7.6% of Indian subjects have significant GERD symptoms. Consumption of non-vegetarian foods was an independent predictor of GERD. BMI was comparable among subjects with or without GERD.
The Indian Motility and Functional Diseases Association and the Indian Society of Gastroenterology developed this evidence-based practice guideline for management of chronic constipation. A modified Delphi process was used to develop this consensus containing 29 statements, which were generated by electronic voting iteration as well as face to face meeting and review of the supporting literature primarily from India. These statements include 9 on epidemiology, clinical presentation, and diagnostic criteria; 8 on pathophysiology; and the remaining 12 on investigations and treatment. When the proportion of those who voted either to accept completely or with minor reservation was 80% or higher, the statement was regarded as accepted. The members of the consensus team believe that this would be useful for teaching, clinical practice, and research on chronic constipation in India and in other countries with similar spectrum of the disorders.
Chronic diarrhea is a common clinical problem in gastroenterology practice and often difficult to diagnose the cause. Presence of villous atrophy in these subjects is not specific as differential diagnosis can be broad. Drug-induced diarrhea is often overlooked during the evaluation. We report a short series of such challenging small bowel diarrhea secondary to olmesartan-related sprue-like enteropathy.
Background: Evaluate prevalence of functional constipation (FC) and irritable bowel syndrome-constipation (IBS-C) in Indian constipated patients and assess their demographic/socio-economic/clinical characteristics.Methods: Patients (≥18 years) who visited their general physician with symptoms of constipation (Rome III criteria for FC or IBS-C as per physician assessment) and willing to participate were enrolled in this prospective, clinical-epidemiological study. Demographic, socioeconomic status, lifestyle and dietary habits, comorbid conditions, treatment history, concomitant medications, stool form (Bristol stool form scale), severity of constipation (constipation scoring system [CSS]), constipation-related symptoms (patient assessment of constipation symptoms [PAC-SYM]) and quality of life (patient assessment of constipation-quality of life questionnaire [PAC-QoL]) were recorded.Results: Out of 925 constipated patients, 75.6% were diagnosed with FC against 24.4% with IBS-C (P < 0.0001). Patients of both subtypes had high average scores of PAC-SYM (FC: 27.1 ± 6; IBS-C: 30.1 ± 4.9) and CSS (FC: 8.4 ± 3.1; IBS-C: 11.2 ± 3), leading to high PAC-QoL score (FC: 38.1 ± 16.8; IBS-C: 42.2 ± 13.6). Hypertension (16%) and diabetes (10%) in patients with FC while acid peptic disorders (21.7%) amongst IBS-C patients were the most common comorbid conditions observed. Laxatives were the most common medication used; osmotic (32.6% versus 40.7%) and bulk laxatives (22.8% versus 37.4%) were the commonest laxatives. However, about 1/5th patients of FC were using home remedies.Conclusions: There was a higher prevalence of FC over IBS-C in Indian constipated patients; both subtypes had high frequency and severity of constipation-related symptoms and poor QoL.
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