection. METHODS: In this cross-sectional study, 233 patients with dyspepsia, referred for endoscopy, were examined regarding the presence of H. pylori infection. During an endoscopic exam, 5 biopsy specimens were taken from the stomach. The criteria for the presence of H. pylori infection was the presence and identification of bacteria in pathology. Two groups of H. pylori-positive and H. pylori-negative patients were compared regarding their demographic, endoscopic, and pathological findings. RESULTS: Of 233 patients, 154 (66.1%) were non-smokers, 201 (86.3%) were not alcohol users, and 153 (65.7%) used tap water. The most common symptom, reported in 157 (67.4%) patients, was epigastric pain. There was a significant difference between patients with and without H. pylori infection in terms of the educational status, occupational status, family history of gastrointestinal cancer, and some gastrointestinal symptoms. Also, there was a significant relationship between the endoscopic and pathological findings of patients with H. pylori. CONCLUSIONS: The results of the present study revealed that H. pylori infection was not associated with sex, alcohol consumption, or non-steroidal anti-inflammatory drug use. The role of H. pylori in the pathophysiology of peptic ulcer was clarified. Also, there was a significant difference in the endoscopic and pathological findings of patients with H. pylori.


Assuntos
Dispepsia , Infecções por Helicobacter , Helicobacter pylori , Estudos Transversais , Demografia , Dispepsia/epidemiologia , Endoscopia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia
10.
Sci Rep ; 11(1): 18605, 2021 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-34545155

RESUMO

Increased prevalence of sleep disorders has been found in patients with functional dyspepsia; however, direction of causality remains unclear. Our aim was to compare the risk of incident functional dyspepsia between patients with and without sleep disturbance from a large population-based sample. Utilizing a nation-wide health insurance administrative dataset, we assembled an 11-year historic cohort study to compare subsequent incidence of diagnosed functional dyspepsia between adult patients with any diagnosis of sleep disturbance and age- and gender-matched controls. Hazard ratios adjusted for other relevant comorbidities and medications were calculated using Cox regression models. 45,310 patients with sleep disorder and 90,620 controls were compared. Patients with sleep apnea had a 3.3-fold (95% confidence interval: 2.82 ~ 3.89) increased hazard of functional dyspepsia compared with controls. This increased risk persisted regardless of previously diagnosed depression coexisted. Sleep disturbance was associated with an increased risk of subsequent functional dyspepsia. Potential mechanisms are discussed.


Assuntos
Dispepsia/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Adulto , Fatores Etários , Idoso , Comorbidade , Depressão/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Risco , Fatores Sexuais
11.
Eur J Gastroenterol Hepatol ; 33(10): 1266-1273, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34334711

RESUMO

BACKGROUND AND AIM: Diagnostic guidelines for the investigation of dyspepsia for patients <50 years have been implemented. However, it is unsure whether these guidelines are used appropriately. We aimed to investigate the adherence to the national guidelines of uninvestigated dyspepsia and to examine the prevalence of upper gastrointestinal pathology in patients 18-50 years. We also aimed to detect any possible risk factors for pathology in esophagogastroduodenoscopy referrals and to evaluate differences between referrals from the hospital and primary health care. METHOD: This is a retrospective review of medical records including patients who underwent esophagogastroduodenoscopy between January 2019 and April 2020 (n = 1809). Odds ratios (OR), positive predictive values (PPV), negative predictive values (NPV), chi-square and Mann-Whitney U-tests were applied. RESULTS: In total 1708 patients were included, of whom 43.6% (n = 744) had a pathologic finding. Age group 41-50 years showed the highest prevalence with an OR 1.34 [95% confidence interval (CI), 1.07-1.69]. Helicobacter pylori testing was performed in 21.1% (n = 167) of patients with dyspepsia lacking alarm symptoms (n = 791). PPV and OR were generally low for a pathologic esophagogastroduodenoscopy. The absence of alarm symptoms showed a high NPV for significant pathology (98.7-99.6%). Significant pathology was almost exclusively found in hospital-based referrals. CONCLUSIONS: Esophagogastroduodenoscopy is widely performed in young adults, often without significant findings. Adherence to the national guidelines was poor. No referral factors were associated with a significant risk for a pathologic finding. Esophagogastroduodenoscopy based on primary healthcare referrals demonstrated almost exclusively benign pathology. Significant pathology was only found via hospital-based referrals.


