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212
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Introduction
Current institution
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July 2008 - present
May 1998 - June 2008
January 2008 - January 2009
Publications
Publications (212)
Objective:
Coffee ground vomiting is a classical symptom of upper gastrointestinal bleeding. However, the clinical usefulness is limited, due to the low positive predictive value. Our goal is to determine if whether an urgent endoscopy does modify our therapeutic management with a real impact on survival.
Patients and methods:
It is a retrospect...
Introducción: el papel del farmacéutico comunitario ha adquirido mayor relevancia en el contexto de las restricciones derivadas por la pandemia de COVID-19.
Objetivo del estudio: identificar el resultado de la indicación farmacéutica ante la consulta por diarrea o estreñimiento durante este período.
Material y métodos: estudio observacional, tra...
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain and altered defecation, usually accompanied by abdominal bloating or distension. The integrated model of bidirectional interaction between the central, autonomic, enteric nervous system, the microbiome, and the gut barrier allows a better unders...
Resumen
Puntos para una lectura rápida
•La ERGE es un reto diagnóstico y terapéutico en Atención Primaria debido a su cronicidad, expresión clínica heterogénea, alta prevalencia e impacto en la calidad de vida.
•La endoscopia debe de indicarse en pacientes con síntomas de alarma, con ERGE de larga evolución y en no respondedores al tratamiento.
•La...
Background
Irritable bowel syndrome with diarrhoea (IBS-D) is a frequent problem associated with a significant socioeconomic implication. Increased gut permeability is an important pathophysiological mechanism. A medical device containing xyloglucan (XG), pea protein and tannins (PPT) from grape-seed extract, and xylo-oligosaccharides (XOS) has pro...
Background:
the impact of the COVID-19 pandemic has led to the interruption of most manometry or impedance-pH monitoring studies. The risk of restarting activities is unknown.
Objective:
assess the risk of SARS-CoV-2 virus infection, both to patients and healthcare workers, in relation to esophageal and anorectal functional tests during the pand...
Introduction:
Activation of mast cells causes alteration in epithelial and neuromuscular function, and is involved in visceral hypersensitivity and dysmotility in gastrointestinal functional disorders.
Objectives:
Primary: Evaluate differences in basal serum tryptase (BST) between patients with irritable bowel syndrome (IBS) and healthy controls...
Jejunal volvules are a very rare condition, barely reported in the literature, that occur in relation to congenital (eg, intestinal duplication) or acquired disorders (eg, diaphragmatic hernias or tumors). In the event that it becomes complicated with an established intestinal ischemia, its prognosis is further overshadowed by the possible conseque...
Granulomatous cheilitis, characterized by persistent inflammation of the lips and a granulomatous histology, is sometimes associated with Crohn’s disease and is a therapeutic challenge. Reported evidence indicates treatment with an anti-TNF agent (mainly infliximab) is the most recommended therapeutic option after failure of conventional treatments...
LINKED CONTENT
This article is linked to Taxonera et al an Garg et al papers. To view these articles, visit https://doi.org/10.1111/apt.15804 and https://doi.org/10.1111/apt.15814.
Background
Data on patients with inflammatory bowel diseases (IBD) who have had 2019 novel coronavirus (SARS‐CoV‐2) disease (COVID‐19) are needed.
Aims
To report the clinical characteristics, including gastrointestinal symptoms, of COVID‐19 in IBD patients, and to assess the risk of COVID‐19 in IBD.
Methods
This case series included consecutive I...
Obstructed defecation syndrome produces constipation with anal blockage and a feeling of incomplete evacuation, due to either anatomic and functional causes. This is a complex and multifactorial entity due to diverse etiological factors that may coexist in many patients. Therefore, a diagnostic approach requires structural and functional assessment...
Aim:
to compare the need for and time to adalimumab dose escalation and de-escalation between patients with Crohn's disease (CD) and ulcerative colitis (UC).
