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Short bowel syndrome

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https://www.readbyqxmd.com/read/28937976/tissue-engineering-for-the-treatment-of-short-bowel-syndrome-in-children
#1
REVIEW
Laura Y Martin, Mitchell R Ladd, Adam Werts, Chhinder P Sodhi, John C March, David J Hackam
Short bowel syndrome is a major cause of morbidity and mortality in children. Despite decades of experience in the management of short bowel syndrome, current therapy is primarily supportive. Definitive treatment often requires intestinal transplantation, which is associated with significant morbidity and mortality. In order to develop novel approaches to the treatment of short bowel syndrome, we and others have focused on the development of an artificial intestine, by placing intestinal stem cells on a bioscaffold that has an absorptive surface resembling native intestine, and taking advantage of neovascularization to develop a blood supply...
September 22, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28932270/repeat-treatment-with-rifaximin-improves-irritable-bowel-syndrome-related-quality-of-life-a-secondary-analysis-of-a-randomized-double-blind-placebo-controlled-trial
#2
Brooks D Cash, Mark Pimentel, Satish S C Rao, Leonard Weinstock, Lin Chang, Zeev Heimanson, Anthony Lembo
BACKGROUND: Diarrhea-predominant irritable bowel syndrome (IBS-D) impairs patient quality of life (QOL). Rifaximin is an oral, nonsystemic antibiotic indicated for IBS-D. The objective of this secondary analysis was to evaluate rifaximin retreatment on IBS-related QOL in patients with IBS-D. METHODS: Patients received open-label rifaximin 550 mg three times daily for 2 weeks. Clinical responders [simultaneously meeting weekly response criteria for abdominal pain (⩾30% improvement from baseline in mean weekly pain score) and stool consistency (⩾50% decrease from baseline in number of days/week with Bristol Stool Scale (BSS) type 6 or 7 stools) during ⩾2 of first 4 weeks posttreatment] who relapsed during an up to 18-week treatment-free observation phase were randomly assigned to receive two 2-week courses of double-blind rifaximin or placebo, separated by 10 weeks...
September 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28920023/re-tubularization-of-highly-ischemic-anti-mesenteric-border-rehab-a-novel-bowel-preservation-technique-in-complex-gastroschisis
#3
Richard J Hendrickson, Ashwini S Poola, Katherine W Gonzalez, Joel Lim, Tolulope A Oyetunji
Complex gastroschisis with bowel necrosis poses an operative challenge. Surgeons must weigh the decision between resection versus preservation of ischemic bowel. As one of the leading causes of short bowel syndrome, aggressive resection in complicated gastroschisis subjects children to prolonged dependence on parenteral nutrition and its attendant complications. Herein, we describe a novel technique aimed towards bowel preservation in complex gastroschisis patients with severe bowel ischemia with the ultimate goal for enteral autonomy...
July 2017: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/28920021/closed-gastroschisis
#4
Mohammed Abdel-Latif, Mohamed H Soliman, Khaled M El-Asmar, Mohamed Abdel-Sattar, Ibrahim M Abdelraheem, Ehab El-Shafei
Closed gastroschisis is a rare entity usually associated with intestinal atresia and short bowel syndrome. We report two cases of closed gastroschisis presenting with neonatal intestinal obstruction and para-umbilical evisceration without an abdominal defect.
July 2017: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/28918445/pre-emptive-intestinal-transplant-the-surgeon-s-point-of-view
#5
REVIEW
Augusto Lauro, Ignazio R Marino, Kishore R Iyer
Pre-emptive transplantation is a well-established practice for certain types of end-organ failure such as in the use of kidney transplantation. For irreversible intestinal failure, total parenteral nutrition (TPN) remains the gold standard, due to the suboptimal long-term results of intestinal transplantation. As such, the only role for pre-emptive transplantation, if at all, will be for patients identified to be at high risk of complications and mortality while on definitive long-term TPN. In these patients, the timing of early listing and transplantation could become life-saving, taking into account that mortality on the waiting list is still the highest for intestinal candidates...
