Identification of early environmental risk factors for irritable bowel syndrome and dyspepsia.

Background: The role of childhood environment including exposure to infection via siblings and pets in irritable bowel syndrome (IBS) and dyspepsia is relatively unknown. We assessed proxy measures of microbial exposure in early childhood to assess if these are associated with IBS and functional dyspepsia in later life.

Methods: Participants (n = 767, response rate = 53%) were a random population sample from Sydney, Australia who previously responded to a validated survey.

α-Methyldopa-induced hepatitis during the postpartum period.

A 34-year-old woman, with a history of pre-eclampsia, was diagnosed with α-methyldopa-induced hepatotoxicity, after she presented with severe jaundice and hepatitis 8 weeks following delivery. Laboratory investigations and liver biopsy ruled out other causes of hepatitis. She continued to improve clinically after cessation of α-methyldopa, and was discharged 10 days after admission.

Duodenal eosinophilia and early satiety in functional dyspepsia: confirmation of a positive association in an Australian cohort.

Background And Aim: Functional dyspepsia (FD), defined by unexplained pain or discomfort centered in the upper abdomen, is common. Diagnosis and treatment of FD based on the symptom-based Rome criteria remains challenging. Recently, eosinophilia in the duodenum has been implicated in the pathophysiology of FD in adults, specifically increased eosinophils in early satiety and postprandial distress, but the association remains controversial.

Psychological impact and risk factors associated with new onset fecal incontinence.

Objectives: We aim to evaluate the psychological impact and risk factors associated with new onset FI over 12 years in adults over 18 years for the first time in a population-based study.

Methods: Participants (n = 1775) were a random population sample from Penrith, Australia who responded to a survey in 1997 and completed a 12-year follow-up survey (response rate = 60%). FI was defined as having leakage of stool over the past 12 months.

The brain--gut pathway in functional gastrointestinal disorders is bidirectional: a 12-year prospective population-based study.

Objective: Psychological factors are known to be associated with functional gastrointestinal disorders (FGIDs) including irritable bowel syndrome (IBS) and functional dyspepsia (FD). No prospective studies have evaluated whether it is the brain (eg, via anxiety) that drives gut symptoms, or whether gut dysfunction precipitates the central nervous system features such as anxiety. In a 12-year longitudinal, prospective, population-based study, we aimed to determine the directionality of the brain-gut mechanism in FGIDs.

The impact of laxative use upon symptoms in patients with proven slow transit constipation.

Background: Constipation severity is often defined by symptoms including feelings of complete evacuation, straining, stool frequency and consistency. These descriptors are mostly obtained in the absence of laxative use. For many constipated patients laxative usage is ubiquitous and long standing.

Gastrointestinal Mantle Cell Lymphoma-A Tale of Two Endoscopies.

Introduction: A 52-year-old male with a 2-year history of typical gastroesophageal reflux symptoms and concomitant weight loss despite good appetite is presented in this paper. Endoscopy showed hypertrophic gastric folds and multiple antral ulcers which were considered benign both histologically and macroscopically. The diagnosis at the time of presentation was moderate chronic gastritis.

Working overseas, weakness, anaemia, and nematodes.

We report the case of a 51-year-old female who went overseas for six-months to teach English and upon her return to Australia developed severe anaemia and weakness. She was admitted to hospital, and had subsequent blood transfusions and a colonoscopy which revealed nematodes. She was treated and made a full recovery.

Rectal bleeding: epidemiology, associated risk factors, and health care seeking behaviour: a population-based study.

Purpose: Rectal bleeding is considered an important sign of colonic disease, particularly colorectal cancer. The epidemiology of rectal bleeding in the community is poorly understood. Moreover, there is little information as to whether individuals seek health care for this problem.

Granulation and fibrotic esophagus.

There is very little information in the medical literature on fibrotic esophageal lesions. These lesions do not appear to be malignant, but are recalcitrant to different treatments including removal, and the use of esophageal stents does not discourage the lesion from continuing to grow. The cause of these lesions remains unknown and the reasons for overgrowth in stents are poorly understood.

Familial aggregation of irritable bowel syndrome: a prospective study.

