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Functional dyspepsia (FD) is a common digestive system disease with unclear pathogenesis and no organic lesions. The treatment plan and strategy urgently need to be further explored. Establishing a mature and complete animal model combining FD disease and syndrome can help further explore the pathogenesis of the disease and evaluate the therapeutic effect of traditional Chinese medicine formulas. This study aims to analyze the commonly used animal modeling methods and evaluation indicators for spleen deficiency syndrome, liver depression syndrome, and liver depression spleen deficiency syndrome in FD. The combination of improper diet or excessive fatigue during the modeling process is more conducive to the stability of the model, which is related to modern lifestyle habits. Spleen deficiency is the foundation of FD. Designing mature and complete animal modeling methods for spleen deficiency in FD may provide new treatment directions and better treatment strategies for treating FD. The existing evaluation indicators for the combination of FD disease and syndrome models generally have strong subjectivity and insufficient objective evidence. How to improve the evaluation system for the combination of FD disease and syndrome animal models is a direction that needs to be worked on in the future. [ABSTRACT FROM AUTHOR]

Objective We aimed to investigate the effects of electroacupuncture at "Zusanli" (ST36) and "Taichong" (LR3) on gastrointestinal motility, gastrointestinal hormones, and brain-gut axis in rats with functional dyspepsia (FD). Methods 48 SD rats were randomly divided into a normal control group, a model group, a cisapride group, and an electroacupuncture group, with 12 rats in each group. A mild tail pinch stimulation combined with intermittent food deprivation was used to establish the FD rat model. Body mass, food intake, and sucrose preference rate were recorded before and after modeling to verify the success of the FD model. After modeling, the normal control group and the model group received no intervention; the cisapride group rats were administered cisapride [0.4 g/(kg·d)] by intragastric perfusion for 6 consecutive days as one course of treatment, with a rest day between each course; the electroacupuncture group rats received electroacupuncture stimulation at bilateral "Zusanli" and "Taichong" (DC, dense-sparse wave, 2/100 Hz, 2-5 mA. Electricity was applied for 30 min), with stimulation every 24 h for 6 consecutive times as one course of treatment, with a rest day between each course. After two courses of treatment, samples were collected to compare gastrointestinal motility indices, blood levels of gastrointestinal hormones [motilin, gastrin, serotonin (5-HT), nitric oxide (NO)], serum and tissue levels of endogenous brain-gut peptides [cholecystokinin (CCK), calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY)] in the hypothalamus, gastric antrum, duodenum, colon, and protein expressions of ghrelin and substance P in the hypothalamus, spinal cord, gastric antrum, and colon. Results Body mass, food intake, and sucrose preference rate were lower of the model rats than those of the normal rats (P < 0.05). Compared with the model group, rats in the electroacupuncture group and cisapride group had (i) lower gastric residual rates, higher rates of small intestinal propulsion and gastric slow wave main frequency and power (P < 0.05); (ii)levels of motilin, gastrin, and 5-HT increased, while NO level decreased (P < 0.05); (iii) serum CCK content increased, while CGRP and NPY levels decreased (P < 0.05); (iv) CCK protein positive expression increased, while CGRP and NPY protein positive expression decreased in the hypothalamus, gastric antrum, duodenum(P < 0.05); (v)ghrelin protein expressions increased, and substance P protein expression decreased in the hypothalamus, spinal cord, gastric antrum, and colon (P < 0.05). There were no significant differences in these indicators between the electroacupuncture group and the cisapride group. Conclusion Electroacupuncture at "Zusanli" and "Taichong" can effectively alleviate gastrointestinal motility disorders in FD rats, regulate gastrointestinal hormone levels, reverse abnormal brain-gut peptide expression, and regulate brain-gut interaction balance. [ABSTRACT FROM AUTHOR]

Background: Anxiety is a psychological condition characterized by excessive fear and worry that is difficult to control. Anxiety plays a significant role in causing dyspepsia through the Brain-Gut Axis mechanism. There is still a lack of research on the relationship between anxiety and dyspepsia in Indonesia. Therefore, this study aimed to determine the relationship between anxiety and dyspepsia. Method: This cross-sectional study was conducted on outpatients at Atma Jaya Hospital. The patient characteristic data, including gender, age, highest level of education, and habits, such as eating spicy food, drinking coffee, alcohol consumption, smoking, and NSAID used were collected. The GAD-7 and SF-LDQ questionnaires, which have been validated in Indonesian, were used in this study. Spearman correlation test was used to analyze the data to find the relationship between anxiety and dyspepsia. Results: This study obtained 158 participants. The age range of participants who experienced dyspepsia the most is 19-44 years(77.53%). The majority of those who experienced dyspepsia are female (79.12%). The highest education level of the participants who experienced dyspepsia is a Master's degree (100%). Participants who consumed spicy food accounted for 61.39% while 54.43% consumed coffee, 6.96% consumed alcohol, 12.66% smoked, and 1.90% used NSAIDs. Additionally, 105 participants (66.46%) experienced both anxiety and dyspepsia. The Spearman correlation test results showed a significant relationship between anxiety and dyspepsia (p-value = 0.000) and a moderate correlation (rs = 0.450). Conclusion: There is a moderate correlation between anxiety and dyspepsia. [ABSTRACT FROM AUTHOR]

Background/Aims:Functional dyspepsia (FD) overlapping with other gastrointestinal disorders are quite common. The characteristics of FD overlap in Chinese population with latest Rome IV criteria were unclear. This large-scale outpatient-based study assessed the characteristics of FD overlap in South China. Methods:Consecutive FD patients visited the Gastroenterology Clinic at 2 tertiary medical centers in Hangzhou, China who fulfilled the Rome IV criteria were enrolled. Complete questionnaires related to the gastrointestinal symptoms (Rome IV criteria), Reflux Disease Questionnaire, anxiety and depression, quality of sleep and life, and demographic information were collected. Results: Among the total of 3281 FD patients, 50.69% overlapped with gastroesophageal reflux disease, 21.46% overlapped with irritable bowel syndrome, 6.03% overlapped with functional constipation. FD overlap had higher proportion of single/divorced/widowed rate, high education level, being employed, drinking, night shift, unhealthy dietary habit than FD only (P < 0.05). They had higher frequency of consultation and economic burden, as well as lower scores in quality of life (P < 0.001). Multivariate logistic regression showed that increasing age, female, low body mass index, history of gastroenteritis, anxiety, depression, and poor sleep quality were independent risk factors for FD overlap. Conclusions:FD overlap was quite common in China with high economic burden and poor quality of life, FD patients with history of gastroenteritis, anxiety, depression, and poor sleep quality were more likely to have overlap disorders. Awareness of the physical and psychosocial stressors in overlapping condition would help optimize the management of FD overlap in clinical practice. [ABSTRACT FROM AUTHOR]

Aim: Our objective was to assess the efficacy and safety of adding alpha-pinene (a herbal terpenoid) to quadruple therapy compared to a placebo in improving symptoms and Helicobacter pylori (H. pylori) eradication rates in Functional dyspepsia (FD) patients. Background: FD is a prevalent upper gastrointestinal condition, and no definitive pharmacological treatment is available for its management. Methods: We conducted a randomized, double-blinded, placebo-controlled trial on FD patients diagnosed with H. pylori infection. We collected baseline demographic data and assessed FD symptoms in the participants. Patients were randomly allocated to receive either standard quadruple therapy with α-pinene capsules (0.25 mg/day) or quadruple therapy with a placebo for two weeks. We employed a validated questionnaire, the Short Form Leeds Dyspepsia Questionnaire (SF-LDQ), to evaluate FD symptoms. The eradication rate of H. pylori was compared between the two groups one month after completing the treatment regimens. Any reported adverse drug reactions (ADRs) were documented throughout the trial. Results: Over four months, a total of 66 patients completed the trial. Notably, there were no significant differences in baseline SFLDQ scores between the two groups (p=0.83); however, a significant divergence emerged at the trial's conclusion (p=0.03). The H. pylori eradication rates did not show notable differences between the two treatment arms (p=0.43). Importantly, there were no dropouts from the trial due to ADRs. Among reported ADRs, participants experienced abdominal pain, headache, diarrhea, and a metallic taste, with no significant variance in incidence rates observed between the two groups (p=0.62). Conclusion: These findings suggest that α-pinene could be an effective and safe agent for reducing FD symptoms. [ABSTRACT FROM AUTHOR]

