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  1. Article ; Online: Probiotics: To Use or Not to Use? That Is the Question.

    Schmulson, Max

    The American journal of gastroenterology

    2021  Volume 116, Issue 7, Page(s) 1396–1397

    Abstract: Abstract: This Editorial analyzes the paper by Schnadower et al on the secondary analysis of 2 randomized placebo-controlled trials evaluating the efficacy of Lactobacillus rhamnosus GG, and a combination of L. rhamnosus R0011 and L. helveticus R0052, ... ...

    Abstract Abstract: This Editorial analyzes the paper by Schnadower et al on the secondary analysis of 2 randomized placebo-controlled trials evaluating the efficacy of Lactobacillus rhamnosus GG, and a combination of L. rhamnosus R0011 and L. helveticus R0052, showing that moderate-to-severe gastroenteritis symptoms as primary endpoint, did not differ between probiotics or placebo. The data is important because probiotics are commonly used and prescribed in clinical practice, many times without strong evidence and producing a high economic burden. Two other examples are addressed. A systematic review of randomized placebo-controlled trial of L. reuteri DSM 17938 finding that this probiotic reduced the duration of diarrhea and hospitalization, to discuss the issue that the effect of probiotics is strain specific. In addition, the different findings of reviews and meta-analyses of probiotics in Irritable Bowel Syndrome in which a common conclusion of all of them was that adequately powered randomized controlled trials are required to better determine the species, strains and doses of probiotics, as well as the treatment duration that is most efficacious. Finally, the fact that probiotics are frequently prescribed despite lacking regulations by pharmaceutical authorities is addressed.
    MeSH term(s) Humans ; Diarrhea ; Gastroenteritis ; Hospitalization ; Lacticaseibacillus rhamnosus ; Probiotics/therapeutic use
    Language English
    Publishing date 2021-03-20
    Publishing country United States
    Document type Editorial ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.14309/ajg.0000000000001299
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Is Post Infection-Irritable Bowel Syndrome Less Frequent in Mexico?

    Schmulson, Max

    The American journal of gastroenterology

    2019  Volume 114, Issue 6, Page(s) 846–848

    MeSH term(s) Humans ; Incidence ; Infections/complications ; Irritable Bowel Syndrome/epidemiology ; Irritable Bowel Syndrome/etiology ; Mexico/epidemiology ; Prevalence
    Language English
    Publishing date 2019-03-08
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.14309/ajg.0000000000000098
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: How to use Rome IV criteria in the evaluation of esophageal disorders.

    Schmulson, Max

    Current opinion in gastroenterology

    2018  Volume 34, Issue 4, Page(s) 258–265

    Abstract: Purpose of review: In 2016, the Rome IV process and criteria were published. They provide a system to standardize patient diagnostic requirements for clinical studies and pharmaceutical trials on functional gastrointestinal disorders (FGIDs), which are ... ...

    Abstract Purpose of review: In 2016, the Rome IV process and criteria were published. They provide a system to standardize patient diagnostic requirements for clinical studies and pharmaceutical trials on functional gastrointestinal disorders (FGIDs), which are now called disorders of gut-brain interaction (DGBI). Although the Rome criteria have limitations in clinical practice, an understanding of the criteria can help clinicians to manage symptoms in patients with DGBI, and with organic diseases as well.
    Recent findings: In this report, the Rome IV criteria for esophageal DGBI, the updated algorithms for esophageal symptoms, and the multidimensional clinical profile (MDCP) are reviewed.
    Summary: The esophageal DGBI comprise functional esophageal chest pain, functional heartburn, globus, functional dysphagia, and the newly introduced reflux hypersensitivity. They are characterized by the presence of chronic symptoms attributed to the esophagus without evidence of esophageal structural, inflammatory, or motility abnormalities. Also, Rome IV suggests for the first time the possibility that functional heartburn or reflux hypersensitivity might overlap with gastroesophageal reflux disease. Accordingly, testing with endoscopy and biopsies, esophageal pH ± impedance monitoring and high-resolution esophageal manometry are necessary to establish esophageal DGBI diagnoses. Algorithms aid in this diagnostic process, and the MDCP that captures the full dimension of each patient's presentation is helpful in planning personalized treatment regimens.
    MeSH term(s) Algorithms ; Chest Pain/diagnosis ; Deglutition Disorders/diagnosis ; Esophageal Diseases/diagnosis ; Esophageal Diseases/physiopathology ; Esophagus/physiopathology ; Gastroesophageal Reflux/diagnosis ; Heartburn/diagnosis ; Humans ; Hyperalgesia/diagnosis ; Practice Guidelines as Topic ; Precision Medicine
    Language English
    Publishing date 2018-05-29
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 632571-3
    ISSN 1531-7056 ; 0267-1379
    ISSN (online) 1531-7056
    ISSN 0267-1379
    DOI 10.1097/MOG.0000000000000443
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Does a low FODMAP diet improve symptoms in Mexican patients with IBS?

