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У статті надано результати дослідження аероіонів повітря, що видихається, у 310 пацієнтів із поєднаною патологією органів травлення. Наведено новий неінвазивний метод діагностики та індивідуалізації комплексного лікування хворих, зокрема дієтотерапії. Обґрунтовано підбір продуктів харчування згідно з основними електрохімічними характеристиками. Оцінено перспективи використання методу аероіонного тестування в клінічній практиці як технології первинного скринінгу та неінвазивного контролю результатів лікування.

We present the case of a 24-year-old woman who presented to the emergency department with mid-epigastric pain and nausea. Contrast enhanced dual-energy CT showed high iodine signal in the small bowel lumen concerning for gastrointestinal bleeding since oral contrast was not given. However, overt bleeding symptoms were absent. Further in-house analysis of the dual-energy CT data revealed the hyperattenuating intraluminal material to be oral indigestion medicine containing magnesium, aluminum, or bismuth, and not extravasated iodine.

Objectives Postprandial distress syndrome (PDS) is associated with food indigestion. Efficacy of drugs used against PDS is limited whereas dietary modifications were shown to have important beneficial effects. Traditional Persian Medicine (TPM) sages suggested a dietary regimen known as Persian metabolic diet (PMD) for the management of PDS patients. In this study, the efficacy of PMD in alleviating the symptoms of PDS was explored. Methods This single-center, parallel-group, randomized clinical trial included 56 patients whom were randomly allocated to PMD group (29 participants) and Optional diet (OD) group (27 participants). They were instructed to follow the protocol for two weeks. Using a standard validated questionnaire, all outcomes were evaluated at baseline, end of the intervention period, and end of follow-up time. Results At the end of the intervention period, comparing the changes of severity scores between the groups showed a statistically significant difference in week 2 (p-value Conclusions This diet prepared based on Persian medicine seems to be effective in relieving the symptoms of patients with PDS.

Background. Escherichiosis remains one of the most common intestinal infections, especially among young children. Indigestion of essential nutrients, transient fermentopathy, imbalance of the symbiotic flora, which develop in escherichiosis in combination with general intoxication and water-electrolyte disturbances, can lead to unfavorable outcomes. One of the factors influencing the course of escherichiosis can be Epstein-Barr virus (EBV) infection in the child. Purpose of the research — improvement of treatment of children with escherichiosis and EBV infection in different periods of the disease. Materials and methods. We examined 74 children aged 2–3 years, who were treated at the Regional Children’s Clinical Infectious Diseases Hospital in Kharkiv with a diagnosis of moderate-to-severe escherichiosis. A group of 36 children was selected, who received conventional therapy with early gradual restoration of nutrition according to the existing protocol, and the restoration of the qualitative and quantitative composition of food was carried out as soon as possible (first group). The second group was represented by 38 children, who received two-day prolonged gradual restoration of the diet: more gradual increasing the volume of food at each feeding and reducing the number of feedings per day. Children of the second group received drugs containing Lactobacillus, milk thistle extract and B vitamins (once daily with meals) from the first day. Ultrasound examination of the abdominal cavity was performed in all children. Results. Analysis of the main clinical, laboratory and instrumental parameters of patients in both groups during their stay in the hospital and one month after the discharge from the hospital revealed that in children of the second group, in whom rational diet therapy was applied, there was a reduction in the duration of bowel dysfunction, abdominal syndrome, flatulence; the parameters of the coprological test and the echosonoscopy of the hepatic parenchyma were normalized more quickly. Patients on the optimal diet regained their weight in a shorter period. The proposed methods of improving the therapy made it possible to prevent exacerbation of escherichiosis in children of the second group at the early convalescence stages. Conclusions. Early detection of EBV infection in children with escherichiosis, correction of therapy enable early restoration of physiological processes in the intestine and bile system, normalization of digestion and absorption of nutrients, and generally has a positive effect on the course of the underlying disease.

In modern era or day to day life cumulative toxicity (Dushivisha) increases the need for antioxidants as the body attempts to neutralize the harmful substances. The factors such as Viruddhahara and Ahitahara, fast foods and cold beverages, alcohol, tobacco, pesticides, metals and pollutants etc. can be considered under Dushivisha (cumulative poison). Aggravate Dosha vitiate the Dhatu (elements of body) specially Rakta Dhatu, it deposits in body tissues due to mild potency in nature, it covered by Kapha dosha and produces many diseases in favorable condition. Acharya Sushruta in Kalp sthana mentioned Ajeya Ghrita as a best remedy for the management of Dushivisha derived diseases. The content of Ajeya ghrita have Laghu, Rukhsha, Tiksna, Katu, Ushna, Kushthaghna, Krimighana Vishghna and antioxidant properties can help the breakdown the pathogenesis of Dushi visha. This formulation is given in 30 patients which is divided in two group having 15 patients in each group in oral dose of 12gm BD with lukewarm water for 30 days with follow up 30 days. Patient having sign and symptoms of fever, Kotha (skin allergies), Kasa (cough), Trishna (increased thirst), abdominal pain, recurrent Avipaka (indigestion)/ Arochak (anorexia), recurrent Chardi (vomiting)/ nausea, recurrent Shirahshool (headache)/ dizziness, recurrent Jwara (fever), recurrent Atisara (diarrhea), premature aging (wrinkling of skin, greying and loss of hair etc.), Smritinasha (loss of memory), recurrent Daurbalya (weakness), result found 1 patient (6.67%) were completely remitted in Group A while group B not found. 4 patients (26.66%) Group A, while in Group B, 3 (20%) were moderately improved respectively. 5 patients (33.33%) were no relief in group A and 4 (40%) in group B, no relief in any symptoms.

This prospective study was conducted on 42 buffaloes diagnosed with reticular diaphragmatic hernia (RDH). The common clinical findings were depressed demeanor, chronic inappetance or anorexia, dehydration, recurrent or persistent tympany, scanty faeces, mushy rumen with normal or increased motility, tachypnea, abdominal distension, and gradual reduction in milk yield. The presence of reticular foreign bodies seemed to be the major predisposing factor. Neutrophil and lymphocyte counts were significantly (p

Today, the term "malabsorption syndrome" is widely used in medical practice as a general term to describe the symptoms of indigestion, absorption, and transport by the intestinal mucosa of adequately digested foods, including vitamins and trace elements, resulting in a variety of metabolic disorders.The purpose of this review is to analyze scientific data that highlight information on modern views on the etiology, mechanisms of development and clinical manifestations of malabsorption syndrome.Conclusion. Today, data on the mechanisms of development and progression of the malabsorption syndrome have been significantly expanded. This makes it possible to develop methods of prevention of the trigger factors, timely correct treatment and prevention of complications of this syndrome.

