Publications by authors named "Kewin T H Siah"

Background: Irritable bowel syndrome (IBS) is a common yet debilitating disorder of gut-brain interaction, characterized by gut-brain axis dysregulation, visceral hypersensitivity, and other comorbidities. Obesity has been hypothesized to be a risk factor linked to IBS, albeit evidence remains conflicting. Given the growing global prevalence of obesity and IBS, we performed a meta-analysis examining their purported association.

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To establish a consensus on the definition and management of idiopathic gastroparesis, international experts (selected by neurogastroenterology and motility societies and initiated by the Rome Foundation) devised 144 statements using the Delphi method, with at least 80% agreement required. This consensus defined idiopathic gastroparesis as the presence of symptoms associated with delayed gastric emptying in the absence of mechanical obstruction. Nausea and vomiting were identified as cardinal symptoms.

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The low fermentable oligo-, di-, mono-saccharides and polyols (FODMAP) diet (LFD) is a second-line dietary intervention for irritable bowel syndrome (IBS) patients, involving FODMAP restriction, reintroduction, and personalization, and it needs to be delivered by dietitians. However, the application of this diet among Malaysian IBS patients is not well understood. This study aimed to explore the practices and barriers in delivering the LFD among Malaysia dietitians.

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Article Synopsis
  • * Overlapping DGBI patients tend to have more severe gastrointestinal symptoms and a higher psychosocial burden, influenced by various factors such as gut motility, brain function, immune response, and genetic markers.
  • * Recent research indicates that alterations in the gut microbiome may play a crucial role in the mechanisms of DGBI, which could help refine diagnostic and treatment approaches for better patient outcomes.
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Recent studies have witnessed the incorporation of herbal medicine into the management of Disorders of Gut-Brain Interactions (DGBIs), reflecting a paradigm shift toward holistic healing modalities. However, there still exists a substantial gap in comprehending the utilization of Traditional Chinese Medicine (TCM) for Irritable Bowel Syndrome (IBS), particularly beyond the confines of China. This study endeavors to bridge this knowledge gap by meticulously identifying existing guidelines, critically reviewing TCM practices, and crafting contemporary treatment recommendations.

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Infectious causes of diarrhea contribute significantly to morbidity in Asia. We conducted a systematic review and meta-analysis of the prevalence of infectious etiologies of persistent and chronic diarrhea in Asian adults. Searches were performed on PubMed and Scopus for studies from January 1, 1970, to May 30, 2023.

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Background And Aim: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder with roots in genetic, immune, psychological, and dietary factors. Recently, the potential correlation between environmental exposures, such as air pollution, and IBS has gained attention. This review aimed to systematically examine existing studies on environmental factors associated with IBS, elucidating this interplay and guiding future research.

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Background: Functional dyspepsia (FD) is a prevalent and challenging gastrointestinal disorder. Conventional medicine often faces limitations in providing effective treatment for FD, thus indicating the need to explore alternative approaches. Traditional Chinese medicine (TCM), which is rooted in ancient Chinese traditions and has evolved over thousands of years, offers a holistic approach to well-being.

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Poria cocos is a popular medicinal food. Polysaccharides are the key component of Poria cocos, forming 70-90 % of the dry sclerotia mass. Recent studies indicate that Poria cocos polysaccharides (PCP-Cs) have multiple beneficial functions and applications.

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Article Synopsis
  • The study examined the effects of proton pump inhibitors (PPIs) on adverse events in cirrhotic patients, using data from 28 studies with over 260,000 patients.
  • The analysis found that while short-term mortality was not significantly affected by PPIs, long-term risks, including mortality, hepatic decompensation, and infections, were notably higher in PPI users.
  • Researchers concluded that PPIs should only be prescribed when absolutely necessary and at the lowest effective dose for patients with cirrhosis due to these risks.
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Objective: Patient-reported outcome measures (PROMs) are useful standardized tools to measure current patient health status and well-being. While there are existing constipation-related PROMs, the majority of PROMs were not developed with adequate patient involvement and few examined content validity. Accordingly, the current study aimed to develop a constipation PROM with multiple phases of patient and clinician involvement.