Assuntos
Dispepsia , Infecções por Helicobacter , Helicobacter pylori , Adulto , Dispepsia/diagnóstico , Dispepsia/epidemiologia , Gastroscopia , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/epidemiologia , Humanos , Pessoa de Meia-Idade , Encaminhamento e Consulta , Estudos Retrospectivos , Adulto Jovem
12.
Lancet Gastroenterol Hepatol ; 6(10): 784-792, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34358486

RESUMO

BACKGROUND: Current treatments for functional dyspepsia have limited efficacy or present safety issues. We aimed to assess spore-forming probiotics in functional dyspepsia as monotherapy or add-on therapy to long-term treatment with proton-pump inhibitors. METHODS: In this single-centre, randomised, double-blind, placebo-controlled pilot trial that took place at University Hospitals Leuven (Leuven, Belgium), adult patients (≥18 years) with functional dyspepsia (as defined by Rome IV criteria, on proton-pump inhibitors or off proton-pump inhibitors) were randomly assigned (1:1) via computer-generated blocked lists, stratified by proton-pump inhibitor status, to receive 8 weeks of treatment with probiotics (Bacillus coagulans MY01 and Bacillus subtilis MY02, 2·5 × 109 colony-forming units per capsule) or placebo consumed twice per day, followed by an open-label extension phase of 8 weeks. Individuals with a history of abdominal surgery, diabetes, coeliac or inflammatory bowel disease, active psychiatric conditions, and use of immunosuppressant drugs, antibiotics, or probiotics in the past 3 months were excluded. All patients and on-site study personnel were masked to treatment allocation in the first 8 weeks. Symptoms, immune activation, and faecal microbiota were assessed and recorded. The primary endpoint was a decrease of at least 0·7 in the postprandial distress syndrome (PDS) score of the Leuven Postprandial Distress Scale in patients with a baseline PDS score of 1 or greater (at least mild symptoms), assessed in the intention-to-treat population. This study is registered with ClinicalTrials.gov, NCT04030780. FINDINGS: Between June 3, 2019, and March 11, 2020, of 93 individuals assessed for eligibility, we included 68 patients with functional dyspepsia (51 [75%] women, mean age 40·1 years [SD 14·4], 34 [50%] on proton-pump inhibitors). We randomly assigned 32 participants to probiotics and 36 to placebo. The proportion of clinical responders was higher with probiotics (12 [48%] of 25) than placebo (six [20%] of 30; relative risk 1·95 [95% CI 1·07-4·11]; p=0·028). The number of patients with adverse events was similar with probiotics (five [16%] of 32) and placebo (12 [33%] of 36). Two serious adverse events occurring during the open-label phase (appendicitis and syncope in two separate patients) were assessed as unlikely to be related to the study product. INTERPRETATION: In this exploratory study, B coagulans MY01 and B subtilis MY02 were efficacious and safe in the treatment of functional dyspepsia. Participants had potentially beneficial immune and microbial changes, which could provide insights into possible underlying mechanisms as future predictors or treatment targets. FUNDING: MY HEALTH.


Assuntos
Suplementos Nutricionais/efeitos adversos , Dispepsia/dietoterapia , Dispepsia/fisiopatologia , Probióticos/uso terapêutico , Adulto , Bacillus coagulans , Bacillus subtilis , Bélgica/epidemiologia , Estudos de Casos e Controles , Método Duplo-Cego , Dispepsia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Placebos/administração & dosagem , Prevalência , Probióticos/administração & dosagem , Probióticos/efeitos adversos , Inibidores da Bomba de Prótons/uso terapêutico , Segurança , Esporos/química , Resultado do Tratamento
13.
Aliment Pharmacol Ther ; 54(5): 627-636, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34247414

