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Background and objective. Proton Pump Inhibitors (PPIs) reduce gastric acid production and they are indicated for myriad gastrointestinal conditions. Prolonged use of PPI has been linked to the risk of inflammatory bowel disease (IBD) though this fact is not well established. We aimed to conduct a systematic review and metaanalysis to estimate the risk of IBD occurrence with PPI use. Methodology. The databases such as PubMed, Scopus, and Cochrane Library were accessed from inception to December 2020. Additionally, the bibliographic search and a random search in Google, Google Scholar, and ResearchGate were performed to find additional sources. The observational studies estimating the risk of IBD following the use of PPI, published in the English language were considered for this review. The methodological quality of included studies was assessed using the Modified Downs and Black checklist. Results. Eight out of 2038 studies with 157,758 participants were included in this meta-analysis. A significantly higher risk of IBD (adjusted odds ratio [aOR] 2.43; 95% Confidence Interval [CI] 1.18-5.02; P=0.02; n=6) was observed in participants taking PPIs for any indication. Moreover, a significant association was observed between PPI exposure on the different types of IBD such as ulcerative colitis and Crohn's disease together (aOR: 3.60; 95% CI: 1.10-11.74), collagenous colitis (OR: 4.73; 95% CI: 1.99-11.22) and lymphocytic Colitis (OR: 3.77; 95% CI: 2.91-4.87), but not with ulcerative colitis (P=0.47) and microscopic colitis (P=0.07) alone. Similarly, a significant association was observed among Europeans (aOR: 3.98; 95% CI: 2.36-6.71), but not with North American (aOR: 0.48; 95% CI: 0.01-26.71) studies. Overall the study quality was good. Conclusion. The current evidence indicates that exposure to PPI is significantly associated with increased risk of IBD. Further, adequately powered studies from various parts of the world are needed for better quantification and generalizability of our findings. [ABSTRACT FROM AUTHOR]

Microscopic colitis (MC) is an inflammatory pathology of the bowel diagnosed predominantly in older patients. MC is a cause of chronic watery, non-bloody diarrhea, that affects the older patients, mostly women, and leads to impaired healthrelated quality of life. The diagnosis and treatment can be often difficult. There are three main histological subtypes: collagenous colitis, lymphocytic colitis and incomplete microscopic colitis. Because of the variable nature of this pathology, the therapeutic options should be individualized for every patient. MC has a variable course, varying from occasional symptoms to recurrent or progressive symptoms. A literature search was performed on the main databases. Data on microscopic colitis was collected and presented. This comprehensive review aims to raise awareness of this pathology while providing the latest data regarding current recommendations. General practitioners and gastroenterologists should always take microscopic colitis into consideration when diagnosing a patient with chronic diarrhea. [ABSTRACT FROM AUTHOR]

Background/aim. Biologics represent a key therapeutic option in inflammatory bowel disease (IBD), but are associated with several side effects. Post-marketing surveillance, through a spontaneous adverse drug reactions (ADRs) monitoring system, is essential to assess the safety profile of biologics. The aim of the study was to prospectively evaluate the occurrence of ADRs in IBD patients treated with biologics from a single centre in Southern Italy. Methods. Data from patients with Crohn's Disease (CD) and Ulcerative Colitis (UC) who underwent biological therapy were prospectively collected. ADRs were classified according to the Medical Dictionary for Regulatory Activities (MedDRA®). Results. Overall, 68 (54% male, 68% with UC and 32% with CD) biologic-na ïve IBD patients underwent biological therapy. Mean follow-up was 11.7 ± 6.2 months. As a results of switches, for 68 patients we obtained 96 biologic prescriptions. Overall, 45 ADRs occurred in 36 (53%) patients, distributed as follows (ADRs/prescriptions): 19/37 with IFX-Remicade, 5/12 with IFX-Remsima, 8/9 with GOL, 11/26 with ADA, and 2/12 with VDZ. Mild ADRs were 29 (64%), moderate 15 (34%) and 1 (2%) severe. General disorders and administration related reactions were the most frequent ADRs (35%), followed by skin and subcutaneous tissue disorders (20%), infections (15%), musculoskeletal (11%), respiratory (6%) blood (4%), gastrointestinal (4%), and vascular disorders (2%). In 9 cases (20%) the ADRs resulted in definitive discontinuation of biologic therapy. Conclusion. In a prospective cohort of IBD patients, more than half experienced ADRs during biologic therapy. General disorders and administration related reactions were the most common ADRs, while infections were less common and rarely led to discontinuation of therapy. Findings underline the importance of surveillance in management of IBD patients during biologic therapy and implementing safety protocols with data from real-life settings. [ABSTRACT FROM AUTHOR]

