We aimed to evaluate clinical symptoms in diarrhea predominant irritable bowel syndrome (IBS-D) receiving berberine hydrochloride in a randomized double-blind placebo-controlled clinical trial. Overall, 196 patients with IBS-D were recruited for this study; consequently, 132 patients randomized to receive daily 400 mg of berberine hydrochloride, delivered twice daily or placebo for 8 weeks followed by a 4-week washout period. After a 2-week run-in period, diarrhea, abdominal pain, urgent need for defecation frequency and any adverse events were recorded daily. Prior to administration of the medication and after completing the treatment, assessment of IBS symptom scores, depression and anxiety scale scores and the IBS scale for quality of life (QOL) was carried out. The effects of berberine hydrochloride on IBS-D, defined by a reduction of diarrhea frequency (P = 0.032), abdominal pain frequency (P < 0.01) and urgent need for defecation frequency (P < 0.01), were significantly more pronounced in the berberine group than the placebo group in the 8 weeks of treatment. A trend of improvement (P < 0.05) was observed with berberine hydrochloride for IBS symptom score, depression score and anxiety score and the IBSQOL, compared with placebo. At last, berberine hydrochloride was well tolerated. So we concluded that berberine hydrochloride is well tolerated and reduces IBS-D symptoms, which effectively improved patients QOL.

Background and Aim Delayed postpolypectomy hemorrhage is relatively common, with occasional extensive blood loss, endangering life. This study aimed to determine the factors associated with postoperative hemorrhage. Methods The study was a retrospective cohort study of patients hospitalized for colonoscopic polypectomy at the Department of Gastroenterology and Hepatology, Tenth People's Hospital of Tongji University, China, between January and December 2015. Data on gender, age, bowel preparation, location, size, number of polyps, operative modality, pathology, and operation practitioner were collected. Patients were divided into two groups based on the presence or absence of postoperative hemorrhage. Results A total of 1962 polyps were detected in patients and they underwent polypectomy; hemorrhage occurred in 41 cases. A correlation was demonstrated between postpolypectomy hemorrhage and each of the following factors: polyp size and operative modality. The odds ratio (OR) was 4.535 (95% confidence interval [CI], 2.331–8.823) for 1–2‐cm polyps, 4.008 (95% CI, 0.904–17.776) for 2–3‐cm polyps, and 22.407 (95% CI, 5.783–86.812) for ≥3‐cm polyps. Compared with argon plasma coagulation, OR was 9.128 (95% CI, 3.548–23.486) for endoscopic mucosal resection and 31.257 (95% CI, 7.009–139.395) for endoscopic submucosal dissection. Conclusions The independent risk factors for delayed postpolypectomy hemorrhage include polyp size and operative modality.