The literature shows, that the prevalence of functional dyspepsia is between 11 and 29.2 % in general population. The first goal of this study was to present a narrative review of the current findings of functional dyspepsia. The second goal was to find out the prevalence of functional dyspepsia in the II. Internal Clinic of Gastroenterology and Geriatry in Teaching Hospital of Olomouc (Czech Republic). According to the clinical experience, the prevalence of patients with functional dyspepsia seems to be not as high as literature shows. Normal gastroscopy findings are mandatory for the diagnosis of functional dyspepsia. That is why we examined 302 patients with indications for gastroscopy. According to the Rome IV criteria and normal gastroscopy findings, the diagnosis of functional dyspepsia was made only in 10 (3.31 %) patients. 108 patients have received repeated gastroscopy after 4 to 6 months period. But, none of them came with the diagnosis functional dyspepsia. Our results suggest, that the prevalence of functional dyspepsia after careful gastroscopic examination is lower than in the previous literature. This observation could change our view of functional dyspepsia and its diagnostics. Keywords: functional dyspepsia - gastroscopy - prevalence - Rome IV criteria.
Dyspepsie je jednou z nejcastějsich přicin navstěvy lekarny ci lekaře. Jde o heterogenni skupinu nepřijemných přiznaků týkajicichse zaživaciho traktu, břicha, přijmu stravy a vyprazdňovani. Naplni prvni casti prace je strucný přehled o problematicezaživacich potiži, zejmena potom funkcnich poruch, a jejich strucna klasifikace. Dale jsou shrnuty možnosti terapie. STW 5(Iberogast®) je kombinovaný bylinný připravek, volně prodejný v lekarnach. Jedna se o ucinný, bezpecný a dobře tolerovanýlek. Druha cast prace se zabýva jeho složenim a souhrnem dat o jeho ucinnosti a bezpecnosti.
Inflammatory bowel disease (IBD) includes Crohns disease (CD) and ulcerative colitis (UC). Those are chronic gastrointestinal disorders of inflammatory nature and not fully known etiology. As a result of their immune-mediated mechanism and complex impact on the whole organism other organs than gastrointestinal system may be affected in many ways. These extraintestinal manifestations (EIM) and complications may severely deteriorate prognosis of the patient, cause his morbidity and worsen the quality of life. While classical extraintestinal manifestations, such as enteropathic arthropathy, skin or eye involvement or primary sclerosing cholangitis, share common immunopathological mechanism with IBD, whole range of other disorders may result from various anatomical or metabolic abnormalities caused by IBD or its treatment. This review focus on the most common extraintestinal complications, such as anaemia, metabolic bone disease, biliary and urolithiasis, which we meet in our daily clinical practice.
Probiotika jsou pĹĂpravky obsahujĂcĂ ĹživĂŠ mikroorganismy, kterĂŠ svĂ˝m pĹŻsobenĂm mohou vĂŠst ke zlepĹĄenĂ zdravotnĂho stavu pĹĂjemce. V poslednĂch letech jsou nejen Äasto inzerovĂĄna, ale takĂŠ studovĂĄna co do jejich efektivity a bezpeÄnosti. PravdÄpodobnÄ nejlĂŠpe prozkoumanĂŠ druhy jsou Lactobacillus, Bifidobacterium, Saccharomyces a kmen Escherichia coli Nissle 1917. Jejich pĹŻsobenĂ je komplexnĂ a zahrnuje imunomodulaci, potlaÄenĂ rĹŻstu patogenĹŻ a zlepĹĄenĂ bariĂŠrovĂŠ funkce stĹevnĂho epitelu. Jejich vyuĹžitĂ je v celĂŠ ĹadÄ onemocnÄnĂ a stavĹŻ, zejmĂŠna v gastroenterologickĂ˝ch indikacĂch. NicmĂŠnÄ vÄdeckĂĄ data ohlednÄ jejich pouĹžitĂ jsou Äasto spornĂĄ, je tedy tĹeba vĹždy zvĂĄĹžit sprĂĄvnou indikaci k jejich uĹžitĂ.