    Schmulson, M

    Revista de gastroenterologia de Mexico

    2015  Volume 80, Issue 3, Page(s) 177–179

    MeSH term(s) Abdominal Pain ; Diet ; Humans ; Irritable Bowel Syndrome
    Language Spanish
    Publishing date 2015-07
    Publishing country Mexico
    Document type Comment ; Editorial
    ZDB-ID 732082-6
    ISSN 0375-0906
    ISSN 0375-0906
    DOI 10.1016/j.rgmx.2015.07.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Conference proceedings: Síndrome de Intestino Irritable (SII) en la DDW 2013.

    Schmulson, M

    Revista de gastroenterologia de Mexico

    2013  Volume 78 Suppl 1, Page(s) 34–36

    Title translation Irritable Bowel Syndrome (IBS) in the 2013 DDW.
    MeSH term(s) Biomarkers ; Humans ; Irritable Bowel Syndrome/epidemiology ; Irritable Bowel Syndrome/etiology ; Irritable Bowel Syndrome/therapy
    Chemical Substances Biomarkers
    Language Spanish
    Publishing date 2013-08
    Publishing country Mexico
    Document type Congresses ; Research Support, Non-U.S. Gov't
    ZDB-ID 732082-6
    ISSN 0375-0906
    ISSN 0375-0906
    DOI 10.1016/j.rgmx.2013.06.037
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The Impact of COVID-19 Pandemic on Neurogastroenterologists in Latin America: Results of an Online Survey.

    Schmulson, Max / Gudiño-Zayas, Marco / Hani, Albis

    Journal of clinical gastroenterology

    2021  Volume 55, Issue 8, Page(s) 684–690

    Abstract: Background: The COVID-19 pandemic has affected medical practice in fields not related to the infection. Neurogastroenterology is a subspecialty of gastroenterology focused on motility and functional gastrointestinal disorders, including consultations, ... ...

    Abstract Background: The COVID-19 pandemic has affected medical practice in fields not related to the infection. Neurogastroenterology is a subspecialty of gastroenterology focused on motility and functional gastrointestinal disorders, including consultations, and conducting procedures (eg, endoscopies, manometries/pH-monitoring).
    Aim: The aim of this study was to determine the impact of COVID-19 on Neurogastroenterology in Latin America.
    Methods: Members of the Latin American Society of Neurogastroenterology were invited by e-mail and social networks to participate in an online anonymous survey. It included 24 questions on demographics, clinical practice and procedure characteristics, impact of the pandemic, Telemedicine, and involvement in COVID-19 patient care.
    Results: Sixty-one members mainly from Colombia, Mexico, and Brazil answered the survey. All reported a negative impact on their practice (88.6%: a 61% to 100% decrease), mainly in office consultations and elective endoscopies. Interestingly, emergency endoscopies decreased by 33.3%, while only 4% stopped performing manometries/pH-monitoring. The main reasons were patients' fear for consulting, country's lockdown, and physician's decision to prevent infection spread. Telemedicine was implemented by 83% but only 64.7% were being remunerated. Almost 46% had to reduce salaries and working hours of their personnel. Fifty-nine percent had colleagues diagnosed with COVID-19, 24.6% were involved in these patients' care, and 11.5% were mobilized to COVID-19 wards. There were country differences: Colombia, lockdown (P=0.001); Mexico, COVID-19 patient-care (P=0.053); Mexico/Colombia, working in COVID-19 wards, (P=0.012); Brazil, less common elective procedures' ban (P=0.012) and Telemedicine/reimbursement (P=0.034).
    Conclusions: The COVID-19 pandemic has negatively impacted the practice and wellness of Neurogastroenterologists in Latin America. Guidelines to resume activities and policies for Telemedicine practice and reimbursement are warranted.
    MeSH term(s) COVID-19 ; Communicable Disease Control ; Humans ; Latin America/epidemiology ; Pandemics ; SARS-CoV-2 ; Surveys and Questionnaires
    Language English
    Publishing date 2021-01-21
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 448460-5
    ISSN 1539-2031 ; 0192-0790
    ISSN (online) 1539-2031
    ISSN 0192-0790
    DOI 10.1097/MCG.0000000000001413
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Disorders of Gut-brain Interaction on the US-Mexico Border: A Survey Using Rome IV Criteria.

