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Li J, Ghosh TS, Arendt E, Shanahan F, O'Toole PW. Cross-Cohort Gut Microbiome Signatures of Irritable Bowel Syndrome Presentation and Treatment. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2308313. [PMID: 39243395 PMCID: PMC11538712 DOI: 10.1002/advs.202308313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 07/02/2024] [Indexed: 09/09/2024]
Abstract
Irritable bowel syndrome (IBS) is a prevalent disorder of gut-brain interaction without a reliable cure. Evidence suggests that an alteration of the gut microbiome may contribute to IBS pathogenesis, motivating the development of microbiome-targeted therapies to alleviate IBS symptoms. However, IBS-specific microbiome signatures are variable across cohorts. A total of 9204 datasets were meta-analyzed, derived from fourteen IBS microbiome discovery cohorts, three validation cohorts for diet-microbiome interactions, and five rifaximin therapy cohorts. The consistent bacterial species and functional signatures associated with IBS were identified. Network analysis revealed two distinct IBS-enriched microbiota clusters; obligate anaerobes that are found commonly in the gut, and facultative anaerobes typically present in the mouth, implying a possible association between oral bacterial translocation to gut and IBS pathogenesis. By analyzing diet-microbiome interactions, microbiota-targeted diets that can potentially modulate the altered gut microbiota of IBS subjects toward a healthy status were identified. Furthermore, rifaximin treatment of IBS subjects was linked with a reduction in the abundance of facultatively anaerobic pathobionts. Gut microbiome signatures were identified across IBS cohorts that may inform the development of therapies for microbiome modulation in IBS. The microbiota-targeted diet patterns described may enable nutritional intervention trials in IBS and for assisting dietary management.
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Affiliation(s)
- Junhui Li
- APC Microbiome IrelandUniversity College CorkCorkT12 K8AFIreland
- School of MicrobiologyUniversity College CorkCorkT12 K8AFIreland
| | - Tarini Shankar Ghosh
- APC Microbiome IrelandUniversity College CorkCorkT12 K8AFIreland
- School of MicrobiologyUniversity College CorkCorkT12 K8AFIreland
- Present address:
Indraprastha Institute of Information Technology DelhiNew Delhi110020India
| | - Elke Arendt
- APC Microbiome IrelandUniversity College CorkCorkT12 K8AFIreland
- School of Food and Nutritional SciencesUniversity College CorkCorkT12 K8AFIreland
| | - Fergus Shanahan
- APC Microbiome IrelandUniversity College CorkCorkT12 K8AFIreland
- Department of MedicineUniversity College CorkCorkT12 K8AFIreland
| | - Paul W. O'Toole
- APC Microbiome IrelandUniversity College CorkCorkT12 K8AFIreland
- School of MicrobiologyUniversity College CorkCorkT12 K8AFIreland
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Liu H, Chen J, Li X, Pang J, Gao Y, Gao J, Yuan Y, Yu X, Li Y, Zhang Y. Prevalence and Influencing Factors of Irritable Bowel Syndrome Among Nurses in China: A Cross-Sectional Study. Gastroenterol Nurs 2024; 47:250-259. [PMID: 39087990 DOI: 10.1097/sga.0000000000000804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 12/06/2023] [Indexed: 08/02/2024] Open
Abstract
The aims of this study were to investigate the prevalence and influencing factors of irritable bowel syndrome among nurses in order to update the epidemiological data. A questionnaire survey was administered to 1,325 clinical nurses. We used a questionnaire for demographic information, the IBS Severity Scoring System, the IBS Quality of Life questionnaire, the Hospital Anxiety and Depression Scale, the Pittsburgh Sleep Quality Index, and the Maslach Burnout Inventory to conduct our survey. Univariate and multivariate analyses were performed to detect factors influencing irritable bowel syndrome among nurses. The prevalence of irritable bowel syndrome was 13.3%, and the severity of symptoms was mostly moderate. The IBS Quality of Life score was significantly reduced (p < .001). Various foods that caused abdominal pain (egg and dairy products [OR = 4.80], greasy food [OR = 5.80], spicy food [OR = 2.66], raw and cold food [OR = 2.43]), a family history of gastrointestinal diseases (OR = 1.64, 95% CI [1.038, 2.587]), drinking weak green tea (OR = 1.71, 95% CI [1.143, 2.552]), mild depression (OR = 1.78, 95% CI [1.005, 3.156]), and the personal accomplishment dimension of occupational burnout (OR = 2.52, 95% CI [1.039, 6.114]) had important effects on nurses suffering from irritable bowel syndrome. On the contrary, exercising 1-2 hours per week (OR = 0.53, 95% CI [0.327, 0.859]) had a protective effect. The prevalence of irritable bowel syndrome among nurses is relatively high and may be influenced by several factors including genetics, diet, exercise, psychology, and occupational burnout.
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Affiliation(s)
- Hongyuan Liu
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Jie Chen
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Xiangning Li
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Juan Pang
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Yajun Gao
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Juan Gao
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Yuan Yuan
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Xiaoping Yu
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Yaoyao Li
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Yu Zhang
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
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Zhao J, Li X, Yang J, Hao X, Tian J, Wang X, Wang X, Li N, Li Z. Prevalence of and factors associated with symptoms consistent with a diagnosis of irritable bowel syndrome among resident physicians in standardised training in China: a cross-sectional study. BMJ Open 2023; 13:e079874. [PMID: 38110383 DOI: 10.1136/bmjopen-2023-079874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2023] Open
Abstract
OBJECTIVES This study aims to investigate the incidence of and factors associated with irritable bowel syndrome (IBS) among resident physicians in standardised training at eight traditional Chinese medicine (TCM) hospitals in China. DESIGN A cross-sectional survey was administered to resident physicians in their first to third years of standardised training at eight TCM hospitals. PARTICIPANTS AND SETTING A total of 514 resident physicians in standardised training were included. MEASURES The questionnaire consisted of two sections, namely: section A collected basic information, and section B included the four-item Perceived Stress Scale (PSS-4), the Patient Health Questionnaire-4 (PHQ-4), the Pittsburgh Sleep Quality Index (PSQI) and the Rome IV criteria for IBS. Univariate and multivariate logistic regression models were constructed to assess the associations of age, sex, body mass index, stress, depression, anxiety, sleep quality and IBS. RESULTS Of the included resident doctors, 77.2% were female, 20.4% were obese or underweight and 8.6% had symptoms consistent with a diagnosis of IBS. There were no statistically significant differences in lifestyle factors (night shift work, overtime work or working efficiency during the COVID-19 pandemic) between patients with IBS and participants without IBS (hereafter, non-IBS participants) (p=0.429, p=0.572 or p=0.464, respectively). Notably, compared with non-IBS participants, patients with IBS had significantly higher mean scores on the PSS-4 and PHQ-4 (p=0.028 and p=0.012, respectively); however, there was not a significant difference in PSQI scores between these two groups (p=0.079). Depression symptoms were significantly associated with IBS (unadjusted OR 0.498, 95% CI 0.265 to 0.935, p=0.030). CONCLUSION These findings suggest that IBS is common among resident physicians in standardised training. Future studies should investigate emotional distress, especially stress and depression, in the development of prevention or treatment of IBS.