Literatúra uvádza, že prevalencia funkčnej dyspepsie u bežnej populácie je 11-29,2 %. Prvým cieľom tejto práce bolo prezentovať narrative review súčasných vedomostí o problematike funkčných porúch. Druhým cieľom bolo zistiť prevalenciu funkčnej dyspepsie na II. internej klinike gastroenterologickej a geriatrickej LF UP a FN Olomouc (Česká republika). Klinická skúsenosť nám totiž neukazuje takú vysokú prevalenciu tohto ochorenia, ako uvádza literatúra. Kľúčovou podmienkou pre diagnózu funkčnej dyspepsie je normálny gastroskopický nález. Preto sme vyšetrili 302 pacientov, u ktorých bola indikovaná gastroskopia. Len u 10 z nich (3,31 %) bola na základe kritérií Rome IV a normálneho endoskopického nálezu stanovená diagnóza funkčnej dyspepsie. 108 pacientov sa v priebehu 4-6 mesiacov dostavilo ku kontrolnej gastroskopii, z pacientov s funkčnou dyspepsiou však neprišiel žiadny. Naše výsledky naznačujú, že pri dôslednom gastroskopickom vyšetrení je prevalencia funkčnej dyspepsie nižšia, ako je doteraz uvádzané v odbornej literatúre. Tento poznatok by mohol viesť k zmene pohľadu na funkčnú dyspepsiu a jej diagnostiku.
Summary: Introduction: Urinary excretion of magnesium is an important preventive factor against nephrolithiasis by inhibiting several key processes in its pathogenesis. Patients with Crohn’s disease (CD) have an approximately 2-fold higher risk of lithiasis, especially those after ileocolic (IC) resection. The aim is to determine the magnesuria level in these patients and compare it with patients with CD and IC involvement without resection and then both groups with healthy controls. The secondary objective was to assess calciuria and other modifying factors. Methods: CD patients aged 18 years or older with IC resection (group 1) and terminal ileal involvement without resection (group 2) were enrolled in the study, with subjects without known bowel disease as controls (group 3). Exclusion criteria were citrate therapy, severe renal insufficiency (GFR < 30 ml/ min/ 1.73 m2), more than two bowel resections, ileostomy, colectomy, short bowel syndrome, acute urinary tract infection and evidence of CD relapse. Anamnestic data were collected by questionnaire, blood and fresh urine samples were collected, renal and gallbladder ultrasound was performed for the presence of lithiasis, and patients underwent 24-hour urine collection to determine oxaluria, citraturia, magnesuria and calciuria. Results: 107 subjects were included in the study, including 34 patients with IC resection, 42 with CD without resection and 31 healthy controls. 43% were women, mean age was 38 ± 11.5 years. There was a significant difference in magnesuria values between the resection and non-resection group (median 2.28 vs. 3.97 mmol/ l; P = 0.047) and especially between the resection group and healthy controls (median 2.28 vs. 4.31 mmol/ l; P = 0.0003). The group without resection vs. healthy controls did not reach a significant difference (median 3.97 vs. 4.31 mmol/ l; P = 0.455). Calciuria values did not differ significantly between groups (median 3.75 vs. 4.6 vs. 4.3 mmol/ l; P = 0.293). Conclusion: Magnesuria values of CD patients after IC resection were significantly lower compared to the group of CD patients with IC involvement without resection and healthy controls. The group without resection achieved results comparable to controls. Calciuria values were not significantly different between groups in our study. We hypothesize that patients with CD after IC resection at higher risk of urolithiasis might benefit from Mg supplementation to prevent concretion formation. However, confirmation of this thesis will require verification by further research. Key words: inflammatory bowel disease – Crohn’s disease – urolithiasis – magnesium – calcium oxalate