    Bashashati, Mohammad / Schmulson, Max J / Sarosiek, Irene / Robles, Alejandro / Casner, Nancy / Espino, Karina / Elhanafi, Sherif E / Zuckerman, Marc J

    Journal of clinical gastroenterology

    2024  Volume 58, Issue 4, Page(s) 330–336

    Abstract: Background: Disorders of gut-brain interaction (DGBI) cause a substantial health burden. Herein we studied the prevalence and characteristics of DGBI and symptoms of bloating/distension in El Paso, Texas on the US-Mexico border, providing a unique ... ...

    Abstract Background: Disorders of gut-brain interaction (DGBI) cause a substantial health burden. Herein we studied the prevalence and characteristics of DGBI and symptoms of bloating/distension in El Paso, Texas on the US-Mexico border, providing a unique opportunity to study the effects of acculturation.
    Methods: Subjects from community centers completed the Rome IV questionnaire for DGBI, short acculturation scale for Hispanics questionnaire, and bloating/distention Pictograms. Data were presented as prevalence (95% CI) and compared using χ 2 .
    Results: Of 216 participants, 197 (127 Hispanics, 90 with English acculturation) were included and 177 completed the Pictograms. Fifty-one [25.9% (20 to 32.6)] subjects fulfilled the criteria for at least one DGBI. Globus and functional dyspepsia were the most common upper DGBI, each in [3.0% (1.1 to 6.5)]. Unspecified functional bowel disorders [8.6% (5.1 to 13.5)], followed by functional abdominal bloating/distention [8.1% (4.7 to 12.9], and irritable bowel syndrome [6.1% (3.2 to 10.4] were the most common functional bowel disorder. Ninety-one (51.4%) reported bloating and/or distension with Pictograms; more frequently in those with DGBI (80.9% vs 40.8%, P < 0.001). Bloating and/or distension were reported by Pictograms in 30% of those not reporting it in the Rome IV Questionnaire. There were no differences based on acculturation or in Hispanics versus non-Hispanics.
    Conclusions: On the US-Mexico border, we found a lower prevalence of DGBI than in the US or Mexico. Functional abdominal bloating/distention was more prevalent on the US-Mexico border than in either country. Bloating/distension was more commonly reported with Pictograms than with verbal descriptors. There were no differences between Hispanics and non-Hispanics, suggesting shared environmental/acquired including dietary factors as the underlying mechanisms.
    MeSH term(s) Humans ; Mexico/epidemiology ; Rome ; Irritable Bowel Syndrome/diagnosis ; Surveys and Questionnaires ; Gastrointestinal Diseases/epidemiology ; Flatulence ; Brain
    Language English
    Publishing date 2024-04-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 448460-5
    ISSN 1539-2031 ; 0192-0790
    ISSN (online) 1539-2031
    ISSN 0192-0790
    DOI 10.1097/MCG.0000000000001858
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Síndrome de intestino irritable (SII) en la DDW 2012.

    Schmulson, M

    Revista de gastroenterologia de Mexico

    2012  Volume 77 Suppl 1, Page(s) 50–52

    Title translation Irritable bowel syndrome (IBS) in the 2012 DDW.
    MeSH term(s) Humans ; Irritable Bowel Syndrome/etiology ; Irritable Bowel Syndrome/therapy
    Language Spanish
    Publishing date 2012-08
    Publishing country Mexico
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 732082-6
    ISSN 0375-0906
    ISSN 0375-0906
    DOI 10.1016/j.rgmx.2012.07.020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Beware: Gastrointestinal symptoms can be a manifestation of COVID-19.

    Schmulson, M / Dávalos, M F / Berumen, J

    Revista de gastroenterologia de Mexico (English)

    2020  Volume 85, Issue 3, Page(s) 282–287

    Abstract: Background: There is an increasing number of reports on the presentation of gastrointestinal symptoms in cases of COVID-19.: Aim: To review the studies reporting gastrointestinal symptoms in COVID-19.: Results: Fifteen articles (2,800 patients) ... ...

