Results: Impaired gastric accommodation to a meal was found in 40% of the patients. The patients presented to the outpatient clinic because of meal-related epigastric symptoms, and all Characteristics of patients with functional dyspepsia Patients with functional dyspepsia were significantly older than healthy subjects, and a higher proportion of the patients were women (P < 0.01). Table 1 summarizes the grading of dyspeptic symptoms in the patient group. . Frequency of severity grading for each of six dyspepsia symptoms in 40 consecutive patients with functional dyspepsia Empty Cell 0 1 2 3 Empty Cell (Absent) (Mild) (Relevant) (Severe) Postprandial fullness 7 (17.5) 0 (0) 2 (5) 31 (77.5) Bloating 7 (17.5) 2 (5) 4 (10) 27 (67.5) Epigastric pain 13 (32.5) 3 (7.5) 2 (5) 22 Discussion Recent studies have reported impaired gastric accommodation to a meal in patients with functional dyspepsia.9, 10, 13 The prevalence of impaired accommodation and its relevance and relationship to symptoms are unknown.

MATERIAL AND METHODS Patient Selection We investigated 20 children consecutively, 10 boys and 10 girls (age range, 7–14 years; mean age, 10.6 years) who were referred to the pediatric gastroenterology unit at the University Hospital in Bergen, Norway, because of RAP that met the criteria outlined by Apley and Naish (1) . These criteria include at least three episodes of abdominal pain occurring during a period of more than 3 months with no known organic cause and severe enough to affect the child's activities. RESULTS Ultrasonography Children with RAP had a significantly smaller sagittal area of the proximal stomach at 10 and 20 minutes after the meal than did healthy control subjects (P = 0.01 for both;Fig. 4 ). Children with RAP had a shorter frontal diameter of the proximal stomach after the meal as well, but this difference was not significant (Table 1 ). Children with RAP had significantly higher emptying fractions of the proximal stomach than healthy control subjects at 10 minutes after ingestion of the meal (P = 0.02;Fig. 5 ). TABLE 1: Measurements of the proximal stomach ( sagittal area, frontal diameter ) , antral area and emptying fraction of the proximal stomach in children with recurrent abdominal pain and healthy controls FIG. 4.: Sagittal area (mean ± SEM) of the proximal stomach in children with recurrent abdominal pain (n = 20) and control subjects (n = 23) after a meat soup meal. * P < 0.05.

Measurements with sieving and laser diffraction methods indicated that chewed particles were much larger in vegetables than in nuts: raw vegetables were transformed into boluses made up of particles larger than 2 mm, and nuts gave a bolus which contained 90% of particles smaller than 2 mm (Peyron and others 2004 ). The median particle sizes (theoretical sieve through which 50% of the particle weight can pass) for some selected foods are 0.82 mm (peanuts), 1.9 mm (carrots), 2.4 mm (Emmental), 2.68 mm (olives), and 3.04 mm (gherkins) (Jalabert-Malbos and others 2007 ). The size of particles resulting from mastication depends on the food texture (Hoebler and others 2000 ; Foster and others 2006 ; Jalabert-Malbos and others 2007 ). Agrawal and others (1997) showed that the rate of food breakdown between the teeth, as indicated by the number of fractures and consequently the number of fragments, is inversely related to the fragmentation index given by (R/E)0.5 , where R is toughness, indicating the energy needed to generate and propagate a fracture through the sample, ranging from approximately 56.97 J/m2 for apple pulp to 4355.45 J/m2 for prune pit (Williams and others 2005 ); E is Young's modulus corresponding to the stress/strain ratio and describes the strength of the material, ranging from 0.07 MPa for gummy bears to 346 MPa for popcorn kernels (Williams and others 2005 ). Moreover, the fragmentation index is significantly related with muscle activities such as masticatory frequency (Foster and others 2006 ). Food texture also affects starch hydrolysis in the mouth. For example, studies have shown that addition of acid-instable emulsions to preprocessed foods led to accelerated gastric emptying, whereas ingestion of acid-stable emulsions delayed gastric emptying and reduced the amount of food consumed (Marciani and others 2007 ). In the future, foods may be structured in such a way as to control the rate of release of macronutrients and to reduce or increase the rate of stomach emptying (Norton and others 2006 ). A recent review provides information on how structured foods may play a role in controlling obesity (Norton and others 2007 ). An enhanced understanding of food disintegration in GI and its relationships with physical and chemical properties of foods may help different clinical studies through the design of specific food microstructures.

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Access through your institution Original Research Full Report: Clinical—Alimentary Tract A Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome Methods In a study of 30 patients with IBS and 8 healthy individuals (controls, matched for demographics and diet), we collected dietary data from subjects for 1 habitual week. As highlighted by Figure 1, symptoms were more than halved in IBS subjects and all measured symptoms were reduced to a level that arguably is Acknowledgments The authors thank Gina Dimitrakopoulos and Debbie King (Monash University) for their assistance with food preparation and packaging; Kelly Liels, Ourania Rosella, and Rosemary Rose (Monash University) for analysis of FODMAP content of meals; Alicia Moltzen (Monash University) for analysis of breath samples; and Minfeng Deng and Chu Kion Yao (Monash University) for statistical analysis.

World J Gastroenterol 2014;20:6013–6023. Article PubMed PubMed Central Google Scholar Hyams JS, Di Lorenzo C, Saps M, Shulman RJ, Staiano A, van Tilburg M. Lactobacillus reuteri in children with functional abdominal pain (FAP). J Paediatr Child Health 2014;50:e68–71. Article Google Scholar Rutten JM, Benninga MA, Vlieger AM.

