Clinical implications of chronic therapy for GERD. Preface.
- SourceAvailable from: Philip SchoenfeldAlimentary Pharmacology & Therapeutics 07/2014; 40(2):209. DOI:10.1111/apt.12837 · 4.55 Impact Factor
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ABSTRACT: To investigate whether sacral nerve stimulation reduces irritable bowel syndrome (IBS)-specific symptoms by a randomized, controlled, crossover study. IBS affects 3% to 22% of the population worldwide, but most patients continue to have symptoms despite treatment. Patients included from our tertiary center had diarrhea-predominant or mixed IBS, with a minimum baseline IBS symptom score (Gastrointestinal Syndrome Rating Scale-IBS questionnaire) of 40 points reduced by a minimum of 30% during the percutaneous nerve evaluation before permanent implantation. Patients were randomized (1:1) to have the stimulator ON or OFF for 1 month and then the opposite for another month. Investigators and patients were not informed of the setting. IBS-specific symptoms and quality of life were assessed through bowel diaries and validated questionnaires. Primary endpoint was the IBS-specific symptom score. Twenty-one patients were randomized. Ten were eligible for analysis in each group. IBS-specific symptom scores were significantly reduced during stimulation: the median difference in the ON-OFF group was 12 (range, -22 to 44) and in the OFF-ON group -17.5 (range, -48 to -1) (P = 0.0009). IBS-specific quality-of-life scores improved significantly during stimulation: the median difference in the ON-OFF group was 16 (range, -24 to 69) and in the OFF-ON group -42.5 (range, -77 to 0) (P = 0.0003). At 1-year follow-up, the median IBS-specific symptom score (25; range, 13-65) was significantly lower than that at baseline (62; range, 45-80) (P = 0.0001). Sacral nerve stimulation significantly reduces symptoms and improves quality of life of highly selected patients with IBS.Annals of surgery 02/2014; 260(1). DOI:10.1097/SLA.0000000000000559 · 7.19 Impact Factor
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ABSTRACT: The purpose of this literature review is to develop a thorough understanding of the research on food intolerance and its relationship to irritable bowel syndrome. Knowledge of the connection between the two conditions will assist allied healthcare professionals in working with patients to better manage their symptoms. Reduced healthcare costs may also result if patients are able to identify problematic foods and experience symptom improvement with diet changes. The review consists of an overview of food intolerance including prevalence, specific foods implicated including an in-depth review of research on bulk sweeteners, as well as methods of diagnosis. In addition, prevalence, specific foods associated with food intolerance in irritable bowel syndrome patients such as carbohydrates and lipids, nutritional consequences of food intolerance, and possible food-related methods of treatment including increased fiber intake are discussed. Finally, suggestions for future research and possible directions allied healthcare professionals can start with in assisting patients are provided.Gastroenterology nursing: the official journal of the Society of Gastroenterology Nurses and Associates 07/2013; 36(4):275-82. DOI:10.1097/SGA.0b013e31829ed911 · 0.56 Impact Factor