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3. Clostridioides difficile Infection in Patients with Inflammatory Bowel Disease May be Favoured by the Effects of Proinflammatory Cytokines on the Enteroglial Network

Author

Bassotti G, Fruganti A, Maconi G, Marconi P, and Fettucciari K

Subjects
clostridioides difficile infection, cytokines, inflammatory bowel diseases, interferon gamma, tumour necrosis factor alpha, Pathology, RB1-214, Therapeutics. Pharmacology, RM1-950
Abstract

Gabrio Bassotti,1,2 Alessandro Fruganti,3 Giovanni Maconi,4 Pierfrancesco Marconi,5 Katia Fettucciari5 1Department of Medicine and Surgery, Gastroenterology, Hepatology & Digestive Endoscopy Section, University of Perugia, Perugia, Italy; 2Gastroenterology & Hepatology Unit, Santa Maria della Misericordia Hospital, Perugia, Italy; 3School of Biosciences and Veterinary Medicine, University of Camerino, Macerata, Italy; 4Department of Biomedical and Clinical Sciences, Gastroenterology Unit, “L. Sacco” Hospital, University of Milano, Milano, Italy; 5Department of Medicine and Surgery, Biosciences & Medical Embryology Section, University of Perugia, Perugia, ItalyCorrespondence: Gabrio BassottiDepartment of Medicine and Surgery, Gastroenterology, Hepatology & Digestive Endoscopy Section, University of Perugia, Perugia, ItalyEmail gabassot@tin.itAbstract: Clostridioides difficile infection is widespread throughout countries and represents an important cause of nosocomial diarrhoea, with relatively high morbidity. This infection often occurs in patients with inflammatory bowel diseases and may complicate their clinical picture. Here, we propose, on the basis of evidence from basic science studies, that in patients affected by inflammatory bowel diseases, this infection might be facilitated by a derangement of the enteric glial cell (EGC) network caused by the effects of proinflammatory cytokines, such as tumour necrosis factor alpha and interferon gamma, which enhance the cytotoxic effects of C. difficile toxin B on EGCs. This hypothesis, if confirmed, could open the door to alternative treatment approaches to fight C. difficile infection.Keywords: Clostridioides difficile infection, cytokines, inflammatory bowel diseases, interferon gamma, tumour necrosis factor alpha

Published
2021

4. OC.15.5: POLIPROTECT IS AN EFFECTIVE TREATMENT TO MANAGE PPI DEPRESCRIBING. A RANDOMIZED CONTROLLED TRIAL (RCT) POST HOC ANALYSIS

Author

Corazziari, E.S., primary, Gasbarrini, A., additional, D'Alba, L., additional, D'Ovidio, V., additional, Riggio, O., additional, Passaretti, S., additional, Annibale, B., additional, Cicala, M., additional, Repici, A., additional, Bassotti, G., additional, Ciacci, C., additional, Di Sabatino, A., additional, Neri, M., additional, Bragazzi, M.C., additional, Ribichini, E., additional, Radocchia, G., additional, Iovino, P., additional, Marazzato, M., additional, Schippa, S., additional, and Badiali, D., additional

Published
2024
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5. T.01.4: PATIENTS WITH NONEROSIVE HEARTBURN AND EPIGATRIC PAIN SYNDROME (EPS) ARE NOT CLINICALLY DISTINGUISHABLE AND BENEFIT OF THE SAME TREATMENT. A RANDOMIZED CONTROLLED TRIAL (RCT) POST HOC ANALYSIS

Author

Corazziari, E.S., primary, Gasbarrini, A., additional, D'Alba, L., additional, D'Ovidio, V., additional, Riggio, O., additional, Passaretti, S., additional, Annibale, B., additional, Cicala, M., additional, Repici, A., additional, Bassotti, G., additional, Ciacci, C., additional, Di Sabatino, A., additional, Neri, M., additional, Bragazzi, M.C., additional, Ribichini, E., additional, Radocchia, G., additional, Iovino, P., additional, Marazzato, M., additional, Schippa, S., additional, and Badiali, D., additional

Published
2024
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6. Chronic Idiopathic Constipation in Adults: A Review on Current Guidelines and Emerging Treatment Options

Author

Bassotti G, Usai Satta P, and Bellini M

Subjects
chronic idiopathic constipation, guidelines, osmotic laxatives, pelvic floor rehabilitation, prokinetics, secretagogues, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Gabrio Bassotti,1 Paolo Usai Satta,2 Massimo Bellini3 1Gastroenterology & Hepatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; 2Gastrointestinal Unit, “G. Brotzu” Hospital, Cagliari, Italy; 3Gastrointestinal Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, ItalyCorrespondence: Gabrio BassottiClinica di Gastroenterologia ed Epatologia, Ospedale Santa Maria della Misericordia, Piazzale Menghini, 1, San Sisto (Perugia), 06156, ItalyEmail gabassot@tin.itAbstract: Chronic idiopathic constipation (CIC) is a common functional bowel disorder characterized by difficult, infrequent, and/or incomplete defecation. It has a great impact on the quality of life and on health care system and represents a heavy economic burden. The diagnosis is based on symptoms, classified by the Rome IV criteria. The aim of this review was to evaluate the current therapeutic guidelines for adult CIC and highlight new emerging treatments. In detail, European, French, Spanish and Korean guidelines have been identified and compared. Osmotic laxatives, and in particular polyethylene glycol, represent the first-line therapeutic approach. Stimulant laxatives are recommended as a second-line therapy. Pelvic floor rehabilitation is recommended in patients with ano-rectal dyssynergia. In patients who fail to improve with pharmacological therapies sacral nerve stimulation is considered as last chance before surgery. Surgical approach has however limited indications in selected cases. Inertia coli refractory to any approach and obstructed defecation are two subtypes which can benefit from surgery. Among emerging agents, prucalopride, a prokinetic agent, is recommended as a second-line treatment in refractory CIC patients. In addition, the secretagogues linaclotide and plecanatide and the bile acid transported inhibitor elobixibat can be effective in patients not responsive to a second-line therapeutic regimen, although they are not worldwide commercially available.Keywords: chronic idiopathic constipation, guidelines, osmotic laxatives, pelvic floor rehabilitation, prokinetics, secretagogues

Published
2021

8. Proinflammatory Cytokines: Possible Accomplices for the Systemic Effects of Clostridioides difficile Toxin B

Author

Fettucciari K, Fruganti A, Marchegiani A, Brancorsini S, Marconi P, and Bassotti G