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Affiliation(s)
- Jun Zhao
- Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xia Li
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiayi Yang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xin Hao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Junjian Tian
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xin Wang
- The Department of Acupuncture and Moxibustion, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Xuefei Wang
- The Department of Acupuncture and Moxibustion, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Ning Li
- Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Zhigang Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Yazbeck G, Malaeb D, Shaaban H, Sarray El Dine A, Hallit S, Hallit R. Irritable bowel syndrome (IBS) among Lebanese adults: unidentified IBS and associated factors. BMC Public Health 2023; 23:1589. [PMID: 37605160 PMCID: PMC10463955 DOI: 10.1186/s12889-023-16543-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is one of the most frequent functional gastrointestinal disorders, but the condition is still underdiagnosed. The high of rate of unidentified IBS by patients can be related to different factors. The aim of this study is to assess the rate of unidentified IBS among Lebanese adults and investigate the role of socio-demographic factors, anxiety, depression, insomnia and eating attitudes on IBS diagnosis. METHODS A cross-sectional study was conducted among Lebanese adults older than 18 years between June 2022 and December 2022, using a self-reporting questionnaire distributed via social media. RESULTS A total of 425 participants was enrolled in the study with around 184 (46.8%) having a possible unidentified IBS. Higher psychological distress (aOR = 1.07) and insomnia severity (aOR = 1.08) were significantly associated with higher odds of having possible unidentified IBS whereas a higher household crowding index (aOR = 0.67) was significantly associated with lower odds of having possible IBS. The correlation of eating attitudes with cigarette smoking (aOR = 1.33; p = .025; 95% CI 1.04; 1.70) and insomnia severity with cigarette smoking (aOR = .89; p = .023; 95% CI .80; .98) were significantly associated with the presence of possible IBS. In nonsmokers, higher psychological distress (aOR = 1.07) and insomnia severity (aOR = 1.10) were significantly associated with higher odds of having possible IBS. In smokers, higher BMI (aOR = .78) was significantly associated with lower odds of having possible IBS, whereas higher eating attitudes scores (more inappropriate eating) (aOR = 1.40) were significantly associated with higher odds of having possible IBS. CONCLUSION The study highlighted the implication of raising awareness about IBS among the Lebanese population to promote early diagnosis and minimize the rate of unidentified IBS by patients. Initiation of appropriate treatment plans, tailored symptomatic management approach, and diet programs should be highly encouraged.
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Affiliation(s)
- Gabriella Yazbeck
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Medical Gulf University, Ajman, United Arab Emirates
| | - Hamid Shaaban
- New York Medical College, New York, USA
- Department of Infectious Disease, Saint Michael's Medical Center, Newark, NJ, USA
| | - Abir Sarray El Dine
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Rabih Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon.
- Department of Infectious Disease, Notre Dame des Secours University Hospital Center, Street 93, Byblos, Postal Code 3, Lebanon.
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Zhang X, Xu W, Zhong W, Zhang W, Yang C, Duan L, Niu H, Dong Y, Liu T, Xia S, Wang B. Exploring the links between gut microbiome changes and irritable bowel syndrome in Han populations in the Tibetan Plateau. J Zhejiang Univ Sci B 2023; 24:823-838. [PMID: 37701958 PMCID: PMC10202748 DOI: 10.1631/jzus.b2200509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/09/2023] [Indexed: 05/23/2023]
Abstract
The gut microbiome shows changes under a plateau environment, while the disbalance of intestinal microbiota plays an important role in the pathogenesis of irritable bowel syndrome (IBS); however, the relationship between the two remains unexplored. In this work, we followed up a healthy cohort for up to a year before and after living in a plateau environment and performed 16S ribosomal RNA (rRNA) sequencing analysis of their fecal samples. Through evaluating the participants' clinical symptoms, combined with an IBS questionnaire, we screened the IBS sub-population in our cohort. The sequencing results showed that a high-altitude environment could lead to changes in the diversity and composition of gut flora. In addition, we found that the longer the time volunteers spent in the plateau environment, the more similar their gut microbiota composition and abundance became compared to those before entering the plateau, and IBS symptoms were significantly alleviated. Therefore, we speculated that the plateau may be a special environment that induces IBS. The taxonomic units g_Alistipes, g_Oscillospira, and s_Ruminococcus_torques, which had been proved to play important roles in IBS pathogenesis, were also abundant in the IBS cohort at high altitudes. Overall, the disbalance of gut microbiota induced by the plateau environment contributed to the high frequency of IBS and the psychosocial abnormalities associated with IBS. Our results prompt further research to elucidate the relevant mechanism.
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Affiliation(s)
- Xingguang Zhang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin 300052, China
- Department of Gastroenterology, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin Key Laboratory of Hepatopancreatic Fiberosis and Molecular Diagnosis & Treatment, Tianjin 300162, China
| | - Wei Xu
- Department of Gastroenterology, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin Key Laboratory of Hepatopancreatic Fiberosis and Molecular Diagnosis & Treatment, Tianjin 300162, China
| | - Weilong Zhong
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin 300052, China
| | - Wencheng Zhang
- Department of Gastroenterology, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin Key Laboratory of Hepatopancreatic Fiberosis and Molecular Diagnosis & Treatment, Tianjin 300162, China
| | - Cheng Yang
- Department of Gastroenterology, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin Key Laboratory of Hepatopancreatic Fiberosis and Molecular Diagnosis & Treatment, Tianjin 300162, China
| | - Lisa Duan
- Department of Gastroenterology, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin Key Laboratory of Hepatopancreatic Fiberosis and Molecular Diagnosis & Treatment, Tianjin 300162, China
| | - Haiyan Niu
- Department of Gastroenterology, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin Key Laboratory of Hepatopancreatic Fiberosis and Molecular Diagnosis & Treatment, Tianjin 300162, China
| | - Yanmei Dong
- Department of Gastroenterology, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin Key Laboratory of Hepatopancreatic Fiberosis and Molecular Diagnosis & Treatment, Tianjin 300162, China
| | - Taotao Liu
- Department of Gastroenterology, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin Key Laboratory of Hepatopancreatic Fiberosis and Molecular Diagnosis & Treatment, Tianjin 300162, China
| | - Shihai Xia
- Department of Gastroenterology, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin Key Laboratory of Hepatopancreatic Fiberosis and Molecular Diagnosis & Treatment, Tianjin 300162, China. ,
| | - Bangmao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin 300052, China.
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Costantino A, Pessarelli T, Vecchiato M, Vecchi M, Basilisco G, Ermolao A. A practical guide to the proper prescription of physical activity in patients with irritable bowel syndrome. Dig Liver Dis 2022; 54:1600-1604. [PMID: 36153192 DOI: 10.1016/j.dld.2022.08.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/27/2022] [Accepted: 08/23/2022] [Indexed: 12/30/2022]
Affiliation(s)
- Andrea Costantino
- Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Tommaso Pessarelli
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Marco Vecchiato
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy; Clinical Network of Sport and Exercise Medicine of the Veneto Region, Padova, Italy
| | - Maurizio Vecchi
- Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Guido Basilisco
- Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Ermolao
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy; Clinical Network of Sport and Exercise Medicine of the Veneto Region, Padova, Italy
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7
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Hwang SK, Lee YJ, Cho ME, Kim BK, Yoon YI. Factors Associated with Gastrointestinal Symptoms among Rotating Shift Nurses in South Korea: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9795. [PMID: 36011441 PMCID: PMC9408213 DOI: 10.3390/ijerph19169795] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Rotating shift work places a serious burden on nurses' physical and psychological health. Gastrointestinal (GI) symptoms are a common complaint among shift workers. This study assessed GI symptoms and identified the associations between dietary habits, psychological status, and sleep quality among rotating shift nurses. Data from 125 female nurses in rotating shifts who worked at two tertiary hospitals in South Korea were collected using a questionnaire that included the Gastrointestinal Symptoms Questionnaire; the Dietary Habit Questionnaire; the Depression, Anxiety, Stress Scale (DASS)-21; and the Pittsburgh Sleep Quality Index (PSQI). All participants experienced various GI symptoms, and 47% of them complained of at least one severe GI symptom. There were significant differences in GI symptom scores according to the status of depression, anxiety, stress, and sleep quality. In multiple linear regression analysis, the factors associated with an increase in the occurrence and severity of GI symptoms were poor sleep quality and morbid anxiety and stress. The model explained power at 43.2%. As most nurses in rotating shifts experience GI symptoms, they should receive counseling and training programs at work to alleviate psychological symptoms, improve sleep quality, and pay more attention to their health status as well as GI symptom management.