Objective: To determine the role of upper GI endoscopy and gastric biopsy to rule out H. Pylori (in patients with long-standing stomach symptoms), which is a manageable cause of chronic dyspepsia. Methods: This cross-sectional study was conducted at the medical OPD Sheikh Zayed Hospital, Rahim Yar Khan. The sample size was 125 patients, having symptoms of chronic dyspepsia. Endoscopy of the participants has been done after getting informed consent. After histopathological analysis, the results were analyzed by SPSS version 23.0. The presence of H pylori has been evaluated in participants of different age groups, residences, symptoms, and conditions. Results: According to the analysed results, a total of 85 (68%) participants have been diagnosed with the presence of H. Pylori. Prevalence of H. Pylori is highest in the age group of 50 and above i.e. 28 (73.7%), followed by the age group 30-49 43 (67.2%), (p=0.5). There is a slightly higher ratio of H. Pylori in males i.e. 47 (72.3%) than in females i.e. 38 (63.3 Chronic dyspepsia patients who had a gastric ulcer on endoscopy had a dominant proportion of 20 (83.3%) who had H. pylori too on biopsy (p=0.07), similarly, patients who had duodenal ulcers also showed a dominant proportion 29 (80.5%) of a positive result for H. pylori on biopsy (p=0.05). Conclusion: The presence of H pylori was more than in patients above 30 years of age. So, it is better to have an endoscopic investigation to rule out any malignancy. Endoscopy is more beneficial and easily available in most parts of the country. [ABSTRACT FROM AUTHOR]

This is a case report of a 19-year-old nulligravid patient with a choroid plexus papilloma tumor in a mature cystic teratoma in the right adnexal area. The patient, who had abdominal pain and dyspepsia, showed a 9 cm diameter mass with a solid/cystic component, initially interpreted as a dermoid cyst in the right adnexal region. Mature cystic teratoma is a benign germ cell tumor and is common in women during the reproductive period. However, choroid plexus papilloma is a rare brain tumor. The diagnosis of ovarian choroid plexus papilloma can be made with imaging tests such as magnetic resonance imaging or computed tomography, and treatment is usually by surgical removal. Only four cases of ovarian teratoma with choroid plexus papilloma have been informed in the English literature, and this issue is the fifth. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to identify the chemical components of Massa Medicata Fermentata (MMF) in different fermentation methods, analyze its regulatory effects on gastrointestinal propulsion and intestinal flora in mice with food accumulation, and further explore its mechanism of action in the treatment of dyspepsia. Methods: The chemical compositions of three kinds of MMF were identified using the UPLC-Q- Exactive Orbitrap mass spectrometer. A model of spleen deficiency and food accumulation in mice was established. The gastric emptying rate and intestinal propulsion rate were calculated, serum gastrin concentration and cholinesterase activity were measured, and 16S rRNA microbial detection was performed in different groups of mouse feces. Results: The results showed that a total of 95 chemical components were identified from the three MMF extracts, 62 of which were the same, but there were differences in flavonoids and their glycosides, organic acids, and esters. MMF, PFMMF, and commercial MMF could all significantly improve the gastric emptying rate, intestinal propulsion rate, and GAS concentration in the serum of model mice; PFMMF has a better effect, while there was no significant difference in cholinesterase activity among the groups (p > 0.05). The 16S rRNA sequencing results showed that the MMF and PFMMF could increase the content of beneficial bacteria Bacteroidetes and decrease the pathogenic bacteria Verrucomicrobia in the intestines of model mice, while the commercial MMF could not. Discussion: Studies suggest that MMF has a variety of possible mechanisms for improving food accumulation and treating gastrointestinal dyspepsia, which provides reference value for the quality evaluation and clinical application of MMF. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of acupuncture for treating depression and anxiety in patients diagnosed with functional dyspepsia (FD). Methods: PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, Sinomed, and VIP Database were searched until April 30, 2023 for Randomized Controlled Trials (RCTs) comparing acupuncture to placebo or drugs for symptom alleviation. Two independent reviewers conducted the study search, data extraction, and bias risk assessment using the Cochrane Risk of Bias tool. Mean difference (MD), risk ratio (RR), and corresponding 95% confidence intervals (CI) were computed. Subgroup and sensitivity analyses were also performed. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was employed to evaluate the evidence level. Results: A total of 16 RCTs involving 1315 participants were included. Acupuncture demonstrated marked superiority over placebo (MD = -7.07, 95%CI: -11.03 to -3.10, very low quality evidence) in mitigating Self-Rating Anxiety Scale (SAS) scores and was found to be more effective in reducing Self-Rating Depression Scale (SDS) scores than either placebo (MD = -4.63, 95%CI: -6.28 to -2.98, low quality evidence) or first-line drugs (MD = -2.71, 95%CI: -5.19 to -0.23, very low quality evidence). In terms of attenuating Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) scores, acupuncture consistently outperformed both placebo (HAMA: MD = -2.58, 95%CI: -4.33 to -0.83, very low quality evidence; HAMD: MD = -1.89, 95%CI: -3.11 to -0.67, low quality evidence) and first-line drugs (HAMA: MD = -5.76, 95%CI: -10.18 to -1.35, very low quality evidence; HAMD: MD = -5.59, 95%CI: -7.59 to -3.59, very low quality evidence). However, no significant difference was observed between acupuncture and placebo in terms of improvement in Hospital Anxiety and Depression Scale (HADS) scores. Conclusions: Based on current clinical evidence, acupuncture might have a positive effect on depression and anxiety in patients with FD. Further large-sample, multi-center, high-quality RCTs validation are required, as the conclusion is limited by the quantity and quality of the included studies. [ABSTRACT FROM AUTHOR]

Diaphragmatic eventration is commonly seen following high-energy traumas, particularly due to traffic accidents and falls from significant heights. This pathology has the potential to influence both the gastrointestinal and cardiorespiratory systems, presenting with a variety of symptoms. A 45-year-old male patient, with a history of trauma from falling off a tree, sought medical attention at our clinic with dyspeptic complaints and symptoms of shortness of breath. During the physical examination, diminished sounds were detected in the right lung field, along with epigastric tenderness. For diagnostic purposes, a posteroanterior chest radiograph (CXRs) and thoracic computed tomography (CT) scan were obtained. A subsequent bronchoscopy, performed with a pulmonology consultation, revealed decreased diaphragmatic movements. Taking into account the findings, a thoracic surgery treatment plan was devised for the patient. This case report underscores the significance of considering the seldom-encountered pathology of diaphragmatic eventration in patients presenting with dyspeptic and respiratory complaints. Keeping in mind that patients with such symptoms frequently turn to family physicians, it highlights the pivotal role of a multidisciplinary primary care approach in initiating the diagnostic trajectory. [ABSTRACT FROM AUTHOR]

Functional dyspepsia (FD) is a syndrome mostly diagnosed by subjective patients' symptoms after excluding organic, systemic and metabolic diseases. Aim: The goal of this study is to evaluate gastric emptying in patients with functional dyspepsia, by measuring the antral area (cm2) after the intake of a test meal using ultrasonography as an objective and widely applicable method. Material and Methods: This study included 30 patients (mean age of 46.53 ±9.73 years) with symptoms of FD according to the ROMA IV criteria and 30 healthy individuals (mean age of 42.87 ±4.42 years). A 5 MHz ultrasound probe was used to measure the stomach antral area at 6 different time points: in the fasting state, following the meal intake at 5, 30, 60, 90 and 120 min postprandially. Results: The antral area was statistically significantly larger after a 30-minute postprandial period in patients with FD comparing to healthy controls (p<0.05). There was a statistically significant difference in the rate of gastric emptying at 120 minutes in patients with functional dyspepsia, compared to healthy subjects (p <0.01). Patients with postprandial distress syndrome had the average value of gastric emptying 48.25 compared to 56.09 in patients with epigastric pain syndrome (p <0.05). The slowest emptying was observed in patients with nausea and postprandial fullness (p <0.05). Conclusion: Functional dyspepsia is associated with delayed gastric emptying. Using ultrasonography to measure the antral area helps us to assess gastric emptying and therefore to assess patients with functional dyspepsia. The antral area was significantly larger in patients with functional dyspepsia compared to healthy subjects after the test meal, suggesting slower gastric emptying in the dyspeptic patients. Since the diagnosis of functional dyspepsia is based mostly on diverse patients' symptoms, using ultrasonography to measure the antral area helps us to objectively assess this problem. [ABSTRACT FROM AUTHOR]