Subjects
clostridioides difficile, toxin b, proinflammatory cytokines, tnf-alpha, ifn-gamma, systemic effects, Pathology, RB1-214, Therapeutics. Pharmacology, RM1-950
Abstract

Katia Fettucciari,1 Alessandro Fruganti,2 Andrea Marchegiani,2 Stefano Brancorsini,1 Pierfrancesco Marconi,1 Gabrio Bassotti3,4 1Department of Experimental Medicine, University of Perugia Medical School, Perugia, Italy; 2School of Biosciences and Veterinary Medicine, University of Camerino, Macerata, Italy; 3Gastroenterology, Hepatology & Digestive Endoscopy Section, Department of Medicine, University of Perugia Medical School, Perugia, Italy; 4Gastroenterology & Hepatology Unit, Santa Maria della Misericordia Hospital, Perugia, ItalyCorrespondence: Katia FettucciariDepartment of Experimental Medicine, University of Perugia Medical School, Piazza Lucio Severi 1, Edificio B IV Piano, Sant’Andrea delle Fratte, Perugia 06132, ItalyTel +39755858124Email katia.fettucciari@unipg.itAbstract: Clostridioides difficile infection (CDI) has a serious impact on the healthcare system, and most of its pathogenic effects are mainly due to the activity of toxins A and B (TcdA and TcdB, respectively). The molecular mechanisms of their cytotoxic activity are well known, especially in the colon, where the infection occurs and normally remains localized. However, the mechanisms causing toxic effects on various systemic organs (extraintestinal manifestations) with frequent lethal outcomes in some patients affected by CDI are still poorly understood. Few studies are available that demonstrate low serum levels of Tcds in both experimental animal models and patients with CDI. Until now, it has remained unclear how low levels of circulating Tcds could lead to serious toxic effects. On the basis of our previous in vitro studies, in which the proinflammatory cytokines TNF-alpha and IFN-gamma strongly potentiated the toxic activity of low doses of TcdB, we hypothesize that the presence of both TcdB in the circulation and a systemic proinflammatory cytokine storm may be responsible for the selective severe effects of TcdB in some patients. This may occur in patients with severe CDI and systemic Tcds, in whom proinflammatory cytokines such as TNF-alpha and IFN-gamma reach a significant concentration in the circulation. This hypothesis could identify therapeutic interventions based on the reduction or neutralization of the indirect toxic action of these cytokines.Keywords: Clostridioides difficile, toxin B, proinflammatory cytokines, TNF-alpha, IFN-gamma, systemic effects

Published
2021

10. Pelvic floor rehabilitation for defecation disorders

Author

Bocchini, R., Chiarioni, G., Corazziari, E., Pucciani, F., Torresan, F., Alduini, P., Bassotti, G., Battaglia, E., Ferrarini, F., Galeazzi, F., Londoni, C., Rossitti, P., Usai Satta, P., Iona, L., Marchi, S., Milazzo, G., Altomare, D. F., Barbera, R., Bove, A., Calcara, C., D’Alba, L., De Bona, M., Goffredo, F., Manfredi, G., Naldini, G., Neri, M. C., Turco, L., La Torre, F., D’Urso, A. P., Berni, I., Balestri, M. A., Busin, N., Boemo, C., and Bellini, M.

Published
2019
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11. Correction to: Simplified Histologic Mucosal Healing Scheme (SHMHS) for inflammatory bowel disease: a nationwide multicenter study of performance and applicability (Techniques in Coloproctology, (2022), 26, 9, (713-723), 10.1007/s10151-022-02628-7)

Author

Caputo A., Parente P., Cadei M., Fassan M., Rispo A., Leoncini G., Bassotti G., Del Sordo R., Metelli C., Daperno M., Armuzzi A., Villanacci V., Caputo, A., Parente, P., Cadei, M., Fassan, M., Rispo, A., Leoncini, G., Bassotti, G., Del Sordo, R., Metelli, C., Daperno, M., Armuzzi, A., and Villanacci, V.

Abstract

In the original publication, the study group author names are listed under Appendix section and it should be listed in Acknowledgement section as follows.

Published
2023

12. T.01.11 AN RC TRIAL COMPARING THE MUCOSAL PROTECTIVE AGENT (MPA) POLIPROTECT (NEOBIANACID®) (P) AND OMEPRAZOLE (O) IN THE TREATMENT OF HEARTBURN AND EPIGASTRIC PAIN/BURNING IN NON-EROSIVE REFLUX DISEASE (NERD) AND EPIGASTRIC PAIN SYNDROME (EPS)

Author

Corazziari, E.S., primary, Gasbarrini, A., additional, D'Alba, L., additional, D'Ovidio, V., additional, Riggio, O., additional, Passaretti, S., additional, Annibale, B., additional, Cicala, M., additional, Repici, A., additional, Bassotti, G., additional, Ciacci, C., additional, Di Sabatino, A., additional, Neri, M., additional, Bragazzi, M., additional, Ribichini, E., additional, Radocchia, G., additional, Marazzato, M., additional, Schippa, S., additional, and Badiali, D., additional

Published
2023
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13. T.06.8 REAL WORD LONG-TERM EFFICACY AND SAFETY OF VEDOLIZUMAB IN MANAGING ULCERATIVE COLITIS VERSUS CROHN'S DISEASE: RESULTS FROM “LONG VEDO” ITALIAN MULTICENTER STUDY

Author

Mocci, G., primary, Maconi, G., additional, Cataletti, G., additional, Mantia, B., additional, Serio, M., additional, Scarcelli, A., additional, Onidi, F.M., additional, Pagnini, C., additional, Graziani, M., additional, Di Paolo, M., additional, Pranzo, G., additional, Luppino, I., additional, Paese, P., additional, Monterubbianesi, R., additional, Faggiani, R., additional, Ferronato, A., additional, Perini, B., additional, Savarino, E., additional, Binaghi, L., additional, Schiavoni, E., additional, Napolitano, D., additional, Scaldaferri, F., additional, Papa, A., additional, Lorenzetti, R., additional, Pica, R., additional, Cocco, A., additional, Rodino, S., additional, Sebkova, L., additional, Zampaletta, C., additional, Gaiani, F., additional, Fanigliulo, L., additional, Allegretta, L., additional, Cuomo, A., additional, Donnarumma, L., additional, Della Valle, N., additional, Forti, G., additional, Dore, M., additional, Antonelli, E., additional, Bassotti, G., additional, Iannelli, C., additional, Aragona, G., additional, Lauria, A., additional, Piergallini, S., additional, Colucci, R., additional, Meucci, C., additional, Usai Satta, P., additional, Elisai, W., additional, and Tursi, A., additional