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Affiliation(s)
- Sun-Kyung Hwang
- College of Nursing, Pusan National University, Yangsan 50612, Korea
- Research Institute of Nursing Science, Pusan National University, Yangsan 50612, Korea
| | - Yun-Ji Lee
- College of Nursing, Pusan National University, Yangsan 50612, Korea
| | - Min-Eun Cho
- Department of Nursing, Graduate School, Pusan National University, Yangsan 50612, Korea
| | - Bo-Kyoung Kim
- Department of Nursing, Graduate School, Pusan National University, Yangsan 50612, Korea
| | - Yea-In Yoon
- Department of Nursing, Pusan National University Yangsan Hospital, Yangsan 50612, Korea
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8
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Prevalence and Influencing Factors of Irritable Bowel Syndrome in Medical Staff: A Meta-Analysis. Dig Dis Sci 2022; 67:5019-5028. [PMID: 35175433 PMCID: PMC8853241 DOI: 10.1007/s10620-022-07401-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 01/15/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a common functional digestive tract disease worldwide, with a high prevalence among medical staff. The purpose of this study is to systematically evaluate the prevalence and influencing factors of IBS in medical staff. METHODS We searched English online databases, including PubMed, The Cochrane Library, Web of Science, Embase, and EBSCOhost. The retrieval time was from database establishment to May of 2021. We screened the literature according to inclusion and exclusion criteria, extracted the relevant information, and evaluated the research quality. A meta-analysis was performed using the Stata 16.0 and Review Manager 5.4.1 software. RESULTS A total of 11 English studies from seven countries were included in this study, including 3,360 medical staff. The results of the meta-analysis showed an overall prevalence of IBS among medical staff of 16% [95%CI (0.15 ~ 0.17)] and that shift work (OR 2.27)), poor sleep quality (OR 4.27), and female gender (OR 2.29) are the major influencing factors of medical staff suffering from IBS. CONCLUSIONS The prevalence of irritable bowel syndrome among medical staff is relatively high, and hospitals can start by looking for targeted interventions from the highly related factors of IBS among medical staff such as shift work patterns, females, and poor sleep quality.
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9
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Influence of Irritable Bowel Syndrome on Stress and Depressive Symptoms in Nurses: The Korea Nurses' Health Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312324. [PMID: 34886050 PMCID: PMC8657383 DOI: 10.3390/ijerph182312324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/20/2021] [Accepted: 11/21/2021] [Indexed: 11/23/2022]
Abstract
Despite the high risk of irritable bowel syndrome (IBS) and stress/depressive symptoms in nurses, limited research has examined the relationship between these conditions in female nurses. The purpose of this study was to determine the prevalence of IBS and the influence of IBS on stress and depressive symptoms in female nurses. We analyzed the data from the Korea Nurses’ Health Study. Among 7667 participants from the 7th survey conducted from December 2018 to September 2019, 178 nurses were identified as having IBS based on the Rome IV criteria. Using the propensity score matching, 712 were selected as a comparison group. Multivariate ordinal logistic regression analyses were conducted to examine the influence of IBS on stress and depressive symptoms. The prevalence of IBS was 2.3% and the prevalence of depressive symptoms among nurses with IBS was 13.5%. Female nurses with IBS were 2.214 times more likely to experience increased stress levels. However, when demographics, dietary habits, sleep quality, and depressive symptoms were considered, having IBS was no longer an influential factor for increased stress levels. When all the variables were considered, female nurses with IBS were still 2.205 times more likely to experience depressive symptoms. Adequate support is needed to relieve depressive symptoms in nurses with IBS.
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10
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Liu TW, Wang CM, Ci YH, Liu J, Qi XS. Effect of psychological problems and interventions on gastrointestinal diseases. Shijie Huaren Xiaohua Zazhi 2021; 29:1043-1048. [DOI: 10.11569/wcjd.v29.i18.1043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Ting-Wei Liu
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China,Graduate School of Jinzhou Medical University, Jinzhou 121001, Liaoning Province, China
| | - Chun-Mei Wang
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China,Graduate School of Jinzhou Medical University, Jinzhou 121001, Liaoning Province, China
| | - Yi-Hong Ci
- Department of Psychology, General Hospital of Northern Theater Command, Shenyang 110016, Liaoning Province, China
| | - Jun Liu
- Military Joint Teaching and Research Office, the 32684 Troop of Chinese PLA, Shenyang 110000, Liaoning Province, China
| | - Xing-Shun Qi
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
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11
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Rogers AE, Hu YJ, Yue Y, Wissel EF, Petit III RA, Jarrett S, Christie J, Read TD. Shiftwork, functional bowel symptoms, and the microbiome. PeerJ 2021; 9:e11406. [PMID: 34026361 PMCID: PMC8121053 DOI: 10.7717/peerj.11406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/14/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There are about 15 million Americans working full-time on evening, night, or rotating shifts. Between 48% and 81.9% of those working rotating or night shifts report abdominal pain, constipation, diarrhea and other symptoms of functional bowel disorders. The basis for this high prevalence of functional bowel disorders, including irritable bowel syndrome (IBS), among shift workers is unknown. Animal studies, however, suggest that circadian disruption, similar to that in shift workers, may contribute to the development of GI complaints among shift workers by altering the composition and normal diurnal rhythmicity of the resident intestinal microbes. Therefore, the present study was designed to determine if there were differences in (1) composition and diversity of the microbiome of night shift workers compared to day shift workers; and (2) the composition and diversity of the microbiome among shift workers experiencing functional bowel symptoms compared to shift workers who did not experience functional bowel symptoms. METHODS Fifty-one full time staff nurses who worked either 12-hour day or night shifts completed demographic information, and the Rome III IBS module. They also collected two samples of gut microbiota before the beginning and at the end of their last work shift on day 14, using validated field-tested methods consistent with the Human Microbiome Project. After DNA extraction, 16S rRNA sequencing and assignment to the genus level was completed, samples were then compared to determine if there were (1) differences in the diversity and profile of the microbiome by shift type; (2) if there were differences in the microbiome by time of day for collection; and (3) whether there were differences in the diversity and profile of the microbiome of nurses with IBS and those without IBS. RESULTS There were no differences in alpha or beta diversity of gut microbiota when specimens from day and night shift nurses were compared. There were however marginal differences in beta diversity when specimens collected at the beginning and end of the shifts were compared, with seven OTUs being differentially abundant when collected from day shift workers in the evening. There were also three OTUs to be differentially abundant in participants reporting IBS symptoms.
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Affiliation(s)
- Ann E. Rogers
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States of America
| | - Yi-Juan Hu
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Ye Yue
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Emily F. Wissel
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States of America
| | - Robert A. Petit III
- Investigational Clinical Microbiology Core, Emory University, Atlanta, GA, United States of America
| | - Simone Jarrett
- Einstein Medical Center Philadelphia, Philadelphia, PA, United States of America
| | - Jennifer Christie
- Division of Digestive Diseases, Emory School of Medicine, Emory University, Atlanta, GA, United States of America
| | - Timothy D. Read
- Division of Digestive Diseases, Emory School of Medicine, Emory University, Atlanta, GA, United States of America
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12
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Health-Related Quality of Life in Irritable Bowel Syndrome: A Systematic Review and Meta-analysis. Gastroenterol Nurs 2021; 43:E102-E122. [PMID: 32487960 DOI: 10.1097/sga.0000000000000530] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Irritable bowel syndrome (IBS) affects up to 20% of the global population and is associated with impaired health-related quality of life (HRQoL). This systematic review and meta-analysis aimed to investigate differences in HRQoL of those with IBS compared with healthy controls and to examine whether HRQoL improves following psychological intervention. Online databases were searched for articles from 2002 to 2017. Studies were screened and data extracted according to predetermined criteria. A total of 4,154 citations were identified from which 36 were eligible for inclusion. Eight studies compared HRQoL of those with IBS (n = 822) with that of healthy individuals (n = 3,809). Those with IBS suffered significant impairment across all HRQoL domains compared with healthy individuals, with the majority of effects (Cohen's d) being moderate to large. Twenty-eight studies investigated HRQoL in IBS following psychological intervention (n = 1,308) relative to controls (n = 1,006). All HRQoL domains improved with large effects following treatment; however, maintenance of these effects was inconsistent. Those with IBS experience poorer HRQoL than the wider community; nevertheless, psychological interventions are associated with improved HRQoL across all domains. High-quality studies are needed to better inform gastroenterological nurses of which interventions are most efficacious in alleviating the burden of IBS, and which IBS subpopulations would benefit.