Methods:
this observational cohort study included patients with luminal CD or patients with UC treated with adalimumab. Adalimumab dose optimization was decided based on the Harvey-Bradshaw...
Background
Linaclotide is approved for the treatment of moderate-to-severe irritable bowel syndrome (IBS) with constipation (IBS-C) in adults. This study aimed to assess factors predictive of a clinical response and improvements in non-IBS symptoms with linaclotide treatment in a Spanish patient population.
Methods
In this open-label phase IIIb st...
Introduction:
The socioeconomic burden of irritable bowel syndrome with constipation (IBS-C) has never been formally assessed in Spain.
Patients and methods:
This 12-month (6-month retrospective and prospective periods) observational, multicentre study assessed the burden of moderate-to-severe IBS-C in Spain. Patients were included if they had b...
Introduction
The socioeconomic burden of irritable bowel syndrome with constipation (IBS-C) has never been formally assessed in Spain.
Patients and methods
This 12-month (6-month retrospective and prospective periods) observational, multicentre study assessed the burden of moderate-to-severe IBS-C in Spain. Patients were included if they had been...
The adjustment of maladaptive thoughts and behaviors associated with emotional memories is central to treating psychiatric disorders. Recent research, predominantly with laboratory animals, indicates that memories can become temporarily sensitive to modification following reactivation, before undergoing reconsolidation. A method to selectively impa...
BACKGROUND
Irritable bowel syndrome (IBS) is a highly prevalent condition. It is diagnosed on the basis of chronic symptoms after the clinical and/or investigative exclusion of organic diseases that can cause similar symptoms. There is no reproducible non-invasive test for the diagnosis of IBS, and this raises diagnostic uncertainty among physician...
Irritable bowel syndrome (IBS) is a highly prevalent functional disorder, characterised by the presence of recurrent abdominal pain associated with changes in bowel habits. Its physiopathology is complex, its clinical manifestations are diverse, and the therapeutic possibilities are multiple and not well known. In clinical practice, the diagnosis o...
Background:
although a number of factors have been associated with a deterioration in quality of life in gastroesophageal reflux disease, it is not known which has an independent influence.
Objective:
to evaluate factors independently associated with the impact of gastroesophageal reflux disease on health-related quality of life.
Methods:
a po...
In the study of obscure gastrointestinal bleeding, which includes iron-deficiency anemia, the capsule endoscopy is a valuable diagnostic tool. In the different series the presence of tumors reaches 16% as the cause of it. We present the case of a rare tumor with metastatic extension in the small intestine in which the capsule endoscopy was key to t...
Irritable bowel syndrome (IBS) is a highly prevalent functional disorder, characterised by the presence of recurrent abdominal pain associated with changes in bowel habits. Its physiopathology is complex, its clinical manifestations are diverse, and the therapeutic possibilities are multiple and not well known. In clinical practice, the diagnosis o...
Background
The aim of this study was to evaluate reliability of four different assays for measuring infliximab trough levels and antibodies to infliximab (ATI).
Methods
In this non-interventional, cross-sectional study including IBD patients, infliximab levels and ATI were measured using four different assays: Lisa-Tracker, Promonitor, Q-Inflixi a...
Background and aim:
To diagnose coeliac disease (CD) in individuals on a gluten free diet (GFD), we aimed to assess the utility of detecting activated γδ and CD8 T cells expressing gut-homing receptors after a short gluten challenge.
Methods:
We studied 15 CD patients and 35 non-CD controls, all exposed to three days of gluten when following a G...
Background:
Beer has been related to gastroesophageal reflux (GER) and dyspepsia, based on its alcohol and gas content. The aim of this study is to evaluate the association between moderate consumption of traditional and alcohol-free beer and upper digestive symptoms, gastric accommodation and GER.
Methods:
Healthy adults without frequent gastro...