Background: Almost 80% of individuals with functional dyspepsia experience meal‐related symptoms and are diagnosed with postprandial distress syndrome (PDS). However, studies evaluating dietary modifications in PDS are sparse. We performed a single‐center randomized trial comparing reassurance and diagnostic explanation (RADE) with or without traditional dietary advice (TDA) in PDS. Methods: Following a normal upper gastrointestinal endoscopy, individuals with PDS were randomized to a leaflet providing RADE ± TDA; the latter recommending small, regular meals and reducing the intake of caffeine/alcohol/fizzy drinks and high‐fat/processed/spicy foods. Questionnaires were completed over 4 weeks, including self‐reported adequate relief of dyspeptic symptoms, and the validated Leuven Postprandial Distress Scale (LPDS), Gastrointestinal Symptom Rating Scale, and Nepean Dyspepsia Index for quality of life. The primary endpoint(s) to define clinical response were (i) ≥50% adequate relief of dyspeptic symptoms and (ii) >0.5‐point reduction in the PDS subscale of the LPDS (calculated as the mean scores for early satiety, postprandial fullness, and upper abdominal bloating). Key Results: Of the 53 patients with PDS, 27 were assigned RADE‐alone and 26 to additional TDA. Baseline characteristics were similar between groups, with a mean age of 39 years, 70% female, 83% white British, and coexistent irritable bowel syndrome in 66%. The primary endpoints of (i) adequate relief of dyspeptic symptoms were met by 33% (n = 9) assigned RADE‐alone versus 39% (n = 10) with TDA; p‐value = 0.70, while (ii) a reduction of >0.5 points in the PDS subscale was met by 37% (n = 10) assigned RADE‐alone versus 27% (n = 7) with TDA; p‐value = 0.43. Response rates did not differ according to irritable bowel syndrome status. There were no significant between‐group changes in the gastrointestinal symptom rating scale and dyspepsia quality of life. Conclusions & Inferences: This study of predominantly white British patients with PDS found the addition of TDA did not lead to significantly greater symptom reduction compared with RADE alone. Alternate dietary strategies should be explored in this cohort. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Vagal nerve stimulation (VNS) can be used to modulate gastrointestinal motility, inflammation, and nociception. However, it remains unclear whether VNSis effective in adult patientswith functional dyspepsia (FD). We investigated the effectiveness of transcutaneous auricular VNS (taVNS) in patients with FD. METHODS: Consecutive patients with FD meetingRome IV criteria with modifiedFD Symptom Diary score ‡10 were enrolled. Patients were randomly allocated to 10-Hz taVNS (V10 group), 25-Hz taVNS (V25 group), or sham group, with 30 minutes of treatment twice a day for 4 weeks. The primary outcome was the response rate at week 4, defined as the proportion of patients whose modified FD Symptom Diary score was reduced ‡5 when compared with the baseline. Secondary outcomes included adequate relief rate and adverse events. RESULTS: A total of 300 patients were randomized to V10 (n 5 101), V25 (n 5 99), and sham groups (n 5 100). After 4 weeks of treatment, V10 and V25 groups had a higher response rate (81.2% vs 75.9% vs 47%, both P < 0.001) and adequate relief rate (85.1% vs 80.8%vs 67%, both P < 0.05) compared with the sham group. There was no significant difference between V10 and V25 in response rate and adequate relief rate (both P > 0.05). The efficacy of taVNS (both 10 and 25 Hz) lasted at week 8 and week 12 during follow-up period. Adverse events were all mild and comparable among the 3 groups (1%--3%). DISCUSSION: Our study firstly showed that 4-week taVNS(both 10 and 25 Hz) was effective and safe for the treatment of adult FD (clinicaltrials.gov number: NCT04668534). [ABSTRACT FROM AUTHOR]

Study design: Cross sectional Background: Functional dyspepsia refers to a chronic condition characterized by persistent pain or discomfort in the upper abdomen, bloating, and fullness, which is often accompanied by an unpleasant sensation of satiety even after eating only small amounts of food.The causes of this condition are not yet fully understood, but it may result from a combination of biological, psychological, and environmental factors. Aim: This study aims to assess prevalence of functional dyspepsia among general population in Aseer region, Southern of Saudi Arabia. Methods:A descriptive cross-sectional study (survey-based study) was conducted in Aseer region, southern region, Saudi Arabia. The electronic survey made by Google forms during the period from March-2023to June 2023.The study survey included questions that assess the prevalence, pattern and the effect of functional dyspepsia beside participants socio-demographic data and body mass index. The tool was uploaded online using social media platforms till no more answers were obtained. Results: A total of 277 participants completed the study questionnaire. Participants ages ranged from 15 to more than 55 years with mean age of 25.2 ± 12.9 years old. Exact of 157 (69.2%) were females. A total of 128 (56.4%) had FD of whom 93 (41%) had PDS, and 81 (35.7%) had EPS. Conclusion:In conclusion, the current study estimated high prevalence for FD relative to estimated literature findings but mostly due to variability in used diagnostic criteria. Postprandial distress syndrome was more frequent than epigastric pain syndrome. Females showed higher rates of FD and subtypes than males with unemployment. [ABSTRACT FROM AUTHOR]

This study (ISRCTN17174559) aimed to explore the efficacy and safety of a kind of herbal porridge (Hou Gu Mi Xi) on the clinical symptoms of functional dyspepsia (FD). This was a single‐center, single‐dose, prospective, double‐blind, randomized controlled trial involving 64 participants with FD (35 cases and 29 controls) for 2 months of intervention and 1 month of follow‐up. The 7‐point Global Overall Symptom Scale (GOSS), 36‐Item Short Form Survey (SF‐36), and other indicators were assessed at baseline (day 0), at days 15, 30, and 60 of treatment, and at follow‐up 1 month after the end of the intervention. Many participants with FD achieved remission of their epigastric symptoms at follow‐up on the 90th day after treatment with herbal porridge compared to the placebo group (45.71% vs. 20.69%, p =.036). Furthermore, herbal porridge appeared to be effective in improving the quality of life of participants with FD, which was reflected in the rising SF‐36 scores for physical role, bodily pain, emotional role, and mental health. Although adverse events were reported, there was no overall difference in the number of adverse events between the two groups (p =.578). Herbal porridge is another effective and safe method for improving the symptoms and quality of life in patients with FD. [ABSTRACT FROM AUTHOR]

Background and Aim: Functional dyspepsia (FD) remains a therapeutic challenge, and the efficacy of antispasmodic agents as adjunctive therapy is not well established. This study aimed to evaluate the efficacy and safety of pinaverium bromide added to omeprazole in treating refractory FD. Methods: We conducted a randomized, placebo‐controlled trial in patients with refractory dyspepsia. Participants were randomly assigned to receive pinaverium (50 mg, 3 times/day, n = 36) or placebo (n = 36) in addition to omeprazole for 8 weeks. The primary endpoint was the responder rate for adequate relief. Secondary outcomes included the Global Overall Symptom Scale (GOSS), quality of life, and safety profile. Results: No statistically significant differences were observed in the adequate relief response rate between the pinaverium bromide and control group at week 2 (58.3% vs. 62.9%, P = 0.697), week 4 (62.9% vs. 78.1%, P = 0.173), week 6 (64.7% vs. 75.0%, P = 0.363), and week 8 (64.7% vs. 75.0%, P = 0.363). Additionally, there were no significant differences observed in the decline of symptom score between the two groups at week 4 (8.4 ± 7.6 vs. 7.7 ± 7.1, P = 0.702) and week 8 (10.9 ± 8.2 vs. 8.4 ± 7.2, P = 0.196). Similarly, there were no significant differences in terms of quality of life between the two groups. Adverse event rates were also comparable between the two groups. Conclusion: Pinaverium bromide was found to be safe in the treatment of refractory dyspepsia, but it did not demonstrate a significant benefit in improving symptoms. [ABSTRACT FROM AUTHOR]

From a physiological standpoint, aging is a progressive reduction in each organ system's capacity to maintain homeostasis in the face of illness or stressors. With advancing age, gastrointestinal (GI) symptoms and signs may increase, not only due to the aging processes but also to the superimposed effects of comorbidities, which can badly affect digestive functions (i.e., diabetes, malignancy, etc.) and environmental exposure. In general, gastrointestinal symptoms in older people more often underlie organic pathologies, while GI functional disorders are less frequently diagnosed in this age group. Moreover, gastrointestinal disease can also present in a nuanced and atypical manner, making the diagnostic hypothesis and, consequently, the correct diagnosis and therapy more challenging. In addition, with reference to this age group, the clinical implications of gastrointestinal pathologies can be more severe due to a decreased physiologic reserve, with a higher risk for malnutrition resulting in falls, depression, social isolation, and a deterioration of functional status. In this review, we focused on the most frequent GI tract disorders, highlighting the main age-related changes, their epidemiological, pathophysiological and clinical implications, and any differences with younger patients. [ABSTRACT FROM AUTHOR]