Sushruta explained about Guda-Roga, i.e. Ano Rectal Disease in Shalya Tantra. It includes no. of disease out of them one is Parikartika," i.e. Fissure – in – Ano. Lifestyle diseases are mainly caused by improper work pattern, stressful life, improper diet intake and improper sleep habits. These causative factors produce indigestion which leads to various lifestyle disorders, specially anorectal disorders like piles, fissure in ano, fistula in ano etc., constitute a significant group. Priyangvaadi Gana siddha tail in the management of Parikartika. The present study is designed as a Randomized, single-blind parallel in which 60 patients will be enrolled. Priyangvaadi Gana Siddha Taila Pichu and Yastimadhu tail Pichu will be given for basti twice a day. Assessment will be done 0th, 7th day, 14thday, and 28th day. The changes are expected to be observed in subjective parameters such as pain bleeding per rectum with itching as well as with objective parameters such as Parikartika Healing. The study is expecting the nonsurgical management of fissure in ano with respect to the impact of Priyangvaadi Gana Siddha tail pichu and Yastimadhu tail Pichu. The research is expecting to be a baseline and benchmark of the prospective studies in Acute Fissure in ano (Parikartika).

Long-term pancreatoduodenectomy (PD) survivors have previously reported favorable quality of life (QoL). However, there has been a paucity of studies utilizing pancreas-specific modules for QoL assessment, which may uncover disability that general modules cannot detect. The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-PAN26 questionnaires were administered to PD survivors who were at least 5 years out of their operations for neoplasms (1998–2011, study cohort) and compared their scores with published preoperative scores of patients with pancreatic cancer (control cohort). The clinical relevance (CR) of differences was scored as small (5–10), moderate (10–20), or large (> 20) based on validated interpretation of clinically important differences. Of 1266 patients who underwent PD, there were 305 survivors with valid contact information, of whom 248 responded to the questionnaire (response rate 81.3%) and made up the study cohort. The median follow-up was 9.1 years (range 5.1–21.2 years). When compared with the control cohort, patients in the study cohort reported higher pancreatic pain (41.7 ± 17.6 vs. 18.1 ± 20.5, p

Laparoscopic cholecystectomy (LC) is a common surgical procedure in acute cholecystitis (AC). Patients often suffer from considerable postoperative pain and indigestion, which prolongs in-hospital stay. The enhanced recovery after surgery (ERAS) program has proven its efficacy in elective surgery and could hypothetically improve outcomes of emergency LC. Currently, there is no ERAS program for LC in patients with AC. A modified ERAS (mERAS) protocol was studied in a prospective, randomized non-blinded clinical trial (NCT03754751). The mERAS group consisted of 88 patients the control group of 101 patients. The modified protocol included a patient information brochure; minimizing drain use; local anesthesia; low-pressure pneumoperitoneum; PONV prophylaxis, early mobilization and oral diet. The primary outcome was postoperative length of stay (pLOS). The postoperative length of stay in the mERAS group was shorter (24 (21–45.5) h) than in the control (45 (41–68) h) (p

Dyspepsia affects a large percentage of the general population and can lead to lost work productivity and reduced quality of life. Patients with dyspepsia younger than 60 should not routinely undergo endoscopy but instead should pursue Helicobacter pylori test-and-treat approach. For patients 60 and older, endoscopy should be performed. Patients without any identifiable cause for their symptoms are diagnosed with functional dyspepsia. Guideline-based treatment includes H pylori eradication and proton pump inhibitor use. If acid suppression is not adequate, treatment with a tricyclic antidepressant followed by a prokinetic agent and psychological therapy are considered. Complementary therapies are not recommended due to limited evidence.

Non Alcoholic Steatohepatitis (NASH) is the most severe histological form of non-alcoholic fatty liver disease (NAFLD). It progress to cirrhosis in 20% population and 40% will have death due to liver pathology. Still consensus on pharmacotherapy is yet to be evolved and till date there is no US FDA approved drug for NASH. Ayurveda formulation Katukyadi churna is explored in the possible management of NASH. Study is a single arm with pre and post test design. Sonologically diagnosed patients of fatty liver (n = 30) were screened. 11 patients meeting elastoghraphic criteria (6.4–11.7 kPa) were enrolled in the study. K. churna was administered in the dose of 6 g twice a day with water at the middle of the meal for a period of 6 months. Subjective parameters were Aruchi (Anorexia), Agnimandhya (loss of appetite), Ajeerna (indigestion), Gouravata. Follow up assessments were done on every 30th day. Study showed that K. churna produced significant improvement in various parameters. Significant decrease in weight, (p

Non- alcoholic fatty liver disease (NAFLD) is also otherwise termed as Hepatic steatosis and Kaphaja yakrit dalludara in Ayurveda. 34 years male patient, highly educated from a high socio-economic group of Non vegetarian diet habit came to hospital with complain of anorexia, indigestion and distention for three months. The clinical findings revealed that he is slightly obese, hyperglycaemia and dyslipidimia along elevated liver enzymes with fatty liver in USG and Fibro scan. The case was treated with Patolakaturohinyadi Kwatham (PKK) in the dose was 30ml Kasaya with equal quantity of luke warm water twice daily in empty stomach preferable morning and evening for six months. This study proved that PKK can significantly reduced blood sugar, serum Lipids and liver enzymes within three months along with reduction weight and BMI, but change in liver architecture required six months in this therapy. The BARD score and NAFLD score changed to normal after six months of therapy. The patient was kept in observation for further one year without medication and advised to practice yoga, exercise and low carbohydrate and fat diet to study the recurrence of disease. The liver architecture as well as biochemical profile of liver is maintained after one year also. PKK may correct the metabolic dysfunction by increase Agni, digest Ama which helped in the correction of hyperglycaemia and dyslipidaemia. PKK is safe in for six months of use in recommended dose (30ml BID) as there was no adverse sign and symptom observed and no change in biochemical and Haematological profile of Patients.PKK is safe and effective in this case of Kaphaja Yakrit dalludara (NAFLD). It can study further in large population to generated evidence for its efficacy and efficacy in larger group.

Any abnormality in digesting food or lack of proper digestion is termed as indigestion. It refers to variety of gastrointestinal complaints, ranging from gas (belching or flatulence) to stomach upset. Common indigestion signs and symptoms are fullness, early satiety, nausea, vomiting, belching, bloating, ulcer, diarrhoea, dyspepsia and some other associated temporary discomforts or long lasting disorders. Treatment options are many which include change in food, drinks, lifestyle, synthetic medication, etc. But amongst all, the one by complementary and alternative medicines (CAMs), especially the time-tested phytotherapeutic traditional herbal remedies is gaining significance and reliance. Herbal medicinal plants and drugs therefrom are arguably the oldest forms of healthcare recognized to humanity and have been used by all cultures throughout history. Plants contain phytochemicals having specific as well as holistic biological functions, which may have a significant role in the treatment and prevention of various digestive disorders. The present review will address the indigestion issue as a common and universal discomfort to human being around the globe and also the magical healing options by some medicinal plants and herbals. With the remarkable surge of and reliance to the so-called CAM, it is imperative that the present and future researchers be aware of both the potential risks as well as the benefits of using herbal medicine in their cutting-edge exercise in the days ahead.

