The Experts below are selected from a list of 10035 Experts worldwide ranked by ideXlab platform
John R Mathias - One of the best experts on this subject based on the ideXlab platform.
-
effect of leuprolide acetate in treatment of abdominal pain and nausea in premenopausal women with Functional Bowel Disease a double blind placebo controlled randomized study
Digestive Diseases and Sciences, 1998Co-Authors: John R Mathias, Mary H Clench, Thomas L Abell, Kenneth L Koch, Glen A Lehman, Malcolm K Robinson, Robin D Rothstein, William J SnapeAbstract:We have previously reported impressive results in using a gonadotropin-releasing hormone analog, leuprolide acetate (Lupron), in the treatment of moderate to severe symptoms (especially abdominal pain and nausea) in patients with Functional Bowel Disease (FBD). Pain is the hallmark of patients with FBD, and there is no consistent therapy for the treatment of these patients. The purpose of the present study was to expand the investigation to study similar patients (menstruating females) in a multicenter, double-blind, placebo-controlled, randomized study using Lupron Depot (which delivers a continuous dose of drug for one month), 3.75 mg (N = 32) or 7.5 mg (N = 33), or placebo (N = 35) given intramuscularly every four weeks for 16 weeks. Symptoms were assessed using daily diary cards to record abdominal pain, nausea, vomiting, early satiety, anorexia, bloating, and altered Bowel habits. Additional assessment tools were quality of life questionnaires, psychological profile, oral-to-cecal transit using the hydrogen breath test, antroduodenal manometry, reproductive hormone levels, and global evaluations by both patient and investigator. Patients in both Lupron Depot-treated groups showed consistent improvement in symptoms; however, only the Lupron Depot 7.5 mg group showed a significant improvement for abdominal pain and nausea compared to placebo (P < 0.001). Patient quality of life assessments and global evaluations completed by both patient and investigators were highly significant compared to placebo (P < 0.001). All reproductive hormone levels significantly decreased for both Lupron Depot-treated groups by week 4 and were significantly different compared to placebo at week 16 (P < 0.001). This study shows that leuprolide acetate is effective in controlling the debilitating symptoms of abdominal pain and nausea in patients with FBD.
-
effect of leuprolide acetate in patients with moderate to severe Functional Bowel Disease double blind placebo controlled study
Digestive Diseases and Sciences, 1994Co-Authors: John R Mathias, Mary H Clench, Vonda G Reevesdarby, Lisa Mehelich Fox, Ping H Hsu, Patricia H Roberts, Lesa L Smith, Norma J StiglichAbstract:Moderate to severe Functional Bowel Disease results in debilitating abdominal pain, nausea, intermittent vomiting, early satiety, bloating, abdominal distension, and/or altered Bowel habits. Because it occurs ∼20–30 times more frequently in women than in men and its symptoms often coincide with the menstrual cycle, we hypothesized that reproductive steroids may antagonize Diseased nerves of the gastrointestinal tract, enhancing the expression of symptoms. No effective or consistent therapy has existed for these patients. We prospectively investigated the effect of a gonadotropin-releasing hormone analog, leuprolide acetate, in 30 women with symptoms of moderate to severe Functional Bowel Disease. The study was phase II, randomized, double blind, and placebo controlled. Lupron Depot 3.75 mg (which delivers a continuous low dose of drug for one month) or placebo were given intramuscularly monthly for three months. Symptom scores were assessed at each four-week visit. Follicle-stimulating hormone, luteinizing hormone, estradiol, and progesterone levels were assessed before and after therapy. Patients treated with low-dose leuprolide improved progressively and significantly in scores for nausea, vomiting, bloating, abdominal pain, and early satiety, and for overall symptoms (P<0.01–0.05). All hormone levels decreased significantly (P<0.05) except luteinizing hormone (P=0.054).