Published
2023
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14. P505 Real word long-term efficacy and safety of vedolizumab in managing ulcerative colitis versus crohn’s disease: results from “long vedo” italian multicenter study

Author

Mocci, G, primary, Maconi, G, additional, Onidi, F M, additional, Cataletti, G, additional, Elisei, W, additional, Scaldaferri, F, additional, Lorenzetti, R, additional, Pagnini, C, additional, Scarcelli, A, additional, Graziani, M G, additional, Di Paolo, M C, additional, Pranzo, G, additional, Luppino, I, additional, Monterubbianesi, R, additional, Faggiani, R, additional, Ferronato, A, additional, Savarino, E, additional, Pica, R, additional, Cocco, A, additional, Rodino, S, additional, Sebkova, L, additional, Zampaletta, C, additional, Gaiani, F, additional, Fanigliulo, L, additional, Allegretta, L, additional, Cuomo, A, additional, Donnarumma, L, additional, Della Valle, N, additional, Forti, G, additional, Antonelli, E, additional, Bassotti, G, additional, Iannelli, C, additional, Aragona, G, additional, Lauria, A, additional, Piergallini, S, additional, Colucci, R, additional, Binaghi, L, additional, Meucci, C, additional, Papa, A, additional, and Tursi, A, additional

Published
2023
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21. Digestive diseases. 2022-2025 edition

Author

Abenavoli Monteblanco, L., Aghemo, A. M., Alvaro, D., Annibale, B., Arcidiacono, P. G., Ardizzone, S., Armuzzi, A., Azzaroli, F., Badiali, D., Baiocchi, L., Baldoni, M., Barone, M., Bassotti, G., Bellini, M., Benedetti, A., Bertino, G., Biagi, F., Biancone, L., Brilanti, S., Bugianesi, E., Burra, P., Calabrese, E., Calvaruso, V., Cammarata, G., Caprioli, F. A., Carbone, M., Cardinale, V., Castiglione, F., Catanzaro, R., Cavestro, G. M., Cazzagon, N., Ciancio, A., Consolo, P., Corleto, V. D., Crocè, S. L., Cuomo, R., de Bortoli, N., Del Vecchio Blanco, G., Dell'Era, A., Di Leo, A., Di Marco, V., Dore, P. M., Eusebi, L. H. U., Fabris, L., Facciorusso, A., Fantini, M. C., Federico, A., Fries, W., Fuccio, L., Fusaroli, P., Gabrielli, A., Galli, A., Giannini, E. G., Corradini, S. G., Gravina, A. G., Grassi, L., Guarino, M. P., Invernizzi, P., Iovino, P., Lahner, E., Lampertico, P., Larussa, T., Latella, G., Luzza, F., Maconi, G. E., Marabotto, E., Marchi, S., Marzioni, M., Merli, M., Milani, S., Montagnani, M., Morelli, O., Morisco, F., Nardone, G. A. P., Pallotta, N., Papa, A., Penagini, R., Petta, S., Picarelli, A., Principi, M., Rapaccini, G. L., Pepici, A., Ricci, C., Ricciardiello, L., Ridola, L., Rispo, A., Romano, M., Rumi, M. G., Russo, F. P., Saracco, G. M., Sarnelli, G., Savarino, E. V., Severi, C., Svegliati Baroni, G., Tarocchi, M., Vecchi, M., Viscido, A., Zagari, R. M., and Zingone, F.

Subjects
colon, liver diseases, diseases of the esophagus, stomach, duodenum, liver diseases, diseases of the biliary tract , pancreas, small intestine, colon, duodenum, diseases of the biliary tract, pancreas, small intestine, diseases of the esophagus, stomach
Published
2022

27. The DICA Endoscopic Classification for Diverticular Disease of the Colon Shows a Significant Interobserver Agreement among Community Endoscopists: an International Study

Author

Tursi A., Brandimarte G., Di Mario F., Lanas A., Scarpignato C., Bafutto M., Barbara G., Bassotti G., Binda G. A., Biondi A., Biondo S., Cassieri C., Crucitti A., Dumitrascu D. L., Elisei W., Escalante R., Herszenyi L., Kruis W., Kupcinskas J., Lahat A., Lecca P. G., Maconi G., Malfertheiner P., Mazzarri A., Mearin F., Milosavljevic T., Nardone G., de Oliveira E. C., Papa A., Papagrigoriadis S., Pera M., Persiani R., Picchio M., Regula J., Stimac D., Stollman N., Strate L. L., Walker M. M. D., Allegretta L., Altavilla N., Amaro P., Annunziata M. L., Barberio F., Basile G., Bedogni G., Belfiori V., Benvenuti S., Bertolami C., Bisello M., El Dammak M. B., Bozzi R., Buono M., Cambie G., Capezzuto E., Casamassima C., Chavoushian A., Ciofani R., Citarella C., Compare D., Cotruta B., D'amico F., Dulk M. D., Dyrda B. E., Festa V., Gallina S., Grasso R., Hanzel J., Taieb J. M., Lai M. A., Latella G., Lisi D., Lodi L., Marangi S., Mardegan A., Marlicz W., Maurano A., Milazzo G., Militaru V., Miraglia S., Monica F., Moskalev A., Natale A., Nicolas C., Pancetti A., Penna A., Pepe A. S., Pisano M., Pontone S., Prati M., Prisco A., Rando L., Hernandez E. R., Rosati O., Rossi G., Passoni G. R., Papa V., Nesme N. S., Schiffino L., Schillaci D., Selvaggi G., Taborchi F., Tornar A., Trebuna F., Triggiani C., Testai F. V., Vassallo R., Violi A., Tursi, A., Brandimarte, G., Di Mario, F., Lanas, A., Scarpignato, C., Bafutto, M., Barbara, G., Bassotti, G., Binda, G. A., Biondi, A., Biondo, S., Cassieri, C., Crucitti, A., Dumitrascu, D. L., Elisei, W., Escalante, R., Herszenyi, L., Kruis, W., Kupcinskas, J., Lahat, A., Lecca, P. G., Maconi, G., Malfertheiner, P., Mazzarri, A., Mearin, F., Milosavljevic, T., Nardone, G., de Oliveira, E. C., Papa, A., Papagrigoriadis, S., Pera, M., Persiani, R., Picchio, M., Regula, J., Stimac, D., Stollman, N., Strate, L. L., Walker, M. M. D., Allegretta, L., Altavilla, N., Amaro, P., Annunziata, M. L., Barberio, F., Basile, G., Bedogni, G., Belfiori, V., Benvenuti, S., Bertolami, C., Bisello, M., El Dammak, M. B., Bozzi, R., Buono, M., Cambie, G., Capezzuto, E., Casamassima, C., Chavoushian, A., Ciofani, R., Citarella, C., Compare, D., Cotruta, B., D'Amico, F., Dulk, M. D., Dyrda, B. E., Festa, V., Gallina, S., Grasso, R., Hanzel, J., Taieb, J. M., Lai, M. A., Latella, G., Lisi, D., Lodi, L., Marangi, S., Mardegan, A., Marlicz, W., Maurano, A., Milazzo, G., Militaru, V., Miraglia, S., Monica, F., Moskalev, A., Natale, A., Nicolas, C., Pancetti, A., Penna, A., Pepe, A. S., Pisano, M., Pontone, S., Prati, M., Prisco, A., Rando, L., Hernandez, E. R., Rosati, O., Rossi, G., Passoni, G. R., Papa, V., Nesme, N. S., Schiffino, L., Schillaci, D., Selvaggi, G., Taborchi, F., Tornar, A., Trebuna, F., Triggiani, C., Testai, F. V., Vassallo, R., Violi, A., Tursi A., Brandimarte G., Di Mario F., Lanas A., Scarpignato C., Bafutto M., Barbara G., Bassotti G., Binda G.A., Biondi A., Biondo S., Cassieri C., Crucitti A., Dumitrascu D.L., Elisei W., Escalante R., Herszenyi L., Kruis W., Kupcinskas J., Lahat A., Lecca P.G., Maconi G., Malfertheiner P., Mazzari A., Mearin F., Milosavljevic T., Nardone G., Chavez De Oliveira E., Papa A., Papagrigoriadis S., Pera M., Persiani R., Picchio M., Regula J., Stimac D., Stollman N., Strate L.L., and Walker M.M.

