Abstract:
BACKGROUND:Chronic continuous abdominal pain (CCAP) is characteristic of centrally mediated gastrointestinal pain disorders. It consumes significant healthcare resources yet is poorly understood, with minimal cohort-specific data in the literature. AIMS:To examine in a large cohort of CCAP patients, (a) diagnostic features, (b) iatrogenic impact of opioids and surgery, (c) drug treatment effects and tolerance. METHODS:Consecutive tertiary CCAP referrals to a neurogastroenterology clinic (2009-2016) were reviewed for Rome IV and neuropathic pain criteria. Medical, surgical and drug histories, interventions and outcomes were correlated with clinical diagnosis and associated opioid use. RESULTS:Of 103 CCAP patients (mean age 40 ± 14, 85% female), 50% had physiological exacerbations precluding full Rome IV Centrally Mediated Abdominal Pain Syndrome criteria. However, there were no significant differences between patients who satisfied Rome IV criteria and those who did not. Overall, 81% had allodynia (a nonpainful stimulus evoking pain sensation). Opioid use was associated with allodynia (P = 0.003). Prior surgery was associated with further operations post CCAP onset (P < 0.001). Although 68% had undergone surgical interventions, surgery did not resolve pain in any patient and worsened pain in 35%. Whilst duloxetine was the most effective neuromodulator (P = 0.003), combination therapy was superior to monotherapy (P = 0.007). CONCLUSIONS:This is currently the largest cohort CCAP dataset that supports eliciting neuropathic features, including allodynia, for a positive clinical diagnosis, to guide treatment. Physiological exacerbation of CCAP may represent visceral allodynia, and need not preclude central origin. Use of centrally acting neuromodulators, and avoidance of detrimental opioids and surgical interventions appear to predict favourable outcomes.
journal_name
Aliment Pharmacol Therjournal_title
Alimentary pharmacology & therapeuticsauthors
Kilgallon E,Vasant DH,Green D,Shields PL,Hamdy S,Lal S,Paine Pdoi
10.1111/apt.15241subject
Has Abstractpub_date
2019-05-01 00:00:00pages
1282-1292issue
10eissn
0269-2813issn
1365-2036journal_volume
49pub_type
杂志文章abstract::In the era of expanding medical therapy for ulcerative colitis, surgery is still a very valid option in those patients, where medicine is not able to control symptoms, both in the acute and chronic stages, and also for those at risk of developing a cancer. The ileal pouch-anal anastomosis (IPAA) will, for the vast maj...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2036.2006.03065.x
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Low-dose thiopurine-allopurinol (LDTA) combination therapy is a commonly applied optimisation strategy in IBD patients with a skewed thiopurine metabolism. AIM:To assess continued LDTA maintenance treatment at annual intervals and explore risk factors for treatment cessation METHODS: Adult IBD patients trea...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.15402
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Third-generation cephalosporins (TGC) constitute the empirical first-line therapy for spontaneous bacterial peritonitis (SBP). Hospitalisation, invasive procedures and use of antibiotics may challenge this concept due to an increase in enterococci and other TGC-resistant microorganisms. AIM:To determine pre...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2012.05076.x
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Although little mortality is associated with irritable bowel syndrome, curative therapy does not exist and thus the economic impact of this disorder may be considerable. METHODS:A systematic review of the literature was performed. Studies were included if their focus was irritable bowel syndrome, and direct...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2036.2003.t01-1-01736.x
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Fructose malabsorption, lactose malabsorption and an early rise in breath hydrogen after lactulose (ERBHAL) may play roles in induction of symptoms in gastrointestinal conditions. AIM:To compare prevalence and interactions of fructose malabsorption, lactose malabsorption and ERBHAL among healthy subjects an...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2009.04018.x
更新日期:2009-07-01 00:00:00
abstract:AIM:To evaluate and compare two 1-week low-dose triple therapies based on lansoprazole, amoxycillin and a macrolide in eradicating Helicobacter pylori. METHODS:Seventy consecutive patients, suffering from dyspeptic symptoms with H. pylori infection, were randomly allocated to one of two treatment groups: (A) (LAC; n =...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2036.1996.d01-533.x
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:The mucosa-associated microbiota appears to be highly relevant to host-microbe interactions in the gastrointestinal (GI) tract. Thus, precise characterisation of the mucosa-associated microbiota may provide important insights for diagnostic and therapeutic development. However, for technical reasons, mucosal...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.13622
