Clinical Gastroenterology Journal

ISSN: 2952-8518

Open Access

Articles in press and Articles in process

    Research Pages: 1 - 6

    Endoscopy and Histopathological Findings of Gastric Fundus mucosa in patients with Hiatus Hernias

    Twaha Muwanga, Francis Basimbe*, Ignatius Kakande and Emmanuel Othieno

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    Background: Hiatal hernia remains a serious medical concern, which occurs quite frequently in the general population, and is characterized by a wide range of non-specific symptoms. Many studies have highlighted the association of hiatus hernia with changes in the distal oesophageal mucosa. Despite the burden of hiatus hernia, little is known about the endoscopic and histopathological changes in the gastric fundus mucosa in patients presenting with this condition and it is known that malignancies involving the fundus and cardia carry a worse prognosis.

    Objective: To assess the endoscopic and histopathological findings of gastric fundus mucosa in patients diagnosed with Hiatus hernias at Endoscopy.

    Methods: A cross-sectional descriptive study of 120 patients diagnosed with hiatus hernia at St. Francis hospital, Nsambya, Kampala was conducted from 1st August 2022 to 28th February 2023. Diagnosis of hiatus hernia at Gastrointestinal Endoscopy and a hill classification of hiatus hernia was documented. Biopsies were taken from the herniating part of the gastric fundus for histopathological assessment. Data on demographics, medical history, endoscopy and histopathological findings were collected using a pre-tested questionnaire. Data were analyzed using STATA version 16.0.

    Results: Among the 120 patients diagnosed with hiatus hernia, 55% were male. The mean age was 42 ± 15.9 years.72% had H. pylori infection. On endoscopy, 5 (4.2%) had normal endoscopy findings, 109 (95%) mucosal hyperemia, 43 (37%) ulcerations; 13 (11%) incarceration. Neither had gangrene nor tumors. None of the patients had normal histopathological findings: 11 (9%) atrophic (chronic) gastritis, 103 (86%) non-atrophic gastritis, 24 (20%) Gastric intestinal metaplasia.

    Conclusion: Majority of patients diagnosed with hiatus hernia had abnormal gastric fundus endoscopy findings, and of concern were the 29% of patients that had Atrophic Gastritis and Gastric intestinal metaplasia that are both premalignant lesions.

    Research Article Pages: 1 - 6

    Percutaneous Endoscopic Gastrostomy: Opinions, Attitudes and Experiences of Patients, Care Takers and Health Workers at a Subsaharan Hospital

    Francis Basimbe*, Victoria Nkore, Othiniel Musana and Gorreti Nassali

    DOI: 10.37421/2952-8518.2023.8.194

    Dysphagia has a high burden of disease with a global prevalence estimated to be at 43.8% and the highest prevalence rate was estimated in Africa at 64.2%. Many medical conditions have been associated with dysphagia including; stroke, Parkinson’s disease, dementia and traumatic brain injury. Dysphagia is associated with malnutrition and carries a significant risk of mortality in many patients. To ensure adequate nutritional intake, enteral nutrition is usually the method of choice in patients with a normally functioning gastrointestinal system. The (European Society on Parenteral Nutrition) ESPEN guidelines recommend Nasogastric tube feeding for short term enteral feeding and Percutaneous Endoscopic Gastrostomy (PEG) for long term feeding (>4 weeks). Despite this recommendation the uptake of PEG Tube feeding has been very low in our setting we therefore set out to explore the opinions, attitudes and experiences of patients, caretakers and health workers towards PEG Tube feeding.

    Methods: This was a cross-sectional, exploratory qualitative study design conducted using semi-structured in-depth interviews to enable participant’s air out their opinions and describe their experiences. Opinions attitudes and experiences of patients, caretakers, health workers that manage patients with PEGs and interact with patients who may require PEG Tube feeding were explored

    Results: Three major themes emerged from interviews with health worker and these were: positive experience; negative experiences and community care. “So the PEG has really improved their life in terms of weight gain. We used to rush to hospital because of aspiration pneumonia, but now we stopped and these events reduced in the frequency.” – Nurse The three main theses that emerged from the care takers and patients were, Need for PEG, Benefits of PEG and the challenges they have faced while with a PEG Tube for feeding and Coping mechanisms “When we went home, we were feeding the tube and the porridge is so good for him. You could see that he had become healthy and the skin at come back soon as and so smooth” – caregiver.

    Conclusion: Our study found that the need for PEG was significant due to the increasing burden of dysphagia and its associated complications. It also noted that PEG has shown to have improved care and better patient outcomes in terms of health and nutrition. . However multiple challenges and set backs were noted and these included cost, lack of knowledge and resistance from patients and families.