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13
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Chen HH, Hung CH, Kao AW, Hsieh HF. Exploring Quality of Life, Stress, and Risk Factors Associated with Irritable Bowel Syndrome for Female University Students in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083888. [PMID: 33917268 PMCID: PMC8068066 DOI: 10.3390/ijerph18083888] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/02/2021] [Accepted: 04/05/2021] [Indexed: 12/13/2022]
Abstract
Irritable bowel syndrome (IBS) is a common recurrent functional gastrointestinal disorder that impacts on patients physically and mentally. Studies on IBS have focused on adults, yet few studies have examined IBS among female university students. The aim of this study was to investigate the prevalence of IBS for female university students and its related factors. Using a cross-sectional study design, a total of 2520 female university students were recruited in southern Taiwan. The structured questionnaires, including the Rome III IBS diagnostic questionnaire, IBS symptom severity scale, Perceived Stress Scale, and World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF) were used for data collection. A total of 1894 female students complete the questionnaires. The response rate was 75.15%. The results indicated 193 female students with IBS and the prevalence of IBS was 10.1%. IBS female students had higher levels of stress and lower QOL than non-IBS female students. The risk factors for female university students developing IBS were dysmenorrhea, food avoidance, class absenteeism, and the lower physical domain of QOL. It is advised to consider these factors when providing students with counselling and relevant services in the expectation of alleviating their IBS symptoms, reducing the incidence rate of IBS, and further improving their QOL.
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Affiliation(s)
- Huan-Hwa Chen
- School of Nursing, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan; (H.-H.C.); (H.-F.H.)
- School of Nursing, Chung Hwa University of Medical Technology, No. 34, Wenhua 1st St., Tainan 717, Taiwan
| | - Chich-Hsiu Hung
- School of Nursing, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan; (H.-H.C.); (H.-F.H.)
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-7-3121101 (ext. 2601)
| | - Ai-Wen Kao
- Department of Internal Medicine, National Cheng Kung University Hospital, No. 138, Shengli Road, Tainan 704, Taiwan;
| | - Hsiu-Fen Hsieh
- School of Nursing, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan; (H.-H.C.); (H.-F.H.)
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung 807, Taiwan
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14
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Chang WP, Peng YX. Differences between fixed day shift workers and rotating shift workers in gastrointestinal problems: a systematic review and meta-analysis. INDUSTRIAL HEALTH 2021; 59:66-77. [PMID: 33408309 PMCID: PMC8010167 DOI: 10.2486/indhealth.2020-0153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/25/2020] [Indexed: 06/12/2023]
Abstract
This study comprised a review and compilation of literature to gain an in-depth understanding of the impact of rotating shift work on gastrointestinal health. PubMed, CINAHL, and the Cochrane Library were searched for studies published between January 1, 1985, and June 30, 2020. Fixed day shifts were defined as work shifts that began between 7:00 and 9:00 in the morning. Shifts beginning at any other time were classified as rotating shifts. A meta-analysis was performed using Comprehensive Meta-Analysis Software (CMA) version 3. In the end, 16 studies were included in the meta-analysis. An odds ratio (OR) of 1.56 (95% confidence interval (CI): 1.24-1.95), indicating that gastrointestinal problems are more common in rotating shift workers than in fixed day shift workers. Four gastrointestinal problems, namely, irritable bowel syndrome, constipation, indigestion, and peptic ulcers, were then analyzed separately. Significant differences between rotating shift workers and fixed day shift workers were found only for indigestion and peptic ulcers. For indigestion, the OR was 1.72 (95% CI: 1.28-2.30). For peptic ulcers, the OR was 1.66 (95% CI: 1.19-2.30). Thus, research indicates that rotating shift work may increase the risk of gastrointestinal problems, particularly indigestion and peptic ulcers.
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Affiliation(s)
- Wen-Pei Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taiwan
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, Taiwan
| | - Yu-Xuan Peng
- Department of Nursing, College of Nursing, Tzu Chi University, Taiwan
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15
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Duran S, Önel Ç, Güloğlu P, Ümit S. The relationship between self-esteem and psychological distress in critical care nurses. Nurs Crit Care 2021; 26:517-522. [PMID: 33728752 DOI: 10.1111/nicc.12618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Self-esteem can be described as negative or positive beliefs people have about themselves. It is an important personal source to combat stress and protect health, and related to job satisfaction. AIMS AND OBJECTIVES The aim of this study was to examine the relationship between self-esteem and psychological distress in critical care nurses. DESIGN A cross-sectional study. METHODS The research population of study consisted of 121 critical care nurses working at a university hospital in Edirne, Turkey between January and April 2017. A questionnaire consisting of 26 questions was used to obtain the personal and demographic information. The Symptom Check List-90-R test was used to determine the emotional status and the self-esteem scale was used to determine the self-esteem status of the participants. Participants were divided into two groups according to the self-esteem scale median score (Group 1: below 60, and Group 2: 60 and above). RESULTS The general severity index of the nurses was 1.11 (95% confidence interval [CI] 1.00-1.21). The general severity index of those with a self-esteem scale score below 60 was 1.47 (95% CI 1.37-1.57), while for those who with a self-esteem score of 60 and above, it was 0.73 (95% CI 0.59-0.87). The general severity index of the nurses in Group 1 was statistically significantly higher than that for those in Group 2. The number of nurses with a high symptom level in Group 1 was statistically significantly higher than those in Group 2. CONCLUSIONS The study showed that the general severity index and poor symptom level ratios associated with mental well-being are high in critical care nurses. However, critical care nurses with high self-esteem had fewer psychological problems than those with lower self-esteem. RELEVANCE TO CLINICAL PRACTICE Critical care nurses with low self-esteem should be given assertiveness, resilience, and interpersonal communication skills training, even outside of health care.
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Affiliation(s)
- Sedef Duran
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Trakya University, Edirne, Turkey
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16
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Zhao L, Yang W, Chen Y, Huang F, Lu L, Lin C, Huang T, Ning Z, Zhai L, Zhong LL, Lam W, Yang Z, Zhang X, Cheng C, Han L, Qiu Q, Shang X, Huang R, Xiao H, Ren Z, Chen D, Sun S, El-Nezami H, Cai Z, Lu A, Fang X, Jia W, Bian Z. A Clostridia-rich microbiota enhances bile acid excretion in diarrhea-predominant irritable bowel syndrome. J Clin Invest 2020; 130:438-450. [PMID: 31815740 PMCID: PMC6934182 DOI: 10.1172/jci130976] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/18/2019] [Indexed: 12/14/2022] Open
Abstract
An excess of fecal bile acids (BAs) is thought to be one of the mechanisms for diarrhea-predominant irritable bowel syndrome (IBS-D). However, the factors causing excessive BA excretion remain incompletely studied. Given the importance of gut microbiota in BA metabolism, we hypothesized that gut dysbiosis might contribute to excessive BA excretion in IBS-D. By performing BA-related metabolic and metagenomic analyses in 290 IBS-D patients and 89 healthy volunteers, we found that 24.5% of IBS-D patients exhibited excessive excretion of total BAs and alteration of BA-transforming bacteria in feces. Notably, the increase in Clostridia bacteria (e.g., C. scindens) was positively associated with the levels of fecal BAs and serum 7α-hydroxy-4-cholesten-3-one (C4), but negatively correlated with serum fibroblast growth factor 19 (FGF19) concentration. Furthermore, colonization with Clostridia-rich IBS-D fecal microbiota or C. scindens individually enhanced serum C4 and hepatic conjugated BAs but reduced ileal FGF19 expression in mice. Inhibition of Clostridium species with vancomycin yielded opposite results. Clostridia-derived BAs suppressed the intestinal FGF19 expression in vitro and in vivo. In conclusion, this study demonstrates that the Clostridia-rich microbiota contributes to excessive BA excretion in IBS-D patients, which provides a mechanistic hypothesis with testable clinical implications.
