Electroacupuncture for acute exacerbation of chronic obstructive pulmonary disease complicated with gastrointestinal dysfunction: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect of electroacupuncture (EA) for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with gastrointestinal dysfunction.@*METHODS@#A total of 100 patients with AECOPD complicated with gastrointestinal dysfunction were randomly divided into an EA group (50 cases, 2 cases dropped off, 1 case excluded) and a medication group (50 cases). Both groups were treated with symptomatic and supportive treatment such as low flow oxygen, nebulized inhalation of short-acting β2 agonist (SABA) or short-acting muscarinic antagonist (SAMA) combined with inhaled corticosteroid (ICS). The EA group was treated with EA at Zusanli (ST 36), Yinlingquan (SP 9), Zhongwan (CV 12), Shuifen (CV 9), Tianshu (ST 25), Chize (LU 5) and Lieque (LU 7), with discontinuous wave, 2 Hz in frequency, 30 min each time, once a day. In the medication group, oral mosapride citrate tablets were given, 3 times a day, 5 mg each time. Both groups were treated for 5 d. Before and after treatment, the gastrointestinal symptom rating scale (GSRS) score was observe, serum procalcitonin (PCT), C-reactive protein (CRP), and plasma oxygenation index (PaO2/FiO2) were detected, and patient satisfaction degree was evaluated in the two groups.@*RESULTS@#Compared with before treatment, except for diarrhea dimension in the medication group, the total scores and each dimension scores of GSRS were decreased (P<0.05), serum PCT and CRP were decreased (P<0.05), plasma PaO2/FiO2 was increased (P<0.05) in the two groups after treatment. After treatment, in the EA group, the total score and abdominal pain, dyspepsia, constipation and diarrhea scores of GSRS were lower than those in the medication group (P<0.05), meanwhile serum PCT and CRP were lower and plasma PaO2/FiO2 was higher than those in the medication group (P<0.05). The improvement of gastrointestinal symptoms, life quality and overall satisfaction degree in the EA group were superior to those in the medication group (P<0.05).@*CONCLUSION@#EA could improve the symptoms of patients with AECOPD complicated with gastrointestinal dysfunction, reduce inflammatory response, improve oxygenation and patient satisfaction degree.

COVID-19 gastrointestinal manifestations: a systematic review

Abstract INTRODUCTION: The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has greatly challenged public health worldwide. A growing number of studies have reported gastrointestinal (GI) symptoms. We performed a systematic review of GI symptoms associated with coronavirus disease 2019 (COVID-19) as well as of the serum levels of biomarkers related to liver function and lesion in SARS-CoV-2-infected individuals. METHODS: We surveyed relevant articles published in English, Spanish, and Portuguese up to July, 2020 in the PubMed, MEDLINE, SciELO, LILACS, and BVS databases. Moreover, we surveyed potentially important articles in journals such as the NEJM, JAMA, BMJ, Gut, and AJG. RESULTS: This systematic review included 43 studies, including 18,246 patients. Diarrhea was the most common GI symptom, affecting 11.5% of the patients, followed by nausea and vomiting (6.3%) and abdominal pain (2.3%). With regard to clinical severity, 17.5% of the patients were classified as severely ill, whereas 9.8% of them were considered to have a non-severe disease. Some studies showed increased aspartate transaminase and alanine aminotransferase levels in a portion of the 209 analyzed patients and two studies. CONCLUSIONS: Our results suggest that digestive symptoms are common in COVID-19 patients. In addition, alterations in cytolysis biomarkers could also be observed in a lesser proportion, calling attention to the possibility of hepatic involvement in SARS-CoV-2-infected individuals.

