The Gastrointestinal Pain Pointer: A Valid and Innovative Method to Assess Gastrointestinal Symptoms.
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ABSTRACT:
SUBMITTER: Henderson WA
PROVIDER: S-EPMC4902787 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundOral iron supplementation is often associated with rapid onset of gastrointestinal side-effects. The aim of this study was to develop and trial a short, simple questionnaire to capture these early side-effects and to determine which symptoms are more discriminating.MethodsThe study was a double-blind placebo-controlled randomized parallel trial with one week treatment followed by one week wash-out. Subjects were randomized into two treatment groups (n = 10/group) to receive either ferrous sulphate (200 mg capsules containing 65 mg of iron) or placebo, both to be taken at mealtimes twice daily during the treatment period. Subjects completed the questionnaires daily for 14 days. The questionnaire included gastrointestinal symptoms commonly reported to be associated with the oral intake of ferrous iron salts (i.e. nausea, vomiting, heartburn, abdominal pain, diarrhoea, and constipation).ResultsSeventy five per cent of participants reporting the presence of one or more symptoms in the first week of the study were in the ferrous sulphate group. In the second week of the study (i.e. wash-out), 67% of the participants reporting one or more symptom(s) were in the ferrous sulphate group. In the first week of the study (treatment) the number of symptoms reported by participants in the ferrous sulphate group (mean ± SEM = 6.7 ± 1.7) was significantly higher than that for participants in the placebo group (1.2 ± 0.5) (p = 0.01). In the second week of the study (wash-out) the number of symptoms reported by participants in the ferrous sulphate group (4.6 ± 2.0) appeared higher than for participants in the placebo group (1.0 ± 0.7) although this did not reach significance (p = 0.12). Events for which the gastrointestinal symptom questionnaire was most discriminatory between ferrous sulphate and placebo groups were: heartburn, abdominal pain and the presence of black stools (all p ≤ 0.03).ConclusionsA tool for the detection of commonly-occurring side effects should not require large study numbers to be effective. With just 10 subjects per group (iron or placebo), this simple questionnaire measures gastrointestinal side-effects associated with oral iron (ferrous sulphate) supplementation, and would be appropriate for use in intervention studies or clinical trials.Trial registrationClinicalTrials.gov Identifier: NCT02146053 (21/05/2014).
| S-EPMC4082414 | biostudies-literature
Project description:ObjectiveTo evaluate the brain's responses to painful visceral and somatic stimuli in diabetic patients with gastrointestinal symptoms.Research design and methodsThe sensitivity to electrical esophageal and median nerve stimulations was assessed in 15 healthy volunteers and 14 type 1 diabetic patients with autonomic neuropathy and gastrointestinal symptoms using a euglycemic-hyperinsulinemic clamp. Evoked brain potentials were recorded.ResultsPatients had reduced sensitivity to esophageal (48%; P < 0.001) and median nerve (80%; P < 0.001) stimulations. They also had increased (8.8%; P = 0.007) and nonreproducible (P = 0.006) latencies of evoked potentials in response to esophageal stimulations, with 26% reduction in amplitude (P = 0.011). No potential differences were seen to median nerve stimulations. In diabetic patients, the topographic location of the first peak in potentials was more central (P < 0.001) and gastrointestinal symptoms correlated with characteristics of brain potentials (P = 0.049).ConclusionsThis study supports that diabetes induces changes in peripheral visceral nerves as well as in the central nervous system.
| S-EPMC2699738 | biostudies-literature
Project description:BackgroundExercise induced gastrointestinal (GI) symptoms can plague athletes, especially runners. Sport nutrition recommendations are nutrient rather than foods focused and do not adequately address strategies to reduce GI symptoms. The objective was to develop a valid and reliable questionnaire to evaluate pre-training and pre-racing voluntary food restrictions/choices, reasons for avoiding foods, and gastrointestinal symptoms in endurance runners.MethodsValidity testing occurred through four Registered Dietitians, three of whom possess Master's degrees, and a dietetic trainee who provided initial feedback. Additionally, one Registered Dietitian is a Board Certified Specialist in Sports Dietetics (CSSD), and another has an International Olympic Committee Diploma in Sports Nutrition. The second version was sent out to nine different experts who rated each question using a Likert scale and provided additional comments. For reliability testing, the questionnaire was administered to 39 participants in a test re-test format. Kappa statistics and the prevalence-adjusted bias-adjusted kappa (PABAK) were used to assess the reliability.ResultsAll questions had an average Likert scale rating of 4/5 or greater. All test re-test results falling under basic information exhibited substantial agreement (kappa ≥0.61). All medical questions including food allergies and intolerances had moderate (kappa ≥0.41) or higher agreement. Responses were less consistent for food avoidances while training (5/28 outcomes) versus racing (0/28 outcomes) with a kappa below 0.41. All reasons for avoiding foods were deemed reliable. Regarding symptoms, side stitch while training and gas while racing were the only flagged categories.ConclusionsOverall, the questionnaire is a valid and reliable tool to evaluate voluntary dietary restrictions among endurance runners. Future studies can use the questionnaire to assess dietary strategies runners employ to reduce GI distress and optimize performance.