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Affiliation(s)
- Ling Zhao
- Institute of Brain and Gut Research, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Wei Yang
- Institute of Brain and Gut Research, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Yang Chen
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fengjie Huang
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Lin Lu
- Institute of Brain and Gut Research, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Chengyuan Lin
- Institute of Brain and Gut Research, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Tao Huang
- Institute of Brain and Gut Research, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Ziwan Ning
- Institute of Brain and Gut Research, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Lixiang Zhai
- Institute of Brain and Gut Research, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Linda Ld Zhong
- Chinese Medicine Clinical Study Center, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Waiching Lam
- Chinese Medicine Clinical Study Center, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Zhen Yang
- Chinese Medicine Clinical Study Center, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Xuan Zhang
- Chinese Medicine Clinical Study Center, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Chungwah Cheng
- Chinese Medicine Clinical Study Center, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Lijuan Han
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qinwei Qiu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaoxiao Shang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Runyue Huang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haitao Xiao
- School of Pharmaceutical Sciences, Health Science Center, Shenzhen University, Shenzhen, China
| | - Zhenxing Ren
- College of Basic Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dongfeng Chen
- College of Basic Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Silong Sun
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Hani El-Nezami
- School of Biological Sciences, Faculty of Science, The University of Hong Kong, Hong Kong SAR, China
| | - Zongwei Cai
- School of Chemistry, Hong Kong Baptist University, Hong Kong SAR, China
| | - Aiping Lu
- Chinese Medicine Clinical Study Center, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Xiaodong Fang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.,College of Basic Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China.,BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Wei Jia
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Cancer Biology Program, University of Hawaii Cancer Center, Hawaii, USA
| | - Zhaoxiang Bian
- Institute of Brain and Gut Research, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China.,Chinese Medicine Clinical Study Center, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
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17
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Zhao DY, Qi QQ, Long X, Li X, Chen FX, Yu YB, Zuo XL. Ultrastructure of intestinal mucosa in diarrhea-predominant irritable bowel syndrome. Physiol Int 2019; 106:225-235. [PMID: 31560236 DOI: 10.1556/2060.106.2019.20] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Impaired intestinal barrier function has been demonstrated in the pathophysiology of diarrhea-predominant irritable bowel syndrome (IBS-D). This study aimed to describe the intestinal ultrastructural findings in the intestinal mucosal layer of IBS-D patients. METHODS In total, 10 healthy controls and 10 IBS-D patients were analyzed in this study. The mucosa of each patient's rectosigmoid colon was first assessed by confocal laser endomicroscopy (CLE); next, biopsied specimens of these sites were obtained. Intestinal tissues of IBS-D patients and healthy volunteers were examined to observe cellular changes by transmission electron microscopy (TEM). RESULTS CLE showed no visible epithelial damage or inflammatory changes in the colonic mucosa of IBS-D compared with healthy volunteers. On transmission electron microscopic examination, patients with IBS-D displayed a larger apical intercellular distance with a higher proportion of dilated (>20 nm) intercellular junctional complexes, which was indicative of impaired mucosal integrity. In addition, microvillus exfoliation, extracellular vesicle as well as increased presence of multivesicular bodies were visible in IBS-D patients. Single epithelial cells appeared necrotic, as characterized by cytoplasmic vacuolization, cytoplasmic swelling, and presence of autolysosome. A significant association between bowel habit, frequency of abdominal pain, and enlarged intercellular distance was found. CONCLUSION This study showed ultrastructural alterations in the architecture of intestinal epithelial cells and intercellular junctional complexes in IBS-D patients, potentially representing a pathophysiological mechanism in IBS-D.
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Affiliation(s)
- D-Y Zhao
- Department of Gastroenterology, Puyang Oilfield General Hospital, Puyang, P. R. China
| | - Q-Q Qi
- Department of Gastroenterology, Qilu Hospital, Shandong University, Shandong Province, P. R. China
| | - X Long
- Department of Gastroenterology, Qilu Hospital, Shandong University, Shandong Province, P. R. China
| | - X Li
- Department of Gastroenterology, Qilu Hospital, Shandong University, Shandong Province, P. R. China
| | - F-X Chen
- Department of Gastroenterology, Qilu Hospital, Shandong University, Shandong Province, P. R. China
| | - Y-B Yu
- Department of Gastroenterology, Qilu Hospital, Shandong University, Shandong Province, P. R. China
| | - X-L Zuo
- Department of Gastroenterology, Qilu Hospital, Shandong University, Shandong Province, P. R. China
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Zhang Y, Qin G, Liu DR, Wang Y, Yao SK. Increased expression of brain-derived neurotrophic factor is correlated with visceral hypersensitivity in patients with diarrhea-predominant irritable bowel syndrome. World J Gastroenterol 2019; 25:269-281. [PMID: 30670915 PMCID: PMC6337018 DOI: 10.3748/wjg.v25.i2.269] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/03/2018] [Accepted: 12/13/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Visceral hypersensitivity is considered to play a vital role in the pathogenesis of irritable bowel syndrome (IBS). Neurotrophins have drawn much attention in IBS recently. Brain-derived neurotrophic factor (BDNF) was found to mediate visceral hypersensitivity via facilitating sensory nerve growth in pre-clinical studies. We hypothesized that BDNF might play a role in the pathogenesis of diarrhea-predominant IBS (IBS-D). AIM To investigate BDNF levels in IBS-D patients and its role in IBS-D pathophysiology. METHODS Thirty-one IBS-D patients meeting the Rome IV diagnostic criteria and 20 age- and sex-matched healthy controls were recruited. Clinical and psychological assessments were first conducted using standardized questionnaires. Visceral sensitivity to rectal distension was tested using a high-resolution manometry system. Colonoscopic examination was performed and four mucosal pinch biopsies were taken from the rectosigmoid junction. Mucosal BDNF expression and nerve fiber density were analyzed using immunohistochemistry. Mucosal BDNF mRNA levels were quantified by quantitative real-time polymerase chain reaction. Correlations between these parameters were examined. RESULTS The patients had a higher anxiety score [median (interquartile range), 6.0 (2.0-10.0) vs 3.0 (1.0-4.0), P = 0.003] and visceral sensitivity index score [54.0 (44.0-61.0) vs 21.0 (17.3-30.0), P < 0.001] than controls. The defecating sensation threshold [60.0 (44.0-80.0) vs 80.0 (61.0-100.0), P = 0.009], maximum tolerable threshold [103.0 (90.0-128.0) vs 182.0 (142.5-209.3), P < 0.001] and rectoanal inhibitory reflex threshold [30.0 (20.0-30.0) vs 30.0 (30.0-47.5), P = 0.032] were significantly lower in IBS-D patients. Intestinal mucosal BDNF protein [3.46E-2 (3.06E-2-4.44E-2) vs 3.07E-2 (2.91E-2-3.48E-2), P = 0.031] and mRNA [1.57 (1.31-2.61) vs 1.09 (0.74-1.42), P = 0.001] expression and nerve fiber density [4.12E-2 (3.07E-2-7.46E-2) vs 1.98E-2 (1.21E-2-4.25E-2), P = 0.002] were significantly elevated in the patients. Increased BDNF expression was positively correlated with abdominal pain and disease severity and negatively correlated with visceral sensitivity parameters. CONCLUSION Elevated mucosal BDNF may participate in the pathogenesis of IBS-D via facilitating mucosal nerve growth and increasing visceral sensitivity.
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Affiliation(s)
- Yu Zhang
- Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Geng Qin
- Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
| | - De-Rong Liu
- Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Yan Wang
- Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
- Beijing Key Laboratory for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing 100029, China
| | - Shu-Kun Yao
- Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
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Sehonou J, Dodo LRS. [Clinical profile and factors associated with irritable bowel syndrome among medical students in Cotonou (Benin)]. Pan Afr Med J 2018; 31:123. [PMID: 31037183 PMCID: PMC6462493 DOI: 10.11604/pamj.2018.31.123.16336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 08/06/2018] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION irritable bowel syndrome (IBS) is a common disorder that often results in general medicine and gastroenterology consultations. This study aims to determine IBS prevalence, to describe its clinical features, to determine its associated factors as well as its impact on the education among medical students in Cotonou. METHODS We conducted a cross-sectional, descriptive and analytical study on medical students over the period 1 August-29 September 2017. The diagnostic criteria were: Rome IV, Bristol scale, Cungi scale and HADS score. Data analysis was performed using SPSS 20.0 software. RESULTS Out of 315 students included in the study, 44 (14%) had IBS. The factors associated with IBS were female gender (OR [CI 95%] = 2.4 [1.2 - 4.7]; p = 0.00), regular consumption of fatty foods (OR [CI 95%] = 2.0 [1.1 - 3.9]; p = 0.03), high to severe levels of stress (OR [CI 95%] = 2.2 [1.1 - 4.7]; p= 0.02) and moderate to severe state of anxiety (OR [CI 95%] = 1.9 [0.9 - 3.6]; p= 0.04). IBS-related absenteeism was rare (1 case; 2.3%). CONCLUSION IBS is common among medical students in Cotonou. The identified modifiable factors associated with IBS were stress, anxiety and regular consumption of fatty foods. No appreciable impact on the education was reported.
