Summary Background:  Peptic ulcer disease is mainly caused by Helicobacter pylori infection and the use of non‐steroidal anti‐inflammatory drugs. Aim:  To investigate the trends in the prevalence of peptic ulcer disease, H. pylori infection and non‐steroidal anti‐inflammatory drug use in uninvestigated dyspeptic patients over recent years in Hong Kong. Methods:  Data from consecutive patients with uninvestigated dyspeptic symptoms referred by family physicians for open access upper endoscopy during 1997 and 2003 were analysed in relation to peptic ulcer disease, H. pylori infection and non‐steroidal anti‐inflammatory drug use. Results:  Among 2700 patients included, 405 (15%) had peptic ulcer disease and 14 (0.5%) had gastric cancer. There was a reduced trend from 1997 to 2003 in the prevalence of peptic ulcer disease (17, 20, 14, 16, 13, 14 and 14%, respectively, χ2 = 5.80, P = 0.016) (mainly because of decrease in duodenal ulcers), H. pylori infection (44, 50, 49, 44, 40, 40, 36 and 43%, respectively, χ2 = 13.55, P < 0.001) and non‐steroidal anti‐inflammatory drug use (13, 5, 5, 6, 3, 4, 4 and 5% respectively, χ2 = 13.61, P < 0.001). The prevalence of peptic ulcer disease, H. pylori infection and non‐steroidal anti‐inflammatory drug use between 2001 and 2003 were significantly lower than that between 1997 and 2000 (17% vs. 13%, OR = 0.78, 95% CI: 0.63–0.96, P = 0.020 for peptic ulcer disease; 47% vs. 39%, OR =0.72, 95% CI: 0.60–0.86, P < 0.001 for H. pylori infection; and 6% vs. 4%, OR = 0.56, 95% CI: 0.39–0.82, P = 0.002 for non‐steroidal anti‐inflammatory drug use). H. pylori infection was associated with both duodenal ulcer (OR = 15.87, 95% CI: 10.60–23.76, P < 0.001) and gastric ulcer (OR = 3.12, 95% CI: 2.15–4.53, P < 0.001) whereas non‐steroidal anti‐inflammatory drug use was only associated with gastric ulcer (OR = 2.97, 95% CI: 1.70–5.20, P < 0.001). Conclusions:  The prevalence of peptic ulcer disease, mainly duodenal ulcers, was reduced in association with a decreasing trend in the prevalence of H. pylori infection and non‐steroidal anti‐inflammatory drug use from 1997 to 2003.

Our study observed further hypoadiponectinemia and IR in NAFLD with metabolic syndrome. The T45G and G276T of the adiponectin gene may not be the important determinants of NAFLD in Chinese people, but some of them still influence serum ALT, BMI, IR, lipid, glucose metabolism and plasma adiponectin concentration.

The Irritable Bowel Syndrome (IBS) is a functional digestive disorder recognised as a Biopsychosocial model, because psychological, social and biological factors influence the development of its symptomatology. A high psychiatric comorbidity is frequently observed in patients with IBS associated to an increase in the severity of symptoms and a low-grade of inflammatory response. Although its pathophysiological mechanism has not been fully understood, an imbalance in bidirectional communication is described in the gut-brain axis that affects psychoneuroimmune status of IBS patients. Diverse psychotherapeutic interventions have been shown to be effective in reducing the psychosocial impact in IBS patients, as well as in reducing their intestinal symptoms. However, at the clinical practice, it is not routinely applied because of its high cost. The Mindfulness-Based Stress Reduction (MBSR) is an alternative program that shown to be effective in reducing the clinical severity and improving the quality of life of patients with IBS. Although MBSR has demonstrated to reduce the levels of pro-inflammatory cytokines, including IL-6, in healthy subjects and cancer’s patients, its effect on the immune response in IBS patients remains unknown. This review discusses the pathophysiological mechanisms underlying the relationship between psychosocial disturbances, clinical symptomatology and low-grade inflammation in IBS. Based on that, we present the arguments that allow proposing the use of MBSR for the IBS treatment.