Biomedical subjects

Magnus Simrén

Publications and source records attributed to Magnus Simrén.

23 records · Page 2Linked to original sources

PubMed2003

Effects of duodenal lipids on gastric sensitivity and relaxation in patients with ulcer-like and dysmotility-like dyspepsia.

BACKGROUND/AIMS: Functional dyspepsia (FD) according to Rome II is divided into ulcer-like dyspepsia (ULD) and dysmotility-like dyspepsia (DLD). The rationale behind this is the assumption that the underlying pathophysiology is different, but this is largely unexplored. Our aim was to elucidate the differences in gastric sensorimotor function in these subgroups of FD. 13 healthy controls (HC) and 20 patients with FD, 10 ULD and 10 DLD, were included. METHODS: A feeding tube was placed fluoroscopically in the proximal duodenum and a barostat balloon was placed in the proximal stomach. Sensory thresholds to gastric distention for first sensation, bloating and discomfort were assessed before and after duodenal lipid infusion (2 kcal/min, 60 min). RESULTS: Volume changes in the balloon were recorded as a measure of gastric tone. In FD patients, sensory thresholds in the fasting state were significantly lower than in HC, mostly due to gastric hypersensitivity in ULD. After lipid infusion, 95% of FD patients fell outside the normal range of HC for first sensation, bloating and/or discomfort, compared with 65% in the fasting state. Patients with ULD but not DLD had impaired fundic relaxation after duodenal lipids compared with HC. CONCLUSIONS: Investigating gastric sensorimotor function after duodenal lipid infusion, FD patients can accurately be differentiated from HC. Impaired fundic relaxation seems to be more common in patients with ULD.

Adult↗

PubMed2002

The prevalence of gastrointestinal symptoms in patients with chronic renal failure is increased and associated with impaired psychological general well-being.

BACKGROUND: Malnutrition occurs frequently in patients with end-stage renal disease (ESRD). Gastrointestinal (GI) symptoms may lead to reduced food intake, resulting in malnutrition and impaired well-being in these patients. The prevalence of GI symptoms in various chronic renal failure (CRF) groups is unexplored. We assessed the prevalence of GI complaints in patients on either haemodialysis (HD), peritoneal dialysis (PD), or in the pre-dialysis stage. Patients with and without diabetic nephropathy were also compared. METHODS: A total of 233 patients with CRF (128 HD, 55 PD, and 50 pre-dialytic patients) completed two self-administered questionnaires: the Psychological General Well-Being (PGWB) index and the Gastrointestinal Symptom Rating Scale (GSRS), which measures GI symptoms. The values were compared with reference values obtained from the general population. The association between GI symptoms and serum (s-)albumin was also studied. RESULTS: The total GSRS score in patients with CRF was significantly higher than the reference values (HD 2.14 (1.97-2.31), PD 2.24 (2.00-2.48), and pre-dialytic patients 2.03 (1.82-2.25) vs controls 1.53 (1.50-1.55; P<0.001). When comparing CRF subgroups there was no overall difference between the groups, but PD patients had more severe reflux and eating dysfunction. In patients with diabetic nephropathy, only eating dysfunction was significantly more common than in the non-diabetic patients. There was a negative correlation between GI symptoms and psychological general well-being in CRF patients (Rho=-0.46, P<0.001) indicating that patients with a high GI symptom profile have impaired psychological general well-being. A negative correlation was found between eating dysfunction and s-albumin (Rho=-0.33, P<0.01). CONCLUSION: The prevalence of GI symptoms is high in patients with CRF and is associated with impairment in psychological general well-being. Presence of dialysis or not, type of dialysis, and presence or absence of diabetes mellitus seem to have limited impact on GI symptoms.

Attitude to Health↗

PubMed2002

Physical activity and the gastrointestinal tract.

Physical exercise is probably both beneficial and harmful for the gastrointestinal tract, depending partly on the training intensity. On the one hand, gastrointestinal symptoms such as heartburn, chest pain, nausea, vomiting, abdominal cramps, side ache and diarrhoea are common during heavy exercise. On the other hand, physical activity seems to protect from colon cancer, cholelithiasis and diverticular disease. Constipation has been shown to be related to inactivity. Despite this, no overwhelming evidence exists for a positive effect of physical exercise as a treatment option for chronic constipation. The reasons behind these somewhat discrepant effects are not understood fully. Altered gastrointestinal blood flow, effects on gastrointestinal motor function, neuroendocrine changes and mechanical effects are probably involved. Conflicting results exist regarding the effects of physical activity on gastrointestinal motility. Modern technologies now make motility studies in various parts of the gastrointestinal tract possible. More studies are needed to understand better the effects of physical exercise on the gastrointestinal tract. In particular, the relationship between the training intensity and duration and positive and negative alterations in gastrointestinal physiology needs to be addressed further.