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Affiliation(s)
- Jean Sehonou
- Clinique Universitaire d’Hépato-gastroentérologie, CNHU Hubert Koutoukou Maga, Cotonou, Bénin,Centre National Hospitalier et Universitaire Hubert Koutoukou Maga de Cotonou CNHU-HKM, Bénin,Corresponding author: Jean Sehonou, Centre National Hospitalier et Universitaire Hubert Koutoukou Maga de Cotonou CNHU-HKM, Bénin
| | - Leoubou Roger Samuel Dodo
- Clinique Universitaire d’Hépato-gastroentérologie, CNHU Hubert Koutoukou Maga, Cotonou, Bénin,Centre National Hospitalier et Universitaire Hubert Koutoukou Maga de Cotonou CNHU-HKM, Bénin
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Arasteh P, Maharlouei N, Eghbali SS, Amini M, Lankarani KB, Malekzadeh R. A Comprehensive Look at Irritable Bowel Syndrome and its Associated Factors Considering the Rome IV Criteria: A Penalized Smoothly Clipped Absolute Deviation Regression Approach in the Pars Cohort Study. Middle East J Dig Dis 2018; 10:149-159. [PMID: 30186578 PMCID: PMC6119837 DOI: 10.15171/mejdd.2018.104] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/19/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND After the introduction of the Rome IV criteria for the diagnosis of irritable bowel syndrome (IBS), studies on the clinical significance of the new criteria in the settings of a large study has been scarce. Objective: Herein we used the infrastructures provided by one the largest cohort studies in Iran to evaluate the epidemiological features related to IBS. METHODS A total of 9264 participants, were enrolled in the initial registry. Diagnosis of IBS was done using the Rome IV criteria. Individuals with IBS were compared with a control group. Since the study included a large sample size of patients, we used the penalized smoothly clipped absolute deviation (SCAD) regression analysis to construct a model for the evaluation of factors associated with IBS. RESULTS Overall, data of 9163 participants entered the final analysis. In total, 1067 (11.6%) individuals were diagnosed with IBS, among which 57 (5.3%) were diarrhea dominant (IBS-D), 380 (35.6%) were constipation dominant (IBS-C), and 630 (59%) did not mention having any of the two (IBS-U). In the regression model, back pain/arthralgia (OR: 1.98, 95% CI: 1.65 - 2.40), insomnia (OR: 1.65, 95% CI: 1.40 - 1.93), depression (OR: 1.64, 95% CI: 1.38 - 1.95), female sex (OR: 1.58, 95% CI: 1.27 - 1.96), anxiety (OR: 1.43, 95% CI: 1.21 - 1.69), and being married (OR: 1.23, 95% CI: 1.03 - 1.48), were associated with higher rates of IBS. We found that IBS prevalence displays a peak at the age of 41 years for both men and women. CONCLUSION The present study provides a background for follow-up studies to be conducted in order to evaluate causality between IBS and some major diseases such as liver disease. We also found that opium use, although not statistically significant, in addition to sex, education, back/joint pain, depression, insomnia, anxiety, and marital status might be a contributing factor in IBS.
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Affiliation(s)
- Peyman Arasteh
- Department of MPH, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Najmeh Maharlouei
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Sajjad Eghbali
- Department of Pathology and Lab Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mitra Amini
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran B. Lankarani
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
OBJECTIVE The aim of this review was to examine (1) the prevalence of smoking in subjects with irritable bowel syndrome (IBS), (2) whether smoking prevalence significantly differs between subjects with and without IBS, and (3) whether smoking significantly predicts the presence or the development of IBS. METHODS Articles were retrieved by systematically searching the Scopus, Web of Science, and PubMed electronic databases from inception to July 2016, using the keywords "smoking" and "tobacco" combined with "irritable bowel syndrome." Reference lists of included articles were also searched. Articles were included if they (1) reported data on smoking prevalence in subjects with IBS and/or on the association (assessed by means of multivariate analyses) between smoking and IBS, (2) identified IBS according to Manning criteria or Rome I-III criteria, (3) were English-language articles, and (4) involved only adult subjects. RESULTS The electronic searches yielded a total of 1,637 records, and 42 articles met inclusion criteria. Another 13 articles were retrieved through manual search, leading to a total of 55 included articles. Smoking prevalence in subjects with IBS was assessed by 48 articles and ranged from 0% in university students to 47.1% in patients with microscopic colitis. Thirty-three articles compared smoking prevalence between subjects with and without IBS. In 25 articles no significant difference was found. In seven articles smoking was significantly more frequent in subjects with IBS compared to those without IBS, while one study found a significantly higher smoking prevalence in controls. Eighteen multivariate analyses assessing the association between smoking and IBS were presented in 16 articles. Only one study employed a prospective design. In 11 analyses, smoking was not significantly associated with IBS after adjusting for covariates. In seven studies smoking independently predicted the presence of IBS. CONCLUSIONS According to the selected articles, a significant association between smoking and IBS cannot be confirmed. However, different shortcomings may hinder generalizability and comparability of many studies. A dimensional assessment of smoking, a prospective design, the differentiation between IBS subgroups, and the recruitment of patients in clinical settings, especially in primary care, are necessary to clarify the role of smoking in IBS.
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Affiliation(s)
- Laura Sirri
- a Laboratory of Psychosomatics and Clinimetrics, Department of Psychology , University of Bologna , Bologna , Italy
| | - Silvana Grandi
- a Laboratory of Psychosomatics and Clinimetrics, Department of Psychology , University of Bologna , Bologna , Italy
| | - Eliana Tossani
- a Laboratory of Psychosomatics and Clinimetrics, Department of Psychology , University of Bologna , Bologna , Italy
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Zhang F, Xiang W, Li CY, Li SC. Economic burden of irritable bowel syndrome in China. World J Gastroenterol 2016; 22:10450-10460. [PMID: 28058026 PMCID: PMC5175258 DOI: 10.3748/wjg.v22.i47.10450] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 11/01/2016] [Accepted: 11/28/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To estimate annual direct and indirect costs for patients diagnosed with irritable bowel syndrome (IBS) and subtypes.
METHODS Patients completed a standardized questionnaire concerning usage of healthcare resources, travel costs, meals, and productivity loss of patients when seeking treatment for IBS. Total annual costs per patient were calculated as the sum of direct (including medical and nonmedical) and indirect costs. Total annual costs per patient among various IBS subtypes were compared. Analysis of variance and bootstrapped independent sample t-tests were performed to determine differences between groups after controlling for IBS subtypes.
RESULTS A total of 105 IBS patients (64.80% female), mean age of 57.12 years ± 10.31 years), mean disease duration of 4.31 years ± 5.40 years, were included. Total annual costs per patient were estimated as CNY18262.84 (USD2933.08). Inpatient and outpatient healthcare use were major cost drivers, accounting for 46.41%and 23.36% of total annual costs, respectively. Productivity loss accounted for 25.32% of total annual costs. The proportions of direct and indirect costs were similar to published studies in other countries. Nationally, the total costs of managing IBS would amount to CNY123.83 billion (USD1.99 billion). Among the IBS subtypes, total annual costs per patient of IBS-M was highest at CNY18891.18 (USD3034). Furthermore, there was significant difference in productivity loss among IBS subtypes (P = 0.031).
CONCLUSION IBS imposes a huge economic burden on patients and healthcare systems, which could account for 3.3% of the total healthcare budget for the entire Chinese nation. More than two-thirds of total annual costs of IBS consist of inpatient and outpatient healthcare use. Among the subtypes, IBS-M patients appear to have the greatest economic burden but require further confirmation.
