Unconventional but effective: breaking through IBS-D clinical practice guidelines - correspondence.

Irritable Bowel Syndrome (IBS) is a chronic, one of the commonest and persistent gastrointestinal (GI) disorder. Previously, the management plan for IBS-D included enhancing awareness; first line treatment included an increased dietary fiber intake, opioids for diarrhea and antispasmodics for pain management. A recent treatment guideline by the American Gastroenterology Association (AGA) suggests a modified approach to treating patients with IBS-D. Eight drug recommendations were made, and a set of instructions on when to employ which medication was devised. With the incorporation of these structured guidelines, a more tailored and focused approach to IBS management may become plausible.

Multiple Sclerosis Relapse Following COVID-19 Vaccination: A Case Report and Literature Review.

Mass vaccination against coronavirus disease 19 (COVID-19) has effectively controlled the pandemic and has been remarkably effective and safe. Reports of a few adverse events have been reported after post-marketing surveillance. We present a rare case of multiple sclerosis (MS) relapse in a female who presented with fatigue, involuntary eye movements, and numbness; autoimmunity following the COVID-19 vaccine has also been described. She was diagnosed with MS six years back and was in remission. She received her COVID-19 vaccine 18 days ago. Her clinical and radiological features confirmed the MS relapse. Her serology for COVID-19 immunoglobulin G (IgG) and IgM was positive, and she was managed with intravenous methylprednisolone and symptomatic management. Our case provides a possible association of vaccine-associated MS relapse; however, more evidence is warranted from future studies.

Role of 25-hydroxyvitamin D in irritable bowel syndrome patients.

We conducted this study on patients diagnosed with irritable bowel syndrome without identifiable stressors and replaced them with vitamin D supplements for 3 months. Almost 97 cases have repeated the vitamin D status that appeared to be sufficient, while 14 patients were missing data for follow-up. The advised option was intramuscular injection replacement but 34 out of 97 were taken oral route for replacement of Vitamin D and incidental finding is noted that serum vitamin D levels rise less in the oral group than in the intramuscular group. Mean age of our subjects was 35.97 ± 9.89 years, comprising 54% males (n = 60) and 46% females (n = 51). In the outcomes of our study, 56.7% of individuals showed complete relief from IBS symptoms after vitamin D replacement, while 36.1% reported considerable improvement. Another 6.2% had exhibited moderate relief with about 14 individuals lost to follow-up.