Introduction:
Chronic constipation is a frequent syndrome which, not only causes an appreciable deterioration in quality of life, but also entails a high economic cost due, among other things, to its treatment. This is because of the widespread use of laxatives, even by subjects who have not sought medical care, as well as little patient satisfact...
Carcinoid tumors are neoplasm that release hormone-like substances. They can produce liver metastasis and present with symptoms of the carcinoid syndrome. A 78 year old man presented with a history of chronic diarrhea, weight loss and shortness of breath.
Constipation is a very common disorder that adversely affects well-being and quality of life. Evidence-based clinical practice guidelines are an essential element for proper patient management and safe, effective treatment.
The aim of these guidelines is to provide health care professionals who care for patients with chronic constipation with a too...
In this Clinical practice guide we examine the diagnostic and therapeutic management of adult patients with constipation and abdominal discomfort, at the confluence of the spectrum of irritable bowel syndrome and functional constipation. Both fall within the framework of functional intestinal disorders and have major personal, health and social imp...
Clinical practice guidelines for the management of constipation in adults aim to generate recommendations on the optimal approach to chronic constipation in the primary care and specialized outpatient setting. Their main objective is to provide healthcare professionals who care for patients with chronic constipation with a tool that allows them to...
Introduction
Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by chronic or recurrent abdominal pain in association with defecation or a change in bowel habits. A predominant disorder of bowel habits, IBS is classified into three main subtypes: constipation-predominant IBS (IBS-C), diarrhea-predominant IBS (IBS-D) and IBS...
In this Clinical practice guide, an analysis is made of the diagnosis and treatment of adult patients with constipation and abdominal discomfort, under the spectrum of irritable bowel syndrome and functional constipation. These have an important personal, health and social impact, affecting the quality of life of these patients. In irritable bowel...
Background and aims:
Chronic constipation is a serious medical condition that affects 30%-40% of people over 60 years old. Although not normally life threatening, constipation reduces quality of life by the same extent as diabetes and osteoarthritis. There are currently no Europe-wide guidelines for treating constipation in older people, although...
Background:
As treatments for constipation become increasingly available, it is important to know when to progress along the treatment algorithm if the patient is not better.
Aim:
To establish the definition of failure of a treatment to provide adequate relief (F-PAR) to support this management and referral process in patients with chronic const...
Resumen
En esta Guía de práctica clínica analizamos el manejo diagnóstico y terapéutico de pacientes adultos con estreñimiento y molestias abdominales, bajo el espectro del síndrome del intestino irritable y el estreñimiento funcional. Tienen una importante repercusión personal, sanitaria y social, afectando a la calidad de vida de los pacientes qu...
Background
faecal impaction (FI) is a common problem in old people living in nursing home. Its prevalence and associated factors remain unknown in the general population.
Aim
to evaluate FI prevalence in the Spanish population older than 65 years and to assess the factors associated with it.
Methods
a telephone survey was carried out of a Spanish...
Resumen
En este artículo se comentan las comunicaciones más interesantes que se han presentado en el congreso americano, durante la Digestive Disease Week celebrada en San Diego, en el área de las alteraciones motoras y los trastornos funcionales digestivos. Sin ninguna duda, una de las comunicaciones más relevantes fue la presentación de los nuevo...
Material and methods:
Body multifrequency bioimpedance analysis (BIA) and a wide and simultaneous analytical profile were prospectively performed in 74 CHC patients (36 male) with known METAVIR fibrosis stage established with liver biopsy or transient elastography. Results were analyzed to identify deviations from the normal range and variations a...
En esta Guía de Práctica Clínica analizamos el manejo diagnóstico y terapéutico de pacientes adultos con estreñimiento y molestias abdominales, bajo la confluencia del espectro del síndrome del intestino irritable y el estreñimiento funcional. Ambas patologías están encuadradas en los trastornos funcionales intestinales y tienen una importante repe...
