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Fysekidis M.,Diabetes | Bouchoucha M.,Avicenne Hospital | Bouchoucha M.,University of Paris Descartes | Bouchoucha M.,Cefred Center Dexploration Fonctionnelle Et Of Reeducation Digestive | And 4 more authors.
Obesity Surgery | Year: 2012

Background: Obesity is considered as a risk factor for many functional digestive disorders. The aim of the present study was to evaluate the prevalence and the association of functional digestive symptoms affecting the upper and the lower digestive tract in patients eligible for bariatric surgery. Methods: Before surgery, 120 consecutive patients with normal upper endoscopy (7.5% males, mean BMI 44±6 m/kg 2) have filled a standard questionnaire in order to evaluate the presence of depressive symptoms and functional digestive disorders according to the Rome criteria. The major symptoms (esophageal, gastroduodenal, anorectal, and abdominal pain) were coded as dichotomous variables. Data analysis was performed using multivariate logistic regression with a backwards selection procedure adjusted only for the variables that were significant in univariate analysis (p<0.05). Results: Functional symptoms were present in 89% of the subjects (2.5 functional digestive symptoms/subject). Depression symptoms were found in 43% of the patients. Esophageal symptoms were independent predictors for the presence of gastric, bowel, and anorectal symptoms. Functional abdominal pain and bowel symptoms were present, respectively, in 19% and 84% of the patients. Approximately half of the patients have specific functional bowel disorders (28.6% constipation, 18% irritable bowel syndrome, 18% diarrhea, 1% bloating) and 35.7% have non-specific bowel disorders. Anorectal symptoms were found in 40% of the patients: difficult defecation in 32% and fecal incontinence in 9.8% of the patients. Depression was an independent predictor for anorectal symptoms. Conclusions: This study shows the high prevalence of functional bowel symptoms in patients complaining of morbid obesity. © 2011 Springer Science + Business Media, LLC. Source

Bouchoucha M.,University of Paris Descartes | Bouchoucha M.,Cefred Center Dexploration Fonctionnelle Et Of Reeducation Digestive | Devroede G.,Universite de Sherbrooke | Raynaud J.-J.,Cefred Center Dexploration Fonctionnelle Et Of Reeducation Digestive | And 3 more authors.
Digestive Diseases and Sciences | Year: 2011

Background: Colonic response to food (CRF) is abnormal in irritable bowel syndrome (IBS) patients. Aims: The aim of this study was to compare CRF in patients who complain of abnormal defecation pattern according to the presence or absence of abdominal pain. Methods: One hundred forty-nine patients and 50 controls were studied: 96 IBS patients (46 IBS-C, 13 IBS-D, 15 IBS-M, and 22 IBS-U not included), 43 patients with functional constipation (group C) and ten with functional diarrhea (group D). Clinical evaluation and visual analog scales about four items (constipation, diarrhea, abdominal bloating and abdominal pain) were filled by all subjects. Colonic transit time (CTT) was measured in fasting conditions and after eating a standard 1,000-cal test meal. CRF was quantified by calculating the variation in number of markers between the two films. Results: The frequency of meal-related symptoms did not vary among the different groups of patients but was significantly higher than in controls. Compared to IBS-C patients, constipated patients of the group C had longer total and segmental colonic transit time, and compared to IBS-D patients, diarrheic patients of the group D had shorter oro-anal and segmental colonic transit time except in the recto-sigmoid area. CRF was different in patients and controls, and differed between IBS and non IBS patients with similar transit abnormalities. Stool output was greater in patients of the group D than in patients of the IBS-D group. Conclusion: The different subgroups of IBS patients have different CRF patterns, distinct from subjects with constipation and diarrhea, but without abdominal pain. © 2011 Springer Science+Business Media, LLC. Source

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