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Background: Dental injury is the leading cause of litigation in anaesthesia but an underrecognized preventable complication of endoscopy.

Aim: To determine frequency and effects of dental injury in endoscopy, we present findings from an audit of outpatient endoscopy procedures conducted at a tertiary university hospital and a systematic review of literature.

Methods: Retrospective review of 11265 outpatient upper endoscopy procedures over the period of 1 June 2019 to 31 May 2021 identified dental related complications in 0.

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Introduction: In light-emitting diode (LED) and LASER colonoscopy, linked color imaging (LCI) and blue light/laser imaging (BLI) are used for lesion detection and characterization worldwide. We analyzed the difference of LCI and BLI images of colorectal lesions between LED and LASER in a multinational study.

Methods: We prospectively observed lesions with white light imaging (WLI), LCI, and BLI using both LED and LASER colonoscopies from January 2020 to August 2021.

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Background: Irritable bowel syndrome (IBS) is associated with obesity and metabolic syndrome. IBS and non-alcoholic fatty liver disease (NAFLD) are highly prevalent entities worldwide and may share similar mechanisms including gut dysbiosis, impaired intestinal mucosal barrier and immune system activation.

Aim: To systematically review their association according to the Preferred Reporting Items for Systemic Review and Meta-analyses guidelines.

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Article Synopsis
  • - The study aimed to investigate differences in clinical characteristics and pancreatic enzyme abnormalities between patients with functional dyspepsia (FD) alone and those with FD overlapping with irritable bowel syndrome (IBS).
  • - Results showed that patients with FD-IBS overlap reported worse symptoms after eating high-fat meals, even though pancreatic enzyme abnormalities were more prevalent in FD alone patients.
  • - The presence of elevated levels of protease-activated receptor 2 (PAR2) in degranulated eosinophils in the duodenum was found to be significantly higher in the FD-IBS overlap group, suggesting a link to the condition's pathophysiology.
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Background: Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disease characterized by intermittent abdominal pain with altered bowel habits. Due to the condition's chronicity, patients suffer from poor quality of life, while the healthcare burden continues to grow. There is currently no reliable biomarker for the diagnosis of IBS, and the current approach depends on ruling-out organic diseases such as inflammatory bowel disease (IBD) and colorectal cancer by markers of inflammation like fecal calprotectin and C-reactive protein, or invasive procedures like a colonoscopy.

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Contemporary systems for the diagnosis and management gastrointestinal symptoms not attributable to organic diseases (Functional GI Disorders, FGID, now renamed Disorders of Gut-Brain Interaction, DGBI) seek to categorize patients into narrowly defined symptom-based sub-classes to enable targeted treatment of patient cohorts with similar underlying putative pathophysiology. However, an overlap of symptom categories frequently occurs and has a negative impact on treatment outcomes. There is a lack of guidance on their management.

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Background: The rise in prevalence of non-alcoholic fatty liver disease (NAFLD) mirrors the obesity epidemic. NAFLD is insidious but may gradually progress from simple steatosis to steatohepatitis, fibrosis and cirrhosis and/or hepatocellular carcinoma. Intervention strategies to ameliorate developmental programming of NAFLD may be more efficacious during critical windows of developmental plasticity.

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Background/aims: Constipation can be a chronic condition that impacts daily functioning and quality of life (QoL). To aid healthcare providers in accurately assessing patient symptoms and treatment outcomes, patient-related outcome measures (PROMs) have been increasingly adopted in clinical settings. This review aims to (1) evaluate the methodological quality and measurement properties of constipation-related PROMs, using the COnsensus-based Standards for the selection of health Measurement INtruments (COSMIN) criteria; and (2) assess the modes of digital dissemination of constipation-related PROMs.

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