Background Distal Roux‐en‐Y gastrojejunal bypass (DRYGJB) gives better weight reduction than standard Roux‐en‐Y gastric bypass (RYGB) but at the risk of increased malnutrition side‐effects. This study compared the effects of RYGB and DRYGJB on gastrointestinal symptoms, eating patterns and health‐related quality of life (QoL). Methods This was a single‐blind RCT from a university‐affiliated obesity centre. Patients with a BMI of 50 kg/m2 or above were invited to participate. Treatment arms were standard gastric bypass with an alimentary limb of 150 cm and a biliopancreatic limb of 60 cm, with a variable common channel length, or DRYGJB with biliopancreatic limb of 200 cm, common channel limb of 150 cm and variable alimentary limb length. Baseline and follow‐up data to 5 years on quality of life, obesity‐related problems and gastrointestinal symptoms were collected using prospectively created and validated questionnaires. Results Some 140 patients were included. Those with a DRYGJB had better weight loss at 5 years (mean(s.d.) 68·3(21·8) kg versus 55·7(19·8) kg for standard RYGB; P = 0·011). Eating patterns improved, with no difference between the groups. Gastrointestinal symptoms (diarrhoea, indigestion) worsened significantly in both groups, but only patients with DRYGJB had significantly worse diarrhoea at the end of the study than at baseline (P = 0·006). Both groups had improved perceived generic QoL over baseline, and obesity‐related problems were markedly reduced. Conclusion Standard RYGB and both improved generic and disease‐specific QoL and eating behavioural pattern. Diarrhoea was increased more following DRYGJB than after RYGB. Registration number: NCT 01514799 (https://clinicaltrials.gov)., Lengthening the biliopancreatic limb in gastric bypass surgery gives enhanced weight loss without compromising patient‐assessed quality of life. Small differences in long‐term outcome

Background Lenvatinib, a novel multi-target tyrosine kinase inhibitor, has been approved for treating differentiated thyroid cancer. Herein, we describe a rare case of acute pancreatitis that developed during lenvatinib treatment in a 65-year-old man with recurrent thyroid cancer. Case presentation The patient was admitted to our department following a complaint of acute-onset epigastric pain and indigestion. He had been receiving lenvatinib since 34 days. Although his serum amylase and lipase levels were normal, he had acute-onset persistent epigastric pain and typical computed tomography findings, which were consistent with those of acute pancreatitis. As other common etiologies were excluded, it was concluded that the patient had lenvatinib-induced acute pancreatitis. On admission day 14, he could consume food orally, after conservative care, including drug cessation, intravenous hydration, and pain control. Conclusion Physicians should consider acute pancreatitis as a differential diagnosis for patients complaining of abdominal pain while on lenvatinib, regardless of hyperamylasemia or hyperlipasemia. Systematic collection of data on acute pancreatitis development during lenvatinib treatment should be considered, and further research is warranted to identify the mechanism of acute pancreatitis associated with multi-target tyrosine kinase inhibitors such as lenvatinib.

It is known that periodontal diseases are a significant part of dental diseases in dogs. Chronic generalized periodontitis deserves the most attention. The disease develops slowly, beginning without visible clinical signs, but later, a combination of certain favorable etiological factors can lead to the loss of the animal's teeth, indigestion, metabolism with serious consequences for the dog. Therefore, the search of the features of the disease and the development of tactics for effective treatment of periodontally ill animals is relevant for modern veterinary dentistry. The aim of the work was to study the features of the course of chronic generalized periodontitis in remission in dogs and to develop tactics for rational treatment of periodontally ill animals. For the study, two groups of animals with chronic generalized periodontitis were formed in remission with 5 dogs in each (control and experimental), selected on the principle of analogues in terms of age and nature of the pathological process. Searches have shown that in chronic generalized periodontitis in remission in dogs there is an increase in the number of pathogenic microflora in the biotopes of the oral cavity, increasing the activity of acid phosphatase, increasing the protein concentration by reducing the content of lysozyme in the oral fluid. It was found that the dogs of the experimental group, after removal of tartar and rehabilitation of the oral cavity, were treated by using to the gums of ceftriaxone, diluted in 1% lidocaine hydrochloride solution in combination with 30 % dimexid solution 1 time per day for 7 days, anfluron injecteed intramuscularly at the rate of 1 ml 1 time per day for 7 days and caforsen – 0.1 ml/kg per day for 4 weeks. The treatment contributed to the recovery of dogs for 10 days, which is 8 days faster than in the control group.

Background and Aim Functional dyspepsia (FD) is characterized by chronic and unexplained indigestion at upper abdomen. Because of unsatisfactory effect of conventional treatments, demand is growing for complementary and alternative medicine. Rikkunshito (RKT) is a herbal medicine, which has been widely used for FD in Asia; however, the evidence is lacking. We carried out systematic review and meta‐analysis to evaluate the effect and safety of RKT in the treatment of FD. Methods Electronic databases were searched in April 2019, including PUBMED, EMBASE, and Cochrane Library. All eligible studies should be randomized controlled trials (RCTs) comparing RKT or combination therapy (RKT and western medicine) group to western medicine group. The primary outcome measure was the total clinical efficacy rate (TCE). The secondary outcomes were total dyspepsia symptom scale, gastric emptying rate, gastrin, motilin, recurrence 6 months after treatment, and Hamilton depression rating scale. Results Fifty‐two RCTs with 5475 patients were involved in this systematic review and meta‐analysis. Compared with western medicine, RKT showed significant better result, with higher TCE (relative risk = 1.21, 95% confidence interval 1.17 to 1.25, P

Primary pancreatic lymphoma (PPL) is extremely rare, comprising fewer than 1% of non-Hodgkin lymphomas. The most common histological subtype of PPL is diffuse large Bcell lymphoma (DLBCL). A 46-year-old man presented with indigestion, epigastric pain, and weight loss for 2 months. Abdominal computed tomography showed a well-defined hypodense mass located at the pancreas head involving the stomach, as well as enlargement of several mesenteric and perigastric lymph nodes. Histological examination was performed by upper gastrointestinal endoscopy of the stomach and endoscopic ultrasound-guided fine-needle aspiration and biopsy of the pancreatic mass. Histology of the pancreatic mass and the stomach revealed pancreatic DLBCL, involving the stomach. The patient received chemotherapy and is currently in complete remission. We report a rare presentation of DLBCL, appearing as a primary pancreatic tumor involving the stomach, which we presume is the first such report in South Korea. (Korean J Med 2020;95:281-286)

Background Little is known about how the menstrual cycle affects gastrointestinal function and self-reported stress in young, healthy women taking oral contraceptives (OC). This study prospectively characterized gastrointestinal function and symptoms on each day throughout the menstrual cycle. Methods Healthy women aged 18–35 years (n = 78) who took OC participated in the 5-week observational study. Stool frequency, self-reported stress, stool form measured by the Bristol Stool Form Scale (BSFS), and gastrointestinal symptoms measured by a modified version of the Gastrointestinal Symptom Rating Scale (GSRS) were assessed daily. GSRS scores were reported (1 = no discomfort at all, 7 = very severe discomfort) and were averaged for individual syndrome scores or summed for the total score. The validated, weekly version of the GSRS was completed at two time points to reflect menstruation and 1 week prior to menstruation (n = 72). Outcomes were analyzed in linear mixed models with the Dunnett’s post hoc test against day 1 of menstrual bleeding or with nonparametric tests. Results Daily stress (P = 0.0018), BSFS score (P = 0.0493), stool frequency (P = 0.0241), abdominal pain (P P = 0.0022), constipation (P = 0.0446), reflux (P = 0.0193), and indigestion (P P P P = 0.002] and abdominal pain [2.00 (1.33–2.67) vs 1.67 (1.33–2.33), P = 0.011] syndrome scores. Conclusion Bowel habits appear to vary across the menstrual cycle and suggest more gastrointestinal discomfort on day 1 of menstrual bleeding in healthy women taking OC. Future interventional studies could identify ways to improve gastrointestinal symptoms in healthy women during menstruation.

