Gut microbiome of pre-adolescent children of two ethnicities residing in three distant cities

Recent studies have realized the link between gut microbiota and human health and diseases. The question of diet, environment or gene is the determining factor for dominant microbiota and microbiota profile has not been fully resolved, for these comparative studies have been performed on populations of different ethnicities and in short-term intervention studies. Here, the Southern Chinese populations are compared, specifically the children of Guangzhou City (China), Penang City (west coast Malaysia) and Kelantan City (east coast Malaysia). These Chinese people have similar ancestry thus it would allow us to delineate the effect of diet and ethnicity on gut microbiota composition. For comparison, the Penang and Kelantan Malay children were also included. The results revealed that differences in microbiota genera within an ethnicity in different cities was due to differences in food type. Sharing the similar diet but different ethnicity in a city or different cities and living environment showed similar gut microbiota. The major gut microbiota (more than 1% total Operational Taxonomy Units, OTUs) of the children population are largely determined by diet but not ethnicity, environment, and lifestyle. Elucidating the link between diet and microbiota would facilitate the development of strategies to improve human health at a younger age

Randomised clinical trial: the effectiveness of Gaviscon Advance vs non-alginate antacid in suppression of acid pocket and post-prandial reflux in obese individuals after late-night supper

©2020 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd Background: Late-night supper increases the risk of postprandial reflux from the acid pocket especially in obesity. An alginate-based, raft-forming medication may be useful for obese patients with GERD. Aims: To compare the efficacy of Gaviscon Advance (Reckitt Benckiser, UK) and a non-alginate antacid in post-supper suppression of the acid pocket and post-prandial reflux among obese participants. Methods: Participants underwent 48 h wireless and probe-based pH-metry recording of the acid pocket and lower oesophagus, respectively, and were randomised to single post-supper (10 pm) dose of either Gaviscon Advance or a non-alginate antacid on the second night. Primary outcomes were suppression of median pH of acid pocket and lower oesophagus, measured every 10-minutes post-supper for 1 h. Secondary outcomes were suppression of % time pH \u3c 4 at lower oesophagus and improvement in frequency and visual analogue score (VAS) of regurgitation. Results: Of the 81 screened participants, 55 were excluded and 26 (mean age 33.5 years, males 77.8% and BMI 32.8 kg/m2) were randomised to Gaviscon Advance (n = 13) or antacid (n = 13). Median pH of the acid pocket but not the lower oesophagus was suppressed with Gaviscon Advance vs antacid (all P \u3c 0.04) Gaviscon Advance but not antacid significantly reduced in % time pH \u3c 4, symptom frequency and VAS on day 2 vs day 1 (all P \u3c 0.05). Conclusions: Among obese individuals, Gaviscon Advance was superior to a non-alginate antacid in post-supper suppression of the acid pocket. (Clinical trial registration unique identifier: NCT03516188)

Predictors of decreased stool frequency in constipated elderly: a hierarchical linear regression model approach

Background/Aims Based on our earlier study among the elderly in primary care, The prevalence of functional constipation was 13.5% and 20% reported stool frequency <3 per week. In the current study, we aimed to determine predictors of decreased stool frequency among constipated elderly using a hierarchical linear regression model approach. Methods Consecutive elderly (above 65 years old) participants were recruited after informed consent. In addition to questionnaires (Rome III Questionnaire, demographic, diet and physical activity), patients underwent anorectal studies including high resolution anorectal manometry (M-Compass, Medspira), balloon expulsion test, and colonic transit study (Sitzmarks). Using multiple linear regression, association between a lower stool frequency in constipated elderly and independent factors (three hierarchical models i.e., model 1 demographic, model 2 risk factors and model 3 anorectal parameters) was determined with p<0.05 as significant. Results Of 71 elderly screened, 31 (2/3 females) were recruited, 17 had constipation and 14 without. With univariable analysis, those with versus without constipation reported lower stool frequency, longer duration of defecation, more Bristol type 1, 2 & 3 stools, water intake <6 glass per day, and less income per month (all p<0.05) (Table 1). With hierarchical model analysis, significant predictors of less frequent stools in elderly were the use of medications (adjusted B, –3.41; 95% confidence interval [CI], –6.61 to –0.22; p=0.037) in model 1, Bristol type 1, 2 & 3 stools (adjusted B, –5.4; 95% CI, –8.59 to –2.22; p=0.002) and longer duration of defecation (adjusted B –2.82; 95% CI, –5.34 to –0.31) in model 2, and lastly hyposensitivity (adjusted B, 0.19; 95% CI, 0.06 to 0.31) in model 3. Conclusions Among constipated elderly, the use of medications, Bristol type 1, 2 & 3 stools, longer duration of defecation and hyposensitivity predict less frequent stools

Validity and Reliability of the Malay Versions of Bloating Severity (BSQ-M) and Quality of Life (BLQoL-M) Questionnaires

Abdominal bloating (AB) is a prevalent and bothersome symptom, but there are no specific measures for severity and quality of life (QoL) other than the Bloating Severity Questionnaire (BSQ) and Bloating Quality of Life (BLQoL). We aimed to translate the BSQ and BLQoL into the Malay language and to validate them using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) approaches. The 12-item BSQ has two components, seven-item severity in general (SevGen) and five-item severity in the past 24 h (Sev24), and BLQOL has five items. Translation to the Malay language (BSQ-M and BLQoL-M) was performed using standard forward and backward processes. EFA followed by CFA were performed in participants with AB due to functional bowel disorders, with the purpose of examining the validity and reliability of the questionnaires translated into Malay. After EFA with 152 participants, all the items of BSQ-M remained in the model. Total variance extracted was 53.26% for BSQ-M and 58.79% for BLQoL-M. The internal consistency based on Cronbach’s alpha values was 0.52 for SevGen, 0.86 for Sev24, and 0.81 for BLQoL-M. After performing CFA with another 323 participants, the final measurement model for BSQ-M and BLQoL-M fit the data well in terms of several fit indices (BSQ-M: root mean square error of approximation (RMSEA) = 0.050, Comparative Fit Index (CFI) = 0.966, Tucker–Lewis Fit Index (TLI) = 0.956, and standardized root mean squared residual (SRMR) = 0.051; BLQoL-M: RMSEA = 0.071, CFI = 0.985, TLI = 0.962, SRMR = 0.021). The composite reliability for BSQ-M and BLQoL-M were satisfactory (SevGen = 0.83, Sev24 = 0.89, BLQoL = 0.80). The intraclass correlation (ICC) results showed excellent stability for BSQ-M and BLQoL-M, ranging from 0.74 to 0.93. The Malay language versions of BSQ-M and BLQoL-M are valid and reliable instruments for measuring the severity and QoL of AB for the Asian population with functional bowel disorders

Author Correction: A Randomised Controlled Trial on the Effectiveness and Adherence of Modified Alternate-day Calorie Restriction in Improving Activity of Non-Alcoholic Fatty Liver Disease

An amendment to this paper has been published and can be accessed via a link at the top of the paper