Digestive diseases and sciences
-
Randomized Controlled Trial Multicenter Study
Efficacy and safety of lubiprostone in patients with chronic constipation.
The aim of this study is to assess the efficacy and safety of lubiprostone in adults with chronic constipation. ⋯ In patients with chronic constipation, lubiprostone produced a bowel movement in the majority of individuals within 24 h of initial dosing, with sustained improvement in frequency as well as other constipation symptoms over 4 weeks of treatment.
-
The objective of this study is to evaluate the utility of gastric electrical stimulation (GES) in the subgroup of patients with refractory nausea and vomiting in the presence of normal gastric emptying. Eighteen patients (15 females) underwent GES implantation for dyspeptic symptoms in the presence of normal gastric emptying. Upper gastrointestinal (UGI) symptom score, health-related quality of life (HR-QOL), nutritional status and weight, and medication use (prokinetics and antiemetics) were assessed at baseline and at 1 year after GES placement. ⋯ Gastric emptying actually became slower in 29% of those who repeated the test after 1 year. No adverse events related to GES placement were recorded. Results of our study suggest that GES improves dyspeptic symptoms in patients with medically refractory nausea and vomiting independent of its effect on gastric emptying and could be considered as a potential therapy in this clinical setting.
-
A common gastrointestinal complication of diabetes is gastroparesis, and patients with gastroparesis may present with early satiety, nausea, vomiting, bloating, postprandial fullness, or upper abdominal pain. However, the pathogenesis is not clear yet. A recent study indicated that atrial natriuretic peptide (ANP) was secreted from the gastric mucosa and the ANP family plays an inhibitory role in the regulation of gastrointestinal motility, but the effect of the natriuretic peptide signal pathway on diabetic gastroparesis has not been reported. ⋯ The cGMP production and pGC activity in response to CNP in gastric muscle tissues were significantly potentiated in STZ-induced diabetic rats. Natriuretic peptide receptor type B (NPR-B) gene was expressed in the gastric smooth muscles of normal and diabetic rats, and the expression was increased in diabetic rats. The results suggest that natriuretic peptide-dependent pGC-cGMP signal is upregulated and may contribute to diabetic gastroparesis in STZ-induced diabetic rats.
-
Pathogenesis of nonalcoholic steatohepatitis (NASH) is considered to be involved in fat accumulation, oxidative stress, inflammation, and fibrosis in liver, but no drug therapy has been established as yet. Eicosapentaenoic acid (EPA) is an agent used clinically to treat hypertriglyceridemia, and has been reported to suppress reactive oxygen species and inflammation. Here, we aimed to assess the effect of EPA on progression of hepatic fibrosis in an animal model of NASH. ⋯ EPA-E prevents progression of hepatic fibrosis in an MCD-induced NASH model with reduction of oxidative stress, inflammation, and initial hepatic steatosis. Thus, EPA-E treatment may be a potential therapy to treat NASH.
-
Comparative Study
Coronary artery disease in patients with liver cirrhosis.
The prevalence of coronary artery disease (CAD) has been reported to be low in patients with liver cirrhosis. Previous studies have, however, included mostly patients with cirrhosis due to hepatitis C. We aimed to determine the prevalence and predictive factors of CAD in a cohort of consecutive patients with cirrhosis of various etiologies compared to the general population. ⋯ Liver cirrhosis, per se, does not seem to confer a protective effect against CAD. In cirrhotics, older age and alcoholic etiology were independently related to CAD.