Taye Kebede,1,2 Hagos Ashenafi2 1Department of Biomedical Sciences and Immunology, Madda Walabu University, Bale-Robe, Oromia Regional State, Ethiopia; 2Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Addis Ababa Administration City, EthiopiaCorrespondence: Taye Kebede, Department of Biomedical Sciences and Immunology, College of Natural Sciences, Madda Walabu University, Bale-Robe, Bale Zone, Oromia Regional State, Ethiopia, Tel +251 0911 355 335, Email tayekebede2012@gmail.comBackground: Helicobacter pylori (H. pylori) is believed to have spread from East Africa, but its burden is still unknown in less privileged regions of Ethiopia. Indigestion is an upset stomach, upper abdomen discomfort, heartburn, and bloating. This study evaluated the burden and risk factors for H. pylori infection among government employees who clinically complained of indigestion but allergic diseases in five public health institutions in Southeastern Ethiopia.Methods: A health facilities-based cross-sectional survey study was conducted in Southeastern Ethiopia from March to November 2022, employing cluster sampling. Blood specimens, clinical data, and semi-structured questionnaires about risk factors were collected. Data analysis was conducted using descriptive, bivariate, and multivariable logistic regression in STATA software, Windows version 16.1.Results: The overall prevalence of infection was found to be 77.6%. The sampled health institution (ρ-value < 0.05), engagement in sideline business (ρ-value < 0.05), sharing local spoon on meal [AOR = 39.30; CI:19.52 − 78.31; ρ-value < 0.001], admitting “Gursha” during meal [AOR = 71.48; CI:3.99 − 1279.77; ρ-value < 0.05], the toilet type [AOR = 1410.98; CI:121.16 − 16,431.19; ρ-value < 0.001], alcohol drinking [AOR = 15.15; CI:1.90 − 120.62; ρ-value < 0.05], sleeping hours length [AOR = 15.01; CI:13.48– 55.96; ρ-value < 0.001], chewing Khat [AOR = 76.73; CI:8.57– 687.07; ρ-value < 0.001], and regular hand washing before eating [AOR = 0.15; CI:0.12– 0.19; ρ-value < 0.05] were the independent predictors of H. pylori infection.Conclusion: The prevalence rate of H. pylori infection in Southeastern Ethiopia is agonizingly high, exceeding the world average by 27.6%, the first report, and seems to be one of the neglected infectious diseases. Hence, the Oromia Region Health Bureau should reinvigorate the basic infectious disease control methods, establish routine laboratory diagnostic platforms, and intervene in selected societal practices spreading infections.Keywords: Burden, determinants of Helicobacter pylori infection, government employees, indigestion, allergic diseases, Southeastern Ethiopia

Background: Breakfast skipping is traditionally viewed as a bad habit. The customary choice for those who skip breakfast is brunch. Changes in gastrointestinal function are correlated with a range of dietary factors. Objective: To evaluate the correlation of the type of first meal of the day with dyspepsia among patients visiting gastroenterology clinics with dyspeptic symptoms. Methods: This cross-sectional study was conducted in the Department of Gastroenterology, Liaquat National Hospital from August 2021 to April 2022. Short-Form Leeds Dyspepsia Questionnaire was used to identify the presence of dyspepsia (SF-LDQ). Breakfast was defined as the meal consumed in the morning and any beverages or food taken in the morning before 11:00 a.m. regularly in a week. Data were analyzed using the statistical package SPSS version 21. Results: A total sample of 390 patients was analyzed in this study with median age and duration of symptoms of 35 (IQR=26- 42) years and 12 (IQR=8-24) months respectively. The frequency of breakfast skipping was 15.6%. The frequency of dyspeptic symptoms including indigestion, heartburn, regurgitation, and nausea was significantly higher among patients taking brunch as the first meal of the day than those who were having breakfast regularly. The frequency of dyspepsia was 75.1%. On univariate and multivariable analysis, the practice of consuming breakfast regularly was found to be associated with a lower risk of dyspepsia than those who were consuming brunch as the first meal of the day. Conclusion: The current study analyzed that type of first meal was significantly associated with dyspepsia. The frequency of dyspeptic symptoms was significantly higher among patients taking brunch at least once a week than patients who were regularly consuming breakfast.

Although functional dyspepsia (FD) is a common functional gastroduodenal disorder with a high socioeconomic burden, little is known about its global prevalence. Thus, we performed a comprehensive study to estimate long-term trends in the prevalence of FD. We searched PubMed/MEDLINE, Embase, and Google Scholar from 1990 to 2022 for population-based studies that reported the prevalence of FD in adults (≥ 18 years old) according to Rome I, II, III, or IV criteria. The prevalence of FD was extracted from included studies to obtain pooled prevalence with 95% confidence intervals (CI) and 95% prediction intervals. Subgroup analysis was performed according to certain characteristics, including geographic region. A total of 44 studies met the eligibility criteria, including 256,915 participants from 40 countries across six continents. The overall global pooled prevalence of FD was 8.4% (95% CI 7.4–.9.5). The prevalence was the highest in Rome I (11.9%; 95% CI 5.1–25.4) and lowest in Rome IV (6.8%; 95% CI 5.8–7.9). Developing countries showed a higher prevalence than developed countries (9.1% versus 8.0%), and prevalence was higher in women, irrespective of the definition used (9.0% versus 7.0%). The pooled prevalence gradually decreased from 1990 to 2020 (12.4% [8.2–18.3] in 1990–2002 versus 7.3% [6.1–8.7] in 2013–2020). The prevalence of FD differs by country, economic status, geographical region, and sex, and the global prevalence has been gradually declining. Despite the heterogeneity of sample population, our study estimates the current global burden of FD and provides information to heath care policy decisions. [ABSTRACT FROM AUTHOR]

Background: Despite evidence that slow‐wave dysrhythmia in the stomach is associated with clinical conditions such as gastroparesis and functional dyspepsia, there is still no widely available device for long‐term monitoring of gastric electrical signals. Actionable biomarkers of gastrointestinal health are critically needed, and an implantable slow‐wave monitoring device could aid in the establishment of causal relationships between symptoms and gastric electrophysiology. Recent developments in the area of wireless implantable gastric monitors demonstrate potential, but additional work and validation are required before this potential can be realized. Methods: We hypothesized that translating an existing implantable cardiac monitoring device, the Reveal LINQ™ (Medtronic), would present a more immediate solution. Following ethical approval and laparotomy in anesthetized pigs (n = 7), a Reveal LINQ was placed on the serosal surface of the stomach, immediately adjacent to a validated flexible‐printed‐circuit (FPC) electrical mapping array. Data were recorded for periods of 7.5 min, and the resultant signal characteristics from the FPC array and Reveal LINQ were compared. Key Results: The Reveal LINQ device recorded slow waves in 6/7 subjects with a comparable period (p = 0.69), signal‐to‐noise ratio (p = 0.58), and downstroke width (p = 0.98) to the FPC, but with reduced amplitude (p = 0.024). Qualitatively, the Reveal LINQ slow‐wave signal lacked the prolonged repolarization phase present in the FPC signals. Conclusions & Inferences: These findings suggest that existing cardiac monitors may offer an efficient solution for the long‐term monitoring of slow waves. Translation toward implantation now awaits. [ABSTRACT FROM AUTHOR]

This paper is framed by Nick Zepke's, Vicki Trowler's, and Paul Trowler's concept of student engagement being "chaotic", suffering from "indigestion" and "fuzziness". This study was conducted at a UK higher education institution that recently moved to a "block and blend" delivery approach. We investigated what students and staff think engagement looks like in an intensive block and blend learning context. Data were gathered from students and staff via an online survey, which consisted of both scaled and openended questions. Findings are synthesised in an elemental map, providing a comparison of students and staff perceptions of engagement. Specifically, students and staff thought engagement in an intensive block and blend context entailed participation and active learning; a mindset that included enthusiasm, interest, focus, and enjoyment; timely completion of assessments; relationships with peers and tutors; doing more than required, such as completing extra readings; and accessing help and support. Participants also identified attendance as an indicator of student engagement and determined that the university has a responsibility to create learning environments to foster student engagement. Overall, the study findings point to elements of student engagement that may be designed into intensive block and blend learning environments. These approaches are also relevant to other similar intensive learning contexts. [ABSTRACT FROM AUTHOR]

Parrot Bornavirus (PaBV) has been reported to cause indigestion and other wasting symptoms such as weight loss and lethargy. The pathogenesis of PaBV has yet to be fully elucidated. This study reports PaBV infections in South Korea and suggests a trend in the genetic information gathered from clinical cases. A total of 487 birds with or without clinical symptoms were tested for bornavirus. Twelve of 361 asymptomatic birds tested positive for bornavirus, while 15 of 126 birds with various symptoms tested positive. A segment of approximately 1,540 bps including the N, X, P and M proteins were obtained from 23 of the positive strains and analyzed with other strains found on GenBank that had clinical information. PaBV was type 2 and 4 in South Korea, and certain amino acid sequences showed a difference between symptom presenting animals and asymptomatic animals in the X protein and P protein. When considering that some asymptomatic cases may have been latent infections at the time of examination, it is plausible these trends may grow stronger with time. Majority of PaBV was type 4 in South Korea. If these trends are confirmed, diagnosis of potentially pathogenic PaBVs in a clinical manner will be possible during the early stages of infection. [ABSTRACT FROM AUTHOR]