-
effect of leuprolide acetate in patients with Functional Bowel Disease long term follow up after double blind placebo controlled study
Digestive Diseases and Sciences, 1994Co-Authors: John R Mathias, Mary H Clench, Patricia H Roberts, Vonda G ReevesdarbyAbstract:We initially investigated the effects of a gonadotropin-releasing hormone analog, leuprolide acetate, in 28 patients with moderate to severe Functional Bowel Disease in a phase-II, randomized, double-blind, and placebo-controlled study using Lupron Depot 3.75 mg (which delivers a continuous low dose of drug for one month) or placebo given intramuscularly. After completing that 12-week study period during which their symptoms had improved significantly (P<0.01–0.5), the 28 patients were allowed to continue receiving leuprolide acetate; they were monitored for an additional 40 weeks. Of those 28, 25 (89%) finished the 52-week treatment. Drug administration was changed from the monthly low-dose form of leuprolide acetate to a daily subcutaneous dose that was gradually increased from 0.5 mg daily to an effective therapeutic dose (1.0–1.5 mg). All subjects received estrogen replacement during this period. Continued use of leuprolide acetate at maximum therapeutic dosage and over longer periods of time produced even more striking and significant changes in the disabling and debilitating symptoms of Functional Bowel Disease. Nausea, abdominal pain, early satiety, anorexia, and abdominal distension decreased markedly (P<0.0001) and vomiting was also reduced (P<0.01) more than in the short-term, low-dosage, double-blind study. Combined total symptom scores and overall assessment also changed significantly in the long-term phase (bothP<0.0001).
Vonda G Reevesdarby - One of the best experts on this subject based on the ideXlab platform.
-
effect of leuprolide acetate in patients with moderate to severe Functional Bowel Disease double blind placebo controlled study
Digestive Diseases and Sciences, 1994Co-Authors: John R Mathias, Mary H Clench, Vonda G Reevesdarby, Lisa Mehelich Fox, Ping H Hsu, Patricia H Roberts, Lesa L Smith, Norma J StiglichAbstract:Moderate to severe Functional Bowel Disease results in debilitating abdominal pain, nausea, intermittent vomiting, early satiety, bloating, abdominal distension, and/or altered Bowel habits. Because it occurs ∼20–30 times more frequently in women than in men and its symptoms often coincide with the menstrual cycle, we hypothesized that reproductive steroids may antagonize Diseased nerves of the gastrointestinal tract, enhancing the expression of symptoms. No effective or consistent therapy has existed for these patients. We prospectively investigated the effect of a gonadotropin-releasing hormone analog, leuprolide acetate, in 30 women with symptoms of moderate to severe Functional Bowel Disease. The study was phase II, randomized, double blind, and placebo controlled. Lupron Depot 3.75 mg (which delivers a continuous low dose of drug for one month) or placebo were given intramuscularly monthly for three months. Symptom scores were assessed at each four-week visit. Follicle-stimulating hormone, luteinizing hormone, estradiol, and progesterone levels were assessed before and after therapy. Patients treated with low-dose leuprolide improved progressively and significantly in scores for nausea, vomiting, bloating, abdominal pain, and early satiety, and for overall symptoms (P<0.01–0.05). All hormone levels decreased significantly (P<0.05) except luteinizing hormone (P=0.054).
-
effect of leuprolide acetate in patients with Functional Bowel Disease long term follow up after double blind placebo controlled study
Digestive Diseases and Sciences, 1994Co-Authors: John R Mathias, Mary H Clench, Patricia H Roberts, Vonda G ReevesdarbyAbstract:We initially investigated the effects of a gonadotropin-releasing hormone analog, leuprolide acetate, in 28 patients with moderate to severe Functional Bowel Disease in a phase-II, randomized, double-blind, and placebo-controlled study using Lupron Depot 3.75 mg (which delivers a continuous low dose of drug for one month) or placebo given intramuscularly. After completing that 12-week study period during which their symptoms had improved significantly (P<0.01–0.5), the 28 patients were allowed to continue receiving leuprolide acetate; they were monitored for an additional 40 weeks. Of those 28, 25 (89%) finished the 52-week treatment. Drug administration was changed from the monthly low-dose form of leuprolide acetate to a daily subcutaneous dose that was gradually increased from 0.5 mg daily to an effective therapeutic dose (1.0–1.5 mg). All subjects received estrogen replacement during this period. Continued use of leuprolide acetate at maximum therapeutic dosage and over longer periods of time produced even more striking and significant changes in the disabling and debilitating symptoms of Functional Bowel Disease. Nausea, abdominal pain, early satiety, anorexia, and abdominal distension decreased markedly (P<0.0001) and vomiting was also reduced (P<0.01) more than in the short-term, low-dosage, double-blind study. Combined total symptom scores and overall assessment also changed significantly in the long-term phase (bothP<0.0001).