Subjects
BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences, Diverticular Disease, Endoscopic classification, Video Recording, Colonoscopy, Gastroenterology, Severity of Illness Index, endoscopic classification, Diverticulum, classification, complications, Diverticular diseases, Endoscopy, methods, Colonic Diseases, 0302 clinical medicine, Community Health Services, Community Health Service, Observer Variation, 0303 health sciences, medicine.diagnostic_test, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti, agreement − colonoscopy − community setting − diverticular disease of the colon− endoscopic classification, 3. Good health, Diverticulosis, Malalties del còlon, Diverticular disease of the colon, Diverticular disease, 616.344-007.64 [udc], Community setting, 030211 gastroenterology & hepatology, Human, medicine.medical_specialty, Scoring system, Colonic Disease, Settore MED/12 - GASTROENTEROLOGIA, Reproducibility of Result, agreement, colonoscopy, community setting, diverticular disease of the colon, Agreement, 03 medical and health sciences, Internal medicine, Severity of illness, medicine, Diverticulosis, Colonic, Humans, Colonic diseases, 030304 developmental biology, Diverticular Diseases, business.industry, Colonoscòpia, Reproducibility of Results, medicine.disease, Inter-rater reliability, business, Kappa
Abstract

Background and Aims: The Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification of diverticulosis and diverticular disease (DD) is currently available. It scores severity of the disease as DICA 1, DICA 2 and DICA 3. Our aim was to assess the agreement on this classification in an international endoscopists community setting. Methods: A total of 96 doctors (82.9% endoscopists) independently scored a set of DD endoscopic videos. The percentages of overall agreement on DICA score and a free-marginal multirater kappa (κ) coefficient were reported as statistical measures of interrater agreement. Results: Overall agreement in using DICA was 91.8% with a free-marginal kappa of 88% (95% CI 80-95). The overall agreement levels were: DICA 1, 85.2%; DICA 2, 96.5%; DICA 3, 99.5%. The free marginal κ was: DICA 1 = 0.753, DICA 2 = 0.958, DICA 3 = 0.919. The agreement about the main endoscopic items was 83.4% (k 67%) for diverticular extension, 62.6% (k 65%) for number of diverticula for each district, 86.8% (k 82%) for presence of inflammation, and 98.5 (k 98%) for presence of complications. Conclusions: The overall interrater agreement in this study ranges from good to very good. DICA score is a simple and reproducible endoscopic scoring system for diverticulosis and DD.

Published
2019

30. Therapeutic agents affecting the immune system and drug-induced inflammatory bowel disease (IBD): A review on etiological and pathogenetic aspects

Author

Del Sordo, R, Lougaris, V, Bassotti, G, Armuzzi, A, and Villanacci, V

Subjects
Tumor Necrosis Factor-alpha, Interleukins, Immunology, Drugs, Protein-Tyrosine Kinases, Inflammatory Bowel Diseases, Inflammatory bowel disease, Crohn's disease, Ulcerative colitis, Immune System, Humans, Immunologic Factors, Immunology and Allergy, Interferons, Isotretinoin, Rituximab, Immune Checkpoint Inhibitors
Abstract

In recent years, therapeutic agents affecting the immune system have been largely implemented in the treatment of various hematological, rheumatological and dermatological disorders. Their clinical use has offered important benefits for affected patients and has also ameliorated clinical outcome and prognosis in many cases. Nonetheless, as any treatment, the use of these drugs may be associated with side effects. One of the target organs in such cases is the gastrointestinal tract. In particular, the exacerbation or the onset of inflammatory bowel disease (IBD) in treated patients is not infrequent, although the mechanism of action of these agents may be different. In this review we will focus on the use of therapeutic agents affecting the immune system and the development or exacerbation of IBD, with a mention on the possible underlying pathogenetic mechanisms.