Irritable bowel syndrome and functional constipation represent a relevant and common health issue. However, real-world clinical practice includes patients with constipation who may or may not have other abdominal complaints (pain, bloating, abdominal discomfort) with variable frequency. The goal of the present study was to obtain information on the...
In this Clinical Practice Guideline we discuss the diagnostic and therapeutic approach of adult patients with constipation and abdominal complaints at the confluence of the irritable bowel syndrome spectrum and functional constipation. Both conditions are included among the functional bowel disorders, and have a significant personal, healthcare, an...
In this Clinical Practice Guideline we discuss the diagnostic and therapeutic approach of adult patients with constipation and abdominal complaints at the confluence of the irritable bowel syndrome spectrum and functional constipation. Both conditions are included among the functional bowel disorders, and have a significant personal, healthcare, an...
Irritable bowel syndrome and functional constipation represent a relevant and common health issue. However, real-world clinical practice includes patients with constipation who may or may not have other abdominal complaints (pain, bloating, abdominal discomfort) with variable frequency. The goal of the present study was to obtain information on the...
Clinical practice guidelines for the management of constipation in adults aim to generate recommendations on the optimal approach to chronic constipation in the primary care and specialized outpatient setting. Their main objective is to provide healthcare professionals who care for patients with chronic constipation with a tool that allows them to...
Constipation is a very common disorder that adversely affects well-being and quality of life. Evidence-based clinical practice guidelines are an essential element for proper patient management and safe, effective treatment. The aim of these guidelines is to provide health care professionals who care for patients with chronic constipation with a too...
Background: Chronic constipation (CC) is common in the community but surprisingly little is known about relevant gastro-intestinal (GI) and non-GI co-morbidities. Objective: The purpose of this study was to assess the epidemiology of CC and in particular provide new insights into the co-morbidities linked to this condition. Methods: In a prospectiv...
Background: Chronic constipation (CC) is common in the community but surprisingly little is known about relevant gastrointestinal (GI) and non-GI co-morbidities. Objective: The purpose of this study was to assess the epidemiology of CC and in particular provide new insights into the co-morbidities linked to this condition. Methods: In a prospective...
Constipation protocols for different kind of patients and situations.
Background
Fecal impaction (FI) is a common problem in the elderly and other at-risk groups, such as patients with a neuro-psychiatric disease. It has been associated with medical problems and high morbi-mortality. A systematic review of this topic might be useful to improve the knowledge in this area and helpful to make an appropriate and early di...
Background and aim:
In high or moderate risk populations, periodic surveillance of patients at risk of progression from gastric precursor lesions (PL) to gastric cancer (GC) is the most effective strategy for reducing the burden of GC. Incomplete type of intestinal metaplasia (IIM) may be considered as the best candidate, but it is still controver...
Introduccion: Un 5% de las hemorragias digestivas se presentan en forma de hemorragia digestiva de origen oscuro (HDOO) oculta o manifiesta. La capsula endoscopica (CE) es la tecnica de eleccion para su diagnostico. Objetivo: Analizar los hallazgos de la CE y las caracteristicas de los pacientes en ambas formas de presentacion. Material y Metodo: A...
Hepatitis C virus infection is a major health burden affecting 130-170 million people worldwide. Approximately 10-30% of those with chronic hepatitis C will progress to cirrhosis over 20-30 years. The development of new direct-acting antivirals has changed the management of the disease, allowing efficacious Interferon-free therapies superior to pri...
Background:
*N.P. and M.P. contributed equally to this study.The current prevalence of esophagitis in southern Europe is unknown. In addition, the risk factors for reflux esophagitis are not fully understood.
Objective:
The objective of this article is to assess the prevalence and risk factors for esophagitis in Spain.
Methods:
A prospective,...
Whipple´s disease is a chronic systemic infection produced by the actinomycete Tropheryma whipplei. Endoscopic tests are key in the diagnosis as they allow biopsy and histopathological examination for definitive diagnosis of this entity. We present a case of Whipple´s disease where capsule endoscopy, uncommon for the diagnosis of this condition, wa...