Gastrointestinal (GI) problems affect half of Western populations. Symptoms can vary from frequent reflux to irritable bowel syndrome. The Nutrition Care (NC) Gut Relief Formula contains a combination of herbs and nutrients including curcumin, Aloe vera, slippery elm, guar gum, pectin, peppermint oil, and glutamine shown to benefit the GI system. The 16-week pre-post study tested the hypothesis that the NC Gut Relief Formula would be tolerable and effective in improving GI symptoms and gut health in adults with digestive disorders. A total of 43 participants completed the study. After a control phase, participants took 5 g/d and then 10 g/d of the formula for 4 weeks. GI symptoms and GI health were assessed by a series of validated questionnaires, for example, Leeds Dyspepsia Questionnaire, Bristol Stool Chart, Birmingham IBS Symptom Questionnaire, and by intestinal permeability and gut microbiota profile. The NC Gut Relief Formula significantly improved the frequency and severity of upper and lower GI symptoms by 60%-80%, including indigestion, heartburn, nausea, constipation or diarrhea, abdominal pain, and troublesome flatulence, and significantly improved physical functioning, energy levels, mood, and sleep by 60%-80%. All participants with normal stool, 90% with hard stool, and 66% with soft stool recovered from intestinal permeability, evident by normal lactulose to mannitol ratios. The NC Gut Relief Formula generally improved microbial profile, with a marked increase in Lactobacillus, Clostridium, and Faecalibacterium prausnitzii. Almost half of the participants with upper GI symptoms taking proton pump inhibitors for heartburn no longer required proton pump inhibitors at the end of the study. A third of participants were able to reintroduce food triggers, such as fermentable oligosaccharides, disaccharides, monosaccharides, and polyols garlic, onion, and beans, or reflux-causing acidic/spicy foods, for example, citrus, tomato, and caffeine, in their diet after 3 months without symptom aggravation. The NC Gut Relief Formula significantly improved GI symptoms and associated quality of life over 3 months while reducing intestinal permeability, improving the microbial profile, reducing the need for reflux medication, and enabling the consumption of previous food triggers.

BACKGROUND: Reflux symptoms including various extra-esophageal manifestations are commonly reported after esophagectomy. However, the intensity and presentation of reflux are both diverse and variable by patients. In this study we assessed reflux symptoms using the reflux symptom index (RSI) questionnaire in patients who underwent esophagectomy for esophageal cancer to order to identify the prevalence of significant reflux and its risk factors. METHODS: From April 2017 to July 2017, we investigated patients who underwent esophagectomy for esophageal cancer. The severity of reflux was evaluated with a self-administered nine-item outcomes instrument (score: 0 to 5). An RSI score ≥13 was considered significant reflux. Multivariable analysis was conducted to identify risk factors. RESULTS: A total of 151 patients was included (mean age, 64.1±8.8 years; male, n=136, 90.1%). The median time after esophagectomy was 22.6 months. The question regarding heartburn, chest pain, indigestion, or acid coming up was most frequently responded (n=104, 68.9%) with 41 (27.2%) patients presenting significant reflux (mean RSI score, 19.9±6.3). Time after esophagectomy

OBJECTIVES: The current study aimed to examine the cross-sectional association between shift work and gastritis using endoscopic evaluation. METHODS: We collected questionnaire data from 964 non-shift workers and 290 shift workers aged 22–40 years at an electronics company, comprising age, smoking status, alcohol consumption, physical activity, occupational stress, and gastrointestinal symptoms. We performed a gastroendoscopy of participants. Along with describing the gastroendoscopic results, we analyzed the correlations between gastritis and shift work using multiple logistic regression analysis. RESULTS: In terms of gastrointestinal symptoms, night shift workers complained more of indigestion than non-shift workers (P

Gastrointestinal (GI) dysfunction is prevalent in Parkinson’s disease (PD). Symptoms are evident throughout the disease course, affect the length of the GI tract and impact on patient quality of life and management. We clarify real-life differences in the frequency and severity of GI symptoms in a cohort of PD and healthy control (HC) subjects. 103 PD patients were compared to 81 HC subjects. Outcome measures collected from validated questionnaires included constipation severity, upper and lower GI symptoms and physical activity. PD patients were three-times more likely to experience constipation than HC subjects, (78.6% vs 28.4%), exhibited a fourfold increase in constipation severity and formed harder stools. PD patients also reported increased symptoms of indigestion, nausea, excessive fullness and bloating, compared to the HCs. A higher mean Leeds Dyspepsia Questionnaire score for PD patients (8.3 (standard deviation (SD) 7.7) vs 4.6 (SD 6.1), p = 0.001)) indicated increased symptom severity. Chronic pain was more frequently reported and correlated with constipation and upper GI dysfunction, being more prevalent and severe in women. Physical activity was notably decreased in the PD cohort (1823.6 (± 1693.6) vs 2942.4 (± 2620.9) metabolic equivalent-minutes/week, p = 0.001) and correlated with constipation severity. PD therapies were associated with increased fullness and bloating and harder stools. PD patients report more prevalent and severe GI dysfunction, although our cohort comprised of many later-stage participants. Earlier recognition of GI dysfunction in PD provides the opportunity to direct treatment for chronic pain and constipation, promote physical activity and rationalise PD therapies for optimal patient care.

Now a day, there are so many changes in life style, behavior and diet. To achieve our desires in limited time produces different types problems like anxiety, worry, anger, depression. In modern medical science symptomatology of Amlapittais equivalent to the features of hyperacidity. Hyperacidity and its complications pose a major threat to future public health resources throughout the world. The Ayurvedic management of Amlapitta aims not only control acid secretions in body but also to treat the root cause of the disease. People don’t follow rules like Dincharya and Rutucharya.Peoples are not awair of Rules of consumption of food which are described in “Aharvidhivishayatan” by Acharya Charak. Because of this all factor causes physiological disorders, which causes Annavaha stratus drusti which cause Mandagni and if the hetu sevan is goes on then it cause Ajeerna which ultimately leads to Aamvish .When Aamvish mixed with pittadi dosha, the original KattuRasa of Pitta changes to amla causes amalapitta disease. Amalapitta is characterised by features like Avipaak (indigestion), Klama (tridness), Utklesha (nausea), Tiktta Amlaa Udagar (sour and bitter belching), gauravata (Heaviness) ,Hrudhkantha daha (Heart and throat burning),and Aruchi. These clinical features are closely related to functional dyspepsia. All these symptoms if left untreated may produces Gastrointestinal disorder like peptic ulcer disease .Many disease like Grahani,skin disease like Shitpitta,Udard occurs as complication of Amlapitta. While describing the progonosis of Amlapitta , it has been stated that it can cured easily if promptly treated as earliest with proper Pathyapathya. The etiological factors like Abhojana, Atibhojana, ganigraha, PanchakarmaVyapat and seasonal variation etc. cause vitiation of Doshas and Agni which ultimately results Mandagni which is treated as mother of all the diseases. This Mandagni leads to Avipaka and due to Avipaka even light and small meals are not digested. This undigested and ill digested food gets shuktatva which leads to the formation of Annavisha. This Annavisha is manifestated in the form of Ajirna . As per Charaka it is said that when diet is not properly digested it gets formented and forms Annavisha. This Ama when mixed with Pitta then it develops the disease Amlapitta.