| S-EPMC6396487 | biostudies-literature
Project description:There is an imminent need for safe and efficient chronic pain medications. Regulator of G-protein signaling 4 (RGS4) is a multi-functional signal transduction protein, widely expressed in the pain matrix. Here, we demonstrate that RGS4 plays a prominentrole in the maintenance of chronic pain symptoms in male and female mice. Using genetically modified mice, we show a dynamicrole of RGS4 in recovery from symptoms of sensory hypersensitivity deriving from hindpaw inflammation or hindlimb nerveinjury. We also demonstrate an important role of RGS4 actions in gene expression patterns induced by chronic pain states in themouse thalamus. Our findings provide novel insight into mechanisms associated with the maintenance of chronic pain states anddemonstrate that interventions in RGS4 activity promote recovery from sensory hypersensitivity symptoms.
2019-09-26 | GSE138024 | GEO
Project description:Based on the findings of increased IEL in duodenal biopsies in CVID, an overlap with celiac disease has been suggested. In the present study, increased IEL, in particular in the pars descendens of the duodenum, was one of the most frequent histopathological finding. We therefore examined the gene expression profile in pars descendens of duodenum in CVID patients with increased IEL (n=13, IEL mean 34 [range 22-56] IEL/100 EC), CVID with normal levels of IEL (n=7), celiac disease (n=10, Marsh grade 3a or above) and healthy controls (n=17) by gene expression microarray GI histopathological findings in 53 CVID patients that underwent upper and lower endoscopic examination were addressed. For the microarray analysis 20 CVID (7 CVID_normal and 13 CVID with incresed IEL), 10 patients with celiac diseases and 17 healthy controls were included.
2015-09-02 | E-GEOD-72625 | biostudies-arrayexpress
Project description:Immune checkpoint inhibitors are emerging as a therapeutic approach for patients with advanced or metastatic gastrointestinal malignancies following the recent Food and Drug Administration and Asian approvals for colorectal, gastric, and hepatocellular carcinoma. As discussed in earlier articles, phase I-II trials demonstrate quite positive clinical activity, particularly in patients with immunogenic cancer subtypes. This outreach paper discusses some of the next innovative immunotherapy strategies under development. Here, tumor-associated macrophages, myeloid-derived suppressor cells, and regulatory T cells are increasingly coming into focus as new targets. Besides the well described use of checkpoint inhibitors, blockade of 'Wnt' or Csf1R signaling pathways as well as combinatorial treatment strategies offer promising examples for overcoming immune silencing within the resistant tumor microenvironment.
| S-EPMC7493693 | biostudies-literature
Project description:Sleep disturbances are common, and perhaps are even more prevalent in irritable bowel syndrome (IBS).To determine the effect of measured sleep on IBS symptoms the following day, IBS-specific quality of life (IBS-QOL) and non-GI pain symptoms.IBS patients' sleep patterns were compared to healthy individuals via wrist-mounted actigraphy over 7 days. Daily bowel pain logs (severity, distress; 10-point Likert) stool pattern (Bristol scale) and supporting symptoms (e.g. bloating, urgency; 5-point Likert) were kept. Validated measures, including the GI Symptom Rating Scale-IBS, Visceral Sensitivity Index, Pittsburgh Sleep Quality Index and the IBS-Quality of Life were collected. Mediation analysis explored the relationship between sleep, mood and bowel symptoms.Fifty subjects (38.6 ± 1.0 years old, 44 female; 24 IBS and 26 healthy controls) completed sleep monitoring. IBS patients slept more hours per day (7.7 ± 0.2 vs. 7.1 ± 0.1, P = 0.008), but felt less well-rested. IBS patients demonstrated more waking episodes during sleep (waking episodes; 12.1 vs. 9.3, P < 0.001). Waking episodes predicted worse abdominal pain (P ? 0.01) and GI distress (P < 0.001), but not bowel pattern or accessory IBS symptoms (P > 0.3 for each). Waking episodes negatively correlated with general- and IBS-specific QOL in IBS (r = -0.58 and -0.52, P < 0.001 for each). Disturbed sleep effects on abdominal pain were partially explained by mood as an intermediate.Sleep disturbances are more common in irritable bowel syndrome, and correlate with IBS-related pain, distress and poorer irritable bowel syndrome-related quality of life. Disturbed sleep effects extend beyond the bowel, leading to worse mood and greater somatic pain in patients with the irritable bowel syndrome.