Published
2022

32. OC.08.3 THE “DICA” ENDOSCOPIC CLASSIFICATION FOR DIVERTICULAR DISEASE OF THE COLON SHOWS A SIGNIFICANT INTEROBSERVER AGREEMENT AMONG COMMUNITY ENDOSCOPISTS: AN INTERNATIONAL STUDY

Author

Tursi, A., primary, Brandimarte, G., additional, Di Mario, F., additional, Lanas, A., additional, Scarpignato, C., additional, Bafutto, M., additional, Barbara, G., additional, Bassotti, G., additional, Binda, G.A., additional, Biondi, A., additional, Biondo, S., additional, Cambiè, G., additional, Cassieri, C., additional, Crucitti, A., additional, Dumitrascu, D., additional, Elisei, W., additional, Escalante, R., additional, Herszènyi, L., additional, Kruis, W., additional, Kupcinskas, J., additional, Lahat, A., additional, Lecca, P.G., additional, Maconi, G., additional, Malfertheiner, P., additional, Mazzari, A., additional, Mearìn, F., additional, Milosavljevic, T., additional, Nardone, G., additional, Chavez De Oliveira, E., additional, Papa, A., additional, Papagrigoriadis, S., additional, Pera, M., additional, Persiani, R., additional, Picchio, M., additional, Regula, J., additional, Štimac, D., additional, Stollman, N., additional, Strate, L., additional, Violi, A., additional, and Walker, M., additional

Published
2020
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33. T03.02.25 SAFE AND EFFICACY OF SINGLE CENTRAL ENDOSCOPIC ULTRASOUND GUIDED NEUROLYSIS OF CELIAC PLEXUS FOR PAIN RELIEF IN UNRESECTABLE PANCREATIC CANCER PATIENTS

Author

Castellani, D., primary, Piciucchi, M., additional, Bertani, H., additional, Sbrozzi Vanni, A., additional, Germani, U., additional, Morelli, O., additional, Petrogiannopoulos, L., additional, Clerici, C., additional, Antonelli, E., additional, Bassotti, G., additional, Conigliaro, R.L., additional, and Manta, R., additional

Published
2020
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34. OC.12.6 PREVALENCE OF ANAEMIA IN INFLAMMATORY BOWEL DISEASE: PRELIMINARY RESULTS OF THE OBSERVATIONAL ITALIAN MULTICENTRE IG-IBD STUDY RIDART 1

Author

Bergamaschi, G., primary, Lenti, M.V., additional, Giuffrida, P., additional, Soriano, S., additional, D'Incà, R., additional, Astegiano, M., additional, Aronico, N., additional, Fries, W., additional, Rizzello, F., additional, Ciacci, C., additional, Bossa, F., additional, Orlando, A., additional, Ghigliazza, G., additional, Castiglione, F., additional, Milla, M., additional, Nardelli, S., additional, Principi, M.B., additional, Scribano, M.L., additional, Ricci, C., additional, Mazzucco, D., additional, Riegler, G., additional, Bassotti, G., additional, Buda, A., additional, Neri, M., additional, Bodini, G., additional, Monica, F., additional, Manca, A., additional, Villa, E., additional, Comberlato, M., additional, Saibeni, S., additional, Bezzio, C., additional, Sidoli, L., additional, Cannatelli, R., additional, Neve, V., additional, Vernia, P., additional, Pieraccini, A., additional, Testa, A., additional, Mengoli, C., additional, Rizzuto, G., additional, Fontana, R., additional, Iovino, P., additional, Valerii, C., additional, Pinto Vraca, T., additional, Ponzo, E., additional, Caccaro, R., additional, Corazza, G.R., additional, and Di Sabatino, A., additional

Published
2020
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37. Italian nationwide survey of pharmacologic treatments in diverticular disease: Results from the REMAD registry

Author

Cremon, C, Carabotti, M, Cuomo, R, Pace, F, Andreozzi, P, Barbaro, Mr, Annibale, B, Barbara, G, on behalf of the REMAD Group, Andrealli, A, Andriulli, A, Ardizzone, S, Astegiano, M, Bachetti, F, Bartolozzi, S, Bargiggia, S, Bassotti, G, Bianco, Ma, Binda, Ga, Biscaglia, G, Bosani, M, Bottiglieri, Me, Cargiolli, M, Ciacci, C, Colecchia, A, Dell’Era, A, De Matthaeis, M, Dinelli, M, Festa, V, Festi, D, Galliani, E, Garribba, A, Germana’, B, Grassini, M, Guido, E, Iafrate, F, Iovino, P, Iuliano, D, Laghi, A, Latella, G, Lorusso, M, Manes, G, Marchi, S, Mauro, B, Maurano, A, Nascimbeni, R, Neri, M, Occhipinti, P, Parravicini, M, Pennazio, M, Peralta, S, Portincasa, P, Radaelli, F, Rossi, M, Salerno, R, Savarino, V, Segato, S, Severi, C, Scaccianoce, G, Usai, P, Valle, V, Virgilio, C, Viscido, A, Cremon C., Carabotti M., Cuomo R., Pace F., Andreozzi P., Barbaro M.R., Annibale B., and Barbara G.

Subjects
Male, medicine.medical_specialty, Treatment outcome, Anti-Inflammatory Agents, symptomatic uncomplicated, symptomatic uncomplicated diverticular disease, registry, previous diverticuliti, Nationwide survey, 03 medical and health sciences, 0302 clinical medicine, pharmacological treatment, Risk Factors, medicine, Diverticulosis, management, pharmacological treatments, previous diverticulitis, registry, symptomatic uncomplicated, Effective treatment, Humans, Registries, Intensive care medicine, Aged, Diverticulosis, Diverticular Diseases, management, pharmacological treatments, previous diverticulitis, business.industry, Diverticulosi, digestive, oral, and skin physiology, Gastroenterology, Original Articles, Middle Aged, medicine.disease, digestive system diseases, Treatment Outcome, Oncology, Italy, 030220 oncology & carcinogenesis, Health Care Surveys, Female, Diverticular disease, 030211 gastroenterology & hepatology, business
Abstract

Background: Although diverticular disease is a common condition, its effective treatment is challenging in clinical practice. Objective: The objective of this article is to assess pharmacological management in different clinical settings of diverticular disease and factors associated with treatment using the Italian registry Registro Malattia Diverticolare (REMAD). Methods: At study enrolment, patients were categorised into subgroups: diverticulosis, symptomatic uncomplicated diverticular disease and previous diverticulitis. We registered demographic, clinical and lifestyle factors, quality of life and the use of treatments for diverticular disease in the last year. Logistic regression analysis assessed the association between clinical factors and treatment consumption. Results: A total of 500 of the 1206 individuals included had had at least one treatment for diverticular disease in the last year: 23.6% (166/702) of patients with diverticulosis, 55.9% (165/295) of patients with symptomatic diverticular disease, and 80.9% (169/209) of patients with previous diverticulitis (p < 0.001). In multivariate analysis, the following factors were significantly associated with treatment use: female gender, family history of colonic diverticula, organic digestive comorbidity and impaired physical quality of life components. Conclusion: Individuals with diverticular disease take medications based on the different clinical settings of disease. We identified different features associated with treatment use in the distinct clinical entities of diverticular disease. ClinicalTrial.gov Identifier: NCT03325829.