Background and aim. Irritable bowel syndrome (IBS) is one of the most frequent and common functional gastrointestinal diseases. For its diagnosis, clinical criteria are still used. Our objective was to asses if there are specific serum biomarkers for the diagnosis of IBS, and as secondary purpose we aimed to analyze the specificity and sensitivity - where determined - for the proposed biomarkers. Methods. We performed a review in order tofind potential serum biomarkers useful for the diagnosis of IBS. MEDLINE and Cochrane databases were searched in May 2015. Inclusion criteria were: original studies that assessed serological markers in IBS patients, markers potentially useful for diagnosing IBS or in differentiating subtypes of IBS. Exclusion criteria were biomarkers assessed in IBS patients not for the diagnosis of IBS, but used in order to exclude other conditions or diseases in these patients; or markers that were not addressed to IBS; or papers that assessed only fecal biomarkers, or histological or surrogate - indirect biomarkers. Results. From the 268 papers retrieved by our initial search, using a modified strategy we identified 58 papers. Out of the 58 papers retrieved by the search, six papers were selected and other nine studies were eventually analyzed. Of the results of the computerized search, a number of papers were not included for various reasons: some were not related to the subject (26), others were not appropriate for the subject (19) because they addressed inflammatory bowel disorders, in others fecal markers were the subject of the study, six were reviews, others were impossible to gain access to (1). Twelve out of the 14 studies included are case-control studies, IBS diagnosis being established in all of the selected results based on the Rome criteria. A higher sensitivity of 81% was found using a combination of markers but with lower specificity, while one study that assessed also a combination of markers, found a higher specificity but sensitivity was only 50 %; none reached the characteristics for an ideal biomarker. Conclusions. For the moment, just one serum biomarker with a high specificity and sensitivity useful in the diagnosis of IBS was identified. We consider that in the future a combination of several biomarkers could better identify IBS than a single biomarker. Therefore, clinical criteria are still to be used for the diagnosis of IBS in attendance for newer research or validation of results. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) is a chronic disease that affects both young adults and also the elderly. This article emphasises the particularities related to age in the epidemiology, diagnosis, natural course of the disease, prognosis and therapy of adult patients with IBD. Even though the main characteristics in geriatric populations with IBD may not differ much from those in younger patients, distinct problems exist. The majority of IBD studies were performed on young subjects, younger than 40 years of age. The optimal therapeutic choice in young individuals with IBD is a challenge for the physician who needs to take in account the risk of untreated or suboptimally treated chronic intestinal inflammation, long term prognosis, quality of life, the impact of side-effects of aggressive therapeutic approaches, the impact on pregnancy, as well as personal and healthcare costs. The diagnosis in elderly patients can be challenging due to the large number of conditions that mimic IBD. The treatment options are those used in younger patients, but a series of considerations related to potential pharmacological interactions and side effects of the drugs must be taken in account. The risks associated with the use of some IBD medications may be increased in older patients, but so is the risk of under-treated IBD and surgery. [ABSTRACT FROM AUTHOR]

Chronic viral hepatitis (VCH) is one of the most common chronic diseases. Main transmission ways are represented by blood and blood products. The standard therapy is based on the combination of alpha-pegylated interferon (PEG-IFN) plus ribavirin (RBV). The efficiency of this therapy was proved by several trials. Unfortunately, the PEG-IFN plus RBV therapy implies several side effects requiring a rigorous follow-up of the patients. Most common side effects are: pseudoflu, hematological, psychical, neurological, autoimmune thyroiditis etc. Other encountered side effects are alopecia, insomnia, sight and hearing troubles, anorexia, interstitial pneumonia, pancreatitis, inflammatory intestinal diseases, psoriasis. The management of side effects supposes periodical evaluation of the patients; when side effects occur, an efficient strategy is necessary to fight these side effects. [ABSTRACT FROM AUTHOR]

This is a comparative study of some presonality factors in two chronic gastrointestinal conditions: Iritable bowel syndrome (IBS) and Inflammatory bowel disease (IBD). A group of 150 outpatients aged 19 to 75 (Mean=45.50, SD=14.66) were investigated: 34 patients with ulcerative colitis, 30 patients with Crohn's disease, 86 patients with IBS and 122 healthy persons were investigated with Benet-Martinez and John's Big Five Inventory - which measures personality traits included in the big five model: neuroticism, extraversion, openness, conscientiousness and agreeableness and with SF-36 for the quality of life. As expected, both disorders were associated with a lower quality of life compared to healthy persons. The results indicate that neuroticism, extraversion and openness are significant predictors for the mental component of general HRQoL in IBS patients. In IBD patients, only neuroticism was found as a significant predictor for both the physical and the mental component of general HRQoL. [ABSTRACT FROM AUTHOR]