RESUMO

BACKGROUND: Psychological distress, strongly associated with functional gastrointestinal disorders (FGIDS), likely plays a central role in the pathophysiology. The role of sleep disturbances in FGIDs is unclear, and an association with psychological factors is uncertain. AIM: To determine whether sleep disturbances are associated with irritable bowel syndrome (IBS) and functional dyspepsia (FD) and if a potential association is explained by psychological distress. METHODS: Adult sample randomly selected from a region in New South Wales, Australia in 2015 who returned a follow-up mail survey in 2018 (response rate, 60.5%) that contained questions on IBS, FD, sleep (MOS-Sleep Scale) and psychological distress (Kessler 6 scale). RESULTS: Among this population, 10.4% (95% CI 8.8-12.2) and 17.9% (95% CI 15.9-20.1) met Rome III criteria for IBS and FD, respectively. The prevalence of any sleep disturbance at least most of the time was common, with a significantly higher prevalence in FGID (IBS and/or FD) compared with the remaining population (41.8% vs 32.2%, P = 0.003). The total sleep problem index was significantly higher for IBS (OR = 1.71 [95% CI 1.29-2.27], P < 0.0001) (IBS-diarrhoea predominant and IBS-mixed but not IBS-constipation) and FD (OR = 1.80 [1.43-2.26], P < 0.0001) (both epigastric pain syndrome and postprandial distress syndrome) even after adjusting for age, sex and psychological distress. CONCLUSION: Both IBS and FD, and most of their major subtypes except IBS-C, are associated with a range of sleep disturbances. These sleep problems do not appear to be explained by psychological factors and may play an independent role in the pathophysiology.


Assuntos
Dispepsia , Síndrome do Intestino Irritável , Angústia Psicológica , Transtornos do Sono-Vigília , Adulto , Austrália/epidemiologia , Dispepsia/epidemiologia , Humanos , Síndrome do Intestino Irritável/complicações , Síndrome do Intestino Irritável/epidemiologia , Prevalência , Sono , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia , Inquéritos e Questionários
14.
Chin Med J (Engl) ; 134(12): 1422-1430, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34091519

RESUMO

BACKGROUND: Functional dyspepsia (FD) has rarely been investigated in areas with a high prevalence of esophageal squamous cell carcinoma (ESCC). This study aims to reveal the epidemiological and clinical features of FD and organic dyspepsia (OD) in such a population. METHODS: A middle-aged and elderly population-based study was conducted in a region with a high incidence of ESCC. All participants completed the Gastroesophageal Reflux Disease Questionnaire and Functional Gastrointestinal Disease Rome III Diagnostic Questionnaire, and they underwent gastroscopy. After exclusion of gastroesophageal reflux disease, uninvestigated dyspepsia (UID) was divided into OD and FD for further analyses. RESULTS: A total of 2916 participants were enrolled from July 2013 to March 2014 in China. We detected 166 UID cases with questionnaires, in which 17 patients with OD and 149 with FD were diagnosed via gastroscopy. OD cases presented as reflux esophagitis (RE), ESCC, and duodenal ulcer. Heartburn (52.94%) and reflux (29.41%) were common in OD, but no symptomatic differences were found between FD and OD. Male sex, low education level, and liquid food were the risk factors for OD, while frequent fresh vegetable consumption was a protective factor. FD included 56 (37.58%) cases of postprandial distress syndrome (PDS), 52 (34.89%) of epigastric pain syndrome (EPS), nine (6.04%) of PDS + EPS, and 32 (21.48%) of FD + functional esophageal disorders. The Helicobacter pylori infection rate in FD patients was not higher than that in the control group (34.23% vs. 42.26%, P = 0.240). Frequent spicy food consumption was associated with PDS (odds ratio [OR]: 2.088, 95% confidence interval [CI]: 1.028-4.243), while consumption of deep well water was protective for PDS (OR: 0.431, 95% CI: 0.251-0.741). CONCLUSIONS: The prevalence of FD was 5.11% in the studied population. Gastroscopy should be prescribed for dyspepsia patients in case that ESCC and RE would be missed in UID cases diagnosed solely by the Rome III questionnaire. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01688908; https://clinicaltrials.gov/ct2/show/record/NCT01688908.


Assuntos
Dispepsia , Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Infecções por Helicobacter , Helicobacter pylori , Idoso , China/epidemiologia , Dispepsia/epidemiologia , Neoplasias Esofágicas/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade
17.
Scand J Gastroenterol ; 56(7): 753-760, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34062084

