Digestive Diseases and Sciences 

About: Digestive Diseases and Sciences is an academic journal published by Springer Science+Business Media. The journal publishes majorly in the area(s): Hepatology & Inflammatory bowel disease. It has an ISSN identifier of 0163-2116. Over the lifetime, 22569 publications have been published receiving 551082 citations.

U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact.

Abstract: Our objective was to obtain national data of the estimated prevalence, sociodemographic relationships, and health impact of persons with functional gastrointestinal disorders. We surveyed a stratified probability random sample of U.S householders selected from a data base of a national market firm (National Family Opinion, Inc.). Questions were asked about bowel symptoms, sociodemographic associations, work absenteeism, and physician visits. The sampling frame was constructed to be demographically similar to the U.S. householder population based on geographic region, age of householder, population density, household income and household size. Of 8250 mailings, 5430 were returned suitable for analysis (66% response). The survey assessed the prevalence of 20 functional gastrointestinal syndromes based on fulfillment of multinational diagnostic (Rome) criteria. Additional variables studied included: demographic status, work absenteeism, health care use, employment status, family income, geographic area of residence, population density, and number of persons in household. For this sample, 69% reported having at least one of 20 functional gastrointestinal syndromes in the previous three months. The symptoms were attributed to four major anatomic regions: esophageal (42%), gastroduodenal (26%), bowel (44%), and anorectal (26%), with considerable overlap. Females reported greater frequencies of globus, functional dysphagia, irritable bowel syndrome, functional constipation, functional abdominal pain, functional biliary pain and dyschezia; males reported greater frequencies of aerophagia and functional bloating. Symptom reporting, except for incontinence, declines with age, and low income is associated with greater symptom reporting. The rate of work/school absenteeism and physician visits is increased for those having a functional gastrointestinal disorder. Furthermore, the greatest rates are associated with those having gross fecal incontinence and certain more painful functional gastrointestinal disorders such as chronic abdominal pain, biliary pain, functional dyspepsia and IBS. Preliminary information on the prevalence, socio-demographic features and health impact is provided for persons who fulfill diagnostic criteria for functional gastrointestinal disorders.

Chronic pancreatitis caused by an autoimmune abnormality : proposal of the concept of autoimmune pancreatitis

Abstract: Several authors have reported a case of chronic pancreatitis associated with Sjogren's syndrome in which an autoimmune mechanism may have been involved in the etiology and in which steroid therapy was effective. We recently encountered a patient with pancreatitis who had hyperglobulinemia, was autoantibody-positive, and responded to steroid therapy. This patient, however, failed to show any evidence of association with Sjogren's syndrome or other collagen diseases. Although the concept of autoimmune hepatitis and the criteria for diagnosing it have been established, autoimmune pancreatitis has not yet been defined as a clinical entity. We report a case of chronic pancreatitis in which an autoimmune mechanism is involved in the etiology and summarize the cases of pancreatitis suspected of being caused by an autoimmune mechanism in the Japanese and English literature.

GSRS—A clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease

Abstract: An interview-based rating scale consisting of 15 items for assessment of gastrointestinal symptoms in irritable bowel syndrome and peptic ulcer disease has been developed. The interrater reliability was estimated by means of independent and simultaneous duplicate ratings by two raters in 20 cases and ranged from 0.86 to 1.00. The scale was easy to apply and proved to be useful in comparing the effectiveness of different modes of treatment in two clinical trials.

Functional bowel disorders - A multicenter comparison of health status and development of illness severity index

Abstract: In a multicenter study of patients with painful functional bowel disorders (FBD), we compared the demographic, health status, and diagnostic features of patients with FBD and developed a functional bowel disorder severity index (FBDSI) for research and clinical care. Two hundred seventy patients with FBD in the United States, England, and Canada were surveyed on symptoms and health status, and their physicians made a diagnosis and rated illness severity as mild, moderate, or severe. Comparisons of 22 demographic and clinical variables were made by study site in addition to physicians' severity ratings. To develop the FBDSI, multiple regression analysis used the demographic and clinical variables to predict the physician's rating of severity. We found that most health status measures of patients with FBD across study sites are comparable and the derived and validated FBDSI scoring system uses three easy to obtain variables: FBDSI = [current pain by visual analog scale (0-100)] + [diagnosis of chronic functional abdominal pain (0 if absent and 106 if present)] + [number of physicians visits over previous six months x 11]. The FBDSI can be used to select patients for research protocols and/or follow their clinical outcome or response to treatments over time.

Peptic ulcer disease.

Abstract: In the final paragraph of that classical volume, \"Peptic Ulcer\" (1) published in 1951, during an era when medical treatment consisted only of special diet and antacids, three of the most eminent gastrointestinal physicians the world has ever known, namely A. C. Ivy, Morton Grossman and William Bachrach, looked towards the future treatment of ulcer. They expressed the hope that \"mutilating operations will be unnecessary\" and predicted that \"future research will reveal orally-active innocuous substances for specifically preventing the formation of acid by the parietal cells and/or rendering the gastric and duodenal mucosa less susceptible to injury\". Over the thirty years which have elapsed since these postulates were put forward many of their requirements have been fulfilled. Certainly, fewer and less mutilating operations are being performed with minimal mortalities but there are still significant and irreversible complications and the chances of ulcer recurrence are appreciable. In the last two decades pharmacological research has achieved the first postulate by developing orally administered agents, now given once daily, which are capable of \"specifically preventing the formation of acid by the parietal cell\". Initially, vagal blockage was attempted with anticholinergics but these were only partially effective and they produced unpleasant side-effects. This state of affairs has been much improved by the development of new muscarine M 1-receptor antagonists such as pirenzepine, which are capable of healing ulcers and have minimal side-effects. There was widespread disappointment when the antihistamine drugs developed in the 1950s were