10 research outputs found
Bloating and functional gastro-intestinal disorders: Where are we and where are we going?
Bloating is one of the most common and bothersome symptoms complained by a large proportion of patients. This symptom has been described with various definitions, such as sensation of a distended abdomen or an abdominal tension or even excessive gas in the abdomen, although bloating should probably be defined as the feeling (e.g. a subjective sensation) of increased pressure within the abdomen. It is usually associated with functional gastrointestinal disorders, like irritable bowel syndrome, but when bloating is not part of another functional bowel or gastrointestinal disorder it is included as an independent entity in Rome III criteria named functional bloating. In terms of diagnosis, major difficulties are due to the lack of measurable parameters to assess and grade this symptom. In addition, it is still unclear to what extent the individual patient complaint of subjective bloating correlates with the objective evidence of abdominal distension. In fact, despite its clinical, social and economic relevance, bloating lacks a clear pathophysiology explanation, and an effective management endorsement, turning this common symptom into a true challenge for both patients and clinicians. Different theories on bloating etiology call into questions an increased luminal contents (gas, stools, liquid or fat) and/or an impaired abdominal empting and/or an altered intra-abdominal volume displacement (abdomino-phrenic theory) and/or an increased perception of intestinal stimuli with a subsequent use of empirical treatments (diet modifications, antibiotics and/or probiotics, prokinetic drugs, antispasmodics, gas reducing agents and tricyclic antidepressants). In this review, our aim was to review the latest knowledge on bloating physiopathology and therapeutic options trying to shed lights on those processes where a clinician could intervene to modify disease course
The prevalence of sexual behavior disorders in patients with treated and untreated gastroesophageal reflux disease.
Abstract
Background: Gastroesophageal reflux disease (GERD)
is a chronic disease. Sexual behavior is often altered in
chronic illness. The aim of this study was to evaluate
sexual behavior in patients affected with GERD before
and after medical or surgical treatment in comparison to
healthy controls (HC).
Methods: Upper GI endoscopy and 24-h ambulatory pH
testing were performed to confirm GERD in symptomatic
patients. GERD patients completed an anonymous
questionnaire on sexual life before and after
medical or surgical treatment.
Results: Compared with HC, untreated patients with
GERD showed more frequent difficulty in attaining
orgasm and painful intercourse. GERD patients after
surgical treatment had significantly more difficulty in
attaining orgasm, while after continuous medical treatment
GERD patients compared with HC had significantly
more difficulty in attaining orgasm, higher painful
intercourse, lower sexual desire, and perceived more
frequently that the partner was unhelpful. When compared
with untreated conditions, GERD patients after
surgical treatment had a significant improvement in
attaining orgasm and in painful intercourse but a significant
decrease in sexual desire, a lower satisfaction
with their sexual life, and a higher prevalence of an
unhelpful partner, whereas GERD patients after medical
treatment had a decrease in all indices of sexual
behavior.
Conclusion: Untreated GERD is associated with disorders
in sexual behavior. Compared with HC, only the
surgical group partially improved after treatment