Original Article ㅣ 2022-01-15 0 814 925

Effect of Sodium Alginate on Gastrointestinal Symptoms after Esophagogastroduodenoscopy with Biopsy: Randomized Controlled Trial

Su Youn Nam , Sang Won Lee , Seong Woo Jeon , and Yong Hwan Kwon

Gut Liver 2022; 16(1):37-43

https://doi.org/10.5009/gnl20298

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Abstract : Background/Aims: After esophagogastroduodenoscopy (EGD) with biopsy, some patients experience gastrointestinal symptoms. This study investigated the effect of sodium alginate on biopsy-related gastrointestinal symptoms. Methods: In this open-label, randomized, controlled trial, patients undergoing EGD with biopsy were randomly assigned to a treatment or control group. In the treatment group, sodium alginate was orally administered for 3 days after EGD. Patients completed questionnaires about their gastrointestinal symptoms at baseline (past week), the day after returning home, and after another 3 days. Gastrointestinal symptoms, including abdominal pain, epigastric pain/soreness, heartburn, acid reflux, nausea/vomiting, borborygmus, abdominal distension, and belching, were rated using an upper gastrointestinal symptom rating scale (GSRS). Results: A total of 210 persons (138 men) who underwent EGD with biopsy were enrolled and allocated to the treatment (n=104) or control (n=106) group. At baseline, the demographic factors and GSRS scores were not different between the control and treatment groups. The epigastric pain/soreness score increased in the control group after endoscopic biopsy (+0.056), whereas the score was decreased in the treatment group (–0.067) (p=0.042). In the treatment group, the scores for acid regurgitation and epigastric soreness decreased during follow-up from those at baseline (p

Original Article ㅣ 2018-03-15 5 480 1009

Clinical Outcomes of Standard Triple Therapy Plus Probiotics or Concomitant Therapy for Helicobacter pylori Infection

Jae Hyun Jung, In Kuk Cho, Chang Hee Lee, Gwan Gyu Song, and Ji Hyun Lim

Gut Liver 2018; 12(2):165-172

https://doi.org/10.5009/gnl17177

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Abstract : Background/AimsThe efficacy of standard triple therapy (STT) in treating Helicobacter pylori infection has decreased. Many investigators have attempted to increase the eradication rate. We investigated the outcomes of concomitant therapy (CT) and STT combined with probiotics (STP) as a first-line treatment for H. pylori infection.MethodsWe reviewed the medical records of 361 patients who received either STP (n=286) or CT (n=75). The STP group received STT combined with a probiotic preparation for 1 week. The CT group received STT and metronidazole for 1 week.ResultsThe intention-to-treat and per-protocol eradication rates were 83.6% (95% confidence interval [CI], 79.0 to 87.7) and 87.1% (95% CI, 81.2 to 89.7) in the STP group and 86.7% (95% CI, 78.7 to 93.3) and 91.4% (95% CI, 83.6 to 97.1) in the CT group (p=0.512 and p=0.324), respectively. The frequency of adverse effects was higher in the CT group (28.2%) than in the STP group (12.8%) (p=0.002).ConclusionsSTP and CT are encouragingly efficacious as first-line treatments for H. pylori infection. Therefore, adding probiotics to STT may be a feasible option to avoid side effects.

Review ㅣ 2012-04-29 522 1900 2941

Epidemiology of Gallbladder Disease: Cholelithiasis and Cancer

Laura M. Stinton, and Eldon A. Shaffer

Gut Liver 2012; 6(2):172-187

https://doi.org/10.5009/gnl.2012.6.2.172

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Abstract : Diseases of the gallbladder are common and costly. The best epidemiological screening method to accurately determine point prevalence of gallstone disease is ultrasonography. Many risk factors for cholesterol gallstone formation are not modifiable such as ethnic background, increasing age, female gender and family history or genetics. Conversely, the modifi able risks for cholesterol gallstones are obesity, rapid weight loss and a sedentary lifestyle. The rising epidemic of obesity and the metabolic syndrome predicts an escalation of cholesterol gallstone frequency. Risk factors for biliary sludge include pregnancy, drugs like ceftiaxone, octreotide and thiazide diuretics, and total parenteral nutrition or fasting. Diseases like cirrhosis, chronic hemolysis and ileal Crohn’s disease are risk factors for black pigment stones. Gallstone disease in childhood, once considered rare, has become increasingly recognized with similar risk factors as those in adults, particularly obesity. Gallbladder cancer is uncommon in developed countries. In the U.S., it accounts for only ~ 5,000 cases per year. Elsewhere, high incidence rates occur in North and South American Indians. Other than ethnicity and female gender, additional risk factors for gallbladder cancer include cholelithiasis, advancing age, chronic infl ammatory conditions affecting the gallbladder, congenital biliary abnormalities, and diagnostic confusion over gallbladder polyps.

Review ㅣ 2017-03-15 84 2431 6444

Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy

Uday C. Ghoshal, Ratnakar Shukla, and Ujjala Ghoshal

Gut Liver 2017; 11(2):196-208

https://doi.org/10.5009/gnl16126

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Abstract : The pathogenesis of irritable bowel syndrome (IBS), once thought to be largely psychogenic in origin, is now understood to be multifactorial. One of the reasons for this paradigm shift is the realization that gut dysbiosis, including small intestinal bacterial overgrowth (SIBO), causes IBS symptoms. Between 4% and 78% of patients with IBS and 1% and 40% of controls have SIBO; such wide variations in prevalence might result from population differences, IBS diagnostic criteria, and, most importantly, methods to diagnose SIBO. Although quantitative jejunal aspirate culture is considered the gold standard for the diagnosis of SIBO, noninvasive hydrogen breath tests have been popular. Although the glucose hydrogen breath test is highly specific, its sensitivity is low; in contrast, the early-peak criteria in the lactulose hydrogen breath test are highly nonspecific. Female gender, older age, diarrhea-predominant IBS, bloating and flatulence, proton pump inhibitor and narcotic intake, and low hemoglobin are associated with SIBO among IBS patients. Several therapeutic trials targeting gut microbes using antibiotics and probiotics have further demonstrated that not all symptoms in patients with IBS originate in the brain but rather in the gut, providing support for the micro-organic basis of IBS. A recent proof-of-concept study showing the high frequency of symptom improvement in patients with IBS with SIBO further supports this hypothesis.