Assessment of the effect of sachet formulation of almond (Amygdalus dulcis L.) on diarrhea prominent irritable bowel syndrome (IBS-D) symptoms: A clinical trial.

OBJECTIVES: Almond has been listed in the low FODMAPs (Fermentable Oligo-, Di-, Mono saccharides And Polyols) and is recommended for infant diarrhea and gastrointestinal problem in Iranian folk medicine. In this work, sachet of almond has been designed, formulated and is studied on the clinical symptoms of diarrhea prominent irritable bowel syndrome (IBS-D). DESIGN: almond was standardized on the basis of total protein and carbohydrate content. A sachet of almond and wheat flour (placebo) was formulated and their physicochemical characteristics were investigated. INTERVENTION: In a double blind randomized trial, fifty IBS-D patients were randomly enrolled into the almond and placebo groups, ranked in respect to the severity of symptoms to mild-moderate and severe disease. The patients received almond or placebo sachet (40 g/day,20 days) respectively. MAIN OUTCOME MEASURE: Patients were assessed for bowel habit, pain severity and frequency and bloating and data was recorded in a data collecting form. RESULTS: The results showed that none of the primary outcomes of the disease is improved in the patients treated with almond. The bowel movement and severity of the pain was significantly increased in the almond treated patients compared to the placebo and baseline (p < 0.05). CONCLUSION: Almond contains high content of oligo-fructan which in high intake might result in a large amount of fermentable carbohydrates that can exacerbate the symptoms of the disease. So, despite the almond inclusion in the low-FODMAPs, the amount of almond intake is a determining factor and here we have controversial results for almond intake in patients with IBS. Mental health and physical activity of patients are also involved in the disease.

Review of Clinical Spectrum of Gastroesophageal Reflux Disease in a General Population; A Study from South-East Iran.

BACKGROUND Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal problems worldwide. The aim of this study was to evaluate the clinical spectrum, prevalence, and some of the variables that are supposed to be the risk factors of this chronic disorder. METHODS This population- based cross-sectional study was conducted in a one-stage randomized clustered sample of adult inhabitants in Kerman city in 2011-2012. A total of 2265 subjects with age range of 15-85 years were enrolled. Face to face interview was performed for all the subjects. GERD was defined as at least weekly heart burn and/or acid regurgitation during the past year. Association of GERD with factors like demographic variables, medical condition, diet and life habits were analyzed. RESULTS A total of 2265 subjects including 988 (43.8%) male and 1275 (56.3%) female patients were evaluated. The prevalence of GERD was 28%. The prevalence was higher in female patients and with aging. There was also a significant association between GERD and the following risk factors: lower educational level (p <0.0001), higher body mass index (p =003), presence of depression(p<0.0001), and anxiety (p <0=0001). CONCLUSION GERD as a common disorder in our region was seen more in elderly and female patients and was associated with some anthropometric, metabolic, medical conditions, and behavioral habits.