Background and Aim: Combining proton pump inhibitors (PPIs) with prokinetics can provide synergistic action in patients with gastroesophageal reflux disease (GERD) and overlapping dyspepsia, but data regarding this is lacking. Methods: This single‐center, prospective study evaluated the efficacy and safety of 6‐week treatment with fixed‐drug combination (FDC) of pantoprazole (PPI) and itopride (prokinetic) in 50 patients with ≥3 month history of GERD and overlapping dyspepsia refractory to pantoprazole. Efficacy was assessed as reduction in GERD symptom assessment scale (GSAS) distress score for 15 symptoms from baseline to week 6. Adverse events (AEs) were monitored up to week 6. Results: Although heartburn was the most common symptom at week 6 (26.8%), its frequency significantly decreased from baseline (84.0%; P <0.01). A similar trend was observed for other symptoms: pressure/discomfort inside chest (19.5%), belching (14.6%), regurgitation (12.2%), bloating (9.8%), flatulence (9.8%), early satiety (7.3%), acidic/sour taste in mouth (7.3%), nausea (7.3%), frequent gurgling in stomach/belly (4.9%), and pressure/lump in throat (2.4%). Mean distress scores of all symptoms markedly decreased at week 6. Three AEs (n = 2) of moderate intensity were reported. Conclusion: The FDC of pantoprazole and itopride showed favorable efficacy and safety in patients with GERD and overlapping dyspepsia refractory to pantoprazole monotherapy. Nevertheless, further studies are warranted. [ABSTRACT FROM AUTHOR]

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The effects of Helicobacter pylori eradication on gastric mucosa-colonizing microbes in patients with functional dyspepsia (FD) remain unclear. Here, we explored microbial variation induced by H. pylori infection and eradication treatment in FD patients. Gastric microbial abundance and diversity were significantly reduced in the H. pylori-infected FD patients. Eradication treatment increased alpha and beta diversity of gastric mucosa-colonizing microbes, and promoted the expansion of several probiotic microbes, such as Leuconostoc mesenteroides, which exhibited a matched antagonistic performance against H. pylori. Significant variation was observed in gastric mucosa-colonizing microbes between H. pylori-positive and H. pylori-negative FD patients. Eradication treatment induced microbial diversity recovery and may provide sufficient nutrition and space for probiotic microbes, such as Leuconostoc mesenteroides. [ABSTRACT FROM AUTHOR]

Current treatment for functional dyspepsia (FD) has limited and unsustainable efficacy. Probiotics have the sustainable potential to alleviate FD. This randomized controlled clinical trial (Chinese Clinical Trial Registry, ChiCTR2000041430) assigned 200 FD patients to receive placebo, positive-drug (rabeprazole), or Bifidobacterium animalis subsp. lactis BL-99 (BL-99; low, high doses) for 8-week. The primary outcome was the clinical response rate (CRR) of FD score after 8-week treatment. The secondary outcomes were CRR of FD score at other periods, and PDS, EPS, serum indicators, fecal microbiota and metabolites. The CRR in FD score for the BL-99_high group [45 (90.0%)] was significantly higher than that for placebo [29 (58.0%), p = 0.001], BL-99_low [37 (74.0%), p = 0.044] and positive_control [35 (70.0%), p = 0.017] groups after 8-week treatment. This effect was sustained until 2-week after treatment but disappeared 8-week after treatment. Further metagenomic and metabolomics revealed that BL-99 promoted the accumulation of SCFA-producing microbiota and the increase of SCFA levels in stool and serum, which may account for the increase of serum gastrin level. This study supports the potential use of BL-99 for the treatment of FD. Functional dyspepsia (FD) is a common chronic gastrointestinal disorder. Here, in a randomized, parallel-group, positive-drug, and placebo-controlled clinical trial, the authors show that supplementation with the probiotic Bifidobacterium animalis subsp. lactis BL-99 (BL-99) improves FD clinical response rate and promotes accumulation of SCFA-producing microbiota. [ABSTRACT FROM AUTHOR]

Background: Functional dyspepsia (FD) is a common disorder characterized by chronic or recurrent upper abdominal pain or discomfort without any structural abnormalities in the gastrointestinal tract. FD is categorized into two subgroups based on symptoms: postprandial distress syndrome (PDS) and epigastric pain syndrome. Summary: The pathophysiology of FD involves several mechanisms. Delayed gastric emptying is observed in approximately 30% of FD patients but does not correlate with symptom patterns or severity. Impaired gastric accommodation is important in the pathophysiology, particularly for PDS. Visceral hypersensitivity, characterized by heightened sensitivity to normal activities, contributes to the perception of discomfort or pain in FD. Alterations to the duodenal mucosa, including impaired mucosal barrier function and low-grade inflammation, are also implicated in the pathogenesis of FD. Microbial dysbiosis and psychological factors such as stress can further exacerbate symptoms. Treatment options include dietary modifications, establishing a physician-patient relationship, acid suppressants, prokinetics, neuromodulators, and behavioral therapies. Dietary recommendations include eating smaller, more frequent meals, and avoiding trigger foods. Acid suppressants are used as the first-line treatment. Prokinetics and neuromodulators aim to improve gastric motility and central pain processing, respectively. Behavioral therapies, including cognitive behavioral therapy and hypnotherapy, have shown benefits for refractory FD. Severe and refractory cases may require combination therapies or experimental treatments. Key Messages: FD is a disorder of gut-brain interaction involving diverse pathophysiological mechanisms. Individualized treatment based on symptoms and responses to interventions is crucial. Further research is needed to improve the understanding of FD and advance the development of effective therapies. [ABSTRACT FROM AUTHOR]

AIM: To investigate the mechanism of action of Wenweiyang decoction （WWYD） in treating functional dyspepsia in rats based on mast cell activation and stem cell factor （SCF）/receptor tyrosine kinase c-Kit signaling pathway. METHODS: Sixty SD rats were randomly divided into control group, model group, ranitidine hydrochloride capsule group, and low-, medium- and high-dose WWYD groups, with 10 rats in each group. The rat model of functional dyspepsia was established by tail clamping and irregular feeding compound senna method. After modeling, the rats in control group and model group were given normal saline, while those in low-, medium- and high-dose（ 0. 743 g/mL, 1. 485 g/mL and 2. 970 g/mL） WWYD groups and ranitidine hydrochloride capsule （3 g/L） group were treated with corresponding drugs by intragastric administration. After treatment, the propulsion rate of the small intestine was measured by the carbon ink propulsion method. Rat duodenal mast cells were observed and counted by toluidine blue staining. ELISA was used for determination of mast cell tryptase （MCT） and histamine （HA） content in rat duodenum. The mRNA levels of SCF and c-Kit in duodenum were detected by RT-qPCR. Western blot and immunohistochemistry were employed to determine the expression levels of SCF and c-Kit in the duodenum. RESULTS: Compared with model group, WWYD treatment significantly increased the propulsion rate of the small intestine in rats （P<0. 05）. ELISA results showed that WWYD reduced the number of mast cells and the content of MCT and HA in the duodenal mucosa tissue of rats （P<0. 05）. Western blot and immunohistochemistry results suggested that WWYD up-regulated the protein expression levels of c-Kit and SCF in the duodenal tissue of rats （P<0. 05）, and increased the numbers of SCF and c-Kit positive cells. RT-qPCR results indicated that WWYD up-regulated the mRNA expression of c-Kit and SCF in the duodenum of rats （P<0. 05）. Moreover, the small intestinal propulsion rate was negatively correlated with MCT and HA content, and positively correlated with the expression of SCF and c-Kit. CONCLUSION: Wenweiyang decoction promotes rat duodenal motility, and its mechanism may be related to the inhibition of rat duodenal MCT and HA production and activation of SCF/c-Kit signaling pathway. [ABSTRACT FROM AUTHOR]

Background/Aims Prokinetic agents and neuromodulators are among the treatment options for functional dyspepsia (FD), but their comparative efficacy is unclear. We aimed to compare the efficacy of mosapride controlled-release (CR) and nortriptyline in patients with FD after 4 weeks of treatment. Methods Participants with FD were randomly assigned (1:1) to receive mosapride CR (mosapride CR 15 mg and nortriptyline placebo) or nortriptyline (mosapride CR placebo and nortriptyline 10 mg) in double-placebo, double-blinded, randomized controlled, parallel clinical study. The primary endpoint was defined as the proportion of patients with overall dyspepsia improvement after 4 weeks treatment. The secondary endpoints were changes in individual symptom scores, anxiety, depression, and quality of life. Results One hundred nine participants were recruited and assessed for eligibility, and 54 in the mosapride CR group and 50 in the nortriptyline group were included in the modified intention-to-treat protocol. The rate of overall dyspepsia improvement was similar between groups (53.7% vs 54.0%, P = 0.976). There was no difference in the efficacy of mosapride CR and nortriptyline in a subgroup analysis by FD subtype (59.3% vs 52.5% in postprandial distress syndrome, P = 0.615; 44.4% vs 40.0% in epigastric pain syndrome, P = > 0.999; 50.0% vs 59.1% in overlap, P = 0.565; respectively). Both treatments significantly improved anxiety, depression, and quality of life from baseline. Conclusion Mosapride CR and nortriptyline showed similar efficacy in patients with FD regardless of the subtype. Both treatments could be equally helpful for improving quality of life and psychological well-being while also relieving dyspepsia. [ABSTRACT FROM AUTHOR]