RESUMO

BACKGROUND AND AIM: The prevalence of gastroesophageal reflux symptoms (GERS) and dyspepsia is high. Overlapping of GERS and dyspepsia has been described to affect quality of life. However, studies are few. This long-term population-based study evaluates how GERS, dyspepsia, and overlapping symptoms, affect quality of life, and the use of health care and medication. METHODS: This study presents data for the control group of the randomised population study, HEP-FYN. At baseline 10,000 individuals, aged 40-65 years, received questionnaires at baseline and after 1, 5 and 13 years. The questionnaire included questions regarding demographics, use of health care resources, gastrointestinal symptoms (the Gastrointestinal Symptom Rating Scale (GSRS)), and the Short-Form 36-Item Health Survey (SF-36) to assess quality of life. RESULTS: Complete data was available for 4.403 individuals at 13-year follow-up. Of these 13.6% reported GERS only, 11.6% dyspepsia only, and 27.1% overlapping symptoms during follow-up. Individuals reporting overlapping symptoms had compared to individuals reporting GERS only or dyspepsia only more visits at general practitioner (last year:16.7% vs. 8.5% vs. 12.3%), more sick leave days (last month: 4.3% vs. 2.9% vs 0.7%), used more ulcer drugs (last month: 30.5% vs 16.4% vs 9.4%). In addition, individuals with overlapping symptoms reported a lower quality of life in all eight dimensions of SF-36 compared to individuals with GERS alone or dyspepsia alone. CONCLUSIONS: Overlapping symptoms was associated with lower quality of life scores and substantial use of health-care resources. Having solely GERS affected quality of life and health care use least.


Assuntos
Dispepsia , Refluxo Gastroesofágico , Estudos de Coortes , Atenção à Saúde , Dispepsia/tratamento farmacológico , Dispepsia/epidemiologia , Refluxo Gastroesofágico/tratamento farmacológico , Refluxo Gastroesofágico/epidemiologia , Humanos , Qualidade de Vida , Inquéritos e Questionários
18.
BMC Gastroenterol ; 21(1): 218, 2021 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-33980172

RESUMO

BACKGROUND: There is no study assessing the risk factors associated with functional dyspepsia (FD) in Chinese children based on the Rome IV criteria. METHODS: In this cross-sectional study, we analyzed data from eight representative primary and secondary schools to assess the risk factors associated with FD in Chinese children based on the Rome IV criteria. RESULTS: A total of 6976 Chinese children were enrolled. The mean age was 14.3 ± 2.5 years, with a range from 7 to 17 years, and 3497 (50.1%) participants were female. FD was prevalent in 209 (3.0%) of the Chinese child population studied. Age (OR = 1.112, P = 0.006), living independent of parents (OR = 1.677, P < 0.001), prolonged school meals (OR = 2.107, P < 0.001), never eat breakfast (OR = 2.192, P = 0.003), often/daily eat cold foods (OR = 2.296, P = 0.002; OR = 2.736, P = 0.011), and often eat pickled foods (OR = 2.390, P = 0.001) were found to be independent risk factors for FD. A nomogram with these risk factors had good discrimination (AUC = 0.727) and calibration (Hosmer-Lemeshow test was 0.851). CONCLUSIONS: Age, living independent of parents, prolonged school meals, never eat breakfast, often/daily eat cold foods and often eat pickled foods were independent risk factors for FD. The nomogram could be used as a quick screening tool to assess FD in Chinese children.


Assuntos
Dispepsia , Adolescente , Criança , China/epidemiologia , Estudos Transversais , Dispepsia/epidemiologia , Dispepsia/etiologia , Feminino , Humanos , Masculino , Fatores de Risco
19.
Aliment Pharmacol Ther ; 54(1): 32-42, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33983640

RESUMO

BACKGROUND: It is uncertain if functional dyspepsia (FD) or irritable bowel syndrome (IBS) are linked to smoking, and smoking cessation is not part of the routine advice provided to these patients. AIM: To assess if smoking is an independent risk factor for FD and IBS. METHODS: Three population-based endoscopy studies in Sweden with 2560 community individuals in total (mean age 51.5 years, 46% male). IBS (14.9%), FD (33.5%), and associated symptoms were assessed using the validated abdominal symptom questionnaire, and smoking (17.9%) was obtained from standardised questions during a clinic visit. The effect of smoking on symptom status was analysed in an individual person data meta-analysis using mixed effect logistic regression, adjusted for snuffing, age and sex. RESULTS: Individuals smoking cigarettes reported significantly higher odds of postprandial distress syndrome (FD-PDS) (OR 10-19 cig/day = 1.42, 95% CI 1.04-1.98 P = 0.027, OR ≥20 cig/day = 2.16, 95% CI 1.38-3.38, P = 0.001) but not epigastric pain. Individuals smoking 20 or more cigarettes per day reported significantly higher odds of IBS-diarrhoea (OR = 2.40, 95% CI 1.12-5.16, P = 0.025), diarrhoea (OR = 2.01, 95%CI 1.28-3.16, P = 0.003), urgency (OR = 2.21, 95%CI 1.41-3.47, P = 0.001) and flatus (OR = 1.77, 95%CI 1.14-2.76, P = 0.012) than non-smokers. Smoking was not associated with IBS-constipation or IBS-mixed. CONCLUSION: Smoking is an important environmental risk factor for postprandial distress syndrome, the most common FD subgroup, with over a twofold increased odds of PDS in heavy smokers. The role of smoking in IBS-diarrhoea, but not constipation, is also likely important.