Exercise↗

PubMed2002

Quality of life in inflammatory bowel disease in remission: the impact of IBS-like symptoms and associated psychological factors.

OBJECTIVES: Quality of life is reduced in inflammatory bowel disease (IBD). Whether or not this is true in IBD patients in long-standing remission is unclear. Symptoms compatible with irritable bowel syndrome (IBS) are common in IBD patients in remission. The importance of psychological factors in this process is a matter of controversy. METHODS: Forty-three patients with ulcerative colitis (UC) and 40 with Crohn's disease (CD), who had been in remission for at least 1 yr according to laboratory parameters and clinical and endoscopical appearance, were included. These patients completed four different self-administered questionnaires, evaluating GI symptoms, anxiety, depression, and psychological general well-being. The two patient groups were compared with the general population, and within-group comparisons in psychometric scores were made between patients with and without IBS-like symptoms. RESULTS: The psychological well-being in IBD patients in long-standing remission was similar to that of the general population, despite the presence of more severe GI symptoms. CD patients reported more psychosocial dysfunction, reduced well-being, and GI symptoms than UC patients. Thirty-three percent of UC patients and 57% of CD patients had IBS-like symptoms. The group with IBS-like symptoms (both UC and CD) had higher levels of anxiety and depression and more reduced well-being than those without. Anxiety and reduced vitality were found to be independent predictors for IBS-like symptoms in these patients. CONCLUSION: The prevalence of IBS-like symptoms in IBD patients in long-standing remission is two to three times higher than that in the normal population. Psychological factors seem to be of importance in this process. However, as a group IBD patients in remission demonstrate psychological well-being comparable to that of the general population.

Adaptation, Psychological↗

PubMedDate not supplied

Treatment with hypnotherapy reduces the sensory and motor component of the gastrocolonic response in irritable bowel syndrome.

OBJECTIVE: Postprandial symptoms in irritable bowel syndrome are common and relate to an exaggerated motor and sensory component of the gastrocolonic response. We investigated whether this response can be affected by hypnotherapy. METHODS: We included 28 patients with irritable bowel syndrome refractory to other treatments. They were randomized to receive gut-directed hypnotherapy 1 hour per week for 12 weeks (N = 14) or were provided with supportive therapy (control group; N = 14). Before randomization and after 3 months, all patients underwent a colonic distension trial before and after a 1-hour duodenal lipid infusion. Colonic sensory thresholds and tonic and phasic motor activity were assessed. RESULTS: Before randomization, reduced thresholds after vs. before lipid infusion were seen in both groups for all studied sensations. At 3 months, the colonic sensitivity before duodenal lipids did not differ between groups. Controls reduced their thresholds after duodenal lipids for gas (22 +/- 1.7 mm Hg vs. 16 +/- 1.6 mm Hg, p <.01), discomfort (29 +/- 2.9 mm Hg vs. 22 +/- 2.6 mm Hg, p <.01), and pain (33 +/- 2.7 mm Hg vs. 26 +/- 3.3 mm Hg, p <.01), whereas the hypnotherapy group reduced their thresholds after lipids only for pain (35 +/- 4.0 mm Hg vs. 29 +/- 4.7 mm Hg, p <.01). The colonic balloon volumes and tone response at randomization were similar in both groups. At 3 months, baseline balloon volumes were lower in the hypnotherapy group than in controls (83 +/- 14 ml vs. 141 +/- 15 ml, p <.01). In the control group, reduced balloon volumes during lipid infusion were seen (141 +/- 15 ml vs. 111 +/- 19 ml, p <.05), but not after hypnotherapy (83 +/- 14 ml vs. 80 +/- 16 ml, p >.20). CONCLUSION: Hypnotherapy reduces the sensory and motor component of the gastrocolonic response in patients with irritable bowel syndrome. These effects may be involved in the clinical efficacy of hypnotherapy in IBS.

Colon↗