    Mini Review Pages: 1 - 2

    A Consequence of Aberrant Blood Supply from the Left Phrenic Artery to an Enlarged Splenule

    Sabez Rahlon

    An acquired gastric Dieulafoy like lesion refers to a rare vascular abnormality found in the stomach that resembles Dieulafoy's lesion, a condition characterized by an abnormally dilated and fragile artery that causes sudden and potentially life-threatening gastrointestinal bleeding. In this case, the acquired lesion is caused by an unusual redirection of blood supply from the left phrenic artery to an enlarged splenule. This comprehensive approach not only enhances clinical practice but also informs health policy development for the betterment of public health

    Mini Review Pages: 1 - 2

    Understanding Psychological Factors Impacting Nutritional Behavior in Motor Neuron Disease: Insights from Health Care Professionals - A Thematic Analysis

    Warif Zaid*

    This suggests that the study is focused on identifying and comprehending the mental and emotional aspects that play a role in influencing nutritional choices and habits in individuals with MND. Psychological factors can include thoughts, emotions, attitudes, and perceptions related to food and eating, this indicates that the study is interested in how these psychological factors affect the dietary choices and eating patterns of people living with MND. It's important to note that MND is a neurodegenerative disease that can impact motor functions, making it relevant to investigate how psychological factors might influence nutritional behaviour in this specific patient population

    Mini Review Pages: 1 - 2

    Nutritional Management in Head and Neck Cancer Patients Undergoing Radiotherapy and Chemotherapy: A Review of Enteral Feeding Methods

    Vamin Salong*

    Nutritional support and intervention are essential aspects of managing head and neck cancer. Many patients with this condition are malnourished upon diagnosis, and most of those undergoing treatment will require nutritional assistance. This paper offers a concise summary of key nutritional considerations for these patients and offers practical recommendations for clinicians in their care.

    Opinion Pages: 1 - 2

    The Impact of Obesity on Gastrointestinal Health and Treatment Considerations

    Swarna Querisi*

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    Brief Report Pages: 1 - 2

    Environmental Epidemiology: Assessing the Impact of Environmental Exposures on Health

    Saraf Wajid*

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      Commentry Pages: 1 - 1

      Diverticulosis: Its Symptoms and Complications

      Nuria Logan and Peter Marck

      Certain thoughts, ideas, and even diseases fall in and out of fashion over time. One example of the latter is diverticulosis. As the older population in wealthy countries grows, diverticulosis is becoming more common. It affects the majority of people over the age of 80, places a significant strain on health-care resources, and is strangely overlooked by many gastroenterologists. There is a startling lack of evidence and many unsolved concerns for such a frequent and possibly essential disorder. Many clinicians, funding agencies, and fundamental scientists have been hesitant to promote study and investigate diverticulosis. It's not unexpected that medical treatment for diverticulosis has progressed slowly during the last half-century.

        Research Article Pages: 2 - 9

        Tinospora Cordifolia (Gulvel/Guduchi) Induced hepatotoxicity

        Dadasaheb maindad

        Background: Drug-induced liver injury (DILI) is caused due to various types of medications, herbs, or other xenobiotics, in the absence of other etiologies. DILI has been observed with different clinical features and biochemical abnormalities. Herbal products are responsible for DILI in many cases (10%). There exists no specialized gold standard method to diagnose or predict DILI, and the disease has been commonly diagnosed with the RUCAM score. Tinospora Cordifolia (Gulvel/Guduchi), which is readily available in the hilly area of western Maharashtra as a wild plant, has been used in Ayurveda for the treatment of hepatotoxicity. Furthermore, it is consumed as an immunemodulator during the COVID 19 pandemic. Case presentations: During last year, there is a sudden increase in hepatitis cases. We observed 16 patients who consumed Tinospora Cordifolia (Gulvel/Guduchi) and depicted instability in liver function tests. This research found no other reason responsible for such complaints in these patients. All these patients had a RUCAM score greater than six. They had mild to severe level symptoms in which fourteen patients were recovered with supportive care. It was noted that elderly females were affected commonly, in which one mortality case happened secondary to ACLF. The study observed no cases in the family even after the consummation of similar products with similar doses. Conclusion: Tinospora Cordifolia (Gulvel/Guduchi) can cause mild to severe grade hepatotoxicity with high doses, most probably in genetically susceptible elderly patients. Additionally, the study also states that mortality is rare. However, to confirm this observation and to provide prompt details, more research must be carried out.

        Research Article Pages: 1 - 4

        The Relationship between Dietary Total Antioxidant Capacity and Inflammatory Bowel Disease: A Case-Control Study

        Soheila Shekari, Asal Ataie Jafari, Mahmood Mahmoodi Majd Abadi, Shahryar Eghtesadi, Seyed Saeed Seyedian

        Diets rich in fruits and vegetables, seeds and nuts play an important role in reducing inflammatory bowel disease. Consumption of dietary antioxidants reduces inflammatory bowel disease. In the present study, the relationship between Dietary Total Antioxidant Capacity (DTAC) and inflammatory bowel disease was studied in Golestan Hospital, Ahvaz, Iran. This study was performed on 86 individuals in the healthy group and 86 patients with inflammatory bowel disease. A 147-item food frequency questionnaire was used to collect data. Ferric ion Reducing Antioxidant Power (FRAP) values were used to calculate the DTAC. Data were analyzed using SPSS software version 23. The mean age was 33.4 ± 7.4 for the healthy group and 36.5 ± 10.7 for the patient group (P<0.05). The control group had a higher dietary antioxidant capacity compared to the patient group (the healthy group received higher antioxidant vitamins including alpha-carotene, lycopene, vitamin C, vitamin A) (P=0.001). In the original model and modified logistic regression models, individuals in the highest quartile of DTAC had a lower risk of IBD (OR: 1.78, 95% CI:(0/51-6.21); P: 0/001). High levels of DTAC were associated with reduced IBD risk. It seems that a diet with high antioxidant capacity can prevent IBD.

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