Epidemiologic survey on the prevalence and distribution of infants' common gastrointestinal symptoms in 7 cities in China: a population-based study / 中华流行病学杂志

Objective Regurgitation,infantile colic,and fnnctional constipation are common gastrointestinal symptoms in childhood,the aim of this study was to explore the prevalence and distribution of these symptoms in China.Methods A screening program in infants aged 0 to 3 years selected through stratified cluster random sampling was carried out in 7 citics in China.Questionnaires were filled,and then diagnosis were made according to Rome Ⅳ criteria.Areas,(urban-rural),age and gender distribution of prevalence of childhood common gastrointestinal symptoms were analyzed.Results Totally,20 932 effective questionnaires were returned.The total number of infants aged 0 to 1 years was 10 193.Regurgitation was diagnosed in 1 960 infants,with the prevalence of 19.2％,among infants aged 0 to 3 months that had highest prevalence (29.8％).The prevalence decreased with age,and differences among different age groups showed significant.For infantile colic,4 470 infants aged 0 to 5 months were analyzed and the prevalence of infantile colic was 7.3％.The prevalence of infantile colic was the highest in infants aged 1 to 2 months (10.0％).Age specific difference was significant.Of all the infants,functional constipation was diagnosed in 1 755 infants with the prevalence of 8.4％,and the lowest prevalence was found in infants aged 0 to 3 months (6.2％),and the highest prevalence was in infants aged 30 to 36 months (10.0％).The differences in different age group were significant.Conclusion Symptoms of regurgitation,infantile colic,and functional constipation are common in infants in China,with age specific difference in prevalence of the symptoms.

Epidemiologic survey on the prevalence and distribution of infants' common gastrointestinal symptoms in 7 cities in China: a population-based study / 中华流行病学杂志

Objective Regurgitation,infantile colic,and fnnctional constipation are common gastrointestinal symptoms in childhood,the aim of this study was to explore the prevalence and distribution of these symptoms in China.Methods A screening program in infants aged 0 to 3 years selected through stratified cluster random sampling was carried out in 7 citics in China.Questionnaires were filled,and then diagnosis were made according to Rome Ⅳ criteria.Areas,(urban-rural),age and gender distribution of prevalence of childhood common gastrointestinal symptoms were analyzed.Results Totally,20 932 effective questionnaires were returned.The total number of infants aged 0 to 1 years was 10 193.Regurgitation was diagnosed in 1 960 infants,with the prevalence of 19.2％,among infants aged 0 to 3 months that had highest prevalence (29.8％).The prevalence decreased with age,and differences among different age groups showed significant.For infantile colic,4 470 infants aged 0 to 5 months were analyzed and the prevalence of infantile colic was 7.3％.The prevalence of infantile colic was the highest in infants aged 1 to 2 months (10.0％).Age specific difference was significant.Of all the infants,functional constipation was diagnosed in 1 755 infants with the prevalence of 8.4％,and the lowest prevalence was found in infants aged 0 to 3 months (6.2％),and the highest prevalence was in infants aged 30 to 36 months (10.0％).The differences in different age group were significant.Conclusion Symptoms of regurgitation,infantile colic,and functional constipation are common in infants in China,with age specific difference in prevalence of the symptoms.

Algorithms for managing common gastrointestinal symptoms in infants / 中华实用儿科临床杂志

Gastrointestinal symptoms such as regurgitation,infantile colic,constipation,dyschezia,and diarrhoea are frequent in infants.These symptoms always were functional gastrointestinal symptoms.It is easily confused with other diseases.The knowledge and management of these symptoms are no uniform or clear.Since double-blind placebo controlled prospective intervention trials are very limited,the algorithms are still based on consensus using the evidence.This article respectively introduces each gastrointestinal symptoms,include clinical manifestations,diagnosis and management referring to Rome Ⅳ and domestic and overseas paediatricians consensus,to improve clinical pediatricians the knowledge of gastrointestinal symptoms and specify the management.