    Title translation Alerta: los síntomas gastrointestinales podrían ser una manifestación de la COVID-19.
    Abstract Background: There is an increasing number of reports on the presentation of gastrointestinal symptoms in cases of COVID-19.
    Aim: To review the studies reporting gastrointestinal symptoms in COVID-19.
    Results: Fifteen articles (2,800 patients) were identified. Gastrointestinal symptom frequency varied from 3.0% to 39.6% and included diarrhea (7.5%), náusea (4.5%), anorexia (4.4%), vomiting (1.3%), abdominal pain (0.5%), and belching/reflux (0.3%). Those symptoms can be the first manifestation of COVID-19, but whether they reflect a better or worse prognosis, is controversial. The potential relation of the angiotensin converting enzyme 2 receptor in the digestive tract as an entry route for the virus is discussed.
    Conclusion: Gastrointestinal symptoms may be common in COVID-19, in some cases appearing as the first manifestation, even before fever and respiratory symptoms. Therefore, clinicians and gastroenterologists must be aware of those atypical cases during the current pandemic, as well as of the fecal-oral route and corresponding preventive measures.
    MeSH term(s) COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/therapy ; Gastroenterologists ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/etiology ; Gastrointestinal Diseases/therapy ; Humans ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/therapy
    Keywords covid19
    Language Spanish
    Publishing date 2020-04-15
    Publishing country Mexico
    Document type Journal Article ; Review
    ZDB-ID 2828765-4
    ISSN 2255-534X ; 2255-534X
    ISSN (online) 2255-534X
    ISSN 2255-534X
    DOI 10.1016/j.rgmx.2020.04.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Fecal microbiota transfer for bowel disorders: efficacy or hype?

    Schmulson, Max / Bashashati, Mohammad

    Current opinion in pharmacology

    2018  Volume 43, Page(s) 72–80

    Abstract: Purpose of review: Dysbiosis has been related to the pathophysiology of disorders of - gut-brain interaction (DGBI) including irritable bowel syndrome (IBS) and functional constipation (FC). Accordingly, modulation of gut microbiota has been proposed as ...

    Abstract Purpose of review: Dysbiosis has been related to the pathophysiology of disorders of - gut-brain interaction (DGBI) including irritable bowel syndrome (IBS) and functional constipation (FC). Accordingly, modulation of gut microbiota has been proposed as a potential treatment for these disorders. Gut microbiota modulation can be effected by probiotics, prebiotics, symbiotics, postbiotics, antibiotics and fecal transplantation (FMT) or bacteriotherapy. The latter is currently used for recurrent or severe Clostridium difficile colitis and has been the focus of recent research in IBS and FC.
    Recent findings: Several case series reported promising results for FMT in patients with IBS and FC, which prompted the conduction of randomized controlled trials (RCT) in these DGBI.
    Summary: Both case series and RCTs are herein discussed. To the best of our knowledge, as of yet, 5 RCTs have been published on IBS and one in FC with slow colonic transit. In IBS, the majority of studies have used the IBS severity scoring system (IBS-SSS) as an outcome measure; however, the selection criteria were different among the trials as well as the route and form of administration of the FMT. Therefore, the results are inconsistent and no conclusion can be drawn. Some studies suggest that the presence of post-infection (PI)-IBS and the baseline microbiota status in the donors could be predictor factors of successful FMT in IBS. In constipation with slow colonic transit, the FMT seems to be more effective, although the data is based on only one RCT. We believe that larger RCTs, controlled with true placebos and considering baseline intestinal microbiota of the study subjects as well as donors' microbiota are still needed before recommending FMT in IBS and/or FC. History of previous GI infection (e.g. PI-IBS) and IBS subtypes should also be taken into account.
    MeSH term(s) Animals ; Dysbiosis ; Fecal Microbiota Transplantation/adverse effects ; Feces/microbiology ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/microbiology ; Gastrointestinal Diseases/physiopathology ; Gastrointestinal Diseases/therapy ; Gastrointestinal Microbiome ; Host-Pathogen Interactions ; Humans ; Intestines/microbiology ; Intestines/physiopathology ; Recovery of Function ; Risk Factors ; Treatment Outcome
    Language English
    Publishing date 2018-09-12
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2037057-X
    ISSN 1471-4973 ; 1471-4892
    ISSN (online) 1471-4973
    ISSN 1471-4892
    DOI 10.1016/j.coph.2018.08.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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