June 1987 Are Chronic Digestive Complaints the Result of Abnormal Dietary Patterns?Diet and Digestive Complaints in Children at 22 and 40 Months of Age Am J Dis Child. 1987;141(6):679-682. doi:10.1001/archpedi.1987.04460060095043 Full Text • We studied 149 healthy children at 22 months of age and 74 at 40 months of age, employing a 24-hour dietary record based on premailed food measurement guide and telephone questionnaire. Chronic digestive complaints decreased from 27% to 5% of the sample over the study period: constipation from 16% to 3%, chronic diarrhea from 8% to 1%, and abdominal pain from 5% to 1%. Excessive fluid intake (1470±600 vs mL/d) correlated most strongly for seven children at 22 months experiencing alternating symptoms of chronic diarrhea and constipation or abdominal pain.

We explored rates of stroke/thromboembolism/transient ischemic attack among the “OAC not recommended” patient group defined according to the 2014 Canadian Cardiovascular Society (CCS) algorithm (based on the C ongestive Heart Failure, H ypertension, A ge, D iabetes, S troke/Transient Ischemic Attack [CHADS] score) who would have been offered OAC using the European Society of Cardiology (ESC) guidelines approach (based on the C ongestive Heart Failure, H ypertension, A ge [≥75 years], D iabetes, S troke/Transient Ischemic Attack, V ascular Disease, A ge [65-74 years], S ex [Female]; CHADS-VASc score). We identified 22,582 nonanticoagulated patients age < 65 years with a CHADS score of 0 who were stratified according to the CHADS-VASc score, except female sex, which would be an indication for OAC according to the ESC guidelines. Nous avons examiné les taux d’accidents vasculaires cérébraux, de thromboembolies et d’ischémies cérébrales transitoires (ICT) d’un groupe de patients chez lesquels l’ACO n’est pas recommandée telle que définie par l’algorithme de la Société canadienne de cardiologie (SCC; selon le score CHADS [C ongestive Heart Failure, H ypertension, A ge, D iabetes, S troke/Transient Ischemic Attack : insuffisance cardiaque congestive, hypertension, âge, diabète, accident vasculaire cérébral/ischémie cérébrale transitoire]), mais serait offerte selon l’approche des lignes directrices de la Société Européenne de Cardiologie (SEC; selon le score CHADS-VASc [C ongestive Heart Failure, H ypertension, A ge (≥ 75 years), D iabetes, S troke/Transient Ischemic Attack, V ascular Disease, A ge (65-74 years), S ex (Female); insuffisance cardiaque congestive, hypertension, âge (≥ 75 ans), diabète, accident vasculaire cérébral/ischémie cérébrale transitoire, maladie vasculaire, âge (65-75 ans), sexe (féminin)]). Le taux général des critères d’évaluation combinés de l’accident vasculaire cérébral ischémique/embolie systémique/ICT a été de 4,32 pour 100 années-personnes (intervalle de confiance [IC] à 95 %, 3,26-5,74) après 1 an chez les patients qui auraient présenté une indication à l’ACO selon les lignes directrices de la SEC, mais pour lesquels l’ACO n’était pas recommandée selon l’algorithme de la SCC.

Furthermore, psychometric tests have indicated personality traits especially associated with IBS patients, and psychotherapy can sometimes be helpful (6). Patients with IBS and symptoms consisting mainly of constipation are sometimes helped by a dietary fiber supplement but dietary fiber supplements have not been successful in the treatment of IBS as measured by double-blind trials (7). There is no efficacious medical treatment for IBS, and many patients rely on changes in their diet, such as intake of fiber supplements to stimulate intestinal movements, or avoidance of foods that tend to produce gas. In a recent report by King et al. it was found that colonic-gas production was greater in patients with IBS than in controls and that both symptoms and gas production were reduced by exclusion diet (10). This may indicate a role for gut bacteria in the symptomatology of IBS patients.

Journal List J Neurogastroenterol Motil v.20(2); 2014 Apr PMC4015196 2014 Apr; 20(2): 228–235. Abstract Background/Aims Carbohydrate malabsorption is frequent in patients with functional gastrointestinal disorders and in healthy volunteers and can cause gastrointestinal symptoms mimicking irritable bowel syndrome (IBS). The aim of this study was to investigate the prevalence of symptomatic lactose and fructose malabsorption in a large population of patients with IBS-like symptoms based on Rome II criteria. Lactose malabsorption has already been well recognized as a cause of non-specific gastrointestinal (GI) symptoms.16 – 18 On the contrary, malabsorption of fructose is less well studied but has recently received growing attention through the fact that restricting rapidly fermentable oligo-, di- and monosaccharides and polyols (FODMAPs) is beneficial in controlling symptoms of abdominal discomfort.19 , 20 Indeed, 2 studies reported a prevalence of fructose malabsorption in functional dyspepsia or unexplained GI symptoms of 40–55% and 73%, respectively.10 , 18 Therefore, it seems to be reasonable to perform routine fructose H2 breath tests in patients with unexplained abdominal symptoms who have had an unremarkable medical check-up including laboratory tests, physical examination, ultrasound and endoscopy and in the absence of “red flags” (e.g., unintended weight loss, rectal bleeding, fever, severe diarrhea or vomiting, persistent pain in the upper or lower right abdomen, family history of inflammatory bowel disease or colon cancer). The gold standard to detect small intestinal bacterial over-growth (SIBO) is the culture of jejunal aspirates.