Clinical Study on Si-Zi Powder for Hot Compress To Improve Living Quality of Hemodialysis Patients / 世界科学技术-中医药现代化

This study was aimed to observe the clinical effect and quality of life (QOL) of Si-Zi (SZ) powder for hot compress to improve gastrointestinal functions of hemodialysis patients.A total of 60 hemodialysis patients were randomly divided into the treatment group and the control group.Gastrointestinal Symptom Rating Scale (GSRS) and QOL of both groups before and after the treatment of SZ powder were compared continuously.The results showed that after intervention,the total relieve rate was 96.7％ in treatment group,and 53.3％ in the control group.The effect of SZ powder group was to obviously improve the gastrointestinal symptoms and QOL (P ＜ 0.05).It was concluded that SZ powder for hot compress can improve gastrointestinal functions and increase QOL of hemodialysis patients.

Clinical Observation of Electroacupuncture for Gastrointestinal Dysfunction After Abdominal Operation / 上海针灸杂志

Objective To compare the therapeutic efficacy between conventional nursing and conventional nursing plus electroacupuncture in treating gastrointestinal dysfunction after abdominal operation, and their effects in recovering gastrointestinal function. Method Sixty patients with gastrointestinal dysfunction after abdominal operation were randomized into an electroacupuncture group and a control group according to their operation time, 30 cases in each group. The electroacupuncture group was intervened by conventional postoperative nursing plus electroacupuncture, by selecting bilateral Zusanli (ST36), Shangjuxu (ST37), Xiajuxu (ST39), Neiguan (PC6) and Taichong (LR3), connected to HANS electroacupuncture device, with frequency at 2 Hz and a tolerable intensity. The treatment was given once a day, for 5 d in total, till the recovery of gastrointestinal function. The control group was intervened by conventional postoperative nursing. The therapeutic efficacy was evaluated at the end of the intervention. The time of first bowel sound, first exhaust time, and first bowel movement time were observed. The gastrointestinal symptom score (GIS) was adopted to evaluate the effects of the two methods in improving gastrointestinal function at the end of the intervention. Result The general therapeutic efficacy of electroacupuncture group was better than that of the control group(P<0.05). In the electroacupuncture group, time taken for the first bowel sound, first exhaust and first bowel movement after the operation was shorter(P<0.05). The GIS dropped in both groups after the treatment, and the improvement was more significant in the electroacupuncture group(P<0.05). Conclusion Electroacupuncture helps promote the recovery of gastrointestinal function in patients with postoperative gastrointestinal dysfunction, and can produce a more significant improvement.

Nutrient Intake and Dietary Behaviors of Patients with Functional Dyspepsia

As a disease that reduces quality of life, functional dyspepsia (FD) is associated with foods that may worsen its symptoms or cause it. The purpose of this study was to examine the nutritional status and dietary behaviors of FD patients. We investigated food intake, food intake frequency, and dietary habits of 45 FD subjects according to the Rome III Diagnosis Criteria. Average age and body mass index (BMI) were 47.7 years and 22.6 kg/m2 (males: 23.4 kg/m2, females: 22.1 kg/m2), respectively. Average energy intake was 77% of Korean Dietary Reference Intake (KDRI), and it was less than that of the Korea National Health and Nutrition Examination Surveys (KNHANES). Other nutrient intake levels were similar to the KNHANES. Energy intake proportion of carbohydrates:protein:fat was 56:18:26, and the ratio of fat intake was higher than that of the KNHANES. Beans, laver, tomato, and yogurt were consumed very frequently. In the results of meal regularity, dietary behaviors and composition of diet were relatively good. It is likely that the patient controlled their diet by eating cautiously and by reducing alcohol drinking and smoking. Our results indicate that FD patients' nutritional status by consumption of nutrients was at a level of normal healthy people and that dietary habits were better than normal adults. However, their fat intake levels were somewhat higher than normal people. Therefore, further research is required to identify the relationship between dietary intakes and FD.

