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6 results

  • Causal association of plasma n-3 PUFA with peptic ulcer disease: a two-sample Mendelian randomisation study

  • Zebin Dai, Qinjian Wang, Bingbing He, Fang Shi, Wei Chen, Qingxi Jiang, Dan Zhou, Zhanxiong Xue, Bo Yang
  • Journal:
    British Journal of Nutrition / Volume 132 / Issue 8 / 28 October 2024
    Published online by Cambridge University Press:
    11 November 2024, pp. 1014-1021
    Print publication:
    28 October 2024
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  • Dietary n-3 PUFA may have potential benefits in preventing peptic ulcer disease (PUD). However, data from observational epidemiological studies are limited. Thus, we conducted a Mendelian randomisation analysis to reveal the causal impact of n-3 PUFA on PUD. Genetic variants strongly associated with plasma levels of total or individual n-3 PUFA including plant-derived α-linolenic acid and marine-derived EPA, DPA and DHA were enrolled as instrumental variables. Effect size estimates of the n-3 PUFA-associated genetic variants with PUD were evaluated using data from the UK biobank. Per one sd increase in the level of total n-3 PUFA in plasma was significantly associated with a lower risk of PUD (OR = 0·91; 95 % CI 0·85, 0·99; P = 0·020). The OR were 0·81 (95 % CI 0·67, 0·97) for EPA, 0·72 (95 % CI 0·58, 0·91) for DPA and 0·87 (95 % CI 0·80, 0·94) for DHA. Genetically predicted α-linolenic acid levels in plasma had no significant association with the risk of PUD (OR = 5·41; 95 % CI 0·70, 41·7). Genetically predicted plasma levels of n-3 PUFA were inversely associated with the risk of PUD, especially marine-based n-3 PUFA. Such findings may have offered an effective and feasible strategy for the primary prevention of PUD.

  • 28 - Gastrointestinal Bleeding

  • from Section 6 - Gastrointestinal Emergencies
  • Edited by Kaushal Shah, Weill Cornell Medical Center, New York, Jarone Lee, Massachusetts General Hospital, Boston
  • Edited in association with Clark G. Owyang, Weill Cornell Medical Center, New York, Benjamin Christian Renne, Massachusetts General Hospital, Boston
  • Book:
    Practical Emergency Resuscitation and Critical Care
    Published online:
    02 November 2023
    Print publication:
    23 November 2023, pp 257-269

  • Summary

    Upper gastrointestinal bleeding (UGIB) is bleeding proximal to the ligament of Treitz (esophageal, gastric or duodenal source). More common than lower gastrointestinal bleeding (LGIB; approximately 70% of GIB). Most common cause is peptic ulcer disease. LGIB is bleeding distal to the ligament of Treitz. Lower gastrointestinal bleeding is less common than UGIB (approximately 30% of GIB). LGIB has lower mortality rate than UGIB. The most common cause is diverticular disease.

  • Investigating the shared genetic architecture of post-traumatic stress disorder and gastrointestinal tract disorders: a genome-wide cross-trait analysis

  • Siquan Zhou, Hang Luo, Ye Tian, Haoqi Li, Yaxian Zeng, Xiaoyu Wang, Shufang Shan, Jingyuan Xiong, Guo Cheng
  • Journal:
    Psychological Medicine / Volume 53 / Issue 16 / December 2023
    Published online by Cambridge University Press:
    23 May 2023, pp. 7627-7635
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  • Background

    Observational studies suggest a correlation between post-traumatic stress disorder (PTSD) and gastrointestinal tract (GIT) disorders. However, the genetic overlap, causal relationships, and underlining mechanisms between PTSD and GIT disorders were absent.

    Methods

    We obtained genome-wide association study statistics for PTSD (23 212 cases, 151 447 controls), peptic ulcer disease (PUD; 16 666 cases, 439 661 controls), gastroesophageal reflux disease (GORD; 54 854 cases, 401 473 controls), PUD and/or GORD and/or medications (PGM; 90 175 cases, 366 152 controls), irritable bowel syndrome (IBS; 28 518 cases, 426 803 controls), and inflammatory bowel disease (IBD; 7045 cases, 449 282 controls). We quantified genetic correlations, identified pleiotropic loci, and performed multi-marker analysis of genomic annotation, fast gene-based association analysis, transcriptome-wide association study analysis, and bidirectional Mendelian randomization analysis.