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23
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Chen X, Liu XS. Hydrogen sulfide from a NaHS source attenuates dextran sulfate sodium (DSS)-induced inflammation via inhibiting nuclear factor-κB. J Zhejiang Univ Sci B 2016; 17:209-17. [PMID: 26984841 DOI: 10.1631/jzus.b1500248] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This study investigated the alleviating effects of hydrogen sulfide (H2S), derived from sodium hydrosulfide (NaHS), on inflammation induced by dextran sulfate sodium (DSS) in both in vivo and in vitro models. We found that NaHS injection markedly decreased rectal bleeding, diarrhea, and histological injury in DSS-challenged mice. NaHS (20 μmol/L) reversed DSS-induced inhibition in cell viability in Caco-2 cells and alleviated pro-inflammation cytokine expression in vivo and in vitro, indicating an anti-inflammatory function for H2S. It was also found that H2S may regulate cytokine expression by inhibiting the nuclear factor-κB (NF-κB) signaling pathway. In conclusion, our results demonstrated that H2S alleviated DSS-induced inflammation in vivo and in vitro and that the signal mechanism might be associated with the NF-κB signaling pathway.
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Affiliation(s)
- Xi Chen
- Medical College, Qingdao University, Qingdao 266021, China.,Department of Gastroenterology, Yantai Municipal Laiyang Central Hospital, Yantai 265200, China
| | - Xi-shuang Liu
- Medical College, Qingdao University, Qingdao 266021, China.,Department of Gastroenterology, the Affiliated Hospital of Qingdao University, Qingdao 266071, China
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24
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Knowles SR, Austin DW, Sivanesan S, Tye-Din J, Leung C, Wilson J, Castle D, Kamm MA, Macrae F, Hebbard G. Relations between symptom severity, illness perceptions, visceral sensitivity, coping strategies and well-being in irritable bowel syndrome guided by the common sense model of illness. PSYCHOL HEALTH MED 2016; 22:524-534. [PMID: 27045996 DOI: 10.1080/13548506.2016.1168932] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Irritable Bowel Syndrome (IBS) is a common condition affecting around 10-20% of the population and associated with poorer psychological well-being and quality of life. The aim of the current study was to explore the efficacy of the Common Sense Model (CSM) using Structural Equation Modelling (SEM) in an IBS cohort. One hundred and thirty-one IBS patients (29 males, 102 females, mean age 38 years) participating in the IBSclinic.org.au pre-intervention assessment were included. Measures included IBS severity (Irritable Bowel Syndrome Severity Scoring System), coping patterns (Carver Brief COPE), visceral sensitivity (Visceral Sensitivity Index), illness perceptions (Brief Illness Perceptions Questionnaire), psychological distress (Depression, Anxiety and Stress Scale), and quality of life (IBS Quality of Life scale; IBS-QoL). Using SEM, a final model with an excellent fit was identified (χ2 (8) = 11.91, p = .16, χ2/N = 1.49, CFI > .98, TLI > .96, SRMR < .05). Consistent with the CSM, Illness perceptions were significantly and directly influenced by IBS severity (β = .90, p < .001). Illness perceptions in turn directly influenced maladaptive coping (β = .40, p < .001) and visceral sensitivity (β = .70, p < .001). Maladaptive coping and visceral sensitivity were significantly associated with psychological distress (β = .55, p < .001; β = .22, p < .01) and IBS-QoL (β = -.28, p < .001; β = -.62, p < .001). Based on these findings, we argue that to augment the adverse impact of IBS severity on IBS-QoL and psychological distress, psychological interventions will be best to target the mediating psychological processes including illness beliefs, visceral sensitivity and maladaptive coping.
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Affiliation(s)
- Simon R Knowles
- a Faculty Health, Arts, and Design, Department of Psychology , Swinburne University of Technology , Melbourne , Australia.,b Department of Medicine , The University of Melbourne , Melbourne , Australia.,c Department of Psychiatry , St Vincent's Hospital , Melbourne , Australia.,d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia
| | - David W Austin
- e Department of Psychology , Deakin University , Melbourne , Australia
| | - Suresh Sivanesan
- d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia
| | - Jason Tye-Din
- d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia.,f Walter and Eliza Hall Institute , Melbourne , Australia
| | - Chris Leung
- d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia.,g The Austin Hospital , Melbourne , Australia
| | | | - David Castle
- b Department of Medicine , The University of Melbourne , Melbourne , Australia.,c Department of Psychiatry , St Vincent's Hospital , Melbourne , Australia
| | - Michael A Kamm
- b Department of Medicine , The University of Melbourne , Melbourne , Australia.,i Department of Gastroenterology and Medicine , St Vincent's Hospital , Melbourne , Australia.,j Division of Immunology , Imperial College , London , UK
| | - Finlay Macrae
- d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia
| | - Geoff Hebbard
- b Department of Medicine , The University of Melbourne , Melbourne , Australia.,d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia
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Ibrahim NK, Al-Bloushy RI, Sait SH, Al-Azhary HW, Al Bar NH, Mirdad GA. Irritable bowel syndrome among nurses working in King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Libyan J Med 2016; 11:30866. [PMID: 27032964 PMCID: PMC4816808 DOI: 10.3402/ljm.v11.30866] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 03/04/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder that can cause disability and economic burden. Nurses are a vital part of the medical team and their well-being is an important issue. Yet, few studies have been done concerning IBS among nurses. OBJECTIVES To determine the prevalence, severity, and predictors of IBS among nurses working at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. MATERIALS AND METHODS A cross-sectional study was conducted among 229 nurses who fulfilled the eligibility criteria. They were selected by stratified random sampling during 2014-2015. A validated, confidential, self-administered data collection sheet was used for collection of personal and sociodemographic data. Rome III Criteria, IBS Severity Scoring System (IBS-SSS), Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index (PSQI) were included. Both descriptive and inferential statistics were done. A multiple logistic regression analysis was done to determine the predictors of IBS. RESULTS The prevalence of IBS among nurses was 14.4%, and IBS-Mixed type was the commonest variety (54.5%). Positive family history of IBS, working in outpatient clinics, having day shift, poor sleep quality, and high anxiety and depression scale scores were significantly associated with IBS. After controlling for confounding factors in regression analysis, the predictors of IBS were food hypersensitivity (aOR=4.52; 95% CI: 1.80-11.33), morbid anxiety (aOR=4.34; 95% CI: 1.49-12.67), and positive family history of IBS (aOR=3.38; 95% CI: 1.12-13.23). CONCLUSION The prevalence of IBS was 14.4%. Food hypersensitivity, morbid anxiety, and family history were the predictors of IBS. Screening and management of IBS, food hypersensitivity, and psychological problems among nurses are recommended.
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Affiliation(s)
- Nahla Khamis Ibrahim
- Family & Community Medicine Department, Prof at King Abdulaziz University, Jeddah, Saudi Arabia
- Epidemiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt;
| | | | - Salma Hani Sait
- Fifth Year Medical Student, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | | | - Ghazal A Mirdad
- Intern at Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Hsu TY, He GY, Wang YC, Chen CY, Wang SH, Chen WK, Kao CH. Alcohol Use Disorder Increases the Risk of Irritable Bowel Disease: A Nationwide Retrospective Cohort Study. Medicine (Baltimore) 2015; 94:e2334. [PMID: 26705226 PMCID: PMC4697992 DOI: 10.1097/md.0000000000002334] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Alcohol use disorder (AUD) is considered a possible risk factor for irritable bowel syndrome (IBS); however, previous studies investigating the association between AUD and IBS have yielded inconsistent results. The study investigated whether AUD increases the risk of IBS by using a population-based database in Taiwan.This retrospective matched-cohort study included the health insurance claims data of 56,355 AUD inpatients and 225,420 randomly selected controls by frequency-matched for sex, age, and index year. Cox proportional hazards regression analysis was performed to measure the risk of IBS among AUD patients compared with non-AUD patients.During the follow-up period, the incidence rate ratio (IRR) of IBS had 12.3-fold (95% CI: 11.9-12.7) in the AUD patients than non-AUD patients and the adjusted hazard ratio (aHR) for IBS in the AUD patients was 5.51 (95% CI: 4.36-6.96). For several comorbidities, the risk of IBS was significantly higher in the AUD patients than in non-AUD patients, with aHRs of 2.14 (95% confidence interval [CI]: 1.19-3.84), 2.05 (95% CI: 1.06-3.96), and 2.91 (95% CI: 1.26-6.72) for sleep disorders, acute pancreatitis, and hepatitis B, respectively. When we stratified the severity of AUD according to the length of hospital stay, the aHRs exhibited a significant correlation (P < 0.001) with severity, yielding aHRs of 3.24 (95% CI: 2.49-4.22), 11.9 (95% CI: 8.96-15.9), and 26.1 (95% CI: 19.4-35.2) for mild, moderate, and severe AUD, respectively.The risk of IBS was higher among AUD patients, and increased with the length of hospital stay.