Assuntos
Dispepsia , Síndrome do Intestino Irritável , Diarreia , Dispepsia/epidemiologia , Dispepsia/etiologia , Feminino , Humanos , Síndrome do Intestino Irritável/epidemiologia , Síndrome do Intestino Irritável/etiologia , Masculino , Pessoa de Meia-Idade , Fumar/efeitos adversos , Inquéritos e Questionários , Suécia/epidemiologia
20.
Clin Transl Gastroenterol ; 12(4): e00334, 2021 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-33878048

RESUMO

INTRODUCTION: Functional dyspepsia (FD), although commoner than organic dyspepsia (OD) in-hospital studies, community data, particularly from rural areas, are lacking. We performed a rural community study in Bangladesh with the primary aims to evaluate (i) the prevalence of uninvestigated dyspepsia (UD), FD, and OD and (ii) the risk factors for UD. METHODS: This house-to-house survey was performed using a translated-validated enhanced Asian Rome III questionnaire and endoscopy with Helicobacter pylori tests, including genotyping. RESULTS: Of 3,351/3,559 responders ([94.15%], age 40.41 ± 16.05 years, female 1924 [57.4%]), 547 (16.3%) had UD (female 346 [18%] vs male 201 [14%]; P = 0.002); 201 (6%), 88 (2.6%), and 258 (7.7%) had postprandial distress (PDS), epigastric pain syndromes (EPS) and PDS-EPS overlap, respectively. On multivariate analysis, age >50 years (adjusted odds ratio [AOR] 1.34 [1.07-1.68]), female sex (AOR 1.42 [1.17-1.74]), being married (AOR 1.57 [1.21-2.07]), lower family income (AOR 1.79 [1.43-2.26]), nonsteroidal anti-inflammatory drug use (AOR 7.05 [2.11-23.55]), previous acute gastroenteritis (AOR 5.42 [1.83-16]), and psychological distress (AOR 5.02 [2.87-8.76]) were risk factors for UD. Of 346/547 (63.25%) undergoing endoscopy, 232 (67.05%) and 114 (32.95%) had FD and OD (peptic ulcers [PU] 99 [28.61%] and erosive esophagitis 13 [3.76%]). About 53% of FD subjects had EPS-PDS overlap, 32% had PDS, and only 15% had EPS. H. pylori was detected in 266/342 (78%) dyspeptics (FD 173/230 [75.2%], vs OD 92/114 [82.1%], P = 0.169). DISCUSSION: Sixteen percent, 11% and 5% of rural Bangladeshi Asian adults had UD, FD, and PU, respectively. One-third of UD subjects had OD, mostly PU.JOURNAL/cltg/04.03/01720094-202104000-00016/inline-graphic1/v/2021-04-15T161418Z/r/image-tiff.


Assuntos
Dispepsia/epidemiologia , Dispepsia/microbiologia , Infecções por Helicobacter/epidemiologia , Helicobacter pylori , Úlcera Péptica/epidemiologia , Úlcera Péptica/microbiologia , Adulto , Bangladesh/epidemiologia , Estudos Transversais , Dispepsia/tratamento farmacológico , Dispepsia/psicologia , Endoscopia Gastrointestinal , Feminino , Infecções por Helicobacter/psicologia , Helicobacter pylori/patogenicidade , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Satisfação do Paciente , Úlcera Péptica/psicologia , Úlcera Péptica/terapia , Estudos Prospectivos , Qualidade de Vida , Fatores de Risco , População Rural , Fatores Socioeconômicos , Virulência
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