September 16, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28915953/syntrophic-imbalance-and-the-etiology-of-bacterial-endoparasitism-diseases
#6
James F White
This article outlines the proposed 'syntrophic imbalance hypothesis' for etiology of bacterial endoparasitism diseases. This hypothesis involves microbes (archaea and bacteria) that exist in human body biofilms in syntrophic associations, where bacteria ferment nutrients to produce short chain fatty acids (SCFAs) that are used by methanogenic archaeons to produce methane. Overgrowth of archaea on human tissues (e.g., in association with intestines, teeth or lungs) results in excessive removal of SCFAs from the biofilms and this triggers bacteria in the free-living biofilm state to convert to the endoparasitic state and become intracellular in host cells where they incite inflammation and disease...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28891824/low-fodmap-a-preliminary-strategy-to-reduce-gastrointestinal-distress-in-athletes
#7
Dana M Lis, Trent Stellingwerff, Cecilia M Kitic, James W Fell, Kiran D K Ahuja
INTRODUCTION: Gastrointestinal (GI) distress in endurance athletes is prevalent and detrimental to performance. Adverse GI symptomatology can be analogous with irritable bowel syndrome, where fermentable oligosaccharide, disaccharide, monosaccharide and polyols (FODMAP) reduction has demonstrated efficacy. This study investigated the effects of low FODMAP (LFOD) diet on GI distress parameters in runners with a history of non-clinical exercise-associated GI symptoms. METHODS: Eleven recreationally competitive runners (5 males, 6 females; 5km personal best 23:00±4:02 min:sec) participated in the study...
September 7, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28885302/postinfection-irritable-bowel-syndrome-the-links-between-gastroenteritis-inflammation-the-microbiome-and-functional-disease
#8
Ian A Downs, Olga C Aroniadis, Libusha Kelly, Lawrence J Brandt
Postinfection irritable bowel syndrome (PI-IBS) is a diarrheal disease that develops after infectious gastroenteritis (IGE). Profound alterations in the microbiota accompany IGE yet only 10% of IGE patients progress to PI-IBS. This review explores research linking IGE severity, psychological comorbidity, PI-IBS, and the microbiome in various patient populations. Selective pressures caused by inflammation and increased gastrointestinal motility during gastroenteritis can alter intestinal bacterial phyla including Bacteroidetes, Firmicutes, and Proteobacteria...
September 6, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28880224/parenteral-nutrition-associated-liver-disease-the-role-of-the-gut-microbiota
#9
REVIEW
Monika Cahova, Miriam Bratova, Petr Wohl
Parenteral nutrition (PN) provides life-saving nutritional support in situations where caloric supply via the enteral route cannot cover the necessary needs of the organism. However, it does have serious adverse effects, including parenteral nutrition-associated liver disease (PNALD). The development of liver injury associated with PN is multifactorial, including non-specific intestine inflammation, compromised intestinal permeability, and barrier function associated with increased bacterial translocation, primary and secondary cholangitis, cholelithiasis, short bowel syndrome, disturbance of hepatobiliary circulation, lack of enteral nutrition, shortage of some nutrients (proteins, essential fatty acids, choline, glycine, taurine, carnitine, etc...
September 7, 2017: Nutrients
https://www.readbyqxmd.com/read/28877534/open-abdomen-improves-survival-in-patients-with-peritonitis-secondary-to-acute-superior-mesenteric-artery-occlusion
#10
Weiwei Ding, Kai Wang, Baochen Liu, Xinxin Fan, Shikai Wang, Jianmin Cao, Xingjiang Wu, Jieshou Li
BACKGROUND: Damage control surgery and open abdomen (OA) have been extensively used in the severe traumatic patients. However, there was little information when extended to a nontrauma setting. The purpose of this study was to evaluate whether the liberal use of OA as a damage control surgery adjunct improved the clinical outcome in acute superior mesenteric artery occlusion patients. STUDY DESIGN: A single-center, retrospective cohort review was performed in a national tertiary surgical referral center...