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Affiliation(s)
- Tai-Yi Hsu
- From the Department of Emergency Medicine, China Medical University Hospital (T-YH, C-YC, W-KC), School of Medicine, College of Medicine, China Medical University, Taichung (T-YH, C-YC, W-KC), Department of Dermatology, National Taiwan University Hospital, Yunlin Branch, Douliou (G-YH), Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei (G-YH), Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan (Y-CW), Altitude Research Center, Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, Colorado, USA (S-HW), Taiwan Wilderness Medical Association, Taipei (S-HW), Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University (C-HK); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK)
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Pedersen N, Andersen NN, Végh Z, Jensen L, Ankersen DV, Felding M, Simonsen MH, Burisch J, Munkholm P. Ehealth: Low FODMAP diet vs Lactobacillus rhamnosus GG in irritable bowel syndrome. World J Gastroenterol 2014; 20:16215-16226. [PMID: 25473176 PMCID: PMC4239510 DOI: 10.3748/wjg.v20.i43.16215] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 07/14/2014] [Accepted: 07/25/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the effects of a low fermentable, oligosaccharides, disaccharides, monosaccharides and polyols diet (LFD) and the probiotic Lactobacillus rhamnosus GG (LGG) in irritable bowel syndrome (IBS).
METHODS: Randomised, unblinded controlled trial on the effect of 6-wk treatment with LFD, LGG or a normal Danish/Western diet (ND) in patients with IBS fulfilling Rome III diagnostic criteria, recruited between November 2009 and April 2013. Patients were required to complete on a weekly basis the IBS severity score system (IBS-SSS) and IBS quality of life (IBS-QOL) questionnaires in a specially developed IBS web self-monitoring application. We investigated whether LFD or LGG could reduce IBS-SSS and improve QOL in IBS patients.
RESULTS: One hundred twenty-three patients (median age 37 years, range: 18-74 years), 90 (73%) females were randomised: 42 to LFD, 41 to LGG and 40 to ND. A significant reduction in mean ± SD of IBS-SSS from baseline to week 6 between LFD vs LGG vs ND was revealed: 133 ± 122 vs 68 ± 107, 133 ± 122 vs 34 ± 95, P < 0.01. Adjusted changes of IBS-SSS for baseline covariates showed statistically significant reduction of IBS-SSS in LFD group compared to ND (IBS-SSS score 75; 95%CI: 24-126, P < 0.01), but not in LGG compared to ND (IBS-SSS score 32; 95%CI: 18-80, P = 0.20). IBS-QOL was not altered significantly in any of the three groups: mean ± SD in LFD 8 ± 18 vs LGG 7 ± 17, LFD 8 ± 18 vs ND 0.1 ± 15, P = 0.13.
CONCLUSION: Both LFD and LGG are efficatious in patients with IBS.
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Liu Y, Liu L, Yang Y, He Y, Zhang Y, Wang M, Chen S, Yao S. A school-based study of irritable bowel syndrome in medical students in beijing, china: prevalence and some related factors. Gastroenterol Res Pract 2014; 2014:124261. [PMID: 25371668 PMCID: PMC4211179 DOI: 10.1155/2014/124261] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 09/21/2014] [Indexed: 02/05/2023] Open
Abstract
Purpose. To investigate the prevalence and some related factors about irritable bowel syndrome (IBS) in medical students. Methods. A cross-sectional study was carried out from February 2014 to Jun 2014 in Beijing University of Chinese Medicine, Beijing, China. All participants were asked to completed self-administered questionnaires. Results. Seven hundred and sixty-seven medical students (23.26 ± 2.88 years, 25.6% males) completed the survey. The prevalence of IBS was 33.3%, with a high prevalence in women (36.1%). Among the IBS patients, 112 cases were IBS-M (43.9%) and 77.6% had moderately severe IBS. There were no statistical differences between control group and IBS patients in anxiety and depression scores (P > 0.05). The total score of Pittsburgh sleep quality index (PSQI) was significantly higher for medical students with IBS and 35.5% of IBS patients had severe sleep disorder; the scores of child trauma questionnaire (CTQ) and student-life stress inventory (SLSI) were also higher in IBS patients. Sex and sleep disorder were independently associated with IBS (OR, 1.914, 95%CI, 1.281-2.860; OR, 1.143, 95%CI, 1.074-1.216). Conclusion. Our study has many valuable findings and they may provide valuable suggestions for the necessary intervention and treatment measures towards medical students.
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Affiliation(s)
- Yang Liu
- Gastroenterology Department, China-Japan Friendship Hospital, Beijing 100029, China
- Beijing University of Chinese Medicine, Beijing 100029, China
| | - Liang Liu
- Gastroenterology Department, China-Japan Friendship Hospital, Beijing 100029, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100073, China
| | - Yi Yang
- Gastroenterology Department, China-Japan Friendship Hospital, Beijing 100029, China
- Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yuxi He
- Gastroenterology Department, China-Japan Friendship Hospital, Beijing 100029, China
- Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yanli Zhang
- Gastroenterology Department, China-Japan Friendship Hospital, Beijing 100029, China
| | - Miao Wang
- Gastroenterology Department, China-Japan Friendship Hospital, Beijing 100029, China
| | - Shuo Chen
- Gastroenterology Department, China-Japan Friendship Hospital, Beijing 100029, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100073, China
| | - Shukun Yao
- Gastroenterology Department, China-Japan Friendship Hospital, Beijing 100029, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100073, China
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Liu L, Liu BN, Chen S, Wang M, Liu Y, Zhang YL, Yao SK. Visceral and somatic hypersensitivity, autonomic cardiovascular dysfunction and low-grade inflammation in a subset of irritable bowel syndrome patients. J Zhejiang Univ Sci B 2014; 15:907-914. [PMID: 25294380 PMCID: PMC4201319 DOI: 10.1631/jzus.b1400143] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 08/30/2014] [Indexed: 02/05/2023]
Abstract
The pathophysiology of irritable bowel syndrome (IBS) is complex and not fully understood, so the aim of this study was to evaluate whether visceral and somatic hypersensitivity, autonomic cardiovascular dysfunction, and low-grade inflammation of the gut wall are associated with diarrhea-predominant IBS (D-IBS). Sixty-two patients with D-IBS and 20 control subjects participated in the study. Using the ascending method of limits (AML) protocol, we demonstrated that D-IBS patients had significantly lower sensory thresholds compared with healthy controls (P<0.001). Using diverse methods, especially the ischemic sensitivity test, for the first time in China, we confirmed that D-IBS patients have somatic hypersensitivity. They had a significantly higher systolic blood pressure and heart rate after a cold stimulus, indicative of autonomic cardiovascular dysfunction. Compared with the control group, D-IBS patients had a significantly higher level of calprotectin (P<0.001). We also found significant correlations between visceral and somatic hypersensitivity, visceral hypersensitivity and autonomic cardiovascular dysfunction, and somatic hypersensitivity and autonomic cardiovascular dysfunction. Our findings may provide valuable suggestions for the treatment of D-IBS.
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Affiliation(s)
- Liang Liu
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
- Graduate School, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Bei-ni Liu
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
- Graduate School, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Shuo Chen
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
- Graduate School, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Miao Wang
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Yang Liu
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
- Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yan-li Zhang
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Shu-kun Yao
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
- Graduate School, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
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