Mary H Clench - One of the best experts on this subject based on the ideXlab platform.
-
effect of leuprolide acetate in treatment of abdominal pain and nausea in premenopausal women with Functional Bowel Disease a double blind placebo controlled randomized study
Digestive Diseases and Sciences, 1998Co-Authors: John R Mathias, Mary H Clench, Thomas L Abell, Kenneth L Koch, Glen A Lehman, Malcolm K Robinson, Robin D Rothstein, William J SnapeAbstract:We have previously reported impressive results in using a gonadotropin-releasing hormone analog, leuprolide acetate (Lupron), in the treatment of moderate to severe symptoms (especially abdominal pain and nausea) in patients with Functional Bowel Disease (FBD). Pain is the hallmark of patients with FBD, and there is no consistent therapy for the treatment of these patients. The purpose of the present study was to expand the investigation to study similar patients (menstruating females) in a multicenter, double-blind, placebo-controlled, randomized study using Lupron Depot (which delivers a continuous dose of drug for one month), 3.75 mg (N = 32) or 7.5 mg (N = 33), or placebo (N = 35) given intramuscularly every four weeks for 16 weeks. Symptoms were assessed using daily diary cards to record abdominal pain, nausea, vomiting, early satiety, anorexia, bloating, and altered Bowel habits. Additional assessment tools were quality of life questionnaires, psychological profile, oral-to-cecal transit using the hydrogen breath test, antroduodenal manometry, reproductive hormone levels, and global evaluations by both patient and investigator. Patients in both Lupron Depot-treated groups showed consistent improvement in symptoms; however, only the Lupron Depot 7.5 mg group showed a significant improvement for abdominal pain and nausea compared to placebo (P < 0.001). Patient quality of life assessments and global evaluations completed by both patient and investigators were highly significant compared to placebo (P < 0.001). All reproductive hormone levels significantly decreased for both Lupron Depot-treated groups by week 4 and were significantly different compared to placebo at week 16 (P < 0.001). This study shows that leuprolide acetate is effective in controlling the debilitating symptoms of abdominal pain and nausea in patients with FBD.
-
effect of leuprolide acetate in patients with moderate to severe Functional Bowel Disease double blind placebo controlled study
Digestive Diseases and Sciences, 1994Co-Authors: John R Mathias, Mary H Clench, Vonda G Reevesdarby, Lisa Mehelich Fox, Ping H Hsu, Patricia H Roberts, Lesa L Smith, Norma J StiglichAbstract:Moderate to severe Functional Bowel Disease results in debilitating abdominal pain, nausea, intermittent vomiting, early satiety, bloating, abdominal distension, and/or altered Bowel habits. Because it occurs ∼20–30 times more frequently in women than in men and its symptoms often coincide with the menstrual cycle, we hypothesized that reproductive steroids may antagonize Diseased nerves of the gastrointestinal tract, enhancing the expression of symptoms. No effective or consistent therapy has existed for these patients. We prospectively investigated the effect of a gonadotropin-releasing hormone analog, leuprolide acetate, in 30 women with symptoms of moderate to severe Functional Bowel Disease. The study was phase II, randomized, double blind, and placebo controlled. Lupron Depot 3.75 mg (which delivers a continuous low dose of drug for one month) or placebo were given intramuscularly monthly for three months. Symptom scores were assessed at each four-week visit. Follicle-stimulating hormone, luteinizing hormone, estradiol, and progesterone levels were assessed before and after therapy. Patients treated with low-dose leuprolide improved progressively and significantly in scores for nausea, vomiting, bloating, abdominal pain, and early satiety, and for overall symptoms (P<0.01–0.05). All hormone levels decreased significantly (P<0.05) except luteinizing hormone (P=0.054).
