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Fulltext Helicobacter pylori Infection and Related Gastrointestinal Diseases in Southeast Asian Countries: An Expert Opinion Survey

Quach DT, Vilaichone RK, Vu KV, Yamaoka Y, Sugano K, Mahachai V

Asian Pac J Cancer Prev, 2018 Dec 25;19(12):3565-3569.
PMID: 30583684

Background: Helicobacter pylori (H. pylori) infection is currently considered as an infectious disease irrespective of symptoms and stage of disease. This study aimed to survey the impact of H. pylori infection and the current management approaches in Southeast Asian countries.
Materials and methods: This is a survey among 26 experts from 9 Southeast Asian countries (Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam), who attended a meeting to develop the ASEAN consensus on H. pylori management in November 2015.
Results: The prevalence of H. pylori varied signiﬁcantly from 20% to 69% among countries, highest in Myanmar and lowest in Malaysia. The rate of H. pylori infection in patients with gastritis, peptic ulcer disease and gastric cancer (GC) also varied signiﬁcantly, not only among countries but also among regions within the same country. The most common method for H. pylori diagnosis before treatment was rapid urease test, followed by urea breath test. In multi-ethnic countries, some ethnic groups including Chinese, Batak and Minahasanese were considered as having higher risk of GC. There have been no national screening programs for GC in all countries, and a majority of patients with GC were diagnosed in advanced stages with very poor 5-year survival.
Conclusions: The prevalence of H. pylori infection and its infection rates in related gastrointestinal diseases were significantly different among Southeast Asian countries. The prognosis of patients with GC in the region was very poor. The result of this survey is a platform for future international and regional research collaboration.

Matched MeSH terms: Gastrointestinal Diseases/etiology*
Fulltext Absence of milk-specific IgE in infants with cow's milk protein-sensitive enteropathy

Yadav M, Iyngkaran N, Seow IKG

Med J Malaysia, 1983 Dec;38(4):266-71.
PMID: 6599980

Infants, one to 56-weeks-old, presenting with persistent diarrhoea were placed on a diet free of cow's milk protein which improved their clinical condition. Six weeks later, 67 infants were challenged with a low-lactose cow's milk formula and jejunal biopsy was taken before and 24-hours after challenge. On the basis of histological changes in the intestinal mucosa and development of clinical symptoms the infants were categorised into three groups: Group 1 (n = 16) with no clinical or mucosal abnormality, Group 2 (n = 20) with mucosal abnormality but lacking clinical symptoms, and Group 3 (n 31) with manifestation of mucosal abnormality and clinical symptoms. In addition to the total IgE the radioallergosorbent test (RAST) was performed on sera from the infants taken before and after milk provocation. The mean total serum IgE level ranged from 288 to 560 IU/ml. In Groups 2 and 3 the prechallenge serum IgE levels were significantly higher than the postchallenge levels but in Group 1 the levels remained unchanged on challenge. A positive RAST to milk proteins was observed in five infants (7.4%), that is, one in Group 2 and four in Group 3, of 67 infants studied. In a survey of 405 consecutive paediatric-age patients admitted for a variety of symptoms, 90 were positive for RAST specific for milk proteins. Interestingly the majority of the patients positive for RAST presented with gastrointestinal ailments. The measurement of specific IgE appears not to be a useful adjunct in the diagnosis of CMPSE in Malaysian children.

Matched MeSH terms: Gastrointestinal Diseases/etiology
Fulltext Low prevalence of infantile functional gastrointestinal disorders (FGIDs) in a multi-ethnic Asian population

Chew KS, Em JM, Koay ZL, Jalaludin MY, Ng RT, Lum LCS, et al.

Pediatr Neonatol, 2021 01;62(1):49-54.
PMID: 32891528 DOI: 10.1016/j.pedneo.2020.08.009

BACKGROUND: Functional gastrointestinal disorders (FGIDs) are common in children. The prevalence of FGIDs varies across the world but is unknown in Malaysia. We aimed to investigate the prevalence of FGIDs in healthy Malaysian infants.
METHODS: This was a cross-sectional study involving healthy infants younger than 12 months of age who attended a well-baby clinic. A universal sampling method was adopted. Children with congenital disorders potentially affecting gastrointestinal functions, chronic debilitating diseases and hypothyroidism were excluded. Rome IV criteria were used to define FGIDs.
RESULTS: Of the total 534 infants recruited (54% males), 92% were born at term; 85% had normal birth weight [range 2.5-4.0 kg], and the mean (±S.D.) age at interview was 6.8 (±3.4) months. Thirty-six percent were breastfed, 29% were formula-fed, and 35% had mixed feeding. Prevalence of infant regurgitation and rumination syndrome was 10.5% and 1.7%, respectively. Prevalence of infant colic was 1.9% (3/160) (infant

Matched MeSH terms: Gastrointestinal Diseases/etiology
Gut microbiota in early life and its influence on health and disease: A position paper by the Malaysian Working Group on Gastrointestinal Health

Lee YY, Hassan SA, Ismail IH, Chong SY, Raja Ali RA, Amin Nordin S, et al.