Although 2% to 4% of the population develop gastroesophageal reflux disease (GERD) annually, factors associated with the onset of GERD are scarcely known.
To assess whether such factors include weight gain and psychological distress.
Two cohorts (first: N=222; second N=754) drawn from 2 case-control studies were followed up for around 5 years. In 2...
Background and purpose of the study: This study assessed the experiences of irritable bowel syndrome patients with the healthcare system. Specifically, this study focused on the barriers that patients found.
Three focus groups were conducted with the participation of 19 patients and 10 healthcare professionals. From this information a script of que...
Randomized trials have confirmed the efficacy of prucalopride for the treatment of chronic constipation up to 12 weeks. This study aimed to assess the efficacy of prucalopride over a 24-week period (ClinicalTrials.gov: NCT01424228).
Adults with chronic constipation and ≤2 spontaneous complete bowel movements (SCBMs)/week were randomized to receive...
This article discusses the most interesting studies on functional and motor gastrointestinal disorders presented at Digestive Diseases Week (DDW), 2015. Researchers are still seeking biomarkers for irritable bowel syndrome and have presented new data. One study confirmed that the use of low-dose antidepressants has an antinociceptive effect without...
Background:
There are no existing studies that provide data regarding the epidemiology of, and risk factors for, fecal impaction, either in the general population or in any sub-group of people.
Objective:
Estimate the prevalence of and factors associated with fecal impaction on a representative sample of the institutionalized elderly population....
Acute liver failure has a high mortality and its most frequent cause in Spain is viral infection. In this article, we present a case of fulminant liver failure. The failure is secondary to an idiosyncratic reaction to ibuprofen, an entity included in the DRESS syndrome. This syndrome plays a key role in the differential diagnosis of acute liver fai...
Aim:
To compare the need for infliximab dose intensification in two cohorts of patients with Crohn's disease (CD) or ulcerative colitis (UC).
Methods:
Single centre, uncontrolled, observational study. Consecutive patients with CD and UC who responded to infliximab induction doses were included. Data collected in a prospectively maintained databa...
AIM: To compare the need for infliximab dose intensification in two cohorts of patients with Crohn’s disease (CD) or ulcerative colitis (UC).
METHODS: Single centre, uncontrolled, observational study. Consecutive patients with CD and UC who responded to infliximab induction doses were included. Data collected in a prospectively maintained database...
Background/aims:
Nausea and vomiting of pregnancy (NVP) impact in the pregnant woman´s quality of life, especially when are persistent or severe. The objective is to estimate the prevalence and factors associated with the persistence of NVP in each trimester of pregnancy.
Methods:
We studied a cohort of 263 pregnant women with gestational age <...
Objectives:
Some patients with chronic constipation (CC) have abdominal pain and discomfort (painful CC) without fulfilling the criteria for irritable bowel syndrome (IBS). Our aim was to investigate similarities and differences among nonpainful CC, painful CC, and CC in patients with IBS according to prevalence, individual symptoms, associated fa...
Scales for aiding physicians diagnose gastro-oesophageal reflux disease (GERD) have not been evaluated in terms of their ability to discriminate between troublesome symptoms (TS) and non-troublesome symptoms (NTS). Our objective is to evaluate the ability of the Reflux Disease Questionnaire (RDQ) to identify GERD according to referral of TS, in pat...
Advances in medicine rely on scientific methods, and objective measurements are critical for applying these. However, medicine is essentially subjective in many senses, especially in information recalled by patients, and other such outcomes. Questionnaires are intended to measure, as objectively as possible, these subjective elements. As measuremen...
This article discusses the most interesting studies on functional and motility gastrointestinal disorders presented in Digestive Diseases Week (DDW) in 2013. New data were reported on the clinical importance of functional gastrointestinal disorders (FGID) and on how they can produce numerous disturbances such as inflammatory bowel disease. These di...
