Impact of upper digestive symptoms in patients with irritable bowel syndrome

Balboa, Agustín; Mearin, Fermı́n; Badı́a, Xavier; Benavent, Jaume; Caballero, Antonio; Domínguez‐Muñoz, Enrique; Garrigues, Vicente; Piqué, J.M.; Roset, Montse; Cucala, Mercedes; Figueras, M.

doi:10.1097/01.meg.0000243870.41207.2f

Cited by 22 publications

(18 citation statements)

References 32 publications

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“…Under this condition, endotoxins like LPS might permeate to the systemic compartment as a consequence of a disturbed gastrointestinal barrier function, stimulate the macrophages to produce pro-inflammatory cytokines, and triggered systemic inflammation [46, 47]. There are pro-inflammatory cytokines such as TNF-α, which promoted tissue repairment, mainly mediated inflammatory reaction and caused tissue damage at a high level; and anti-inflammatory cytokines such as IL-10 [48, 49], mainly inhibited the release of inflammatory mediators [50]. In current study, elevated productions of colonic TNF-α and IL-10 were observed in HHPD-induced constipated mice.…”

Section: Discussionmentioning

confidence: 99%

The immune-regulating effect of Xiao’er Qixingcha in constipated mice induced by high-heat and high-protein diet

Yang

Zheng³

et al. 2017

BMC Complement Altern Med

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BackgroundXiao’er Qixingcha (EXQ) has been extensively applied to relieve dyspepsia and constipation in children for hundreds of years in China. However, the therapeutic mechanism underlying its efficacy remained to be defined. The present study aimed to clarify the possible laxative and immune-regulating effects of EXQ on two models of experimental constipation in mice, which mimicked the pediatric constipation caused by high-heat and high-protein diet (HHPD).MethodsThe two models of constipated mice were induced by HHPD or HHPD + atropine respectively. To investigate the laxative and immune-regulating activities of EXQ, animals were treated with three doses of EXQ (0.75, 1.5 and 3 g/kg) for 7 consecutive days. The fecal output parameters (number and weight), weight of intestinal content and, the thymus and spleen indexes were measured. The levels of sIgA, IL-10, TNF-α and LPS in colon and serum were determined by ELISA. Furthermore, the pathological changes of colon tissue were examined after routine H&E staining.ResultsBoth HHPD and HHPD + atropine treatments obviously inhibited the fecal output and reduced the colonic sIgA, prominently increased the levels of IL-10 and TNF-α in colonic tissue and elevated the contents of LPS in serum and colonic tissues. In contrast, oral administration of EXQ significantly improved the feces characters and dose-dependently decreased the intestinal changes in both models. In HHPD model test, EXQ efficaciously boosted the sIgA level in a dose-dependent manner, significantly elicited decreases in TNF-α and IL-10 levels, and evidently decreased the spleen and thymus indexes. In HHPD + atropine model test, EXQ treatment reversed the pathological changes by not only dramatically decreasing the spleen index and the levels of LPS and IL-10, but also markedly elevating the thymus index. Furthermore, microscopic observation revealed that EXQ treatment maintained the integrity of colonic mucosa, and protected the colonic tissues from inflammation in the both models.ConclusionsEXQ exhibited prominent laxative activity and effectively protected the colonic mucosal barrier in two models of constipated mice, of which the mechanism might be closely associated with its propulsive and immune-regulating properties. The current results not only validated the rationale for the clinical application of EXQ in pediatric constipation related symptoms, but also threw new light on the immune-inflammatory responses accompanied with chronic constipation pathology.

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Section: Discussionmentioning

confidence: 99%

The immune-regulating effect of Xiao’er Qixingcha in constipated mice induced by high-heat and high-protein diet

Yang

Zheng³

et al. 2017

BMC Complement Altern Med

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“…In recent studies on IBS patients, coexisting upper gastrointestinal symptoms, compatible with the diagnosis of FD, seem to increase the level of psychopathology [8,9]. A study by Talley et al .…”

Section: Discussionmentioning

confidence: 99%

“…A subsequent study by Balboa et al . [9] shows that the presence of FD in IBS patients has a significant negative impact on the psychological status. On the other hand, a recent study by Mikocka-Walus et al .…”

Section: Discussionmentioning

confidence: 99%

“…[8] and Balboa et al . [9], which used the Rome II diagnostic criteria. The present study applied the Rome III criteria and assessed the association of psychopathological features with IBS-FD overlap, differently from Mikocka-Walus et al .…”

Section: Discussionmentioning

confidence: 99%

“…It is unclear whether the co-occurrence of IBS and FD impairs the psychological status to a greater degree than the occurrence of IBS or FD alone. A number of studies support this hypothesis, having found that the presence of upper gastrointestinal symptoms in IBS patients increases the incidence and severity of psychopathology [8,9]. However, a recent study seems to contradict these findings [10].…”

Section: Introductionmentioning

confidence: 99%

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Psychopathological features of irritable bowel syndrome patients with and without functional dyspepsia: a cross sectional study

et al. 2011

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BackgroundIrritable bowel syndrome (IBS) and functional dyspepsia (FD) show considerable overlap and are both associated with psychiatric comorbidity. The present study aimed to investigate whether IBS patients with FD show higher levels of psychopathology than those without FD. As a preliminary analysis, it also evaluated the psychopathological differences, if any, between IBS patients featuring the two Rome III-defined FD subtypes, i.e. postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS).MethodsConsecutive outpatients (n = 82, F = 67, mean age 41.6 ± 12.7 years) referred to our third level gastroenterological centre, matching the Rome III criteria for IBS and, if present, for concurrent FD, were recruited. They were asked to complete a 90-item self-rating questionnaire, the Symptom Checklist 90 Revised (SCL-90-R), in order to assess the psychological status. Comparisons between groups were carried out using the non-parametric Mann-Whitney U test.ResultsPatients with IBS only were 56 (68.3%, F = 43, mean age 41.6 ± 13.3 years) and patients with both IBS and FD were 26 (31.7%, F = 24, mean age 41.8 ± 11.5 years), 17 of whom had PDS and 9 EPS. Patients with both IBS and FD scored significantly higher on the SCL-90-R GSI and on eight out of the nine subscales than patients with IBS only (P ranging from 0.000 to 0.03). No difference was found between IBS patients with PDS and IBS patients with EPS (P ranging from 0.07 to 0.97), but this result has to be considered provisional, given the small sample size of the two subgroups.ConclusionsIBS-FD overlap is associated with an increased severity of psychopathological features. This finding suggests that a substantial subset of patients of a third level gastroenterological centre with both IBS and FD may benefit from psychological assessment and treatment.

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Definition and Prevalence

Oshima

Miwa

2018

Functional Dyspepsia

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Impact of upper digestive symptoms in patients with irritable bowel syndrome

Cited by 22 publications

References 32 publications

The immune-regulating effect of Xiao’er Qixingcha in constipated mice induced by high-heat and high-protein diet

The immune-regulating effect of Xiao’er Qixingcha in constipated mice induced by high-heat and high-protein diet

Psychopathological features of irritable bowel syndrome patients with and without functional dyspepsia: a cross sectional study

Definition and Prevalence

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