Pelvic Floor Symptom Related Distress in Chronic Constipation Correlates With a Diagnosis of Irritable Bowel Syndrome With Constipation and Constipation Severity but Not Pelvic Floor Dyssynergia

BACKGROUND/AIMS: Although symptoms related to the pelvic floor, such as pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTS), are common in patients with chronic constipation (CC), its impact is not clear. Our aims were to investigate the following (1) compare pelvic floor symptom related dysfunction in irritable bowel syndrome with constipation (IBS-C) and functional constipation (FC), and (2) symptom correlation with findings on anorectal manometry (ARM) and balloon expulsion test. METHODS: This was a retrospective analysis of patients with CC undergoing ARM. IBS-C and FC were diagnosed by Rome III criteria. Pelvic Floor Distress Inventory (PFDI-20) was used to measure pelvic floor symptom distress. Constipation Severity Scale was used to assess constipation severity. RESULTS: A total of 107 patients underwent ARM (64 FC, 43 IBS-C). The overall PFDI-20 score in IBS-C was higher compared with FC patients (118.0 vs 79.2, P = 0.001). In those with IBS-C, POP, LUTS, and colorectal symptoms subscales were all higher compared with FC patients (P < 0.05 for each). On multivariable regression, IBS-C (P = 0.001) and higher constipation severity (P = 0.001) were both independently associated with higher PFDI scores. ARM parameters and abnormal balloon expulsion test did not correlate with PFDI scores. CONCLUSIONS: Compared with FC patients, those with IBS-C have significantly higher distress from pelvic floor specific symptoms including POP and LUTS. Higher abdominal pain among IBS-C patients did not entirely explain these findings. A diagnosis of IBS-C and higher constipation severity correlated with PFDI-20 scores, but dyssynergia did not.

Pivot to Asia: inflammatory bowel disease burden

No abstract available.

Optimization of process variables for enhanced lactic acid production utilizing paneer whey as substrate in submerged fermentation process

In the present study lactic acid production was enhanced by optimizing the three process variables viz; inoculum size, temperature and pH using three factor five level CCRD [central composite rotatable design] by Lactobacillus delbruckii under SMF [submerged fermentation process]. Paneer [dairy byproduct] whey was used as sole substrate for lactic acid production. Design Expert 8.0.2.0 software depicted that an optimum concentration of 8% [v/v] size of inoculum, 5.50 pH and 36.53°C temperature gave lactic acid and biomass yield of 5.61 g/L[-1] and 4.27 g/L[-1], respectively. Lactic acid production was scale up in 7.5 L bioreactor under optimized conditions and it gave lactic acid and biomass yield of 39.2 +/- 1.4 and 47.6 +/- 0.8 g/L[-1], respectively. micro[g], Y[P/S], Y[P/X] and productivity were found to be 0.14 h[-1], 0.66 g/g, 0.7 g/g and 1.98 g/L[-1] h, respectively. Leudking Piret equation deduced that lactic acid production was growth associated which varies from earlier reports. Lactic acid was characterized by FTIR [Fourier transform infrared spectroscopy] and HPLC

Psychiatric, Somatic and Other Functional Gastrointestinal Disorders in Patients With Irritable Bowel Syndrome at a Tertiary Care Center

BACKGROUND/AIMS: To study the prevalence of somatic and psychiatric co-morbidities in the patients of irritable bowel syndrome (IBS) and to assess the quality of life (QOL) of these patients. METHODS: One hundred and eighty-four IBS patients and 198 controls were included. Diagnosis of IBS, its sub-classification and assessment of other functional gastrointestinal disorders (FGIDs) was made on basis of Rome III criteria. Severity of IBS was assessed using IBS severity scoring system. Psychiatric evaluation was done using Patient Heath Questionnaire. QOL was evaluated using WHO QOL-BREF. RESULTS: One hundred and forty-seven (79.9%) and 158 (85.9%) patients with IBS had at least one other FGID or at least one somatic co-morbidity, respectively. Higher number of patients had at least one psychiatric co-morbidity compared to controls (79.9% vs 34.3%; P < 0.001). Major depressive syndrome (47.3% vs 5.1%; P < 0.001), somatoform disorder (50% vs 14.6%; P < 0.001) and panic syndrome (44% vs 11.6%; P < 0.001) were more common in IBS than controls. Only 14 (7.6%) patients were receiving drug treatment for their psychiatric illness. Severe IBS symptoms were present in significantly higher number of patients with constipation predominant IBS than diarrhea predominant IBS. Those with severe disease had higher prevalence of psychiatric (95.1%) and somatic (96.7%) co-morbidities compared with mild disease. QOL of IBS patients was significantly lower in all four domains compared to controls. Presence of at least one other FGID was significantly associated with presence of one or more psychiatric co-morbidity (P < 0.001). CONCLUSIONS: Majority of IBS patients presenting to a tertiary care center had associated psychiatric, somatic co-morbidities and reduced QOL. Very few of them received specific psychiatric treatment.