J Paediatr Child Health, 2017 Dec;53(12):1152-1158.
PMID: 29205651 DOI: 10.1111/jpc.13640

The role of gut microbiota in early life and its impact on gut health and subsequent diseases remain unclear. There is a lack of research and awareness in this area, especially in the Asia-Pacific region, including Malaysia. This paper reports the position of a Malaysian Working Group on some key issues surrounding gut microbiota in early life and its role in gut health and diseases, as well as experts' stand on probiotics and prebiotics. The group reached a consensus that certain factors, including elective caesarean; premature deliveries; complementary feeding; use of antibiotics, prebiotics and/or probiotics; and exposure to the external environmental, have an impact on gut microbiota in early life. However, as evidence is lacking, especially from the Asia-Pacific region, further studies are needed to understand how gut microbiota in early life affects subsequent diseases, including allergy, inflammatory bowel disease, obesity and infantile colic. Lastly, although beneficial in acute diarrhoeal disease and probably allergic eczema, probiotics (and/or prebiotics) should be used cautiously in other gut dysbiotic conditions until more data are available.

Matched MeSH terms: Gastrointestinal Diseases/etiology*
Impact of Klebsiella pneumoniae in lower gastrointestinal tract diseases

Kaur CP, Vadivelu J, Chandramathi S

J Dig Dis, 2018 May;19(5):262-271.
PMID: 29573336 DOI: 10.1111/1751-2980.12595

The 2016 Global Burden of Disease report by WHO revealed that diseases of the gastrointestinal tract (GIT) had one of the highest incidence rates worldwide. The plethora of factors that contribute to the development of GIT-related illnesses can be divided into genetic, environmental and lifestyle factors. Apart from that, the role that infectious agents play in the development of GIT diseases has piqued the interest of researchers worldwide. The human gut harbors approximately 1014 bacteria in it with increasing concentration toward the lower GIT. Among the various microbiota that colonize the human gut, Gram-negative bacteria have been most notoriously linked to GIT-related diseases such as inflammatory bowel disease (IBD) including Crohn's disease and ulcerative colitis and colorectal cancer (CRC). Some of the notable culprits that have been attributed to these diseases are Bacteroides fragilis, Fusobacterium nucleatum, Escherichia coli and Helicobacter pylori. However, studies in recent years are beginning to recognize a new player, Klebsiella pneumoniae (K. pneumoniae) in the causation and progression of GIT diseases. Once synonymous with infections and diseases of the upper respiratory tract, K. pneumoniae has now emerged as one of the pathogens commonly isolated from patients with GIT diseases. However, extensive studies attributing K. pneumoniae to GIT diseases, particularly that of CRC are scanty. Therefore, this review intends to shed light on the association of K. pneumoniae in gastrointestinal diseases such as Crohn's disease, ulcerative colitis as well as CRC.

Matched MeSH terms: Gastrointestinal Diseases/etiology*
Fulltext Enteric neuropathy in diabetes: Implications for gastrointestinal function

Abdalla MMI

World J Gastroenterol, 2024 Jun 14;30(22):2852-2865.
PMID: 38947292 DOI: 10.3748/wjg.v30.i22.2852

Diabetes, commonly known for its metabolic effects, also critically affects the enteric nervous system (ENS), which is essential in regulating gastrointestinal (GI) motility, secretion, and absorption. The development of diabetes-induced enteric neuropathy can lead to various GI dysfunctions, such as gastroparesis and irregular bowel habits, primarily due to disruptions in the function of neuronal and glial cells within the ENS, as well as oxidative stress and inflammation. This editorial explores the pathophysiological mechanisms underlying the development of enteric neuropathy in diabetic patients. Additionally, it discusses the latest advances in diagnostic approaches, emphasizing the need for early detection and intervention to mitigate GI complications in diabetic individuals. The editorial also reviews current and emerging therapeutic strategies, focusing on pharmacological treatments, dietary management, and potential neuromodulatory interventions. Ultimately, this editorial highlights the necessity of a multidisciplinary approach in managing enteric neuropathy in diabetes, aiming to enhance patient quality of life and address a frequently overlooked complication of this widespread disease.