An analysis of gastrointestinal symptoms and sleep disturbance in disaster area after the Wen-Chuan earthquake / 中华内科杂志

Objective To analyze the association of gastrointestinal symptoms and sleep disturbance after Wen-Chuan earthquake. *Methods Using random sampling method, compared with Beijing publics at the same time, within two weeks, questionnaire was performed in the disaster area population.Gastrointestinal symptoms were diagnosed according to the Rome Ⅲ standard, and were analyzed in relation to sleep investigation. Results Among 956 disaster area individuals, 459 (48.0%) have gastrointestinal symptoms. Among 1021 Beijing publics, the corresponding number was 78(7. 6% ) ,which was significantly lower. The main gastrointestinal symptoms included abdominal pain ( 14. 0% ), distension ( 12. 1% ),constipation ( 10. 3 % ), heartburn (8. 6% )and dysporia (8. 3% ). Compared with Beijing publics (24. 4% ),the disaster area publics ( 83.7% ) with gastrointestinal symptoms had significant differences in sleep disturbance (P ＜0. 05 ). Early awakening with acratia had significant differences in disaster area publics (P ＜ 0. 05). Conclusion There was relatively high incidence of gastrointestinal symptom after Wen-Chuan earthquake. The incidence of gastrointestinal symptom was related to sleep disturbance, and gastrointestinal symptoms were related to early awakening with acratia.

Improved Gastrointestinal Symptoms and Quality of Life after Conversion from Mycophenolate Mofetil to Enteric-Coated Mycophenolate Sodium in Renal Transplant Patients Receiving Tacrolimus

It is reported that a conversion from mycophenolate mofetil (MMF) to enteric-coated mycophenolate sodium (EC-MPS) relieves gastrointestinal (GI) symptom burden and improves health-related quality of life (HRQoL). However, it is unclear whether renal transplant recipients using tacrolimus receive the same benefit from the conversion. In this prospective, multi-center, open-label trial, patients were categorized into two groups by their GI symptom screening. Equimolar EC-MPS (n=175) was prescribed for patients with GI burdens; those with no complaints remained on MMF (n=83). Gastrointestinal Symptom Rating Scale (GSRS) and Gastrointestinal Quality of Life Index (GIQLI) were evaluated at baseline and after one month. Patients and physicians completed Overall Treatment Effect (OTE) at one month. EC-MPS-converted patients had worse GSRS and GIQLI scores at baseline than MMF-continued patients (all P<0.001). Significant improvements in GSRS and GIQLI scores were observed for EC-MPS-converted patients at one month, but MMF-continued patients showed worsened GSRS scores (all P<0.05). OTE scale indicated that EC-MPS patients improved in overall GI symptoms and HRQoL more than MMF patients did (P<0.001). In tacrolimus-treated renal transplant recipients with GI burdens, a conversion from MMF to EC-MPS improves GI-related symptoms and HRQoL.

Analysis of the Gastrointestinal Symptoms of Uninvestigated Dyspepsia and Irritable Bowel Syndrome

BACKGROUND/AIMS: Epidemiological studies suggest that there is a considerable overlap between functional dyspepsia (FD) and irritable bowel syndrome (IBS). The aim of this study was to examine concurrent gastrointestinal symptoms in FD and IBS. METHODS: A total of 186 college students filled out a questionnaire regarding whether they had uninvestigated dyspepsia (UD, FD without endoscopic examination) and IBS based on Rome-II criteria. Gastrointestinal symptoms were measured using the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. RESULTS: A total of 181 students (98 males, mean age 24.6 years) completed both questionnaires. The prevalence of UD, IBS, and UD+IBS overlap was 12 (6.7%), 40 (22.1%), and 8 (4.4%), respectively. A significant UD+IBS overlap was observed (66.7% IBS in UD, 20.0% UD in IBS). Reflux scores of GSRS in either UD or IBS were significantly greater than in those without. Gastroesophageal reflux disease (GERD), defined as weekly occurring moderate symptoms of heartburn and/or acid regurgitation and evaluated using the GSRS, was found in 16 (8.8%) of the subjects. The prevalence of IBS was significantly higher in GERD patients than in non-GERD patients (50.0% vs 19.4%). CONCLUSIONS: The considerable overlap not only between UD and IBS, but also between GERD and IBS, suggests the involvement of common pathophysiological disturbances in the two conditions.