    Results

    PTSD globally correlates with PUD (rg = 0.526, p = 9.355 × 10−7), GORD (rg = 0.398, p = 5.223 × 10−9), PGM (rg = 0.524, p = 1.251 × 10−15), and IBS (rg = 0.419, p = 8.825 × 10−6). Cross-trait meta-analyses identify seven genome-wide significant loci between PTSD and PGM (rs13107325, rs1632855, rs1800628, rs2188100, rs3129953, rs6973700, and rs73154693); three between PTSD and GORD (rs13107325, rs1632855, and rs3132450); one between PTSD and IBS/IBD (rs4937872 and rs114969413, respectively). Proximal pleiotropic genes are mainly enriched in immune response regulatory pathways, and in brain, digestive, and immune systems. Gene-level analyses identify five candidates: ABT1, BTN3A2, HIST1H3J, ZKSCAN4, and ZKSCAN8. We found significant causal effects of GORD, PGM, IBS, and IBD on PTSD. We observed no reverse causality of PTSD with GIT disorders, except for GORD.

    Conclusions

    PTSD and GIT disorders share common genetic architectures. Our work offers insights into the biological mechanisms, and provides genetic basis for translational research studies.

  • Depression and risk of gastrointestinal disorders: a comprehensive two-sample Mendelian randomization study of European ancestry

  • Dongze Chen, Yali Zhang, Tao Huang, Jinzhu Jia
  • Journal:
    Psychological Medicine / Volume 53 / Issue 15 / November 2023
    Published online by Cambridge University Press:
    15 May 2023, pp. 7309-7321
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  • Background

    Major depressive disorder (MDD) is clinically documented to co-occur with multiple gastrointestinal disorders (GID), but the potential causal relationship between them remains unclear. We aimed to evaluate the potential causal relationship of MDD with 4 GID [gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), peptic ulcer disease (PUD), and non-alcoholic fatty liver disease (NAFLD)] using a two-sample Mendelian randomization (MR) design.

    Methods

    We obtained genome-wide association data for MDD from a meta-analysis (N = 480 359), and for GID from the UK Biobank (N ranges: 332 601–486 601) and FinnGen (N ranges: 187 028–218 792) among individuals of European ancestry. Our primary method was inverse-variance weighted (IVW) MR, with a series of sensitivity analyses to test the hypothesis of MR. Individual study estimates were pooled using fixed-effect meta-analysis.

    Results

    Meta-analyses IVW MR found evidence that genetically predicted MDD may increase the risk of GERD, IBS, PUD and NAFLD. Additionally, reverse MR found evidence of genetically predicted GERD or IBS may increase the risk of MDD.

    Conclusions

    Genetically predicted MDD may increase the risk of GERD, IBS, PUD and NAFLD. Genetically predicted GERD or IBS may increase the risk of MDD. The findings may help elucidate the mechanisms underlying the co-morbidity of MDD and GID. Focusing on GID symptoms in patients with MDD and emotional problems in patients with GID is important for the clinical management.

  • Chapter 41 - Maternal complications of fetal surgery

  • from Section 5 - Serious problems related to pregnancy
  • Edited by Marc van de Velde, Helen Scholefield, Lauren A. Plante
  • Book:
    Maternal Critical Care
    Published online:
    05 July 2013
    Print publication:
    04 July 2013, pp 462-471

  • Summary

    Management of the pregnant woman with an acute abdomen is a typical multidisciplinary challenge. Regardless of the type of surgery and anesthesia, close cooperation and communication between surgeons, anesthesiologists, obstetricians, radiologists, the intensivist, as well as nurses and midwives, is essential. Non-obstetric causes of acute abdomen in pregnancy include appendicitis, bowel obstruction, inflammatory bowel disease, spontaneous esophageal rupture, peptic ulcer disease and perforated gastric ulcer, cholecystitis and pancreatitis. Obstetric causes of acute abdomen involving liver are spontaneous hepatic rupture, ruptured splenic artery aneurysm and aortic aneurysm. Nephrolithiasis, or kidney stones, is uncommon in pregnancy. Careful preoperative assessment of the woman should be made and all preparative measures taken in order to minimize the risk and possible harm of the anesthetic procedure. For major abdominal surgery, the use of epidural analgesia is safe and beneficial provided there is a stable hemodynamic situation.

  • Neuropathy – diabetic

  • from Chief complaints and diagnoses
  • Edited by Stephen H. Thomas
  • Book:
    Emergency Department Analgesia
    Published online:
    18 December 2009
    Print publication:
    25 September 2008, pp 280-284

  • Summary

    This chapter groups the clinically distinct, but similarly treated, entities of gastritis and peptic ulcer disease (GPUD). It focuses on patients with organic disease, with some concluding notes on the challenging management of functional dyspepsia. The most basic treatment for patients with GPUD is administration of antacids. A typical trial finds that administration of colloidal bismuth subcitrate provides significant pain relief in just over half of patients with either gastritis or duodenitis. The reason that agents such as antacids and bismuth salts are reserved for occasional symptomatic relief is that more consistent success is achieved with newer agents such as the proton pump inhibitors (PPIs). The PPIs also relieve symptoms better than does the gastroprotective agent sucralfate when altered gastroduodenal motility is a postulated occasional cause of gastritis, the prokinetic drugs have been employed to treat GPUD.