October 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28872123/ileectomy-induced-bile-overaccumulation-in-mouse-intestine
#11
Rongli Zhang, Jonathan W Ray, Mukesh K Jain, Shuxin Han
Intestinal resection is a common therapeutic approach for human diseases such as obesity, inflammatory bowel disease, Crohn's disease, and colon cancer that often results in severe short bowel syndrome-like adverse effects including bile acid diarrhea, dehydration, electrolyte disturbances, and nutrient malabsorption. Here we introduce a murine ileal resection model, termed ileectomy, to evaluate tissue communication and the maintenance of systemic homeostasis. After ileal resection, circulating blood is permanently devoid of the ileum-specific endocrine hormone fibroblast growth factor 15 (FGF15), which releases its endocrinal inhibition of bile acid synthesis in the liver...
August 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28854852/effects-of-self-management-interventions-in-patients-with-irritable-bowel-syndrome-systematic-review
#12
Xiaomei Cong, Mallory Perry, Katherine M Bernier, Erin E Young, Angela Starkweather
Irritable bowel syndrome (IBS) is a prevalent and costly condition, with expenditures exceeding US$21 billion annually. As there is no known cure for IBS, treatment is focused on symptom self-management strategies. The purpose of this systematic review was to investigate the efficacy and overall effect of self-management interventions for patients with IBS. Of the 64 publications that were identified, 20 were included in the systematic review. Self-management interventions were found in diverse formats, including web-based, self-training booklets, individual and/or group interventions with health care providers, and cognitive-behavioral therapy or exercise-based interventions...
August 1, 2017: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28837507/clinical-report-intestinal-rehabilitation-programs-in-the-management-of-pediatric-intestinal-failure-and-short-bowel-syndrome
#13
Russell J Merritt, Valeria Cohran, Bram P Raphael, Timothy Sentongo, Diana Volpert, Brad W Warner, Praveen S Goday
Intestinal failure is a rare, debilitating condition that presents both acute and chronic medical management challenges. The condition is incompatible with life in the absence of the safe application of specialized and individualized medical therapy that includes surgery, medical equipment, nutritional products, and standard nursing care. Intestinal rehabilitation (IR) programs are best suited to provide such complex care with the goal of achieving enteral autonomy and oral feeding with or without intestinal transplantation...
August 23, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28834539/butyrate-stimulates-the-growth-of-human-intestinal-smooth-muscle-cells-by-activation-of-yes-associated-protein
#14
Li-Na Dai, Jun-Kai Yan, Yong-Tao Xiao, Jie Wen, Tian Zhang, Ke-Jun Zhou, Yang Wang, Wei Cai
Intestinal smooth muscle cells play a critical role in the remodeling of intestinal structure and functional adaptation after bowel resection. Recent studies have shown that supplementation of butyrate (Bu) contributes to the compensatory expansion of a muscular layer of the residual intestine in a rodent model of short-bowel syndrome (SBS). However, the underlying mechanism remains elusive. In this study, we found that the growth of human intestinal smooth muscle cells (HISMCs) was significantly stimulated by Bu via activation of Yes-Associated Protein (YAP)...
August 23, 2017: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/28827911/short-bowel-syndrome-an-uncommon-clinical-entity-and-a-therapeutic-challenge-our-experience-and-review-of-literature
#15
Lalit Aggarwal, Swati Sattavan, Romesh Lal, Deborshi Sharma, Saurabh Borgharia, Nishit Shrivastava, Rama Alagappan, Ranvir Singh
Short bowel syndrome (SBS), one of the commonest types of intestinal failure, usually secondary to extensive bowel resection, traditionally has been associated with a high mortality rate and hence a big challenge for the treating surgeons. It requires comprehensive clinical care to minimise the morbidities and mortality associated with the condition. We report a retrospective review of a series of seven patients with SBS, who presented at our surgical emergency within a period of 1 year and their outcome so as to encourage others in managing such a challenge with more positive mindsets...
August 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28818841/distinct-intestinal-adaptation-for-vitamin-b12-and-bile-acid-absorption-revealed-in-a-new-mouse-model-of-massive-ileocecal-resection
#16
Yuka Matsumoto, Wakana Mochizuki, Shintaro Akiyama, Taichi Matsumoto, Kengo Nozaki, Mamoru Watanabe, Tetsuya Nakamura
Ileocecal resection (ICR), one of several types of intestinal resection that results in short bowel syndrome (SBS), causes severe clinical disease in humans. We here describe a mouse model of massive ICR in which 75% of the distal small intestine is removed. We demonstrate that mice underwent 75% ICR show severe clinical signs and high mortality, which may recapitulate severe forms of human SBS, despite an adaptive response throughout the remnant intestine. By using this model, we also investigated whether the epithelium of the remnant intestine shows enhanced expression of factors involved in region-specific functions of the ileum...