Gastric adenocarcinoma is uncommon among young Nigerians. We present Mrs O.V. a 41year old Nigerian who presented with one year history of recurrent epigastric pain that was peppery/burning in nature, non-radiating, aggravated by eating and temporarily relieved with the use of antacids. There is associated progressive weight loss and secondary amenorrhea since the onset of her illness. She started vomiting two weeks prior to presentation which was non-projectile, containing both recently ingested meals and partially digested stale food substances, vomitus was non-bilous. Episodes of vomiting is usually preceded by abdominal bloating or feeling of indigestion. Clinical examination revealed a chronically ill-looking young woman with a positive succussion splash on abdominal examination. Examination of the other systems was normal. Provisional diagnosis was suspected Chronic Gastric Antral Ulcer complicated by Gastric Outlet Obstruction to rule out Gastric Antral Adenocarcinoma. Abdominal ultrasound and CT scans showed features consistent with Gastric Outlet Obstruction. Upper GI Endoscopy revealed Gastric Antral Adenocarcinoma with Duodenal extension and Chronic Duodenal Ulcer complicated by Gastric Outlet Obstruction. Histology showed well differentiated Gastric Antral Adenocarcinoma. She had a Bilroth II procedure(Partial Gastrectomy and Gastro-Jejunostomy)and was commenced on adjunct chemotherapy: FAM regimen(5-Fluorouracil, Adriamycin and Mitomycin). She was also placed on long term proton pump inhibitor therapy. She has sustained remarkable clinical improvement with resolution of all her initial symptoms and she is currently on regular clinic follow-up. More cases of Gastric Adenocarcinoma among young Nigerians are being reported. There is a need for more extensive studies on this and possibly an indication for commencing endoscopy screening at an earlier age among individuals presenting with recent onset dyspepsia. Key words: Gastric, Adenocarcinoma, Young, Nigerians.

Background: The gastrointestinal symptom score (GIS) is used in a standardized form to ascertain dyspeptic symptoms in patients with functional dyspepsia in clinical practice. As a criterion for evaluating the effectiveness of a treatment, the change in the summed total point value is used. The total score ranges from 0 to 40 points, in which a higher score represents a more serious manifestation of the disease. Each symptom is included with equal importance in the overall evaluation. The objective of this study was to test this assumption from a patients’ perspective. Our aim was to measure the priorities of patients for the ten gastrointestinal symptoms by using best–worst scaling. Method: A best–worst scaling (BWS) object scaling (Case 1) was applied. Therefore, the symptoms of the GIS were included in a questionnaire using a fractional factorial design (BIBD—balanced incomplete block design). In each choice set, the patients selected the component that had the most and the least impact on their well-being. The BIB design generated a total of 15 choice sets, which each included four attributes. Results: In this study, 1096 affected patients were asked for their priorities regarding a treatment of functional dyspepsia and motility disorder. Based on the data analysis, the symptoms abdominal cramps (SQRT (B/W): −1.27), vomiting (SQRT (B/W): −1.07) and epigastric pain (SQRT (B/W): −0.76) were most important and thus have the greatest influence on the well-being of patients with functional dyspepsia and motility disorders. In the middle range are the symptoms nausea (SQRT (B/W): −0.69), acid reflux/indigestion (SQRT (B/W): −0.29), sickness (SQRT (B/W): −0.26) and retrosternal discomfort (SQRT (B/W): 0.26), whereas the symptoms causing the least impact are the feeling of fullness (SQRT (B/W): 0.80), early satiety (SQRT (B/W): 1.54) and loss of appetite (SQRT(B/W): 1.95). Discussion: Unlike the underlying assumption of the GIS, the BWS indicated that patients did not weight the 10 symptoms equally. The results of the survey show that the three symptoms of vomiting, abdominal cramps and epigastric pain are weighted considerably higher than symptoms such as early satiety, loss of appetite and the feeling of fullness. The evaluation of the BWS data has illustrated, however, that the restrictive assumption of GIS does not reflect the reality of dyspeptic patients. Conclusions: In conclusion, a preference-based GIS is necessary to make valid information about the real burden of illness and to improve the burden of symptoms in the indication of gastrointestinal conditions. The findings of the BWS demonstrate that the common GIS is not applicable to represent the real burden of disease. The results suggest the potential modification of the established GIS by future research using a stated preference study.

Amavata is term derives from the word as Ama and vata.Ama is a type of metabolic toxin; it is an essential factor in development of pathology.Mandagni (low digestive fire) produce Ama in the body,when ama get associated with vitiated vata and starts circulating in the body accupies in shleshmal sthana(asthi sandhi) results in painful disease Amavata. Madhavakara (900 AD) has identified first time the disease.Amavata as seprate entity and discribed the disease in detail.Madhavakara describes etiopathology of amavata that the person with weak digestion (Mandagni) if he is posseses a secondary life (nishchalasya)or if he indulges into virrudha aaharaand vihara e.g.excessive exercise after taking heavy and fatty food,ama is produced and vata get vitiated. This ama provoks by vata (Vayuna preritah),Circulates in the body especially towards shleshmal sthanas. the resultant of cardinal symptoms of amvata are painful swelling of the joints (sarujashotham ) of hands,feet,ankle,knee,hip,Spinal column,and stiffness(jadyata),fever( Jwara),loss of appetite (aruchi),indigestion (apaka),Constipation(vibandhata),gurguling(antrakujanam)etc. this impairs the day to day functions of person.in spite of presence of NSAID,DMRD,steroids etc. the rheumatology remains refractory to treatment but Ayurvedic drug which are therapeutically safe and effectiveness.

By its nature, Gulf war illness (GWI) is multisymptomatic and affects several organ systems in the body. Along with other symptoms, veterans who suffer from GWI commonly report chronic gastrointestinal issues such as constipation, pain, indigestion, etc. However, until recently, most attention has been focused on neurological disturbances such as cognitive impairments, chronic fatigue, and chronic pain among affected veterans. With such high prevalence of gastrointestinal problems among Gulf war (GW) veterans, it is surprising that there is little research to investigate the mechanisms behind these issues. This review summarizes all the available works on the mechanisms behind gastrointestinal problems in GWI that have been published to date in various databases. Generally, these studies, which were done in rodent models, in vitro and human cohorts propose that an altered microbiome, a reactive enteric nervous system or a leaky gut among other possible mechanisms are the major drivers of gastrointestinal problems reported in GWI. This review aims to draw attention to the gastrointestinal tract as an important player in GWI disease pathology and a potential therapeutic target.

A geriatric German shepherd dog was presented for indigestion and ascites. The dog was lethargic, had tachycardia with intermittent vomiting, episodes of weakness, occasional pulse deficits, and anorexia. Radiography, ultrasonography, quick assessment tests, and a complete blood (cell) count (CBC)/biochemistry panel indicated internal hemorrhage and potential problems with hemostasis. The dog was euthanized. A necropsy, with histopathology confirmed diagnosis of splenic hemangiosarcoma.

