1,721,000 research outputs found
Probiotics in children
No full textProbiotics, a word of Greek origin composed of “pro” (promoting) and “biotic "(life), have been defined by the Food and Agriculture Organization of the United Nations (FAO) as “live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host." More than 500 different types of bacteria reside in the human digestive system. In recent years, the study of intestinal microbiota and therefore the use of probiotics have been extensively studied in promoting health, as well as in treating several diseases and not solely regarding the gastrointestinal system. This book summarizes the more recent knowledge about intestinal microbiota, its pathological correlations and the use of probiotics in children for the maintenance, recovery, and strengthening of healthy strains at the expense of bad ones
Case report: Successful endoscopic removal of a large rectal foreign body
No full textIncidence of emergency access due to retained large rectal foreign bodies is increased in the last years. Such situations are a challenge because often, due to their size and physical characteristics, the large foreign bodies of the rectum cannot be extracted manually or by endoscopy, thus requiring surgery, as reported in the literature. We report a case of a 59-old male with a retention of a large vegetable rectal foreign body (whole eggplant) successfully subjected to endoscopic removal without the need for surgery
THERAPEUTIC CHOICES IN ACUTE GASTROENTERITIS IN ADULTS
No full textAcute diarrhea is a very common illness among populations of all ages. Infective diarrhea accounts for most episodes of acute gastroenteritis in adults, and viruses are the most common etiologic agents. In developing countries, acute diarrhea is still cause of mortality, while in developed countries it impacts importantly the quality of life and may worsen underlying diseases such as nephropathies, cardiac diseases or diabetes. Therefore, the optimization of the treatment of acute gastroenteritis is essential all over the world. Acute diarrhea may be managed in hospitalization or with home medication, based on the severity of the disease and eventual comorbidities of the patient or complications. Therapy of acute diarrhea is based generally on the correction of fluid and electrolytes loss, on symptoms control and on the use of specific medications depending on etiology. Dehydration management should always be prompt and adapted to the severity of dehydration; oral rehydration is usually preferred, by using oral rehydration solutions; nonspecific antidiarrheal drugs are mainly used for symptoms controls and include antimotility drugs loperamide and dyphenoxylate, and antisecretory drugs bismuth subsalicylate and racecadotril; adsorbent agents as diosmectite may be applied as adjunctive treatments; antimicrobial therapy is indicated in case of acute infectious diarrhea, although it is not necessary for all etiologies; specific probiotic strains may be also applied in diarrhea’s treatment as they help in the reestablishment of a balanced intestinal microbiota
ACUTE GASTROENTERITIS IN ADULTS: EPIDEMIOLOGY, GUIDELINES, AND HEALTH COSTS
No full textAcute gastroenteritis is a common cause of illness resulting in visits to the emergency department and outpatient clinics, hospitalizations and lost quality of life occurring in both domestic settings and among those traveling abroad. In addition, it is cause of outbreaks in closed communities such as schools, nursing homes and cruise ships. It is estimated that 1 in 6 people in the United States is subject to gastroenteritis each year with an estimated annual burden of 179 million outpatient visits, nearly 500,000 hospitalizations, and more than 5,000 deaths at an estimated cost upwards of US$150 million to the health-care economy. In Europe and Canada, the estimated annual incidence is between 0.1 to 3.5 episodes per person-year while in resource-limited countries the incidence of acute gastroenteritis is often not evaluated nor included in any specific review. It usually occurs at a baseline frequency, superimposed with epidemic cases of diarrhea, either dysentery or watery diarrhea.Acute gastroenteritis is considered a major public health issue against which control efforts are needed. Several societies and government-sponsored guidelines for the diagnosis and management of acute gastroenteritis in adults are updated periodically, globally the most used and updated are those provided by the World Gastroenterology Organization (WGO), the Infectious Diseases Society of America (IDSA) and the American College of Gastroenterology (ACG). Illness and death from clinical conditions caused by gastroenteritis, especially those related to contaminated food, are a constant threat to public health and a significant obstacle to socio-economic development worldwide. In 2010 a specific Reference Group (FERG) established by World Health Organization (WHO) found that the global burden of acute gastroenteritis is comparable to those of the major infectious diseases, HIV/AIDS, malaria and tuberculosis. The diagnosis of acute gastroenteritis is mainly clinical with evidence diarrhea of rapid onset that lasts less than two weeks and may be accompanied by nausea, vomiting, fever, or abdominal pain. Stool examination and culture to determine etiology should be performed on patients at high risk of severe illness and for whom identification of a pathogen would be important both for the patient and for public health. The treatment of the acute disease is based on: Fluid maintenance and repletion; adaptation of diet; use of probiotics and antibiotics depending on the etiology; use of non-specific anti-diarrheal drugs
Transverse flap duodenoplasty (TFD): a new technique in autologous bowel reconstructive surgery