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:The low Fermentable Oligo-, Di- Monosaccharides, and Polyoles (FODMAP) diet is a new treatment option for irritable bowel syndrome (IBS). Experts refer to the diet as supported by high level of evidence, but an evaluation of the quality of trials is lacking. AIM:To provide a systematic review of the quality...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/apt.14065
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Many studies report a high prevalence of lactose intolerance in patients with functional, gastrointestinal disease. AIM:To evaluate the role of small intestinal bacterial overgrowth (SIBO) in condition of lactose intolerance and the mechanism by which SIBO may impact lactose tolerance in affected patients. ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2010.04252.x
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:In view of the high diagnostic accuracy of immunoglobulin-A-tissue transglutaminase antibodies for detecting coeliac disease, we have explored whether a small bowel biopsy is always required to establish the diagnosis. AIM:To define the transglutaminase antibody level giving a positive predictive value for ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2008.03609.x
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Cross-sectional studies suggest insulin resistance is strongly associated with hepatic steatosis and fibrosis in patients with chronic hepatitis C (CHC), which might affect the efficacy of antiviral therapy. Aim To investigate retrospectively the impact of insulin resistance on treatment response in Chinese ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2008.03823.x
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Owing to the importance of early treatment, simple and reliable methods for monitoring inflammatory bowel disease (IBD) are needed. AIMS:To determine whether circulating microRNAs are reliable biomarkers for IBD monitoring. METHODS:Serum levels of 17 candidate microRNAs were measured by quantitative real-t...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.15159
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:It is believed that women with inflammatory bowel disease (IBD) have heightened symptoms around their menses. However, there is little information regarding normative changes and which symptoms emerge in relation to menses. AIM:To determine the relationship between gastrointestinal and other symptoms and me...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2012.05155.x
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:The herbal treatment with myrrh, dry extract of chamomile flowers and coffee charcoal has anti-inflammatory and antidiarrhoeal potential and might benefit patients with UC. Aminosalicylates are used as standard treatment for maintaining remission in ulcerative colitis (UC). AIM:To compare the efficacy of th...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1111/apt.12397
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Butyrate, propionate and acetate are short chain fatty acids (SCFA), important for maintaining a healthy colon and are considered as protective in colorectal carcinogenesis. However, they may also regulate immune responses and the composition of the intestinal microbiota. Consequently, their importance in a ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/apt.14689
更新日期:2018-07-01 00:00:00
abstract::In a double-blind randomized study, the profile of 24-h intragastric acidity and nocturnal gastric secretion was measured in a group of patients with healed gastric ulcer on placebo and 400 mg cimetidine b.d. and 800 mg nocte. Neither cimetidine regimen significantly decreased daytime intragastric acidity, but the 800...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1365-2036.1990.tb00472.x
更新日期:1990-06-01 00:00:00
abstract:BACKGROUND:The incidence rates of gastric and oesophageal adenocarcinoma are changing significantly, but little is known about specific sub-sites. AIM:To use a population-based approach to describe the trends in the site-specific incidence of oesophageal and gastric adenocarcinoma. METHODS:Using the Rochester Epidemi...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2006.03229.x
更新日期:2007-02-15 00:00:00
abstract:BACKGROUND:Locally acquired hepatitis E is an emerging infection in developed countries and can be misdiagnosed as drug-induced liver injury. AIM:To study the role of hepatitis E virus (HEV) testing in drug-induced liver injury. METHODS:Retrospective review of a cohort of patients with suspected drug-induced liver in...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2036.2007.03504.x
更新日期:2007-11-15 00:00:00