Background/Aims It has been suggested that STW5 (Iberogast) reduces heartburn symptoms in patients with functional dyspepsia, but underlying mechanisms of action are unclear. The aim of this study is to investigate whether STW5 affects esophageal sensitivity or esophageal motility, thereby reducing occurrence and perception of reflux events. Methods We performed a double-blind, randomized, placebo-controlled, crossover trial in patients with functional dyspepsia (Rome IV) and reflux symptoms. After 4 weeks of treatment with either placebo or STW5, patients were studied with an esophageal acid perfusion test and ambulatory 24-hour pH-impedance monitoring. Results A total of 18 patients (7 men, median age 54, range [19-76]), were included in the study. Although we found no statistical difference in our primary outcome the total Reflux Disease Questionnaire score 2.33 (0.25-4.33) vs 2.67 (1.17-4.00), P = 0.347, "gastroesophageal reflux disease" and "regurgitation" subscale scores were lower after STW5 treatment compared to placebo (P = 0.049 and P = 0.007). There was no statistical difference in number of reflux events, acid exposure time and acid sensitivity scores between STW5 and placebo. In a subgroup analysis of patients with pH-metry confirmed gastroesophageal reflux disease, treatment with STW5 significantly reduced the total number of acidic reflux events (P = 0.028). Moreover, in patients with reflux esophagitis, the median lag time to acid perception increased after STW5 treatment (P = 0.042). Conclusions We found some indications pointing towards a beneficial effect of STW5 on reflux symptoms in dyspeptic patients, with reduction of esophageal hypersensitivity as a potential underlying mechanism. Our findings will have to be confirmed in larger studies. [ABSTRACT FROM AUTHOR]

Context Research on the effects of gluten on dyspeptic symptoms has shown conflicting results. Objective The aim of this systematic review and meta-analysis of clinical trials was to assess the effects of gluten on dyspeptic symptoms. Data Sources A systematic search of the PubMed, ISI Web of Science, Scopus, Cochrane, and Embase online databases was performed up to May 2022. Data Extraction Randomized controlled trials (RCTs) and non-RCTs that examined the impact of a gluten-free diet, a low-gluten diet, or a gluten challenge on dyspeptic symptoms, including early satiety, epigastric pain, bloating, and nausea, were selected independently by 2 authors. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework was used to assess the certainty of the evidence. Results were pooled using a random-effects model and expressed as weighted mean differences (WMDs) and 95%CIs. Data Analysis Of the 7641 citations retrieved, 27 articles (18 RCTs and 9 non-RCTs) were included in the systematic review. Of those, 5 RCTs were eligible for the meta-analysis. The pooled results indicated that gluten challenge significantly increased the severity of bloating (WMD = 0.67; 95%CI, 0.37–0.97; I2  = 81.8%; n = 6), early satiety (WMD = 0.91; 95%CI, 0.58–1.23; I 2 = 27.2%; n = 5), and epigastric pain (WMD = 0.46; 95%CI, 0.17–0.75; I 2 = 65.8%; n = 6). However, the effect of gluten challenge on the severity of nausea (WMD = 0.13; 95%CI, −0.17 to 0.43; I2  = 0.0%, n = 5) was nonsignificant. Conclusion Gluten challenge significantly worsened dyspeptic symptoms, including bloating, early satiety, and epigastric pain, but did not affect nausea. These findings suggest that gluten restriction could be efficient in reducing dyspeptic symptoms. Well-designed large RCTs recruiting homogenous groups of patients with functional dyspepsia are needed to clarify the effectiveness of gluten restriction on dyspeptic symptoms. [ABSTRACT FROM AUTHOR]

Background: Cytokines have been presumed to play an important role in the pathophysiology of functional dyspepsia (FD). Electroacupuncture (EA) has been used for FD treatment; however, its mechanisms remain largely unknown. This study aimed to (1) compare the plasma levels of cytokines, including tumor necrosis factor (TNF)‐α, interleukin (IL)‐1β, IL‐6, and IL‐10, in "FD" rats with normal control rats; (2) investigate whether EA, using chronically implanted electrodes, could inhibit the release of these cytokines; and (3) explore the correlation of cytokine levels with plasma norepinephrine (NE) levels and gastric emptying (GE). Methods: A rodent model of FD was established via neonatal treatment with intragastric iodoacetamide. After 8 weeks, the rats were implanted with electrodes at acupoint ST36 for EA. The plasma levels of cytokines and NE were measured using enzyme‐linked immunosorbent assay. We explored the correlations of cytokine levels with NE levels and GE. Key Results: (i) "FD" rats demonstrated increased levels of TNF‐α, IL‐1β, and IL‐6 (p < 0.05 each) compared with the control rats. (ii) EA significantly decreased the plasma levels of TNF‐α, IL‐1β, and IL‐6 in "FD" rats (p < 0.05 each) compared with sham EA. (iii) The plasma levels of NE were positively correlated with those of IL‐6 (r = 0.86, p < 0.05) and IL‐1β (r = 0.81, p < 0.05), whereas NE levels and GE were negatively correlated with IL‐10 levels (r = −0.870, p < 0.05 and r = −0.791, p < 0.05, respectively). Conclusions: EA inhibits the release of proinflammatory cytokines probably via the suppression of sympathetic activity in "FD" rats. [ABSTRACT FROM AUTHOR]

Background: There is limited data on gastric emptying in dyspeptic children. We aimed to determine solid and liquid emptying rates in dyspeptic children and correlate with clinical characteristics. Methods: Charts of dyspeptic children undergoing 4‐hour dual‐phase gastric scintigraphy were reviewed for demographics, symptoms, and comorbidities. Key Results: In 1078 dyspeptic patients (65% females, median age 13 years) vomiting (55%), nausea (53%), and abdominal pain (52%) were the most common symptoms. The most common comorbidities were mental health (32%), neurologic (27%), and hypermobility spectrum disorders (20%). Solid and liquid emptying rates were aligned in 61.23%. Delayed solid with normal liquid emptying were noted in 2.5%, compared to delayed liquid with normal solid emptying in 26.16%. Abdominal pain had a trend for association with delayed or normal solid emptying (p = 0.06). Nausea was mostly reported with normal solid emptying (p < 0.0001) and underreported in patients <12 years with vomiting (29%). Abnormal solid emptying (rapid and delayed) was noted more frequently in children with mental health disorders (p = 0.027). Rapid liquid emptying was more common in children with genetic disorders (p = 0.032). Conclusion and Inferences: Over half of children with dyspepsia had delayed liquid gastric emptying, and one quarter had delayed liquid with normal solid emptying. Dual‐phase gastric emptying studies may help target therapy in dyspeptic children. Nausea is not a reliable symptom for dyspepsia in younger children. Given the significant association of abnormal gastric emptying in children with mental health disorders, we recommend screening and treating children with dyspepsia. [ABSTRACT FROM AUTHOR]

INTRODUCTION: We investigated the efficacy and safety of virtual reality (VR) for functional dyspepsia. METHODS: Patients were randomized 2:1 between active vs sham VR. Symptoms were assessed using the Patient Assessment of Gastrointestinal Disorders-Symptom Severity Index (PAGI-SYM) over 2-week. RESULTS: Patients in the active VR group had greater numerical improvement in PAGI-SYM scores (mean difference -0.7; P< 0.001) compared with sham VR (mean difference -0.4; P = 0.032). Active VR led to significant improvements for all PAGI-SYM subscales, except lower abdominal pain, whereas sham only improved heartburn/regurgitation and nausea/vomiting. Half of the total patients reported nonserious adverse effects, although only 1 patient withdrew from the study because of adverse effects. DISCUSSION: VR is safe and results in significant symptom improvement in functional dyspepsia. Larger trials are warranted. [ABSTRACT FROM AUTHOR]

Objective: The current study aimed to determine the frequency and associations of depression in patients with & without Functional dyspepsia. Method: This case-control study was conducted at the Dept. of Medicine, RIHS, Islamabad (Jan-June 2023) after ethical approval. Cases & controls (150 each) were selected from outdoor clinics according to inclusion/exclusion criteria & informed consent was obtained. The previous medical record (including findings of upper GI Endoscopy) was reviewed. Selected cases and controls were asked questions from DSM-IV Criteria of Depression. Data was analyzed by SPSS with significant p<0.05. Results: There were 72(48 %) males & 78(52%) females in each group. Mean age was 43.7+13.79 years (FD patients) vs. 46.24+15.27 years (controls). Mean BMI was 24.84+4.18 (FD patients) vs. 25.38+4.52 (controls). There was no significant difference in gender, marital status & background of both groups. There was significantly more depression in FD patients Vs. controls (p<0.05). Among FD patients 57(38%) had major depression, 41(27.33%) minor depression & 52(34.66%) were not depressed. Among controls 41(27.33%) had major depression, 30(20%) minor depression & 79(52.66%) not depressed. Among FD patients, depression wasn't associated with age. Controls above 40 years had significantly higher major depression (p<0.001). Female gender & unemployment were significantly associated with depression in both groups (p<0.05). 49.3% of FD patients were employed vs. 67.3% of controls. Conclusion: The adjustment for gender, age, marital status, BMI, background & monthly income confirmed the association between Functional dyspepsia & depression. Female gender, unemployment and low educational status are possible risk factors for depression among FD patients. As compared to normal healthy people, FD patients are likely to have depression at a younger age. [ABSTRACT FROM AUTHOR]

The article focuses on describing the plant kesum, also known as Persicaria minor, detailing its physical characteristics, common names, and botanical classification within the Polygonaceae family. It discusses the culinary and medicinal uses of kesum, particularly in Malaysian and Southeast Asian cuisines, as well as its cultivation and limited international trade.