Background: There are a variety of treatment regimens containing several antimicrobial compounds to treat Helicobacter pylori infection. Objectives: The aim of this study was to eradicate H. pylori infection in patients with gastrointestinal problems after the administration of a four-drug regimen. Methods: This study was performed among 100 patients with gastrointestinal problems visiting Imam Khomeini Hospital in Urmia, Iran. The data were collected using a checklist that included patient information and analyzed by chi-square and t-test. Results: Out of the 100 patients visiting the clinic, 60 (60%) were male, and the rest were women. Also, 67% of the patients had pain type dyspepsia, and 33% of them postprandial distress type. In pathologic study, 38% of the patients had H. pylori infection, with a significantly higher incidence in patients with pain type dyspepsia. Conclusions: The results showed a relationship between the type of indigestion and the improvement of symptoms after receiving a four-drug regimen, indicating the need for proper planning to diagnose and treat the type of indigestion.

Despite the continuing decline in incidence, stomach cancer remains one of the most common and deadly neoplasms in the world [1]. According to the literature, stomach cancer is the third leading cause of cancer deaths worldwide, ranking third after lung cancer and colorectal in global cancer mortality. About 1 in 12 neoplasm deaths can be attributed to stomach cancer, which has 5 times the highest incidence among all cancers, and over one million new cases of stomach cancer are diagnosed each year worldwide.[2] Our objectives were: Evidence and detailed statistical description of demographic, diagnostic, clinical, pathological data of stomach cancer patients are included in this study were hospitalized in two clinical surgery medical centers in the period from January 2009 to January 2019, in University Clinical Center in Prishtina-Department of Surgery, Regional Hospital in Ferizaj-Department of Surgery. Material and methods; The study included 115 patients who met the criteria, and the Study variables were obtained from clinical record data that include: Gender (Male, Female); Age; Clinic of the disease: (indigestion Weakness, Weight loss, anorexia, Melena, Abdominal pain, Epigastric pain, Vomiting…); Tumor stage, histopathologic and lesion type... Conclusion; Stomach cancer affects both sexes with a preference of men with a ratio of 1.4: 1 (M; F). The most affected age group is 51-70 years which includes about 61.3% of patients. Depending on the localization of gastric cancer, the most affected part of our study was the body of the stomach (46%), the antral part 38%, the cardia part with 15.7%. Typical symptoms in our patients included; Indigestion 46 (40%); Loss of appetite 41 (35.6%); Abdominal pain 70(60.8%); Nausea/ vomiting 35( 30.4%); Postprandial pain 39 (33.9%); Weight loss 56 (48.6%); Melena 19 (16.5%)...

Gastrointestinal symptoms (GIS) are common in kidney transplant candidates and recipients and may be worsened by HIV. Objective: To determine the frequency and severity of GIS in HIV-positive kidney transplant recipients from HIV-positive donors, and those waiting to receive one. A GIS rating scale (GSRS) was completed by 76 participants at baseline and at 6 months. GIS frequency was defined as having at least one symptom (GSRS > 1). Severity was indicated by the GSRS score. Transplant candidates: GIS frequency was 88.9% and 86.3% at baseline and 6 months respectively. Indigestion was the most frequent (79.6% and 66.7% at baseline and 6 months), and severe GIS (GSRS 2.3). Women reported global mean (p = 0.030) severity significantly more than men. Transplant recipients: GIS frequency was 95.2% and 76.2% at baseline and 6 months respectively. At both assessment points, indigestion occurred most frequently (85.7% and 61.9% respectively). Highest GSRS was reported for indigestion at baseline (2.33) and at 6 months (1.33). Waist circumference (WC) was positively associated with the severity of constipation GSRS. GIS are common in both groups, especially indigestions. WC in transplant recipients should be monitored.

Hochu-ekki-to (HET) is a traditional Japanese herbal (Kampo) medicine for the treatment of severe weakness, loss of appetite, and indigestion in elderly patients and for the prevention of opportunistic infections. The impact of HET on patients with chronic wounds refractory to conventional therapies was investigated in a prospective, randomized trial, including 18 patients divided into medication (7.5 g oral HET per day, n = 9) and control (n = 9) groups. Wound healing during the 12-week study period was scored based on depth, exudate, size, inflammation/infection, granulation tissue, necrotic tissue, and pocket size. At 12 weeks, wound healing progressed in all nine patients in the medication group, whereas wound healing progressed in only three patients in the control group (significant difference, p < 0.01; relative risk: 3.00). In the medication group, the total score decreased significantly at 8 weeks and later. To the best of our knowledge, this study was the first to show that HET promoted the healing of chronic wounds resistant to conventional treatments. HET may be a choice as an adjunctive therapy for chronic wounds, particularly for patients with malnutrition. This trial was registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN000031620).

Temporal eruption for children is a natural and physiological process. However, in some cases, it may be accompanied by numerous unpleasant symptoms, such as fever, decreased appetite, anxiety, sleep disorders and indigestion. These symptoms nonspecific and may occur in other somatic diseases. The Violation of stages, timing of eruption may be indicated a variety of somatic diseases and the development of further pathology of the dental-jaw system, as well as depends of the child`s constitutional characteristics. In this article we are presents an analysis, which dedicated problems of infant`s tooth eruption. Special attention is paid to the available means for the normalization of pathological symptoms, which accompanied the process of teething. Sometimes, parents try to alleviate the child`s condition and use different means independently, but uncontrolled and prolonged use of NSAIDs and local anesthetics can leads to allergic or toxic effects. Currently, with the help of research, it has been established that the use of herbal preparations is better, they are safer.

Supplemental digital content is available in the text., Objectives Pancreatic cancer (PC) and its treatments can result in pancreatic exocrine insufficiency that requires pancreatic enzyme replacement therapy (PERT). Appropriate PERT usage is during meals and snacks. The aim was to determine the frequency of appropriate use of PERT and its impact on symptom alleviation in PC through a patient-reported outcomes online platform. Methods Users in the Pancreatic Cancer Action Network's Patient Registry were prompted to answer a standalone questionnaire about their experience with PERT. Results Two hundred sixty-two users completed the PERT questionnaire (January 2016–January 2018). Patients who reported taking PERT with meals had higher alleviation of symptoms compared with those taking PERT prior to or after meals. Specifically, “feeling of indigestion,” “light-colored or orange stools,” and “visible food particles in stool” were significantly decreased. Patients taking PERT with meals reported weight gain and less weight loss. Conclusions Of the 89% of PC patients prescribed PERT, 65% were prescribed PERT appropriately with all meals and snacks. Overall compliance with PERT administration guidelines was low (50% [105/208]). Improvement in symptoms significantly correlated with appropriate use of PERT. Increase in PC patient and provider education about appropriate PERT usage and administration is warranted.

Case Presentation A 70-year-old lifelong nonsmoking woman with a past medical history of hypertension was referred to the respiratory clinic for evaluation of chronic cough. She presented with a 5-month history of dry cough, night sweats, fatigue, and a 4.5-kg weight loss. Her cough tended to be worse while lying flat. She denied having shortness of breath, chest pain, wheeze, or hemoptysis. She was taking amlodipine for her blood pressure as well as omeprazole for indigestion. She denied having any reflux symptoms or heartburn. She worked as a receptionist for an optician. She did not have any pets at home and had no family history of asthma or allergic conditions. She had not been abroad recently.