abstract:BACKGROUND:Eosinophilic oesophagitis (EoE) has evolved from a supposedly rare entity to one whose incidence rates are approaching that of inflammatory bowel disease. The factors responsible for this apparent increase in the incidence remain obscure. AIM:To assess various endoscopist and pathologist factors that might ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.12053
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Irritable bowel syndrome is a widespread disorder with a marked socioeconomic burden. Previous studies support the proposal that a subset of patients with features compatible with diarrhoea-predominant IBS (IBS-D) have bile acid malabsorption (BAM). AIM:To perform a systematic review and meta-analysis to as...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,meta分析,评审
doi:10.1111/apt.13227
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Helicobacter pylori eradication is a challenge in patients allergic to penicillin, especially those who have failed a first-eradication trial. AIM:To assess the efficacy and tolerability of H. pylori first-line treatment and rescue options in patients allergic to penicillin. METHODS:Prospective single cent...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2005.02687.x
更新日期:2005-11-15 00:00:00
abstract:BACKGROUND:Proton pump inhibitors effectively suppress intragastric acid. Nocturnal acid breakthrough occurs on any dosing regimen of oral proton pump inhibitors. Histamine(2)-receptor antagonists (H(2)RA) suppress intragastric acidity independently of meals and help to control nocturnal acid breakthrough. Because prot...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2036.2002.01171.x
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Currently, the relationship between depression and non-alcoholic fatty liver disease (NAFLD) is not clearly defined. AIM:To determine whether depression is associated with NAFLD and NAFLD-related advanced fibrosis in a large population sample. METHODS:We performed a cross-sectional analysis using the 2007-...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.15395
更新日期:2019-09-01 00:00:00
abstract::Eighteen healthy volunteers were included in a cross-over, double-blind study where 500 mg naproxen b.d. was given for 1 week with 20 mg famotidine b.d., 40 mg nocte or placebo. Endoscopic evaluation of the gastroduodenal mucosa was performed before and after each treatment period, with separate evaluation of the mid-...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章
doi:10.1111/j.1365-2036.1990.tb00474.x
更新日期:1990-06-01 00:00:00
abstract::Bismuth preparations are commonly used to treat a variety of gastrointestinal disorders, including peptic ulcers and dyspepsia. The safety profile of currently approved bismuth preparations, such as tripotassium dicitrato bismuthate (De-Nol), bismuth subsalicylate (Pepto-Bismol) and ranitidine bismuth citrate (Pylorid...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2036.1996.22163000.x
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:HCV-TARGET is a longitudinal observational study of chronic hepatitis C virus (HCV) patients treated with direct-acting anti-viral agents (DAAs) in a US consortium of 90 academic and community medical centres. AIM:To assess utilisation of response-guided therapy (RGT) and sustained virological response (SVR...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1111/apt.13095
更新日期:2015-04-01 00:00:00
abstract::One hundred and twenty-five patients with duodenal ulcer disease were given continuous ranitidine therapy after initial acute healing. Cumulative remission rates indicated that 95% of patients were ulcer-free after 1 year, 89% at 2 years, 81% at 3 years, 70% at 4 years and 60% at 5 and 6 years. Nine patients had a sec...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1111/j.1365-2036.1994.tb00171.x
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:The disease severity of non-alcoholic fatty liver disease (NAFLD) and the distinction between simple steatosis and non-alcoholic steatohepatitis (NASH) are based on the pathohistological presence of steatosis, inflammation, ballooning and fibrosis. However, little is known about the relation between such str...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.15293
更新日期:2019-07-01 00:00:00
abstract::The United Network for Organ Sharing database revealed that over the last 4-5 years, an average of 1800 patients were removed from the cadaveric waiting list annually because of patients' death and an additional 400-500 were removed from the list because of the severity of their illnesses. The pre-transplant evaluatio...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2036.2005.02357.x
更新日期:2005-04-15 00:00:00
abstract:BACKGROUND:The Gut and Obesity Asia (GO ASIA) workgroup was formed to study the relationships between obesity and gastrointestinal diseases in the Asia Pacific region. AIM:To study factors associated with nonalcoholic steatohepatitis (NASH) and advanced fibrosis, and medical treatment of biopsy-proven nonalcoholic fat...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.14506
更新日期:2018-03-01 00:00:00