At present, irritable bowel syndrome (IBS) is a common medical problem all over the world that implies considerable social burden and high costs. Considering the different pathophysiological pathways, unitary management for IBS is not possible. Of the therapeutic approaches that have been proposed so far, only a few have been demonstrated to have beneficial effects in IBS patients. The implication of gut microbiota in IBS is obvious, similarly to the therapeutic effect of pro‑/prebiotics, which is reflected by the latest publications. The intake of inulin seems to regulate the bowel peristalsis and colonic transit, the consistency and frequency of the stools, as it changes the composition of gut microbiota. The beneficial effect of inulin in patients with IBS‑constipation form (IBS‑C) is obvious, but still, more randomized controlled clinical trials involving large samples of patients are needed in order to provide more evidence.
Background and Objectives: The aim of this study was to investigate the association between H. pylori positivity with specific symptoms, risk factors and endoscopic patterns among the pediatric population in northeastern Romania. Materials and Methods: A prospective study was performed in 18 months on 185 children aged 6–18 years with an indication for upper digestive endoscopy. Demographic, anamnestic, symptomatic, endoscopic and histologic data were recorded. Results: Of 116 H. pylori-positive children, the most affected group was 15–17 years. Most (65.5%) of them were girls, with a significant association (p < 0.001). The majority (66.4%) lived in a rural area and 47.4% of children had an unsafe source of water and lived in overcrowded houses with no basic sanitary comfort. The most frequent symptom was epigastric pain (56.9%), and the main endoscopic appearance was nodularity and hyperemia. Patients diagnosed with H. pylori started triple-therapy treatment for 14 days. Only 13.8% stopped the treatment, mainly because of a misunderstanding of the treatment protocol (9.5%). Conclusions: Romanian teen girls living in rural areas are at high risk for H. pylori infection. Epigastric pain and endoscopic nodularity of the gastric mucosa were associated with the infection. As the resistance of the bacteria is unknown in our country, future research is needed in order to improve the eradication rate.
(1) Background: Irritable bowel syndrome (IBS) is a common disease, with multiple pathophysiological mechanisms involved. A single treatment for all the patients with IBS is not possible. Prebiotics may have a beneficial effect on IBS patients with constipation. (2) Methods: A randomized cross-over case-control study was conducted, including patients with IBS and constipation (IBS-C), who were randomized into two groups receiving a specific constipation diet with or without a food supplement containing inulin, choline and silymarin (Stoptoxin®, Fiterman Pharma, Iasi, Romania). Patients were evaluated at baseline, after four and eight weeks, using a questionnaire to assess IBS symptoms. (3) Results: 51 IBS-C patients were included, of which 47 patients finished the trial (33 women, mean age 52.82 years). Adding Stoptoxin® to a diet for constipation brought extra benefits. Abdominal pain severity improved by 68.3% after the diet and Stoptoxin® (p = 0.004) and abdominal bloating severity parameter improved by 34.8% (p = 0.040). The stool number per week and the stool consistency according to the Bristol scale were improved, but without statistical significance between groups (p > 0.05). (4) Conclusions: The combination of inulin, choline and silymarin associated with a specific-constipation diet had obvious clinical beneficial effects on IBS-C patients in terms of bowel movement, abdominal pain and bloating.
The presence of teeth on babies earlier than four months is a rare condition. Therefore, adequate treatment for each case should be instituted as soon as possible, considering that certain complications may arise. This report describes a rare case in which a newborn baby required the extraction of two mobile mandibular natal teeth to prevent the risk of aspiration. After two years, the clinical re-evaluation showed a residual tooth instead of a temporary one. This case report shows that adequate diagnosis should include a radiographic examination to determine whether these teeth are components of normal or supernumerary dentition, as well as further investigations on the relationship with the adjacent teeth. Another important aspect highlighted in this case report is the need for a post-extraction curettage of the socket in order to reduce the risk of ongoing development of the dental papilla cells.