September 15, 2017: Biology Open
https://www.readbyqxmd.com/read/28807218/teduglutide-effects-on-gene-regulation-of-fibrogenesis-on-an-animal-model-of-intestinal-anastomosis
#17
Beatriz P Costa, Ana C Gonçalves, Ana M Abrantes, Paulo Matafome, Raquel Seiça, Ana B Sarmento-Ribeiro, Maria Filomena Botelho, Francisco Castro-Sousa
BACKGROUND: Teduglutide is an enterotrophic analog of glucagon-like peptide 2 approved for the rehabilitation of short-bowel syndrome. This study aims to analyze the effects of teduglutide administration on the gene regulation of fibrogenesis during the intestinal anastomotic healing on an animal model. METHODS: Wistar rats (n = 62) were assigned into four groups: "Ileal Resection and Anastomosis" or "Laparotomy," each one subdivided into "Postoperative Teduglutide Administration" or "No Treatment," and sacrificed at the third or at the seventh days, with ileal sample harvesting...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28805088/the-current-therapeutic-options-for-crohn-s-disease-from-medical-therapy-to-intestinal-transplantation
#18
Augusto Lauro, Francesco D'Amico, Gabriel Gondolesi
Crohn's disease (CD) has an annual incidence per 100.000 person-year of 20.2 in North America and 12.7 in Europe, and the purpose of this review is to evaluate its medical management, from diagnosis to transplant. Pharmacologic manipulation with nutritional care aims to achieve and maintain remission, but more than half of patients will undergo an intestinal resection, very often repeated over time. They could experience short bowel syndrome (SBS) requiring total parenteral nutrition (TPN). Intestinal transplantation (ITx) represents an alternative in case of irreversible intestinal failure (IF) with life-threatening TPN complications...
August 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28804974/rome-iii-vs-rome-iv-criteria-for-irritable-bowel-syndrome-a-comparison-of-clinical-characteristics-in-a-large-cohort-study
#19
L Vork, Z Z R M Weerts, Z Mujagic, J W Kruimel, M A M Hesselink, J W M Muris, D Keszthelyi, D M A E Jonkers, A A M Masclee
BACKGROUND: The Rome criteria for irritable bowel syndrome (IBS) have been revised and are expected to apply only to the subset of Rome III IBS subjects with abdominal pain as predominant symptom, occurring at least once a week. The aim of this study was to determine the percentage of Rome III IBS subjects that fulfills Rome IV criteria and to evaluate differences between Rome IV-positive and Rome IV-negative subjects. METHODS: Four hundred and four Rome III IBS subjects completed a 14-day end-of-day symptom diary, the Gastrointestinal Symptom Rating Scale (GSRS), Hospital Anxiety and Depression Scale, and RAND 36-item Short-Form Health Survey (SF-36)...
August 14, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28794309/enteral-formula-containing-egg-yolk-lecithin-improves-diarrhea
#20
Tetsuro Akashi, Ayano Muto, Yayoi Takahashi, Hiroshi Nishiyama
Diarrhea often occurs during enteral nutrition. Recently, several reports showed that diarrhea improves by adding egg yolk lecithin, an emulsifier, in an enteral formula. Therefore, we evaluated if this combination could improve diarrhea outcomes. We retrospectively investigated the inhibitory effects on watery stools by replacing a polymeric fomula with that containing egg yolk lecithin. Then, we investigated the emulsion stability in vitro. Next, we examined the lipid absorption using different emulsifiers among bile duct-ligated rats and assessed whether egg yolk lecithin, medium-chain triglyceride, and dietary fiber can improve diarrhea outcomes in a rat model of short bowel syndrome...
August 8, 2017: Journal of Oleo Science
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