No full textBackground: Bowel dilatation is a common adaptive mechanism after intestinal resection. The symptomatic dilated dysmotile duodenum is difficult to manage, since conventional bowel tailoring and lengthening techniques are potentially hazardous because of the anatomy of the duodenal blood supply, the proximity to the pancreas, and the risk of injury to the common bile duct. Methods: A 2-month-old child with short bowel and a symptomatic massively dilated duodenum was treated with a Transverse Flap Duodenoplasty (TFD). The duodenum was opened longitudinally along its antimesenteric border preserving an intact strip of tissue overlying the pancreatic head. Three full thickness vascularized pedicle flaps were cut on both the anterior and posterior walls and were spirally rotated and sutured to create a uniform propulsive duodenum without diverticulae. Results: Healing was complicated by a soft anastomotic duodeno-ileal stenosis that resolved after three elective balloon dilatations. Oral feeding established rapidly. The child is growing, does not vomit, and passes 1–2 semiformed motions daily. Conclusions: TFD is a safe and versatile technique that preserves all duodenal absorptive mucosa and that removes any risk to the pancreas, bile duct, and ampulla of Vater. Our experience, although limited, has been encouraging and leads us to suggest TFD for the management of the difficult symptomatic dysmotile dilated duodenum
Congenital malformations of the gastrointestinal tract
No full textCongenital malformations of the gastrointestinal tract are relatively rare diseases that can involve any part of the digestive system from the mouth to the anus and glands related to it. The severity of these diseases is highly variable, sometimes they are only occasional findings in asymptomatic patients, sometimes they are real emergencies that threaten the patient's life. In order to understand the genesis of gastrointestinal malformations it is useful to know the embryogenesis of gastrointestinal tract. The digestive system takes its origin from the three germ layers, endoderm gives rise to epithelia, ectoderm gives rise to the mouth and the anus, and mesoderm gives rise to muscle and connective tissue structures. The primitive gut is formed by tubulization of sheets. This tubular structure first undergoes obliteration of the lumen, and later a subsequent recanalization. Then the primitive gut gradually lengthens gradually and undergoes successive stages of rotation until the final disposition of the adulthood. Failure in one of these processes determines malformations in the definitive bowel. The main malformations of gastrointestinal tract are abnormalities of the intestinal lumen, including atresia, stenosis, and duplication; intestinal malrotation, volvulus; anal-rectal malformation; intestinal agangliosis; defect of abdominal wall, including gastroschisis and onphaloceles. Treatment of these malformations is mainly based on surgical correction, while the role of digestive endoscopy is primarily reserved to the post-surgical follow-up. In particular, patients suffering from esophageal atresia, with or without tracheoesophageal fistula, and undergoing surgery are burdened by a high post-surgical morbidity. Digestive endoscopy is useful in diagnosis, and sometimes in treatment of complications such as gastroesophageal reflux with esophagitis (or colitis in case of coloplastic), anastomotic stricture, and recurrent fistula
Peripheral neuropathy and gastroenterologic disorders: An overview on an underrecognized association
No full textBackground and aim of the work: Although peripheral neuropathies in children are often of genetic origin, acquired causes should be carefully looked for and ruled out also in the pediatric age. Gastroenterological disorders can be complicated by peripheral neuropathy as a result of micronutrients deficiency, drug toxicity or because of shared pathophysiological mechanisms. Methods: In this descriptive review we sought to give an overview on the most relevant clinical conditions in which peripheral neuropathies are associated with gastrointestinal disorders or symptoms. Results: We describe the clinical, demographic, and electrophysiological features of peripheral neuropathy in three main clinical scenarios: in the context of common gastroenterological disorders (inflammatory bowel and celiac disease), in the context of micronutrients deficiencies arising from malabsorption irrespective of etiology, and in a rare degenerative mitochondrial disorder, mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) disorder. Conclusions: The association between gastrointestinal and peripheral nervous system symptoms is probably still underrecognized but has to be actively sought, in order to provide prompt diagnosis resulting in optimal care and long-term management with the aim to improve quality of life and, at least in some conditions, try to impact on prognosis. (www.actabiomedica.it)
Gut Microbiota in Celiac Disease: Is There Any Role for Probiotics?
Full text linkCeliac disease (CD) is an immune-mediated disorder initiated by the ingestion of gluten in genetically predisposed individuals. Recent data shows that changes in the gut microbiome composition and function are linked with chronic inflammatory diseases; this might also be the case for CD. The main aim of this manuscript is to discuss our present knowledge of the relationships between gut microbiota alterations and CD and to understand if there is any role for probiotics in CD therapy. PubMed was used to search for all of the studies published from November 2009 to November 2019 using key words such as “Celiac Disease” and “Microbiota” (306 articles), “Celiac Disease” and “Gastrointestinal Microbiome” (139), and “Probiotics” and “Celiac Disease” (97 articles). The search was limited to articles published in English that provided evidence-based data. Literature analysis showed that the gut microbiota has a well-established role in gluten metabolism, in modulating the immune response and in regulating the permeability of the intestinal barrier. Promising studies suggest a possible role of probiotics in treating and/or preventing CD. Nevertheless, human trials on the subject are still scarce and lack homogeneity. A possible role was documented for probiotics in improving CD-related symptoms, modulating the peripheral immune response and altering the fecal microbiota, although the results were not consistent in all of the studies. No evidence was found that probiotic administration might prevent CD onset. Knowledge of the role of intestinal bacteria in the development of CD opens new possibilities for its treatment through probiotic administration, even though further studies are needed to better clarify whether probiotics can help treat or prevent the disease and to define which probiotics to use, at what dose and for how long
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