Background Despite increased emphasis on patient‐reported outcomes, few studies have focused on abdominal pain symptoms before and after Roux‐en‐Y gastric bypass (RYGB). The aim of this study was to quantify chronic abdominal pain (CAP) in relation to RYGB. Methods Patients with morbid obesity planned for RYGB were invited to participate at a tertiary referral centre from February 2014 to June 2015. Participants completed a series of seven questionnaires before and 2 years after RYGB. CAP was defined as patient‐reported presence of long‐term or recurrent abdominal pain lasting for more than 3 months. Results A total of 236 patients were included, of whom 209 (88·6 per cent) attended follow‐up. CAP was reported by 28 patients (11·9 per cent) at baseline and 60 (28·7 per cent) at follow‐up (P

The article presents clinical, laboratory, instrumental data in children with functional biliary dyskinesias. Studies were conducted for the period 2014–2018. on the clinical base of the National Center for Maternal and Child Welfare. The object of the study were 120 children from 7 to 14 years. It has been established that the formation of a symptom complex in most cases is ambiguous and develops against the background of various diseases that were previously experienced. The presence of a large variation in the duration of the disease indicates a delayed diagnosis of pathology. Determining the type of biliary dyskinesia allows you to choose the most effective treatment regimen.

Gastro-oesophageal reflux disease is an unpleasant condition, reported to account for about 5% of GP consultations in western Europe ( United European Gastroenterology, 2018 ). Patients often describe a number of symptoms, which can make identifying the underlying cause challenging. The problem is reported to affect 25% of the population and is two to three times more common in men than in women, with 1% of the population suffering daily symptoms ( Ford and Moayyedi, 2009 ). This article will provide non-medical prescribers an overview of treatment and management and aims to give them more confidence in prescribing for their patients with this condition.

To understand possible medication overprescribing, it would be important to know which classes are the most prescribed, for which indications, for what duration, and for which age groups. Among the 10 most frequently prescribed medication classes for US adults, four were evaluated for overprescribing, and systematically assessed in relation to their primary indication. The assessment included usage patterns, trends, age of recipients, treatment duration, and benefits versus adverse consequences. The findings in this selective review are supported by an extensive search of the medical literature. The four selected medication categories and their most common indication included opioids for chronic pain, proton pump inhibitors for indigestion, levothyroxine for subclinical hypothyroidism, and antidepressants for subsyndromal levels of depression. These medications, grouped by their most frequent indication along with polypharmacy, have experienced major prescription increases in recent years, particularly among older patients. Most concerning is that they have been frequently prescribed for extended periods, usually with inadequate evidence of benefit. High drug usage patterns can aid in quantifying overprescribing within polypharmacy by age group.

Alendronate is a drug of the bisphosphonate group used for the treatment and prevention of osteoporosis in postmenopausal women. However, when given orally, alendronate can cause indigestion and osteonecrosis of the jaw. It also has a poor bioavailability. Taking these disadvantages into account, an injection formulation of alendronate was created in this study to act on the site locally. Beside alendronate, the injection also contains bovine hydroxyapatite and gelatin as alendronate carriers. Both, besides being able to act as carriers, are also able to reduce bone damage caused by osteoporosis. The aim of this study was to determine the effectiveness of alendronate injection for fractures caused by osteoporosis in mouse models that were ovariectomized. The parameters used in this study were ALP concentration in blood and bone radiology. The results of ALP concentration showed that there were no significant differences in each group. The average ALP concentration of the negative control group was 277.67 ± 46.090, in the positive control group 270.33 ± 189.716, in the BHA-Gel group 406.33 ± 212.547 and in the BHA-Gel Alendronate group 325.00 ± 73.750. Bone radiology results and macroscopic observations still showed bone defects in each group.Yet in the negative control group, the BHAGel-Alendronate group and the BHA-Gel group, bone defects were almost entirely ameliorated. On the contrary, bone defects were still present in the positive control group. Based on the results obtained, it was shown that the injection of alendronate has not been shown to significantly overcome osteoporosis fractures. Keywords: Osteoporosis, Alendronate, Ovariectomy, Bovine hydroxyapatite, Gelatin

The study included (29) patients with gallstones who were visiting the New Kirkuk Hospital and whose condition was confirmed by conducting pathological examinations and ultrasound examination (sonar) in comparison to (29) healthy subjects.This study aimed on estimating of some chemical variables in blood serum, including measurement of total Bilirubin, direct and indirect Bilirubin. In addition, measuring the activities of Aspartate Aminotransferase (AST/GOT) and Alanine Aminotransferase (ALT/GPT), blood sugar, in relation to the percentage of patients consuming soft drinks, and the state of intestines and stool samples in both male and female for different age groups.A comparison was made between patients with gallstones and was confirmed to have jaundice and patients with gallstones who did not develop jaundice. A significant increase in blood sugar, the levels of total Bilirubin, direct and indirect Bilirubin, Aspartate Aminotransferase (AST/GOT) and Alanine Aminotransferase (ALT/GPT) was observed regardless to the patient’s gender, rate of soft drink consumption, and the bowel condition didn’t have effect in forming gallstone in comparison to healthy subjects.Comparison between patients with gallstones and healthy people has revealed the presence of significant differences in the bowel condition between two groups. Very high levels of total Bilirubin, direct and indirect Bilirubin, Aspartate Aminotransferase (AST/GOT) and Alanine Aminotransferase (ALT/GPT) in patients with lethargy of the intestine and indigestion. However, there were no significant differences in the percentage of blood sugar or the amount of soft drinks consumed between two groups. Gender has no effect on the results obtained.

Purpose Bariatric surgery alters gastrointestinal anatomy. In this exploratory study, the SmartPill® wireless motility capsule (WMC) was used to study changes in gastrointestinal physiology following biliopancreatic diversion with duodenal switch (BPD/DS). Material and Methods Twenty-eight BPD/DS patients (35 ± 11 years, 50% females, body mass index [BMI] 56 ± 5) were to be examined preoperatively and postoperatively. In addition to transit time, appetite control and gastrointestinal symptoms were studied by patient-scored questionnaires (visual analogue scale and Gastrointestinal Symptom Rating Scale (GSRS)). Data was compared to 41 lean unoperated controls. Results About 1.8 years postoperatively, 18 patients (BMI 35.8 ± 8.3) returned for a second WMC test. As expected, small bowel transit time was reduced, from 3.9 ± 1.6 h to 2.8 ± 2.0, p = 0.02, and at both these time points, it was shorter than in lean controls (5.4 ± 1.9 h, p = 0.001). Postoperatively, a trend towards reduced colon and whole gut transit times was seen in BPD/DS-patients, thus approaching those of lean controls. Surprisingly, BPD/DS patients scored higher satiety than controls preoperatively as well as increased hunger and desire to eat postoperatively. Compared to lean, BPD/DS patients reported a higher total GSRS score at both time points (1.2 ± 0.2 vs 1.7 ± 0.6 and 2.3 ± 0.5, p < 0.001). Postoperatively, the scores for diarrhea and indigestion increased. Conclusions The novel use of the SmartPill system in BPD/DS patients gave the expected readouts. Although small bowel transit time was further shortened after BPD/DS, whole gut transit time did not differ from controls. Typical gastrointestinal symptoms were reported postoperatively. Graphical abstract