Published
2019

38. Sclerosing angiomatoid nodular transformation presenting with abdominal hemorrhage: First report in infancy

Author

Pelizzo, G., Villanacci, V., Lorenzi, L., Doria, O., Caruso, A. M., Girgenti, V., Unti, E., Putignano, L., Bassotti, G., and Calcaterra, V.

Subjects
TheoryofComputation_LOGICSANDMEANINGSOFPROGRAMS, Sclerosing Angiomatoid Nodular Transformation, Infant, Case Report, Spleen
Abstract

A limited number of sclerosing Angiomatoid Nodular Transformation (SANT) have been reported in pediatric age. We describe the first case of SANT occurring in a nine-week-old female infant that was admitted to our unit for severe abdominal distension and rectal bleeding. Enlarged spleen was detected on physical examination. Laboratory investigations revealed severe anemia and coagulation abnormalities. Abdominal ultrasound and computed tomography revealed ascites and splenomegaly with a large mass at the lower medial splenic pole. A diagnosis of intraabdominal hemorrhage was presumed and an exploratory laparotomy was performed. A complete transformation of the giant splenomegaly to bossellated masses and multiple bleeding capsular ruptures without subcapsular hematoma were found and an urgent splenectomy was performed. At histology, a SANT was diagnosed (CD34, CD31, CD8 positivity). The postoperative follow up was uneventful. SANT may also occur in infancy with a potentially lifethreatening presentation. Splenectomy may represent the only treatment in severe cases.

Published
2019

39. International consensus on diverticulosis and diverticular disease. Statements from the 3rd international symposium on diverticular disease

Author

Tursi, A., Brandimarte, G., Di Mario, F., Lanas, A., Scarpignato, C., Bafutto, M., Barbara, G., Bassotti, G., Binda, G. A., Biondi, Alberto, Biondo, S., Cambie, G., Cassieri, C., Crucitti, Antonio, Dumitrascu, D. L., Elisei, W., Escalante, R., Herszenyi, L., Kruis, W., Kupcinskas, J., Lahat, A., Lecca, P. G., Maconi, G., Malfertheiner, P., Mazzari, A., Mearin, F., Milosavljevic, T., Nardone, G., de Oliveira, E. C., Papa, Alfredo, Papagrigoriadis, S., Pera, M., Persiani, Roberto, Picchio, M., Regula, J., Stimac, D., Stollman, N., Strate, L. L., Violi, A., Walker, M. M. D., Biondi A. (ORCID:0000-0002-2470-7858), Crucitti A. (ORCID:0000-0003-3496-4185), Persiani R. (ORCID:0000-0002-1537-5097), Tursi, A., Brandimarte, G., Di Mario, F., Lanas, A., Scarpignato, C., Bafutto, M., Barbara, G., Bassotti, G., Binda, G. A., Biondi, Alberto, Biondo, S., Cambie, G., Cassieri, C., Crucitti, Antonio, Dumitrascu, D. L., Elisei, W., Escalante, R., Herszenyi, L., Kruis, W., Kupcinskas, J., Lahat, A., Lecca, P. G., Maconi, G., Malfertheiner, P., Mazzari, A., Mearin, F., Milosavljevic, T., Nardone, G., de Oliveira, E. C., Papa, Alfredo, Papagrigoriadis, S., Pera, M., Persiani, Roberto, Picchio, M., Regula, J., Stimac, D., Stollman, N., Strate, L. L., Violi, A., Walker, M. M. D., Biondi A. (ORCID:0000-0002-2470-7858), Crucitti A. (ORCID:0000-0003-3496-4185), and Persiani R. (ORCID:0000-0002-1537-5097)

Abstract

The statements produced by the Chairmen and Speakers of the 3rd International Symposium on Diverticular Disease, held in Madrid on April 11th-13th 2019, are reported. Topics such as current and evolving concepts on the pathogenesis, the course of the disease, the news in diagnosing, hot topics in medical and surgical treatments, and finally, critical issues on the disease were reviewed by the Chairmen who proposed 39 statements graded according to level of evidence and strength of recommendation. Each topic was explored focusing on the more relevant clinical questions. The vote was conducted on a 6-point scale and consensus was defined a priori as 67% agreement of the participants. The voting group consisted of 124 physicians from 18 countries, and agreement with all statements was provided. Comments were added explaining some controversial areas.

Published
2019

41. Non Celiac Gluten Sensitivity and Diagnostic Challenges

Author

Casella, G., Villanacci, V., Bassotti, G., Bold, Justine, and Rostami, K.

Subjects
nutritional and metabolic diseases, R1, digestive system diseases
Abstract

Non-celiac gluten sensitivity (NCGS), also referred to as non-celiac wheat sensitivity (NCWS), is a clinical syndrome characterized by both intestinal and extra-intestinal symptoms responsive to the withdrawal of gluten-containing food from the diet. The aim of this review is to summarize recent advances in research and provide a brief overview of the history of the condition for the benefit of professionals working in gastroenterology. Academic databases such as PubMed and Google Scholar were searched using key words such as ”non-celiac gluten sensitivity”, “gluten related disorders”, and the studies outlined in reference page were selected and analysed.\ud \ud Most of the analysed studiers agree that NCGS would need to be diagnosed only after exclusion of celiac disease and wheat allergy, and that a reliable serological marker is not available presently. The mechanisms causing symptoms in NCGS after gluten ingestion are largely unknown, but recent advances have begun to offer novel insights. The estimated prevalence of NCGS, at present, varies between 0.6 and 6%. There is an overlap between irritable bowel syndrome and NCGS with regard to the similarity of gastrointestinal symptoms. The histologic characteristics of NCGS are still under investigation, ranging from normal histology to slight increase in the number of T lymphocytes in the superficial epithelium of villi. Positive response to gluten free diet for a limited period (e.g., 6 weeks), followed by the reappearance of symptoms after gluten challenge appears, at this moment, to be the best approach for confirming diagnosis. The Salerno expert criteria may help to diagnose NCGS accurately in particular for research purposes but it has limited applicability in clinical practice.