| S-EPMC5020700 | biostudies-literature
Project description:Currently, the primary techniques applied for the assessment of facial changes over time utilize 2D images. However, this approach has important limitations related to the dimensional reduction and the accuracy of the used data. 3D facial photography has been recently introduced as a risk-free alternative that overcomes these limitations. However, the proper reference areas that should be used to superimpose serial 3D facial images of growing individuals are not yet known. Here, we tested various 3D facial photo superimposition reference areas and compared their outcomes to those of a standard anterior cranial base superimposition technique. We found that a small rectangular area on the forehead plus an area including the middle part of the nose and the lower wall of the orbital foramen provided comparable results to the standard technique and showed adequate reproducibility. Other reference areas that have been used so far in the literature were less reliable. Within the limitations of the study, a valid superimposition reference area for serial 3D facial images of growing individuals is suggested. The method has potential to greatly expand the possibilities of this highly informative, risk free, and easily obtained 3D tool for the assessment of facial changes in growing individuals.
| S-EPMC8361153 | biostudies-literature
Project description:Based on the findings of increased IEL in duodenal biopsies in CVID, an overlap with celiac disease has been suggested. In the present study, increased IEL, in particular in the pars descendens of the duodenum, was one of the most frequent histopathological finding. We therefore examined the gene expression profile in pars descendens of duodenum in CVID patients with increased IEL (n=12, IEL mean 34 [range 22-56] IEL/100 EC), CVID with normal levels of IEL (n=8), celiac disease (n=10, Marsh grade 3a or above) and healthy controls (n=17) by gene expression microarray
2015-09-02 | GSE72625 | GEO
Project description:BACKGROUND:Clinical guidelines produced in developed nations may not be appropriate in resource-constrained environments, due to differences in cultural, societal, economic and policy contexts. The purpose of this article is to describe an innovative and resource-efficient method to develop a clinical practice guideline (CPG), using the CPG contextualisation approach. METHODS:The four phased contextualisation framework was applied to produce a contextualised, multidisciplinary CPG for the primary health care of adults with chronic musculoskeletal pain (CMSP) in the South African context. The four phases were: a contextual analysis, evidence synthesis, contextual integration and external evaluation. Qualitative methodology was used to investigate context factors influencing health care in this environment. A systematic review was conducted to identify current, high-quality CPGs on the topic, and to synthesise a core set of clinical recommendations from the CPGs. Consensus methods were used to integrate context information with recommendations. A multidisciplinary panel of local experts authenticated and contextualised recommendations. The resultant CPG was externally reviewed using a survey. RESULTS:The results from the contextual analysis phase indicated a wide range of contextual factors that could influence the applicability and implementability of the recommendations, including: the personal characteristics of the patient and clinician, social and environmental circumstances, healthcare interventions available, and healthcare system factors. During phase two, six existent high quality CPGs were identified and a core set of multidisciplinary recommendations were sourced from them. The contextual integration phase produced the validated recommendations, accompanied by its underpinning body of evidence and context specific information. The outcome of phase four (external review) was that the recommendations were confirmed as relevant for the intended setting. CONCLUSION:CPG contextualisation was found to be a practical approach to develop a contextualised multidisciplinary CPG for the primary health care of adults with CMSP in a South African setting. The contextualisation approach enhanced the integration of multiple stakeholder perspectives and highlighted the importance of considering clinical, social and economic complexities during CPG development. Attention to contextual information is advocated to enhance the uptake of CPG recommendations, particularly in resource constrained settings. TRIAL REGISTRATION:Health Research Ethics Committee of Stellenbosch University, South Africa (S14/01/018); the review protocol was registered on PROSPERO (registration number CRD42015022098 ).
| S-EPMC6599395 | biostudies-literature