Matched MeSH terms: Gastrointestinal Diseases/etiology
Fulltext Helicobacter pylori: prevalence, clinical and endoscopic findings in children who underwnet upper endoscopy for abdominal ailments

Nur Atiqah NA, Lim CB

Med J Malaysia, 2001 Dec;56(4):414-7.
PMID: 12014759

A total of 97 children aged 1 month to 16 years (mean 6.6 years) had upper endoscopies performed in Paediatric Institute, Kuala Lumpur Hospital between January 1997 and December 1999 for various gastrointestinal symptoms. Of these 70 children were tested for Helicobacter pylori. The four most common indications for upper endoscopy were recurrent abdominal pain, upper gastrointestinal bleeding, epigastric pain and vomiting. The overall prevalence of this infection in this heterogenous group of symptomatic children was 10% (7/70). This study shows that H.pylori positivity in a routine endoscopy population is low and does not appear to be associated with specific symptoms.

Matched MeSH terms: Gastrointestinal Diseases/etiology*
To breast feed or not?

Nutr Rev, 1972 May;30(5):112-4.
PMID: 4554312
Matched MeSH terms: Gastrointestinal Diseases/etiology
Fulltext The incidence of upper gastro-intestinal disease in a Malaysian community

Ross IN, Nair S, Jayakumar CR

Singapore Med J, 1985 Jun;26(3):271-8.
PMID: 4048988

The results of 2449 investigations of the upper gastrointestinal tract were analysed to determine the incidence of disease. Abnormalities were detected in 53% of patients who had endoscopy, but were found in only 24% of patients who had barium studies (p <= 0.001). Altogether 916 patients had abnormal findings. Duodenal ulcer accounted for 42% of cases, gastric ulcer 16% and gastric cancer 9%. The prevalence of perforated ulcer was 13%. The annual incidence/1000 in males and females (>14 years) were respectively, for duodenal ulcer 1.66 and 0.42, for gastric ulcer 0.57 and 0.25, for perforated ulcer 0.36 and 0.05, and for gastric cancer 0.29 and 0.14. Most types of gastro-duodenal disease were less common in Malays than expected (p = <0.001). However oesophageal cancer and varices were more common in Indians compared to Malays and Chinese (p = <0.001). This study showed that the pallern of perforating ulcers was not the same as that of non-peforating ulcers, suggesting a differing pathogenesis. Identification of the factors causing a different prevalence of disease between the three ethnic groups would help in the understanding of the causes of upper gastrointestinal disease.

Matched MeSH terms: Gastrointestinal Diseases/etiology
Fulltext Sustained benefit from intravenous immunoglobulin therapy for gastrointestinal involvement in systemic sclerosis

Raja J, Nihtyanova SI, Murray CD, Denton CP, Ong VH

Rheumatology (Oxford), 2016 Jan;55(1):115-9.
PMID: 26320139 DOI: 10.1093/rheumatology/kev318

OBJECTIVE: IVIG is known to confer significant benefit in rheumatologic conditions, including inflammatory myopathy. This study aimed to assess the efficacy of IVIG across different aspects of internal organ involvement in refractory active SSc, particularly the gastrointestinal (GI) system.
METHODS: SSc patients with overlap polymyositis who remained active and unresponsive to conventional disease-modifying agents and who subsequently received IVIG were identified. GI symptoms were assessed using validated questionnaires. The Medical Research Council Sum Score for muscle strength and modified Rodnan skin score (mRSS) were assessed. Serial measurements were undertaken at baseline prior to the first IVIG treatment and post-treatment in the most recent assessment.
RESULTS: Fifteen SSc patients were consecutively recruited into this observational study. The mean duration of IVIG treatment was 2.3 years, with treatment frequency ranging from every 6 weeks to 4 months. Compared with baseline, there was a significant reduction in gastro-oesophageal reflux frequency and intensity mean scores (P = 0.006 and P = 0.013, respectively). Significant improvement in the Gastrointestinal Tract (GIT) 2.0 score from a baseline mean score of 1.07 (s.d. 0.67) to 0.60 (0.46) (P = 0.002) was observed. There was regression in the markers of muscle disease with a reduction in the mean (s.d.) Medical Research Council sum score and the median creatine kinase level (P = 0.001 and P = 0.025, respectively). Significant amelioration of the mean basal modified Rodnan skin score from 21.5 (s.d. 13.8) to 10 (10.6) (P = 0.005) was observed.
CONCLUSION: IVIG may be a helpful adjunctive therapy in the amelioration of some key clinical aspects in refractory SSc. Sustained benefit from IVIG suggests a specific immunomodulatory effect on those with established SSc GI complications.
Study site: Royal Free Hospital, United Kingdom

Matched MeSH terms: Gastrointestinal Diseases/etiology