Psychiatric Considerations on Pediatric Psychosomatic Disorders with Gastrointestinal Symptoms / 대한소아소화기영양학회지

Gastrointestinal (GI) symptoms in children and adolescents are influenced by diverse psychiatric components such as psychosocial stresses, familial environment, school-related situations, and comorbid psychiatric conditions. Absolutely psychiatric symptoms of pediatric patients are also affected by problems of GI system. Lots of symptoms including anorexia, dyspepsia, nausea and so on are commonly originated from either GI or psychiatric causes or both. Sometimes the negative interactions between GI and psychiatric problems aggravate the severity and eventually decline the functions of children and adolescents with GI symptoms. We summarized the common GI and psychiatric conditions which have GI and psychiatric associations. To a clinician who manages pediatric GI disorders, psychiatric considerations can be beneficial to understand the clinical manifestations of patients and to find the way to relieve them. This short and somewhat superficial review may help to have a bird's-eye view on this topic.

Intestinal microsporidiosis: A new entity in Malaysia?

Intestinal microsporidia is an emerging human disease caused by microsporidia. A study was conducted to determine the prevalence of microsporidia in patients with gastro-intestinal symptoms and to examine the clinical manifestations associated with intestinal microsporidiosis. A descriptive cross-sectional study using a well-structured questionnaire; a review of medical records was also undertaken. Positive stool samples were defined as presence of one or more pinkish-violet ovoid structures with a belt-like stripe under high power field (100x) using modified gram-chromotrope stain (MGC). A total of 353 faecal specimens of patients was examined and 100 patients were found to have positive stool samples for microsporidia. The overall prevalence of microsporidia was 28.3%. Acute and chronic diarrhoea were seen in 49.0% and 36.0% patients, respectively. The commonest clinical presentations were diarrhoea (85.0%) with 83.0% of patients having loose or watery stools, vomiting (75.0%), foul-smelling stools (60.0%), nausea (59.0%) and cramping abdominal pain (39.0%). The least common symptoms were fever (15.0%), mucous in stool (5.0%) and blood in stool (4.0%). This study concludes that the prevalence of microsporidia is still high (28.3%) and the majority of patients (93.0%) are symptomatic; the most common gastro-intestinal symptom is diarrhoea with loose or watery stools. Hence, it is recommended that a stool screening for microsporidia be done in selected patients presented with gastrointestinal symptoms.

The Infection Rate of Helicobacter pylori and Its Relation to Gastrointestinal Symptoms in Patients with Chronic Renal Failure / 대한소화기내시경학회지

BACKGROUND/AIMS: Helicobacter pylori (H. pylori) can survive in the acid milieu of stomach by producing urease, which generates acid neutralizing ammonia by splitting gastric urea and creates a satisfactory environment for H. pylori. Thus the patients with chronic renal failure (CRF) with increased diffusion of blood urea to gastric lumen may be theoretically more susceptible to colonization with H. pylori. To investigate the infection rate of H. pylori in CRF and its relation to gastrointestinal symptoms, we performed prospective controlled study. METHODS: We performed gastroscopy in forty-two patients with CRF. Rapid urease test and histologic examination for H. pylori infection were performed. Histological gastritis was graded by updated Sydney classification. Gastrointestinal symptoms were assessed in all CRF patients and serum blood urea nitrogen and creatinine levels were also measured. RESULTS: Twenty-one (50.0%) demonstrated H. pylori infection in patients with CRF. H. pylori infection and major endoscopic findings were not related to the gastrointestinal symptoms in patients with CRF. In H. pylori-positive CRF patients, density of H. pylori and grade of histological gastritis were not related to the severity of gastrointestinal symptoms. CONCLUSIONS: The infection rate of H. pylori was 50% in patients with CRF. Gastrointestinal symptoms in CRF were related to factors other than H. pylori infection.