Amelioration of inflammatory responses by Chlorogenic acid via suppression of pro-inflammatory mediators.

The premise of the present investigation was to evaluate the detailed anti-inflammatory properties of chlorogenic acid (CGA) and to delineate the possible mode of action. To explore the anti-inflammatory profile, we evaluated the effect of CGA on TNF-alpha expression (in vitro); carrageenan induced rat paw edema and carrageenan induce pleurisy (in vivo). In our studies, CGA significantly inhibited the TNF-alpha expression, paw edema and antioxidant enzymes in livers of rats in pre-treatment schedule but failed to exert any effect when administered 1 h after carrageenan injection. CGA was also found to be safe, as confirmed by the results of acute toxicity studies and MTT assay. CGA also caused reduction in total leucocytes count most probably by inhibiting neutrophils, but could not alter mononuclear cells count in carrageenan induced pleurisy. Inhibition of exudation was evidenced by the less exudate formation in CGA treated animals, which may be due to decrease in vascular permeability which was further confirmed in acetic acid induced vascular permeability model in mice where significant decrease in vascular permeability was observed. CGA was highly effective in reducing the arachidonic acid metabolites, nitric oxide and pro-inflammatory cytokines production in a dose dependent manner and in some conditions effect observed was almost comparable to ibuprofen. Result of the present investigation shows the anti-inflammatory effects of CGS in different models.

Prevalence of Irritable Bowel Syndrome: A Community Based Study From Northern India

BACKGROUND/AIMS: The prevalence of irritable bowel syndrome (IBS) varies from 4% to 20% in different Asian nations. Prevalence of IBS in native North Indian community is not known. METHODS: Between November 2008 to December 2009, we estimated the prevalence of IBS in a rural community of Ballabgarh block, located in Haryana state. A structured questionnaire based on Rome III module was used to collect symptoms related to IBS from all the participants in a door to door survey. A Rome III criterion was used for diagnosis of IBS. IBS was further classified based on predominance of symptoms as constipation predominant, diarrhea predominant, mixed and unspecified based on Rome III module. RESULTS: There were 4,767 participants (mean age 34.6 +/- 10.8, males 50%). Overall, 555 (11.6%; 95% CI, 10.7-12.5) had constipation, 542 (11.4%; 95% CI, 10.5-12.3) diarrhea and 823 (17.3%; 95% CI, 16.2-18.4) abdominal pain. The overall prevalence of IBS was 4% (95% CI, 3.5-4.6). The prevalence of constipation predominant IBS was 0.3% (95% CI, 0.16-0.49), diarrhea predominant IBS 1.5% (95% CI, 1.18-1.90), mixed IBS 1.7% (95% CI, 1.35-2.11) and unsubtyped IBS 0.5% (95% CI, 0.32-0.75). The prevalence of IBS was significantly higher in females compared with males (4.8% vs 3.2%, P = 0.008). However, there was no significant difference between males and females in the prevalence of different subtypes of IBS. The prevalence increased with age. CONCLUSIONS: The prevalence of IBS in a North Indian community is 4%. IBS poses a significant burden on the rural adults.

Separation of biological proteins by liquid chromatography

After the success of human genome project, proteome is a new emerging field of biochemistry as it provides the knowledge of enzymes [proteins] interactions with different body organs and medicines administrated into human body. Therefore, the study of proteomics is very important for the development of new and effective drugs to control many lethal diseases. In proteomics study, analyses of proteome is essential and significant from the pathological point of views, i.e. in several serious diseases such as cancer, Alzheimer's disease and aging, heart diseases and also for plant biology. The separation and identification of proteomics is a challenging job due to their complex structures and closely related physic-chemical behaviors. However, the recent advances in liquid chromatography make this job easy. Various kinds of liquid chromatography, along with different detectors and optimization strategies, has been discussed in this article. Besides, attempts have been made to include chirality concept in proteomics for understanding mechanism and medication of various disease controlled by different body proteins