-
effect of leuprolide acetate in patients with Functional Bowel Disease long term follow up after double blind placebo controlled study
Digestive Diseases and Sciences, 1994Co-Authors: John R Mathias, Mary H Clench, Patricia H Roberts, Vonda G ReevesdarbyAbstract:We initially investigated the effects of a gonadotropin-releasing hormone analog, leuprolide acetate, in 28 patients with moderate to severe Functional Bowel Disease in a phase-II, randomized, double-blind, and placebo-controlled study using Lupron Depot 3.75 mg (which delivers a continuous low dose of drug for one month) or placebo given intramuscularly. After completing that 12-week study period during which their symptoms had improved significantly (P<0.01–0.5), the 28 patients were allowed to continue receiving leuprolide acetate; they were monitored for an additional 40 weeks. Of those 28, 25 (89%) finished the 52-week treatment. Drug administration was changed from the monthly low-dose form of leuprolide acetate to a daily subcutaneous dose that was gradually increased from 0.5 mg daily to an effective therapeutic dose (1.0–1.5 mg). All subjects received estrogen replacement during this period. Continued use of leuprolide acetate at maximum therapeutic dosage and over longer periods of time produced even more striking and significant changes in the disabling and debilitating symptoms of Functional Bowel Disease. Nausea, abdominal pain, early satiety, anorexia, and abdominal distension decreased markedly (P<0.0001) and vomiting was also reduced (P<0.01) more than in the short-term, low-dosage, double-blind study. Combined total symptom scores and overall assessment also changed significantly in the long-term phase (bothP<0.0001).
Mark Pimentel - One of the best experts on this subject based on the ideXlab platform.
-
lactose intolerance and the role of the lactose breath test
The American Journal of Gastroenterology, 2010Co-Authors: Jeffrey L Conklin, Mark PimentelAbstract:Lactose intolerance is a common cause of gastrointestinal symptoms in all populations worldwide. Generally, lactose intolerance is suspected in patients who develop symptoms of bloating, gas, and even diarrhea after the ingestion of lactose-containing food products. The prevalence varies by community and ethnic group. In South America, Africa, and Asia, rates of lactose intolerance exceed 50%, with some countries in Asia having a prevalence approaching 100% (1). In the United States the prevalence is reported to be 15% among Caucasians, 53% among Hispanic Americans, and 80% among Americans of African ancestry (2). Its wide epidemiologic spectrum of prevalence makes lactose intolerance a challenge to study. In addition, symptoms of lactose intolerance can be confused with Functional Bowel Disease or even organic Diseases such as inflammatory Bowel Disease or celiac Disease. Thus, accurate diagnostic testing to identify true lactose-related symptoms and malabsorption is needed.
-
a combination of rifaximin and neomycin is most effective in treating irritable Bowel syndrome patients with methane on lactulose breath test
Journal of Clinical Gastroenterology, 2009Co-Authors: Kimberly Low, Laura Hwang, Johnson Hua, Amy L Zhu, Walter Morales, Mark PimentelAbstract:There is a growing interest in methane and its association with constipation in Functional Bowel Disease. Neomycin-based treatment of methane-positive subjects has resulted in improvement of constipation. Rifaximin, although superior for the treatment of irritable Bowel syndrome compared with other
Nicholas J. Talley - One of the best experts on this subject based on the ideXlab platform.
