Analysis of the Burden of Bowel Preparation for Colonoscopy : A Qualitative Study Using Semi-structured Interviews

The burden of bowel preparation with laxatives and dietary restrictions is one of the reasons for the low acceptance rate of colonoscopies. This study aimed to extract concepts related to the burden of bowel preparation. Semi-structured interviews were conducted with 25 adults (13 men, median age 61 years [range 30-83 years]) who underwent a colonoscopy in an outpatient setting from June to August 2022. The interview contents were analyzed and classified into six categories of physical, psychological, and social burdens due to dietary restrictions and laxatives, respectively. The findings can be used to construct a scale that can comprehensively assess the burden of bowel preparation and improve strategies for this.大腸内視鏡検査の受検割合が低いことの原因の一つとして，食事制限と下剤で腸管内容物を排出させる処置（以下，大腸前処置)の負担が大きいことが挙げられる。本研究では，大腸前処置の負担感に関する概念を抽出することを目的とした。2022年6月～8月，外来で大腸検査を受検した成人25人（男性13人，年齢中央値61[範囲 30-83]歳)に対して，半構造化面接を行った。発言を分析し，食事制限と下剤のそれぞれによる身体的負担，心理的負担，社会的負担の6つのカテゴリに分類した。今回得られた知見は，大腸前処置の負担感を網羅的に評価可能な尺度の開発や，負担の軽い大腸前処置の確立につながることが期待される

Translation and Validation Testing of the Constipation-Related Quality of Life Scale for Use in Japan

Introduction Establishing a scale that can easily be used to appropriately measure the impact of constipation on the quality of life in Japan is a first step toward addressing this important health issue. We developed a Japanese language version of the Constipation-Related Quality of Life scale, which has 18 items and four subscales, and then subjected it to validation testing. Methods After translation according to a standardized and commonly used procedure, the Japanese version of the Constipation-Related Quality of Life scale was administered to people in an internet-based panel, in March 2023. The participants included 1,276 adults who had constipation (median age: 60 years, 690 {54.1%} males). The outcome measures included the Constipation-Related Quality of Life scale, the Constipation Scoring System (an index of constipation severity), and the Medical Outcomes Study (MOS) eight-item short form (a measure of generic health-related quality of life). Results Confirmatory factor analysis (four-factor model) indicated that all 18 Constipation-Related Quality of Life items had sufficiently high factor loadings (0.686-0.926). Internal consistency reliability was high (Cronbach's alpha: 0.86-0.94). Scores on the social impairment subscale and on the distress subscale of the Constipation-Related Quality of Life scale were significantly worse in the participants who had worse scores on the social functioning and mental health domains, respectively, of the MOS eight-item short form, which indicates good concurrent validity. Regarding criterion-based validity, the four subscale scores differed significantly among the four constipation-severity groups. The four subscale scores were also 1.16-4.53 times more sensitive than the MOS eight-item short form's mental component score to differences among the four constipation-severity groups (relative validity: 1.16-4.53), which indicates good discriminant validity. Conclusion The Japanese version of the Constipation-Related Quality of Life scale can be used with confidence in its factor structure, its concurrent, criterion-based, and discriminant validity, and its internal consistency reliability

A bacterial sulfoglycosidase highlights mucin O-glycan breakdown in the gut ecosystem

Mucinolytic bacteria modulate host–microbiota symbiosis and dysbiosis through their ability to degrade mucin O-glycans. However, how and to what extent bacterial enzymes are involved in the breakdown process remains poorly understood. Here we focus on a glycoside hydrolase family 20 sulfoglycosidase (BbhII) from Bifidobacterium bifidum, which releases N-acetylglucosamine-6-sulfate from sulfated mucins. Glycomic analysis showed that, in addition to sulfatases, sulfoglycosidases are involved in mucin O-glycan breakdown in vivo and that the released N-acetylglucosamine-6-sulfate potentially affects gut microbial metabolism, both of which were also supported by a metagenomic data mining analysis. Enzymatic and structural analysis of BbhII reveals the architecture underlying its specificity and the presence of a GlcNAc-6S-specific carbohydrate-binding module (CBM) 32 with a distinct sugar recognition mode that B. bifidum takes advantage of to degrade mucin O-glycans. Comparative analysis of the genomes of prominent mucinolytic bacteria also highlights a CBM-dependent O-glycan breakdown strategy used by B. bifidum. [Figure not available: see fulltext.]