Published
2018

42. Prevalence of anaemia in Italian patients with inflammatory bowel disease: Preliminary results of the observational multi-centre IG-IBD study RIDART 1

Author

Giuffrida, P., Fries, W, Aronico, N., and D'Inca, R, Lenti, Mv, Ciacci, C, Cococcia, S, Bossa, F, Ghigliazza, G, Castiglione, F, Principi, Mb, Ricci, C, Mazzucco, D, Manetti, N, Scribano, Ml, Riegler, G, Bodini, G, Bassotti, G, Monica, F, Masotti, M, Vernia, P, Manca, A, Buda, A, Villa, E, Neri, M, Comberlato, M, Testa, A, Fontana, R, Iovino, P, Sturniolo, Gc, Corazza, Gr, and Di Sabatino, A.

Published
2018

43. PREVALENCE OF ANAEMIA IN INFLAMMATORY BOWEL DISEASE: PRELIMINARY RESULTS OF THE OBSERVATIONAL ITALIAN MULTICENTRE IG-IBD STUDY RIDART 1

Author

Bergamaschi, G, Giuffrida, P., Fries, W, Aronico, N., D'Inca, R, Lenti, Mv, Ciacci, C, Cococcia, S, Bossa, F, Ghigliazza, G, Castiglione, F, Principi, Mb, Ricci, C, Mazzucco, D, Milla, M, Pieraccini, A, Scribano, Ml, Riegler, G, Bodini, G, Bassotti, G, Monica, F, Masotti, M, Vernia, P, Manca, A, Buda, A, Villa, E, Neri, M, Comberlato, M, Testa, A, Soriano, S, Fontana, R, Iovino, P, Sturniolo, Gc, Corazza, Gr, and Di Sabatino, A.

Published
2018

44. PC.01.4 PREVALENCE OF ANAEMIA IN INFLAMMATORY BOWEL DISEASE: PRELIMINARY RESULTS OF THE OBSERVATIONAL ITALIAN MULTICENTRE IG-IBD STUDY RIDART 1

Author

Bergamaschi, G., primary, Giuffrida, P., additional, D'Incà, R., additional, Lenti, M.V., additional, Astegiano, M., additional, Aronico, N., additional, Fries, W., additional, Rizzello, F., additional, Cococcia, S., additional, Ciacci, C., additional, Bossa, F., additional, Orlando, A., additional, Ghigliazza, G., additional, Castiglione, F., additional, Milla, M., additional, Nardelli, S., additional, Principi, M.B., additional, Scribano, M.L., additional, Ricci, C., additional, Mazzucco, D., additional, Riegler, G., additional, Bassotti, G., additional, Buda, A., additional, Neri, M., additional, Bodini, G., additional, Monica, F., additional, Manca, A., additional, Villa, E., additional, Masotti, M., additional, Comberlato, M., additional, Saimbeni, S., additional, Sidoli, L., additional, Cannatelli, R., additional, Neve, V., additional, Vernia, P., additional, Pieraccini, A., additional, Testa, A., additional, Mengoli, C., additional, Rizzuto, G., additional, Fontana, R., additional, Iovino, P., additional, Valerii, C., additional, Vraca, T. Pinto, additional, Ponzo, E., additional, Caccaro, R., additional, Corazza, G.R., additional, and Di Sabatino, A., additional

Published
2019
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45. P.02.12 PREDICTIVE VALUE OF THE “DICA” ENDOSCOPIC CLASSIFICATION ON THE OUTCOME OF DIVERTICULAR DISEASE OF THE COLON: A 1-YEAR ANALYSIS FROM THE INTERNATIONAL, MULTICENTER, PROSPECTIVE STUDY

Author

Tursi, A., primary, Brandimarte, G., additional, Di Mario, F., additional, Elisei, W., additional, Picchio, M., additional, Allegretta, L., additional, Annunziata, M.L., additional, Astegiano, M., additional, Bafutto, M., additional, Baldi, F., additional, Bassotti, G., additional, Bianco, M.A., additional, Colucci, R., additional, Conigliaro, R., additional, Danese, S., additional, Dumitrascu, D.L., additional, Escalante, R., additional, Faggiani, R., additional, Fiorella, S., additional, Forti, G., additional, Franceschi, M., additional, Giorgetti, G., additional, Grad, S., additional, Graziani, M.G., additional, Lai, M.A., additional, Lammert, F., additional, Latella, G., additional, Lisi, D., additional, Maconi, G., additional, Murphy, M.M., additional, Nardone, G., additional, De Oliveira, L. Camara, additional, De Oliveira, E. Chaves, additional, Papa, A., additional, Papagrigoriadis, S., additional, Penna, A., additional, Pietrzak, A., additional, Pontone, S., additional, Portincasa, P., additional, Poskus, T., additional, Pranzo, G., additional, Reichert, M., additional, Rizzo, G.L., additional, Rodinò, S., additional, Regula, J., additional, Scaccianoce, G., additional, Scaldaferri, F., additional, Schiffino, L., additional, Stundiene, I., additional, Vassallo, R., additional, Walker, M., additional, Zampaletta, C., additional, and Zullo, A., additional

Published
2019
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47. OC.03.3 THE “DICA” ENDOSCOPIC CLASSIFICATION FOR DIVERTICULAR DISEASE OF THE COLON SHOWS A SIGNIFICANT INTEROBSERVER AGREEMENT AMONG COMMUNITY ENDOSCOPISTS

