RECENT FINDINGS: Disordered immune reactions and release of cytokines with resultant gut inflammation and dysfunction appear to be key features of PI-IBS. Disordered brain-gut-microbiota interactions, type of infecting agent, and host-genetic susceptibility are risk factors but also are reasons for the varying spectrum of clinical severity. Although prognosis is generally good, symptoms and inflammation may persist for a long time. Symptomatic relief with antidiarrheals, antispasmodics, 5HT3 antagonists, mesalamine, probiotics, and low-dose antidepressants remain the primary approaches, but in some difficult cases, a combination of drugs that target the pathophysiology may be helpful. PI-IBS has many overlapping features with IBS-D and shares similar pathophysiology and management approaches.
METHODS: Articles published in PubMed, MEDLINE, CINAHL and Science Direct from 2005 to 2015 were searched systematically. Studies were included if constipation satisfied the Rome II and or III criteria. Study populations consisted of Asian adults above 18 years old and with sample size above 50.
RESULTS: Of 2812 articles screened, 11 met the eligibility criteria. Constipation among Asian adults was characterized by three core symptoms of 'straining' at 82.8%, 'lumpy and hard stool' at 74.2% and 'sensation of incomplete evacuation' at 68.1% and the least frequent symptom was 'manual maneuver to facilitate defecation' at 23.3%. There was heterogeneity in frequency patterns of core symptoms between different Asian studies but also differences in core symptoms between constipation subtypes of functional constipation and irritable bowel syndrome with constipation.
CONCLUSIONS: In general, Asian adults perceive constipation symptoms in a similar but not equivalent manner to the West. Recognition of core symptoms will increase the diagnostic confidence of constipation and its subtypes but more studies of the various specific Asian populations are needed to address their differences.
METHODS: We searched up to June 5, 2022, for randomized controlled trials of gastric acid-related diseases that included erosive esophagitis, symptomatic gastroesophageal reflux disease (GERD), peptic ulcers, and Helicobacter pylori infection. The pooled risk ratio (RR) was evaluated for the efficacy outcome and treatment-emergent adverse events (TEAEs) as the safety outcome. Sensitivity analyses were performed to test the robustness of the study findings.
RESULTS: Of the 710 screened studies, 19 studies including 7023 participants were analyzed. The RRs for the healing of erosive esophagitis with Vonoprazan versus PPI were 1.09 (95% confidence interval [CI] 1.03-1.14), 1.03 (95% CI 1.00-1.07), and 1.02 (95% CI 1.00-1.05) in Weeks 2, 4, and 8, respectively. There were no differences in the improvement of GERD symptoms and healing of gastric and duodenal ulcers between PCAB and PPI. The pooled eradication rates of H. pylori were significantly higher in Vonoprazan versus PPI first-line treatment (RR 1.13; 95% CI 1.04-1.22). The overall RR of TEAEs with Vonoprazan versus PPI was 1.08 (95% CI 0.89-1.31). Overall, the risk of bias was low to some concerns. Furthermore, sensitivity analyses confirmed the robustness of the study's conclusion.
CONCLUSION: Vonoprazan is superior to PPI in first-line H. pylori eradication and erosive esophagitis but non-inferior in other gastric acid-related diseases. Likewise, short-term safety is comparable in both treatment groups.
SUBJECTS/METHODS: The height, weight, and WC of four-hundred-and-ninety adults (n = 490) in Malaysia were measured using standard procedures. The three-day 24-hour dietary recalls were conducted on 422 out of the 490 adults and their dietary intakes were evaluated in detail. The selected dietary intake variables were used to determine the associations with the obesity indicators.
RESULTS: Among the participants, 52.8% were overweight or obese. After data analysis, the mean energy intake was 1,550 kcal/day, in which male participants had a significantly higher energy and macronutrients intake than females. Protein consumption and its percentage of energy contribution exceeded the recommended range. The consumption of fruits, vegetables, and milk and milk products were lower than the recommended number of servings for a healthy diet. The male participants consumed significantly more servings of carbohydrate-based foods, meat, and fats, oils, and sweets than females. Among the selected dietary intake variables, only the carbohydrate intake was negatively associated with the BMI (Estimate b = -0.008) and WC measurements (Estimate b = -0.019) after adjusting for covariates.
CONCLUSIONS: This study evaluated the dietary intakes of a sample of Malaysian adults and its association with the obesity indicators. The results highlight the need for improvements and modifications of the dietary intake of Malaysians to reduce the overweight and obesity rates.