The circumstances of the illness and death of the great writer Nikolai Vasilyevich Gogol are surrounded with riddles and mysticism. Gogol’s abdominal pain disturbed him throughout his life. He was referring to doctors with complaints of breakdown and pain in different parts of his abdomen. Doctors made assumptions of «catarrh of the intestines», which turned into «typhus», the unfavorable course of gastroenteritis and «indigestion» complicated by «inflammation». The writer himself believed that he had an incurable disease, calling it «the devil sitting in his belly». In his last days, Gogol refused food, water and communication, weakened to the limit both morally and physically. One of the doctors found only «catarrh of the intestines», another one diagnosed inanitione ex gastroenteritis (?). The invited doctors noted the state of extreme exhaustion in the absence of fever and any somatic disease. The consilium offered various medical manipulations — from bloodletting to hypnosis and forced feeding. However, leeches, dousing with cold water, mustard plasters, mercury preparation etc. didn’t help him. He lost consciousness and stopped breathing by morning. An autopsy was not performed, that’s why various hypotheses about his death appeared. Gogol’s death is shrouded in myths that the grave was opened twice; that his skull was removed from the coffin during the second burial; that the body in the coffin was in a half‑bent position, etc. The reason for the popular hypothesis of lethargic sleep was Gogol’s testament, in which he asked to bury him only after the appearance of obvious signs of decay. However, the lethargic sleep of the great writer was impossible, at least because of the technology for making the death mask. Many doctors were inclined to consider Gogol’s complaints as a manifestation of hypochondria. However, the renowned oncologist surgeon P. A. Herzen concluded by describing the symptoms of the disease: the writer died of pancreatic cancer. This explains Gogol’s sharp weight loss («the spine was palpated through the stomach») and a complete rejection of food due to the inability to swallow even a small piece. Severe cachexia is typical for patients with pancreatic cancer. Contemporary medical experts held several analytical meetings and drew conclusion that Gogol’s progressive disease with possible development of pancreatic cancer proceeded from pancreatitis.

The ability to appreciate an unusual comment or minor abnormality can lead people to the correct diagnosis. General malaise and debility, breathlessness, cyanosis and difficulty with particular movements or an abnormal gait are much more obvious during exercise. The full history of the main complaint or complaints must be recorded in detail, with precise dates. It is important to get right back to the beginning of the problem. When a patient complains of indigestion, for example, it is sensible, after recording the history of the indigestion, to move on at this point to other questions about the alimentary system. Patients are rarely able to make useful guesses at the amount of blood vomited up, and the addition of gastric juice makes questions on the volume of blood vomited of little value. Cardiac pain typically begins in the midline behind the sternum, but may occasionally be experienced in the epigastrium.

Background: In the clinical setting, it is not common practice to consider a vector bite, such as from a tick or flea, to be a contributing factor to chronic digestive symptoms. This article investigates associations we have observed among symptomatic patients and positive blood tests for vector-borne illness (VBI). Methods: Patients who visited an urban gastroenterology clinic over a 3-year period were retrospectively reviewed. A total of 270 patients presenting with a constellation of digestive symptoms — and who had no apparent digestive pathology and reported no prior diagnosis or treatments for VBI — were analyzed. Before the initial visit, all patients completed a review of systems medical history form, which comprised 19 gastrointestinal (GI) symptoms and 73 non-GI-related symptoms and conditions. Patients were tested for small intestinal bacterial overgrowth (SIBO) by lactulose breath test. VBI (babesiosis, ehrlichiosis, anaplasmosis, bartonellosis, borreliosis) was established using 1 or more of several blood tests. Odds ratio (OR) analysis determined associations between exposure to VBI, SIBO, and presenting symptoms/conditions. Two age groups (≤ 35 years and ≥ 36 years) were studied using Cochran-Mantel-Haenszel stratum-based test. Results: A higher OR (2.03, 95% CI: 1.5–3.6) was found between patients with ≥ 3 digestive symptoms and positive blood tests for ≥ 1 VBI. Five of the 19 GI symptoms were independently associated with VBI-positive samples: food intolerance, indigestion, nausea/vomiting, constipation, and heartburn. A similar association in patients with ≥ 3 non-GI symptoms (OR: 2.83, 95% CI: 1.3–6.4) was observed. Five of the 73 non-GI symptoms/conditions were independently associated with VBI-positive samples: chest pain, shortness of breath, extremity or joint pain, anxiety, and night sweats. Having ≥3 of any digestive or nondigestive symptoms generated significant relative risk of being VBI-positive. Presence of SIBO alone did not identify significant relative risk for a VBI, and age was not a confounder. Conclusions: Findings revealed an association between positive blood tests for vector-borne illness and chronically symptomatic patients regardless of whether symptoms were digestive or nondigestive. The manifestation of 3 or more gastrointestinal and/or extraintestinal symptoms should raise suspicion for a VBI.

Background and Objectives: Helicobacter pylori (H. pylori) infection impairs quality of life. However, whether eradication therapy ameliorates gastrointestinal symptoms remains questionable. The main objective of this study was to evaluate the influence of H. pylori eradication therapy on gastrointestinal symptoms. Materials and Methods: A total of 140 patients, 59 women and 81 men, with a mean age of 61 and suffering from H. pylori infection in the University Hospital of Split, Croatia, were enrolled in the study. Patients were randomly assigned to either concomitant or hybrid therapies. The Gastrointestinal Symptom Rating Scale (GSRS) questionnaire was completed by patients prior to and after the eradication therapy. Results: In both groups, the total GSRS score improved significantly after therapy. In the concomitant group, the abdominal pain score, reflux symptoms score and indigestion score decreased significantly after therapy. In the group with hybrid therapy, all five groups of symptoms (abdominal pain, reflux symptoms, indigestion, diarrhea and constipation) significantly decreased after therapy. Patients with adverse events had significantly higher total GSRS scores after eradication therapy. Conclusions: H. pylori eradication therapy could alleviate gastrointestinal symptoms regardless of the treatment used, but the favorable effect seemed to be more pronounced after hybrid therapy.

Digestion is a main process of human body. Food is essential for body and digestion, conversion of foodtakes place in digestive tract.AnnavahaSrotasDushti leads to indigestion, anorexia, lack of interest towardsfood which leads to Anorectic disorders like Arsha,Parikartika etc.Contrarily this seems to be an increasingincidence of the commonest of all anal disease, i.e. Haemorrhoids and fissure in ano. Though Sushrutahasdescribed detailed of, however as lifestyle has been changed significantly therefore it is of great importanceto study other causes of Haemorrhoids according to modern era. Hence, the diseases of ano-rectal area arethe commonest of all the diseases of GI tract. This study aimed at Annavahsroto-dushti and its relationin Pathogenesis of ArshaVyadhi and its management.They were well known for time immemorial to thephysician and surgeon due to the worldwide distribution and trouble caused by them.