Author

Tursi, A., primary, Brandimarte, G., additional, Di Mario, F., additional, Nardone, G., additional, Scarpignato, C., additional, Picchio, M., additional, Elisei, W., additional, Allegretta, L., additional, Annunziata, M.L., additional, Astegiano, M., additional, Baldi, F., additional, Bassotti, G., additional, Bianco, M.A., additional, Cambiè, G., additional, Capezzuto, E., additional, Caroli, A., additional, Cassieri, C., additional, Cicu, A.S., additional, Ciliberto, E., additional, Colucci, R., additional, Conigliaro, R., additional, Damiani, A., additional, De Colibus, P., additional, De Medici, A., additional, De Pretis, G., additional, Favero, G. Del, additional, Valle, N. Della, additional, Di Cesare, L., additional, Faggiani, R., additional, Febbraro, S., additional, Ferrini, L., additional, Fiorella, S., additional, Forti, G., additional, Franceschi, M., additional, Frunzio, A., additional, Germanà, B., additional, Giorgetti, G., additional, Giovannone, M., additional, Graziani, M.G., additional, Lai, M.A., additional, Latella, G., additional, Lisi, D., additional, Lopetuso, L.R., additional, Maconi, G., additional, Mandelli, E.D., additional, Marmo, R., additional, Maurano, A., additional, Pallotta, L., additional, Papa, A., additional, Parmeggiani, F., additional, Penna, A., additional, Pigò, F., additional, Pontone, S., additional, Pranzo, G., additional, Ricciardelli, C., additional, Rizzo, G.L., additional, Rodinò, S., additional, Savarino, E., additional, Scaccianoce, G., additional, Scaldaferri, F., additional, Schiffino, L., additional, Semeraro, C., additional, Stroppa, I., additional, Urgesi, R., additional, Vassallo, R., additional, Violi, A., additional, Zampaletta, C., additional, Lecca, P.G., additional, Zilli, M., additional, and Zullo, A., additional

Published
2019
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48. Confirmatory factor analysis of the Patient Assessment of Constipation-Symptoms (PAC-SYM) among patients with chronic constipation

Author

Neri L, Conway PM, Basilisco G, Altomare DF, Annese V, Badiali D, Bassotti G, Battaglia E, Bazzocchi G, Bellini M, Bendia E, Benini L, Biscaglia G, Biviano I, Bocchini R, Bonfrate L, Bonventre S, Bossa F, Brandimarte G, Cannizzaro R, Cicala M, Cipolletta L, Clara V, Cogliandro R, Comandini G, Corazziari E, Crotta S, CUOMO, ROSARIO, D'Alba L, De Giorgi F, Del Piano M, Di Fonzo M, Di Mario Francesco, Di Stefano M, D'Onofrio V, Efthymakis K, Fiore P, Fortuna M, Fries W, Gaetani E, Galeazzi F, Gasbarrini A, Geccherle' A, Giangregorio F, Girardi L, Grassini M, Groppo M, Guarnieri G, Iovino P, Lo Cascio M, Lolli R, Luzza F, Macarri G, Marino M, Miraglia S, Monastra S, Neri MC, Neri M, Noris RA, Orselli S, Passaretti S, Paviotti A, Pazzi P, Pilotto A, Portincasa P, Ranaldo N, Ravelli P, Rogai F, Sablich R, Savarino V, Spinzi G, Stanghellini V, Tammaro L, Torresan F, Usai Satta P, Valle C., Neri, L, Conway, Pm, Basilisco, G, Stanghellini, V, Neri, L., Conway, P., Basilisco, G., Bonventre, S, Altomare, Df, Annese, V, Badiali, D, Bassotti, G, Battaglia, E, Bazzocchi, G, Bellini, M, Bendia, E, Benini, L, Biscaglia, G, Biviano, I, Bocchini, R, Bonfrate, L, Bossa, F, Brandimarte, G, Cannizzaro, R, Cicala, M, Cipolletta, L, Clara, V, Cogliandro, R, Comandini, G, Corazziari, E, Crotta, S, Cuomo, Rosario, D'Alba, L, De Giorgi, F, Del Piano, M, Di Fonzo, M, Di Mario, Francesco, Di Stefano, M, D'Onofrio, V, Efthymakis, K, Fiore, P, Fortuna, M, Fries, W, Gaetani, E, Galeazzi, F, Gasbarrini, A, Geccherle', A, Giangregorio, F, Girardi, L, Grassini, M, Groppo, M, Guarnieri, G, Iovino, P, Lo Cascio, M, Lolli, R, Luzza, F, Macarri, G, Marino, M, Miraglia, S, Monastra, S, Neri, Mc, Neri, M, Noris, Ra, Orselli, S, Passaretti, S, Paviotti, A, Pazzi, P, Pilotto, A, Portincasa, P, Ranaldo, N, Ravelli, P, Rogai, F, Sablich, R, Savarino, V, Spinzi, G, Tammaro, L, Torresan, F, Usai Satta, P, and Valle, C.

Subjects
Adult, Male, medicine.medical_specialty, Abdominal pain, Constipation, Constipation severity, Chronic constipation, Chronic non-organic constipation, Quality of life, Chronic Disease, Female, Humans, Middle Aged, Patient Care, Quality of Life, Reproducibility of Results, Surveys and Questionnaires, Factor Analysis, Statistical, Public Health, Environmental and Occupational Health, Medicine (all), Reproducibility of Result, Internal medicine, medicine, Criterion validity, Surveys and Questionnaire, Settore MED/12 - Gastroenterologia, business.industry, Minimal clinically important difference, Environmental and Occupational Health, Settore MED/09 - MEDICINA INTERNA, Statistical, medicine.disease, Confirmatory factor analysis, Settore MED/18 - Chirurgia Generale, Physical therapy, Functional constipation, Public Health, medicine.symptom, business, Factor Analysis, Human
Abstract

Background and aim: PAC-SYM is widely adopted to asses constipation severity. However, it has been validated in a small sample, few items have been included based on expert opinion and not on empirical grounds, and its factor structure has never been replicated. We aimed at evaluating the psychometric properties of PAC-SYM in patients with chronic constipation. Methods: We enrolled 2,203 outpatients with chronic constipation in two waves. We used wave I sample to test the psychometric properties of the PAC-SYM and wave II sample to cross-validate its factor structure, to assess criterion validity, responsiveness to clinical change, and its minimal clinically important difference. Results: Only a minority of patients reported any rectal tearing (38 %). Deletion of such item leads to a 11-item version (M:PAC-SYM). The remaining items in the rectal domain were moderately correlated with the stool domain. Exploratory factor analysis and confirmatory factor analysis revealed a bifactor structure with two subscales (stool and abdominal symptoms) and a general severity factor. The M:PAC-SYM demonstrated excellent reliability, moderate correlation with SF-12 and treatment satisfaction (r = 0.28–0.45), discrimination across Rome III criteria for functional constipation and abdominal pain, and responsiveness to clinical change (β = −0.49; ω 2 = 0.25). M:PAC-SYM minimal clinically important difference was 0.24. Conclusion: Our analysis shows that the rectal domain may not represent a relevant cluster of symptoms for patients with chronic constipation. We developed a modified version of the PAC-SYM which might better represent symptom severity of most patients seeking care in gastroenterology referral centers

Published
2014

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