Volume 87 - 2024 - Fasc.3 - Original articles
Investigation of the prevalence of functional constipation and its related factors for in older outpatients
Background: Functional constipation (FC) is a geriatric syndrome that is common in the older adult’s population and can seriously affect the quality of life and may be a frequent cause of hospital visits. In this study, we planned to investigate the relationship between FC and its related factors for in older outpatients.
Patients and Methods: Participants aged 65 and over who applied to the geriatrics outpatient were included in the study. The diagnosis of FC was made according to the presence of the Rome IV criteria. Frailty was screened by the using FRAIL scale, ≥ 3 a score of were evaluated as frail. Participants quality of life was evaluated by Euro-Quality of Life Visual Analog Scale (EQ-VAS).
Results: The study included 602 participants. FC prevalence was found 28.7%. In univariate analyses, FC was found related to age, having a diagnosis of depression or Parkinson diseases, frailty, urinary incontinence, sleep disorders, number of chronic diseases, and EQ-VAS. In multivariate analyses, FC was not found to be associated by the frailty while the number of chronic diseases [OR=1.212, 95%CI (1.084-1.355), p=0.001] and EQ-VAS were found to be related [OR=0.988, 95%CI (0.978-0.997), p=0.012].
Conclusion: In the results of this study, FC was not found to be associated by frailty in older outpatients but it emerged as a syndrome that should be screened frequently in patients with a high number of chronic diseases and a low general quality of life. (Acta gastroenterol. belg., 2024, 87, 361-365.
Are nucleot(s)ide analogues a negative factor for HBsAg seroconversion in acute hepatitis B?
Background and study aim: There are several studies comparing
patients treated with lamivudine and those not given antiviral
therapy in acute hepatitis B. Some of these studies showed that
antiviral treatment significantly contributed to survival, whereas
one other study suggested that antiviral treatment had no effect.
The aim of this study was to investigate the efficacy of tenofovir
disoproxil fumarate (TDF) therapy and its effect on HBsAg
seroconversion in patients with acute viral hepatitis B.
Patients and methods: The files of 126 patients who were
under follow-up for acute HBV infection in the Department of
Gastroenterology were analyzed retrospectively. Demographic
data, molecular, ELISA, and biochemistry tests at the time of
diagnosis and in the follow-up, period were evaluated using the
hospital automation system.
Results: The rate of chronicity of HBV was found to be higher in
the TDF group than in the group without antiviral treatment. The
rate of protective anti-HBs acquisition was found to be lower in the
TDF group (p<0.05).
Conclusion: Antiviral treatment with TDF in acute HBV
infection may increase the rate of chronicity. It may reduce the
development of natural immunity. Further studies are warranted.
Prevalence of metabolic dysfunction-associated fatty liver disease after pancreatic surgery in a historical Belgian cohort and review of the literature
Background and objectives: Metabolic dysfunction-associated
fatty liver disease (MAFLD) has been reported as a complication
after pancreatic surgery. The aim of this study is to assess this
phenomenon in a Belgian population, specifically in a period in
time when less perioperative chemotherapy was given.
Methods: We performed a retrospective monocentric cohort
study with 124 selected patients who underwent pancreatic
surgery – pancreaticoduodenectomy (PD), distal pancreatectomy
(DP) or total pancreatectomy – between 2005 and 2014. Steatosis
was assessed radiologically, using Hounsfield units on liver and
spleen. Data on imaging, liver function, weight and other relevant
parameters were gathered preoperatively as well as 2 and 6 months,
1 and 2 years after surgery.
Results: Thirty-eight (31%) out of 124 patients developed liver
steatosis at least at one point in time in the two years following
surgery, with a prevalence of 21.0% at 2 months, 28.6% at 6 months,
16.4% at 1 year and 20.8 % at 2 years. A statistically significant
association with preoperative AST and ALT values, administration
of pancreatic enzyme supplementation as a surrogate for pancreatic
exocrine insufficiency (PEI) and weight loss at 2 years was detected.
Conclusion: MAFLD is seen in 31% of patients with PD or DP
pancreatic resection in this retrospective analysis of a monocentric
Belgian cohort. Both early and late onset of MAFLD was observed,
implying that long-term follow-up is necessary. Clinical impact as
well as a direct correlation with patients’ weight and oral enzyme
supplements needs to be further investigated.
Bile acid malabsorption investigated by selenium-75-homocholic acid taurine (75SeHCAT) scans, a retrospective single-centre experience
Background: Bile acid malabsorption (BAM) is a common
entity in patients experiencing chronic watery diarrhea. However,
literature suggests that BAM is underdiagnosed and undertreated.
In many countries 75SeHCAT is the gold standard for diagnosing
BAM (1-5). The aim of this retrospective study was to investigate
the frequency of BAM using 75SeHCAT scintigraphy and the
response to treatment with bile acid sequestrants.
Methods: We retrospectively evaluated the clinical data of 420
patients who had a 75SeHCAT scan from January 2016 to January
2023. Electronic medical records were investigated for risk factors
of BAM. BAM was defined as a 75SeHCAT retention of less than
15%. Response to bile acid sequestrants was evaluated based on
outpatient clinical reports.
Results: Median age at the time of 75SeHCAT test was 47 years
(range 14-87). Out of 420 patients, 192 (46%) had a positive result
for BAM. Cholecystectomy and ileal resection were significant
predictors for BAM (p<0.001). BAM type 1 is statistically more
likely to be more severe compared to type 2 (p<0.0001) and
compared to type 3 (p=0.0021). In patients who fulfilled Rome
IV criteria for IBS-D or functional diarrhea, 75 out of 121 (38%)
tested positive for BAM. Overall, treatment with bile acid binders
was effective in 76%.
Conclusions: This retrospective study of patients who underwent
SeHCAT scanning confirms that about 1/3 patients presenting
with therapy-resistant chronic diarrhea in secondary care suffer
from BAM. Including the test in clinical management protocols
of chronic diarrhea allows early and quantitative diagnosis and
treatment of BAM.
Noninvasive evaluation of significant liver fibrosis in chronic hepatitis B patients
Background & Aims: Chronic hepatitis B is still a major cause
of morbidity and mortality worldwide. In recent years, there has
been increasing research on inexpensive, noninvasive, reproducible
methods for detecting fibrosis in the liver. In this study, we examined
the efficacy of 15 different noninvasive fibrosis markers for
predicting significant liver fibrosis in chronic hepatitis B patients.
Methods: Patients who underwent liver biopsy for chronic
hepatitis B between 01.01.2010 and 01.01.2022 were retrospectively
analysed. The study population was divided into two groups
according to significant fibrosis (F≥3). Receiver operating
characteristic analysis was performed to examine the diagnostic
performance of these noninvasive fibrosis markers for the
prediction of significant fibrosis. Multiple logistic regression
analysis was used create a model which predicts significant fibrosis
better than the individual markers.
Results: In total, 234 chronic hepatitis B patients were enrolled
in this study. Among the 15 noninvasive fibrosis markers, King’s
score was found to have the biggest AUC in predicting significant
fibrosis (F≥3). Furthermore, a model containing King’s score,
GUCI and GPR has the ability of prediction of significant fibrosis
better than every individual marker (cut-off of the model >0,3356,
p<0.0001).
Conclusion: According to our study results, the model
containing King’s score, GUCI and GPR can be used to predict
significant liver fibrosis in chronic hepatitis B patients followed-up
in countries with limited sources.