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INTRODUCTION: Colonoscopy is regarded as a safe diagnostic and therapeutic procedure, nevertheless, some patients may still encounter post-colonoscopy gastrointestinal symptoms. This study aimed to evaluate the utilization of probiotics before and after colonoscopy to relieve those symptoms. METHODOLOGY: This study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines. Included studies were all interventional studies examining the effects of probiotics use before and after colonoscopy. Articles were retrieved from MEDLINE, EBSCO-Host, Cochrane, ProQuest, and Google Scholar electronic databases, utilized specific keywords ( " Probiotic " OR " Probiotics ") AND (" Colonoscopy " OR " Colonoscopies "). The Cochrane Risk of Bias (RoB) 2 and Joanna Briggs Institute (JBI) Critical Appraisal tools were used for study quality assessment, as well as Review Manager (RevMan) 5.4 to perform the meta-analysis. RESULTS: A total of ten studies were included in this systematic review. Six studies assessed the effect of probiotics consumption after colonoscopy, three examined the impact before colonoscopy, and one study assessed both. The most common type of probiotics used were Lactobacillus and Bifidobacterium. Quantitative synthesis of probiotics before colonoscopy showed no significant differences among bloating, abdominal pain, nausea, and vomiting symptoms (p=0.49, p=0.14, p=0.30, and p=0.42, respectively). Similarly, quantitative synthesis of probiotics after colonoscopy showed no significant differences in bloating and abdominal pain (p=0.16 and p=0.63, respectively). CONCLUSIONS: Probiotic administration pre- and post-colonoscopy exhibited preliminary evidence for reducing gastrointestinal symptoms, but a quantitative synthesis revealed non-significant findings, necessitating further investigations.
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Objective: This study aimed to evaluate the effects of the combination of curcumin and piperine supplementation on Fasting Plasma Glucose (FPG), Homeostatic Model of Insulin Resistance (HOMA-IR), and Body Mass Index (BMI) in patients with prediabetes and type 2 Diabetes Mellitus (T2DM). This review was done to identify potential herbal remedies that may help improve glycemic parameters, leading to better health outcomes in combination with current antidiabetic treatment. Methodology: This systematic review was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). It was conducted in 2023 with sources and databases from MEDLINE, EBSCO-Host, ScienceDirect and ProQuest. This paper included randomized-controlled trials exploring the effects of the combination of curcumin and piperine on patients with prediabetes and T2DM. Systematic reviews, observational studies, case reports, case series, conference abstracts, book sections, commentaries/editorials, non-human studies and articles with unavailable full-text and written in non-English language, were excluded. The key terms for the literature search were "curcumin," "piperine," "prediabetes" and "Type 2 Diabetes Mellitus." We use Cochrane Risk of Bias (RoB) 2 for quality assessment of the included studies and Review Manager (RevMan) 5.4 to do the meta-analysis. Results: A total of three studies were included in this systematic review. Two studies from Neta et al., and Cicero et al., showed no significant difference in HOMA-IR, BMI and FPG levels between the curcumin, piperine and placebo groups. One study from Panahi et al. demonstrated a significant difference in BMI levels between the curcumin and piperine and placebo groups (p <0.01). The meta-analysis showed that FPG levels, HOMA-IR and BMI improved among patients with diabetes given in curcumin and piperine with reported mean differences (MD) of = -7.61, 95% CI [-15.26, 0.03], p = 0.05, MD = -0.36, 95% CI [-0.77 to 0.05], p = 0.09, and MD = -0.41, 95% CI [-0.85 to 0.03], p = 0.07, respectively). Conclusions: The supplementation of curcumin and piperine showed a numerical reduction in FPG, HOMA-IR and BMI, but were not statistically significant. Further research is needed as there is a paucity of studies included in the review.