Prevalence and risk factors of Helicobacter pylori infection in general population

BACKGROUND: It was reported that Helicobacter pylori causes duodenal ulcer and chronic active gastritis, but is still controversial on the relationship with gastric cancer. H. pylori is still clinically significant despite improvements in microbiologic, pathologic and therapeutic aspects. The purpose of this study is to evaluate the prevalance of H. pylori infection according to age and sex, the risk factors of H. pylori infection and the relationship with upper gastrointestinal symptoms. METHODS: The subjects were 409 people who underwent esophagogastroscopy and CLO test from Feb. to Jun. in 1997 at Health Promotion Center, Pundang CHA General Hospital. Six types of upper gastrointestinal symptoms and demographic characterastics were surveged by questionnaire. The relationship with H. pylori infection according to age, sex, education, smoking,alcohol, coffee, stress and exercise was evaluated. And, the frequencies of H. pylori according to the presence of symptoms and the six different symptoms(indigestion, frequent belching, dyspepsia, nausea/vomiting, distension, anorexia) were anallyzed by Chi-square test. RESULTS: CLO test was positive for 264(64.5%) in total, 156(65.3%) in females. not different significantly in each group. The frequency of CLO test positive was 53.5%(under 30 years old), 64%(thirties), 67.9%(fifties), 48%(over 60years old). H. pylori infection increased slightly as age increased, but deacreased in over sixties. The frequency of H. pylori infection according to sex, education, smoking, alchol, coffee, stress, and exercise was not different significantly. 174(60.2%) of 284 symptomatic subjects(who had more than one symptom) was positive by CLO test and 93(74.4%) of 125 asymptomatic subjects was positive. The frequency of H. pylori infection according to six symptoms was not different significantly. The sensitivity, specificity, false negative rate, false positive rate, positive predictive value and negative predictive value of CLO test to pathologic report were 77.4%, 81.3%, 22.6%, 18.7%, 93.2%, 52% respectively. CONCLUSIONS: The prevalence of H. pylori infection was 64.5% and showed no difference by sex. H. pylori infection infection increased slightly as age increased. Education, smoking, alcohol, coffee, stress, exercise were not considered as risk factors. The relationship of upper gastrointestinal symptoms and H. pylori infection infection was not significant biostatiscally.

Sleeping Patterns and Gastrointestinal Disorders According to the Shift Works in Female Textile Workers / 예방의학회지

To investigate the sleeping patterns and gastrointestinal disorders of shift workers, the auther studied 434 female workers who worked at textile industry ill Taejon city from september 1 ,1992 to september 31 ,1992. Shift pattern were divided into 3 categories; 3 shift (shifts per 8 hours), 2 shift (day and night shift) and day work. The results obtained were as follows: 1. The average sleeping hours when adjusted for the education level of the total study subjects was 6.1 hours. That of 3 shift workers was 6.1 hours, 2 shift workers was 6.0hours, but that of day workers was 6.5 hours. There were no significant difference among the shift workers. 2. For the 3 shift workers, the average physiologic adjusted duration in day shirt(2.2 days) was shorter than that or night shift(2.7 days) and there were significant difference among the rotating shift works (P<0.001). The sleeping problems in day shift was less than those of night shift (P<0.001). 3. 44.9% of 3 shift workers, 39.3% of 2 shift workers and 33.1% of day workers complained gastrointestinal symptoms when adjusted for the age, education level, job tenure, work post. And the rates of gastrointestinal symptoms complained increase with job tenures (P<0.001). 4. The most frequent gastrointestinal diseases were gastitis and gastric ulcer with 14.2 %, Irritable bowel syndrome with 3.1%, duodenitis and duodenal ulcer with 2.1% and combined gastrointestinal disease with 2.1%. Age, eating habit, amount of coffee per day, job tenure, work post and shift pattern showed no significant difference with the gastrointestinal diseases when adjusted for the age. According to the above results, the auther suggested that the shift pattern and job tenure can affect to the sleeping problem and gastrointestinal symptoms.