Background: Patients with irritable bowel syndrome (IBS) often report family members with similar symptoms, but family studies are lacking. We hypothesised that if there is familial aggregation, there would be an increased frequency of IBS in first degree relatives of IBS patients compared with relatives of controls (the patient's spouse).

Methods: A valid self report bowel disease questionnaire (BDQ) that recorded symptoms, the somatic symptom checklist (a measure of somatisation), and a family information form (FIF) to collect the names and addresses of all first degree relatives were mailed to two groups of patients and their spouses (patients attending an IBS educational programme and residents of Olmsted County, Minnesota, who had been coded as IBS on a database).

Is irritable bowel syndrome more likely to be persistent in those with relatives who suffer from gastrointestinal symptoms? A population-based study at three time points.

Background: We tested the hypothesis that subjects with relatives who suffered from abdominal pain or bowel dysfunction would be at an increased risk of more persistent irritable bowel syndrome.

Methods: A valid, self-report questionnaire was mailed to an age- and gender-stratified random sample of residents, aged 30-64 years, in Olmsted County, MN, USA, on three occasions over a 4-year period. Persistent irritable bowel syndrome was defined as the presence of irritable bowel syndrome on at least two of the three surveys, and fluctuating irritable bowel syndrome was defined as the presence of irritable bowel syndrome on only one of the surveys.

Prevalence of faecal incontinence and associated risk factors; an underdiagnosed problem in the Australian community?

Objective: To determine the prevalence of faecal incontinence in the community and evaluate identifiable risk factors.

Design And Setting: Cross-sectional survey using a validated questionnaire. A short version of the questionnaire was sent to 220 subjects and a long version to 770 subjects, randomly selected from western Sydney, Australia.

Demographic and endoscopic characteristics of patients with Helicobacter pylori positive and negative peptic ulcer disease.

Objective: To identify demographic and endoscopic characteristics of patients with Helicobacter pylori positive and negative chronic peptic ulcer disease.

Design: Cross-sectional study of peptic ulcer disease in prospectively recruited PATIENTS undergoing gastroscopy.

Patients: 277 consecutive patients referred for gastroscopy in 1996-1998.

Can helicobacter pylori serology still be applied as a surrogate marker to identify peptic ulcer disease in dyspepsia?

Background: Helicobacter pylori infection and associated peptic ulcer disease (PUD) has become less common in some countries.

Aim: To determine if H. pylori serology alone or combined with a history of ingestion of non-steroidal anti-inflammatory drugs (NSAIDs) and an age threshold can be used as an indirect ulcer test.

High sensitivity and specificity of a laboratory-based serological test, pylori DTect ELISA, for detection of Helicobacter pylori infection.

A number of commercial ELISA kits are now available for detection of Helicobacter pylori infection. Generally, whereas the manufacturers have claimed high sensitivity and specificity, independent studies have often failed to confirm the results. The aim of this study was to independently evaluate the pylori DTect ELISA, a commercial kit for detection of H.

Antral-type mucosa in the gastric incisura, body, and fundus (antralization): a link between Helicobacter pylori infection and intestinal metaplasia?

Objectives: Helicobacter pylori is a carcinogen; gastric carcinoma involves a multistep process from chronic gastritis to atrophy, intestinal metaplasia, and dysplasia. The aims of this study were to determine the types of mucosa at different gastric sites in H. pylori-infected and uninfected patients, and whether the presence of antral-type mucosa in the incisura, body, and fundus is associated with gastric atrophy and intestinal metaplasia.

The effects of lottery incentive and length of questionnaire on health survey response rates: a randomized study.

Maximizing the response rate of self-administered questionnaires is key in survey research. We aimed to evaluate the effects of lottery incentive and length of questionnaire on health survey response rates when used in isolation or combined. A random sample of 440 residents in Western Sydney, Australia was randomly allocated to four equal groups to receive or not receive an instant lottery ticket and a long (seven page) or short (one page) questionnaire.

Disease-specific outcomes assessment for irritable bowel syndrome.

Irritable bowel syndrome (IBS) is a common disorder that results in many physician visits and health care costs. Because IBS is so common, patients presenting with abdominal pain, constipation, and diarrhea must be evaluated as cost-effectively as possible. Little data exist to guide the clinician on how to best use endoscopy in IBS.