Inflammation, impaired motor function and visceral hypersensitivity: the main mechanisms of functional disorders of the gastrointestinal tract (materials of the Expert Council and literature review)

Vt, Ivashkin; Маев, И. В.; Трухманов, А. С.; Шептулин, А. А.; Лапина, Т. Л.; Симаненков, В. И.; Соколов, К. А.

doi:10.22416/1382-4376-2022-32-1-7-14

Cited by 4 publications

(1 citation statement)

References 35 publications

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“…Functional digestive diseases are often accompanied by low levels of inflammation in the intestinal wall with its infiltration by lymphocytes, eosinophils, mast cells, and other cells [ 9 , 10 , 11 , 12 , 13 ]. This inflammation is considered a response to the increased permeability of the intestinal barrier, which is a common feature of these diseases [ 14 , 15 , 16 , 17 , 18 , 19 ], and can disrupt the mechanisms of gastrointestinal sensitivity and motility, contributing to the development of functional digestive diseases [ 9 , 10 , 11 , 12 , 13 ]. Increased permeability can result in enterocytic disorders, manifested, in part, by the increased formation of fatty acid-binding proteins (FABPs) [ 20 , 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Rebamipide on the Intestinal Barrier, Gut Microbiota Structure and Function, and Symptom Severity Associated with Irritable Bowel Syndrome and Functional Dyspepsia Overlap: A Randomized Controlled Trial

Kovaleva,

Poluektova,

Maslennikov

et al. 2023

JCM

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Treatment of functional digestive disorders is not always effective. Therefore, a search for new application points for potential drugs is perspective. Our aim is to evaluate the effect of rebamipide on symptom severity, intestinal barrier status, and intestinal microbiota composition and function in patients with diarrheal variant of irritable bowel syndrome overlapping with functional dyspepsia (D-IBSoFD). Sixty patients were randomized to receive trimebutine (TRI group), trimebutine + rebamipide (T + R group), or rebamipide (REB group) for 2 months. At the beginning and end of the study, patients were assessed for general health (SF-36), severity of digestive symptoms (Gastrointestinal Symptom Rating and 7 × 7 scales), state of the intestinal barrier, and composition (16S rRNA gene sequencing) and function (short-chain fatty acid fecal content) of the gut microbiota. The severity of most digestive symptoms was reduced in the REB and T + R groups to levels similar to that observed in the TRI group. The duodenal and sigmoidal lymphocytic and sigmoidal eosinophilic infiltration was decreased only in the REB and T + R groups, not in the TRI group. Serum zonulin levels were significantly decreased only in the REB group. A decrease in intraepithelial lymphocytic infiltration in the duodenum correlated with a decrease in the severity of rumbling and flatulence, while a decrease in infiltration within the sigmoid colon correlated with improved stool consistency and decreased severity of the sensation of incomplete bowel emptying. In conclusion, rebamipide improves the intestinal barrier condition and symptoms in D-IBSoFD. The rebamipide effects are not inferior to those of trimebutine.

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Section: Introductionmentioning

confidence: 99%

Effect of Rebamipide on the Intestinal Barrier, Gut Microbiota Structure and Function, and Symptom Severity Associated with Irritable Bowel Syndrome and Functional Dyspepsia Overlap: A Randomized Controlled Trial

Kovaleva,

Poluektova,

Maslennikov

et al. 2023

JCM

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Functional Dyspepsia and Gastroesophageal Reflux Disease: From Pathogenesis to Current Treatment Strategies

Trukhmanov,

Rumyantseva

2024

Rossijskij žurnal gastroènterologii, gepatologii, koloproktolog

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Aim: to present a modern view on the combination of functional dyspepsia (FD) and gastroesophageal reflux disease (GERD) and to evaluate the effectiveness of acotiamide in patients with FD and GERD.Key points. The high frequency of the combination of FD and GERD is caused by common pathogenetic mechanisms and presents an urgent problem in clinical practice. The concurrent occurrence of these diseases alters the clinical picture, complicates differential diagnostics, and leads to inadequate prescription of drugs. Medical treatment for patients with FD and GERD includes the use of proton pump inhibitors (PPIs) and prokinetics. Currently, acotiamide is recognized as an effective drug that affects the motility of the upper gastrointestinal tract. Acotiamide is an antagonist of muscarinic M1 and M2 receptors and a reversible inhibitor of acetylcholinesterase. The clinical efficacy of this drug has been demonstrated not only in patients with FD but also in those with a combination of FD and GERD.Conclusion. Administration of acotiamide is pathogenetically justified in patients with the combination of GERD and FD.

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Prevalence of combination of functional dyspepsia and irritable bowel syndrome: a meta-analysis of studies using the Rome III–IV Criteria

Andreev

Bordin

Vyuchnova

et al. 2022

Terapevticheskii arkhiv

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Aim. To systematize data on the prevalence of the combination of functional dyspepsia (FD) and irritable bowel syndrome (IBS) using the Rome IIIIV Criteria. Materials and methods. A search in electronic databases MEDLINE/PubMed, EMBASE, and Cochrane was conducted. The depth of search was 17 years (from January 2006 to May 2022). Original publications from peer-reviewed periodicals that applied the Rome IIIIV Criteria for diagnosis of FD and IBS in an adult patient population with detailed descriptive statistics to allow the resulting data to be included in the meta-analysis were selected for final analysis. Results. The final analysis included 38 studies involving 17,993 patients with FD and 15,883 patients with IBS. In the overall pool of studies using the Rome IIIIV Criteria, the pooled prevalence of FD in patients with IBS was 34.625% (95% confidence interval [CI] 28.15941.390), and the pooled prevalence of IBS in patients with FD was 37.549% (95% [CI] 31.51143.787). A random-effects model was used in the analyses since significant heterogeneity between results was found (p0.0001; I298%). Using the Rome III Criteria, the pooled prevalence of FD in patients with IBS was 31.993% (95% CI 26.13538.150; I2=98.17%), while the prevalence of IBS in patients with FD was 34.694% (95% [CI] 29.31940.273; I2=97,89%). An analysis of papers using the Rome IV Criteria demonstrated that the pooled prevalence of FD in patients with IBS was 42.614% (95% CI 18.58868.675; I2=98.97%), and the prevalence of IBS in patients with FD was 50.444% (95% CI 37.95662.904; I2=94,39%). Conclusion. This meta-analysis demonstrated that the prevalence of the combination of FD and IBS identified using the Rome IIIIV Criteria is high and is reported in approximately 1 in 3 patients with the functional gastrointestinal disorders concerned. The prevalence of a combination of FD and IBS identified using the Rome IV Criteria is at least 10% higher than that using the Rome III Criteria.

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Inflammation, impaired motor function and visceral hypersensitivity: the main mechanisms of functional disorders of the gastrointestinal tract (materials of the Expert Council and literature review)

Cited by 4 publications

References 35 publications

Effect of Rebamipide on the Intestinal Barrier, Gut Microbiota Structure and Function, and Symptom Severity Associated with Irritable Bowel Syndrome and Functional Dyspepsia Overlap: A Randomized Controlled Trial

Effect of Rebamipide on the Intestinal Barrier, Gut Microbiota Structure and Function, and Symptom Severity Associated with Irritable Bowel Syndrome and Functional Dyspepsia Overlap: A Randomized Controlled Trial

Functional Dyspepsia and Gastroesophageal Reflux Disease: From Pathogenesis to Current Treatment Strategies

Prevalence of combination of functional dyspepsia and irritable bowel syndrome: a meta-analysis of studies using the Rome III–IV Criteria

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