-
genetics and Functional Bowel Disease
Journal of Pediatric Gastroenterology and Nutrition, 2008Co-Authors: Nicholas J. TalleyAbstract:participate and interact with established investigators in the field.Finally, the symposium intendedto developa research agenda for collaborative studies to define the pathophysiology and treatment strategies for childhood FAP. During the symposium the biopsychosocial model was endorsed to provide a framework to integrate the biological and psychosocial components of FGID. The biopsychosocial model assumes that the individual genetic background and early life experiences influence the biological and psychosocial predisposition to symptom development in response to a variety of physiological or noxious stimuli later in life. This response is affected by physical, environmental, and social exposures that influence the patient’s attitude toward illness. The first module of the symposium discussed the basic and pathophysiological mechanisms underlying FGID, including the role of early life events, genetics, and environment. Given that the biopsychosocial model has been adopted by investigators dealing with non-GI Functional disorders, such as fibromyalgia, autonomic dysfunction, and migraine, experts from non-GI disciplines were asked to share their experiences in the second module of the symposium. The absence of a consistent biological marker in FGID has led to the development of symptom-based criteria to diagnose these disorders. The third module was dedicated to discussion of the Rome criteria (7–9). Finally, the last didactic module discussed medical, behavioural, and complementary treatment strategies for pediatric FGIDs. The end of the symposium was dedicated to the discussion of a research agenda and the creation of a pediatric multicenter consortium for the study of FGIDs, and brought together representatives from the National Institutes of Health, industry, and many interested pediatric gastroen
-
identification of distinct upper and lower gastrointestinal symptom groupings in an urban population
Gut, 1998Co-Authors: Nicholas J. Talley, Philip Boyce, Michael P JonesAbstract:Background—The current classification dividing patients with Functional gastrointestinal symptoms into subgroups remains controversial. Aims—To determine whether distinct symptom groupings exist in the community. Methods—A random sample of Sydney residents in Penrith, Australia was mailed a validated self report questionnaire. Gastrointestinal symptoms including the Rome criteria for irritable Bowel syndrome (IBS) and dyspepsia were measured. Results—Among 730 respondents, the 12 month age and gender adjusted prevalence (adjusted to the Australian population) of IBS, dyspepsia, and gastro-oesophageal reflux were 11.8% (95% confidence interval (CI) 9.3 to 14.3%), 11.5% (95% CI 9.6 to 14.6%), and 17.5% (95% CI 14.2 to 19.9%), respectively. In total, 60% of the population reported four or more gastrointestinal symptoms. There was considerable overlap of IBS with dyspepsia and among the dyspepsia subgroups by application of the Rome criteria. Independently, 10 symptom groupings were identified by factor analysis. The underlying constructs measured by these factors were generally the major abdominal syndromes recognised by the Rome classification: dyspepsia, IBS, reflux, painless constipation, painless diarrhoea, and bloating, in addition to a number of more specific symptom groupings. Conclusion—Gastrointestinal symptoms are common and overlap in the community, but distinct upper and lower abdominal symptom groupings can be identified. Keywords: Functional Bowel Disease; irritable Bowel syndrome; Rome criteria; dyspepsia; factor analysis
-
relation of colonic transit to Functional Bowel Disease in older people a population based study
Journal of the American Geriatrics Society, 1998Co-Authors: Jonathan M Evans, Nicholas J. Talley, Kevin C Fleming, Cathy D Schleck, Alan R Zinsmeister, Joseph L MeltonAbstract:OBJECTIVE: The pathophysiology underlying chronic constipation in older people is poorly understood. Our objective was to determine if Functional Bowel Disease (particularly constipation) in this population is associated with risk factors (age, immobility, low dietary fiber intake, and medication use) or directly with slow colonic transit. METHODS: A previously validated questionnaire was administered to a random sample of older residents (age range 65–104 years, n = 1609) of Olmsted County, MN. A random subset who met standard diagnostic criteria for Functional constipation (n = 52) or irritable Bowel syndrome (IBS) (n = 55) and a group without gastrointestinal symptoms (n = 93) were selected for further study. Each subject underwent structured interview and physical examination. Total caloric and fiber intake were assessed by dietitian interview, a food frequency questionnaire, and a food diary. Physical activity was assessed using a previously validated instrument. Medication use was determined by self-report, physician interview, and review of medical records. Total and segmental colonic transit was assessed radiographically using radio-opaque markers. RESULTS: Total colonic transit times were prolonged in subjects with Functional constipation (median 50.4 hours) but not in subjects with IBS (median 34.2 hours) or in healthy controls (median 28.8 hours); however, only rectosigmoid transit was delayed significantly. Age, gender, physical activity, and dietary fiber intake were not associated with total transit times, nor could they discriminate among the three patient groups. Laxative use was associated with prolonged total transit times independent of patient group. CONCLUSIONS: Older subjects can be classified by abdominal pain and Bowel symptoms, which reflect colonic transit times. Older subjects with constipation symptoms generally have prolonged rectosigmoid transit. Other potential risk factors do not distinguish symptom subgroups, nor are they associated with altered colonic transit although older people who use laxatives regularly have prolonged colonic transit.