In small ruminants, gastrointestinal disorders are serious health and economic issue that cause significant financial loss. GIT dysfunction continues to be the leading cause of animal mortality, slowed weight increase, and decreased productivity in the small ruminant sector. The examination of 110 sheep and goats revealed that 71(65%) suffer from simple indigestion, the rumen is full, solid, and doughy; deep examination rarely causes pain. diarrhea, fewer fasces than usual, and increased direness no widespread response. No systemic reaction. To correct this disorder, recent alternative trends in goat rearing have led to the use of prebiotic, and probiotic treatment by oral administration. selected 10 kids from field cases of goats suffering from indigestion for were divided into 2 groups (group I - group II) and group III of 5 healthy animals as a control group. Group, I treated by AMINO GAR (mannan and B glucan 2g per Kg for 3 days as prebiotic, Group II treated by Digest punch (probiotic lactobacillus acidophilus with bacillus subtilis and bacillus licheniformi as 1ml per Kg for 3 days, taken serum samples to detect biochemical examination for examination of liver function test (AlT and AST, creatinine for rough detection of kidney function. Examination of ruminal fluid and ruminal juice. The results revealed that probiotic and prebiotic give good results for improving ruminal microflora and enhancing digestion, but prebiotic is potent than probiotic and improvement of liver and kidney function but prebiotic group improvement of liver function but non-significant effect on kidney creatinine. [ABSTRACT FROM AUTHOR]

Functional dyspepsia (FD) is commonly known as chronic indigestion and manifests as a group of upper gastrointestinal symptoms such as epigastric pain or burning, postprandial fullness, bloating, belching, nausea, vomiting, and early satiety without any organic or structural cause. In Ayurveda, these symptoms can be considered Ajīrna. A 25-year-old male patient with FD, taking on and off conventional treatment for the past few months without much relief, presented to the outpatient department. As the pathophysiology of FD is complex and multifactorial, it is difficult to manage it only with oral medication. Pawanamuktāsana-II and Vajrāsana were advised, along with Hingwāșțaka Cūrna, to manage the related symptoms. After 4 months of treatment, the signs and symptoms of the disease significantly decreased. The present case report elucidates the role of Yoga as an adjuvant therapy in the Āyurvedic management of FD. [ABSTRACT FROM AUTHOR]

Aim: Dry powder hypertonic saline inhalation use possibilities evaluation in moderate asthma and functional dyspepsia patients. Materials and Methods: 68 moderate asthma and functional dyspepsia patients were examined and treated according to the standard protocols, serum and erythrocytes membrane fatty acid levels were evaluated. The groups of patients with (n=35) and without (n=33) additional dry powder hypertonic saline inhalation use were compared after 1 month. Results: After additional use of dry powder hypertonic saline inhalations vs only standard treatment the rate of well controlled asthma was 3 fold higher with significantly higher FEV1. We also observed positive dynamics of serum arachidonic and docosahexaenoic acids levels indicating resolution of inflammatory reaction with erythrocytes membranes linoleic acid level normalization (source of antiinflammatory cytokines synthesis) among patients with dry powder hypertonic saline inhalation use vs without it. Among patients who used only standard therapy compared to the control group, the erythrocytes membrane linoleic acid level remained decreased with high serum arachidonic and docosahexaenoic acids levels. Follow-up results (after 1 year) showed a significant decrease in exacerbations frequency among patients who underwent dry powder hypertonic saline inhalation vs only the standard treatment. Conclusions: Among moderate asthma patients with functional dyspepsia use of dry powder hypertonic saline inhalation therapy additionally to the standard treatment allows to improve not only clinical and functional parameters but serum and erythrocytes membranes fatty acids spectrum as well leading to the systemic inflammatory reaction reduction and exacerbations prevention in remote period. [ABSTRACT FROM AUTHOR]

Functional dyspepsia (FD) is a common functional gastrointestinal disorder. The pathophysiology remains poorly understood; however, alterations in the small intestinal microbiome have been observed. Current treatments for FD with drugs are limited, and there are certain safety problems. A class of active probiotic bacteria can control gastrointestinal homeostasis, nutritional digestion and absorption, and the energy balance when taken in certain dosages. Probiotics play many roles in maintaining intestinal microecological balance, improving the intestinal barrier function, and regulating the immune response. The presence and composition of intestinal microorganisms play a vital role in the onset and progression of FD and serve as a critical factor for both regulation and potential intervention regarding the management of this condition. Thus, there are potential advantages to alleviating FD by regulating the intestinal flora using probiotics, targeting intestinal microorganisms. This review summarizes the research progress of probiotics regarding improving FD by regulating intestinal flora and provides a reference basis for probiotics to improve FD. [ABSTRACT FROM AUTHOR]

Numerous adolescents diagnosed with adolescent idiopathic scoliosis (AIS) often manifest symptoms indicative of functional gastrointestinal disorders (FGIDs). However, the precise connection between FGIDs and AIS remains unclear. The study involved adolescents drawn from sample datasets provided by the Korean Health Insurance Review and Assessment Service spanning from 2012 to 2016, with a median dataset size of 1,446,632 patients. The AIS group consisted of individuals aged 10 to 19 with diagnostic codes for AIS, while the control group consisted of those without AIS diagnostic codes. The median prevalence of FGIDs in adolescents with AIS from 2012 to 2016 was 24%. When accounting for confounding factors, the analysis revealed that adolescents with AIS were consistently more prone to experiencing FGIDs each year (2012: adjusted odds ratio (aOR), 1.21 [95% confidence interval (CI), 1.10–1.35], p < 0.001; 2013: aOR, 1.31 [95% CI, 1.18–1.46], p < 0.001; 2014: aOR, 1.24 [95% CI, 1.12–1.38], p < 0.001; 2015: aOR, 1.34 [95% CI, 1.21–1.49], p < 0.001; and 2016: aOR, 1.35 [95% CI, 1.21–1.50], p < 0.001). These findings suggest that AIS is correlated with an elevated likelihood of FGIDs, indicating that AIS may function as a potential risk factor for these gastrointestinal issues. Consequently, it is recommended to provide counseling to adolescents with AIS, alerting them to the heightened probability of experiencing chronic gastrointestinal symptoms. [ABSTRACT FROM AUTHOR]

Background: There is no study evaluating the association between exercise and functional dyspepsia (FD) based on the Rome IV criteria. We aimed to investigate the prevalence of FD and evaluate the association between exercise and FD based on Rome IV criteria among a sample of Chinese armed police recruits. Methods: An on-site questionnaire survey on FD among a sample of Chinese armed police recruits was conducted based on the Rome IV criteria in 2021. Potential confounders included age, body mass index (BMI), race, marriage, education, smoking, and drinking variables were adjusted. Results: A total of 2594 recruits were enrolled, including 46 FD participants and 2548 non-FD participants. In the model adjusted for all demographic variables among participants excluding irritable bowel syndrome (IBS) and functional constipation (FC), compared with no exercise participants, 1 h < each exercise time ≤ 2 h (OR = 0.15, 95% CI: 0.03–0.77, P = 0.0230) was inversely associated with FD and compared with no exercise participants, mild exercise (OR = 0.09, 95% CI: 0.01–0.71, P = 0.0220) was significantly inversely associated with FD. Conclusions: The incidence rate of FD in this sample Chinese armed police recruits was 1.77%, and 1 h < each exercise time ≤ 2 h and mild intensity exercise were independently inversely associated with FD. However, the causal relationship needs to be verified by further randomized controlled trials. [ABSTRACT FROM AUTHOR]

Background: Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are caused and exacerbated by consumption of fatty foods. However, no study has evaluated brain activity in response to food images in patients with disorders of gut–brain interaction (DGBI). This study aimed to compare food preference and brain activity when viewing food images between patients with DGBI and healthy controls. Methods: FD and IBS were diagnosed using the ROME IV criteria. Food preference was assessed using a visual analog scale (VAS). Brain activity in the prefrontal cortex (PFC) in response to food images was investigated using functional near-infrared spectroscopy (fNIRS). Results: Forty-one patients were enrolled, including 25 with DGBI. The mean VAS scores for all foods (controls vs. FD vs. IBS: 69.1 ± 3.3 vs. 54.8 ± 3.8 vs. 62.8 ± 3.7, p = 0.02), including fatty foods (78.1 ± 5.4 vs. 43.4 ± 6.3 vs. 64.7 ± 6.1, p < 0.01), were the lowest in patients with FD among all groups. Patients with FD had significantly higher brain activity in the left PFC than those with IBS and healthy controls (mean z-scores in controls vs. FD vs. IBS: − 0.077 ± 0.03 vs. 0.125 ± 0.04 vs. − 0.002 ± 0.03, p < 0.001). Conclusions: Patients with DGBI, particularly those with FD, disliked fatty foods. The brain activity in patients with DGBI differed from that in healthy controls. Increased activity in the PFC of patients with FD was confirmed. [ABSTRACT FROM AUTHOR]

This study aimed to assess and compare psychometric properties of the 3 health-related quality of life (HRQOL) instruments EQ-5D Youth version (EQ-5D-Y), Child Health Utility 9D (CHU-9D), and Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) in children and adolescents with functional dyspepsia (FD) in China. A consecutive sample of FD outpatients were recruited from 6 tertiary medical centers in Hangzhou. The patients self-completed the 3 instruments in random order. Their feasibility, acceptability, construct validity (convergent, divergent, and known-group validity), and sensitivity were assessed. Multiple linear regression was used for identifying HRQOL-associated factors. A total of 1100 patients (mean age, 9.2 years; girl, 56.8%) completed the survey with no missing responses. Ceiling effect was quite higher in EQ-5D-Y (60.9%) than CHU-9D (33.8%) and PedsQL 4.0 (1.0%). The EQ-5D-Y and CHU-9D utility scores and PedsQL 4.0 total score were highly correlated (|r| = 0.593-0.661), except for the EuroQol visual analog scale score (EQ-VAS). The intraclass correlation coefficient between the 2 utility scores was fair (0.542). Most conceptually similar dimensions among the 3 instruments showed moderate to high correlations (|r| > 0.3) as hypothesized. The difference was statistically significant for the 2 utility scores and PedsQL 4.0 total score in varied severity groups (P <.001), and PedsQL 4.0 total score had higher relative efficiency and effect size values. The child's age, severity of FD symptoms, and their guardian's education had significant impact on HRQOL (P <.001). EQ-5D-Y, CHU-9D, and PedsQL 4.0 demonstrated acceptable psychometric properties in Chinese children with FD. PedsQL 4.0 showed superior sensitivity and is recommended. EQ-5D-Y and CHU-9D utility scores were not interchangeable. The measurement properties of EQ-VAS need to be further explored. • The EQ-5D Youth version, Child Health Utility 9D, and Pediatric Quality of Life Inventory 4.0 are widely used pediatric health-related quality of life (HRQOL) instruments. Nevertheless, no study has yet tested and compared their performance in populations with functional dyspepsia (FD). • This study demonstrated the potential of EQ-5D Youth version, Child Health Utility 9D, and Pediatric Quality of Life Inventory 4.0 in measuring HRQOL in Chinese children and adolescents with FD. • The findings provide insights for choosing appropriate instruments to accurately measure HRQOL in children and adolescents with FD, which is valuable for disease burden survey, clinical efficacy evaluation, and health technology assessment. [ABSTRACT FROM AUTHOR]

Objective To evaluate the methodological quality of papers that performed meta-analyzed and systematically reviewed acupoint selections for the treatment of functional dyspepsia (FD) and to identify the ideal acupoint combinations for FD. Methods Chinese databases including China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), China Biology Medicine (CBM), and Wanfang Database, as well as English databases including PubMed, Embase, and Cochrane Library were searched to retrieve papers about meta-analysis and systematic literature reviews on acupuncture for FD. The time span for the paper retrieval was set from the foundation of the databases to April 30, 2022. The Veritas scores of the papers based on their publication year, study type, Assessment of Multiple Systematic Reviews 2 (AMSTAR2), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), heterogeneity, and publication bias were rated to assess the methodological quality of the included studies. Then, randomized controlled trials (RCTs) were extracted from those meta-analysis papers or systematic literature reviews for analyzing acupoints frequency, meridian frequency, and association rules with the use of R software (V 4.3.1). Results Eight meta-analysis papers were included in the study after screening. The mean Veritas scores of the papers based on publication year, type of study, AMSTAR2, PRISMA, heterogeneity, and publication bias were 4.50, 8.00, 4.63, 4.63, 4.50, and 6.13, respectively. The analysis of the scores revealed insufficiencies in the reviews pertaining to the methodology, comprehension of the research strategy, detailed list of excluded studies, sources of funding, assessment of potential bias risks impact on meta-analysis results in each study, explanation of heterogeneity, and identification of potential conflicts of interest. Furthermore, a total of 85 RCTs were obtained from the eight meta-analysis papers involving 85 acupuncture prescriptions and 67 acupoints for subsequent data mining. The most commonly used meridian was Stomach meridian of Foot-Yangming (ST). Zusanli (ST36), Neiguan (PC6), Zhongwan (CV12), Taichong (LR3), Tianshu (ST25), Gongsun (SP4), Weishu (BL21), Pishu (BL20), Neiting (ST44), and Yinlingquan (SP9) topped the list of frequently selected acupoints. Additionally, a total of 28 association rules were identified, including 10 second-order, 15 third-order, and 3 fourth-order association rules. The top-ranking association rules in each order were "Neiguan (PC6) → Zusanli (ST36)" "Zhongwan (CV12) + Neiguan (PC6) → Zusanli (ST36)" and "Zhongwan (CV12) + Taichong (LR3) + Neiguan (PC6) → Zusanli (ST36)", respectively. Conclusion Acupuncture could alleviate the clinical symptoms of FD. However, the quality of methodology applied in the meta-analysis papers on the subject needs to be improved. Through data mining, a combination of Neiguan (PC6), Zusanli (ST36), Zhongwan (CV12), and Taichong (LR3) was identified as an essential acupoint combination for the treatment of FD. [ABSTRACT FROM AUTHOR]

Background: Evidence‐based dietary management approaches for symptoms of dyspepsia are lacking. This study aimed to compare dietary factors, symptoms, quality of life (QOL) and salivary cortisol in dyspepsia participants and healthy controls. Method s : A cross‐sectional survey was completed by adults with dyspepsia (n = 121) meeting Rome IV criteria and healthy controls (n = 52). Outcome measures included self‐reported questionnaires about dietary habits, triggers, restrictions, dietary management approaches, nutritional intake, psychological variables, QOL, gastrointestinal symptoms, and optional cortisol awakening response (CAR) via saliva samples. Data were analyzed using Chi‐square or Mann–Whitney U. Cortisol awakening response data was analyzed using moderated regression controlling for age, gender and distress. Key Results: Fermentable carbohydrates (FODMAPs) (55%) were the most reported trigger in adults with dyspepsia. The dyspepsia group (88%) followed special diets more than controls (47%; p < 0.001), with a low FODMAP diet being most common (69%). The dyspepsia group consumed less fiber (p = 0.014), calcium (p = 0.015), and total FODMAPs (p < 0.001) than controls. There was a greater prevalence of comorbid anxiety (41%) and depression (31%) in dyspepsia compared to controls (15% and 12%, respectively, p < 0.001 and p = 0.006). The dyspepsia group had poorer QOL and greater gastrointestinal symptom severity than controls (p < 0.001). There was a negative association between anxiety and CAR (p = 0.001) in dyspepsia but not in controls. Conclusions & Inferences: Adults with dyspepsia follow special diets more than controls and perceive FODMAPs as a key dietary trigger. These findings highlight the importance of monitoring nutritional adequacy and QOL, and emphasize mechanisms of depleted stress response in dyspepsia, warranting further exploration. [ABSTRACT FROM AUTHOR]

Study design: Cross sectional Background: Functional dyspepsia refers to a chronic condition characterized by persistent pain or discomfort in the upper abdomen, bloating, and fullness, which is often accompanied by an unpleasant sensation of satiety even after eating only small amounts of food.The causes of this condition are not yet fully understood, but it may result from a combination of biological, psychological, and environmental factors. Aim: This study aims to assess prevalence of functional dyspepsia among general population in Aseer region, Southern of Saudi Arabia. Methods:A descriptive cross-sectional study (survey-based study) was conducted in Aseer region, southern region, Saudi Arabia. The electronic survey made by Google forms during the period from March-2023to June 2023.The study survey included questions that assess the prevalence, pattern and the effect of functional dyspepsia beside participants socio-demographic data and body mass index. The tool was uploaded online using social media platforms till no more answers were obtained. Results: A total of 277 participants completed the study questionnaire. Participants ages ranged from 15 to more than 55 years with mean age of 25.2 ± 12.9 years old. Exact of 157 (69.2%) were females. A total of 128 (56.4%) had FD of whom 93 (41%) had PDS, and 81 (35.7%) had EPS. Conclusion:In conclusion, the current study estimated high prevalence for FD relative to estimated literature findings but mostly due to variability in used diagnostic criteria. Postprandial distress syndrome was more frequent than epigastric pain syndrome. Females showed higher rates of FD and subtypes than males with unemployment. [ABSTRACT FROM AUTHOR]