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  1. Article: Prevalence of idiopathic fecal incontinence in a community-based sample.

    Ilnyckyj, Alexandra

    Canadian journal of gastroenterology = Journal canadien de gastroenterologie

    2009  Volume 24, Issue 4, Page(s) 251–254

    Abstract: Background: The epidemiology of fecal incontinence (FI) remains incompletely understood. The use of different interview questions in highly selected populations has resulted in widely varying reported rates.: Aim: To define the prevalence of ... ...

    Abstract Background: The epidemiology of fecal incontinence (FI) remains incompletely understood. The use of different interview questions in highly selected populations has resulted in widely varying reported rates.
    Aim: To define the prevalence of idiopathic FI in a Canadian urban community sample using a validated interview questionnaire.
    Methods: Respondents completed a telephone interview regarding bowel health as part of the 2006 Winnipeg Area Study (WAS). The WAS has been conducted annually by the Department of Sociology at the University of Manitoba (Winnipeg, Manitoba) since 1981. The household was the primary sampling unit. An eligible respondent was an individual 18 years of age or older who lived at that address, matched a randomly preassigned sex and provided consent. Respondents were asked whether they had ever been diagnosed by a physician with colon cancer, ulcerative colitis, Crohn's disease or irritable bowel syndrome. They were also asked, 'In the past 12 months have you experienced accidental leakage of liquid or solid stool?' Respondents were asked not to consider short-term diarrheal illness. Finally, respondents were asked to rank eight attributes of bowel habit on a 10-point scale. Answers ranking 5 points or greater were defined as having the attribute.
    Results: In the city of Winnipeg, population 650,000, 1153 households were contacted. Of these, 727 (63%) agreed to participate and formed the study sample. Of the respondents, 361 were men and 366 were women (mean age 47 years). The sociodemographics of these respondents were comparable with those reported in previous WAS samples and the 2001 Canadian census data. Respondent cooperation, high interview quality and willingness for repeat contact were rated by the interviewers at 93%, 89% and 90%, respectively. FI was reported by 3.7% of the sample. There was no difference in sex or age of those reporting FI when compared with the rest of the sample. With physician-diagnosed gastrointestinal conditions removed from the analysis, 2.0% of the sample reported FI. Of the gastrointestinal conditions, only irritable bowel syndrome demonstrated a significant correlation with FI (one-sided X(2) test 11.567, degrees of freedom = 1; P=0.001). Four bowel habit attributes demonstrated strong correlation with FI (P=0.0001 for each t test): admission to any type of bowel accident, inability to delay toileting, inability to control passage of stool and need to wear a pad due to soiling. These four bowel habit attributes were reported (ranked 5 points or greater) by 1.5%, 22%, 2.4% and 1.5% of the sample, respectively.
    Conclusion: The prevalence of idiopathic FI in a well-defined community sample was 2.0%. There was no sex preference and the mean age of affected individuals was 47 years - demographic variables that did not vary among the sample. These findings suggest the need to develop a new paradigm beyond aging and childbirth injury to study the pathophysiology of FI. It is imperative to control for subjects with known irritable bowel syndrome in epidemiological studies because their inclusion in the present analysis doubled the calculated prevalence of FI.
    MeSH term(s) Adult ; Aged ; British Columbia/epidemiology ; Community-Based Participatory Research/statistics & numerical data ; Fecal Incontinence/epidemiology ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Young Adult
    Language English
    Publishing date 2009-12-29
    Publishing country Canada
    Document type Comparative Study ; Journal Article
    ZDB-ID 639439-5
    ISSN 1916-7237 ; 0835-7900
    ISSN (online) 1916-7237
    ISSN 0835-7900
    DOI 10.1155/2010/894631
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Surgical treatment of inflammatory bowel diseases and pregnancy.

    Ilnyckyj, Alexandra

    Best practice & research. Clinical gastroenterology

    2007  Volume 21, Issue 5, Page(s) 819–834

    Abstract: Ulcerative colitis (UC) and Crohn's disease (CD) affect women of reproductive age. Surgical intervention is often required. Therefore, the implications of disease treatment and pregnancy need to be understood. The standard surgery for UC is ... ...

    Abstract Ulcerative colitis (UC) and Crohn's disease (CD) affect women of reproductive age. Surgical intervention is often required. Therefore, the implications of disease treatment and pregnancy need to be understood. The standard surgery for UC is proctocolectomy, followed by ileal pouch anal anastomosis (IPAA). This review summarises the literature describing the effects of IPAA on gynaecologic and sexual health, fertility, pregnancy, labour and delivery. The emerging role of laparoscopic IPAA and the limited role of ileo-rectal anastomosis (IRA) are discussed. The experience with emergency surgery in pregnant women with ulcerative colitis is also presented. The literature explores two key issues of pregnancy in CD: the possible effect of pregnancy decreasing resection rates, and the optimal mode of delivery, especially in the setting of perianal CD. These two issues together with the available literature describing stoma function during pregnancy and the foetal outcome after surgical therapy are presented.
    MeSH term(s) Anal Canal/surgery ; Anastomosis, Surgical ; Colonic Pouches ; Comorbidity ; Delivery, Obstetric ; Female ; Humans ; Ileum/surgery ; Infertility/epidemiology ; Inflammatory Bowel Diseases/epidemiology ; Inflammatory Bowel Diseases/surgery ; Laparoscopy ; Pregnancy ; Pregnancy Complications/surgery ; Proctocolectomy, Restorative/methods
    Language English
    Publishing date 2007
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2048181-0
    ISSN 1521-6918
    ISSN 1521-6918
    DOI 10.1016/j.bpg.2007.05.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Resident trainees do not affect patient satisfaction in an outpatient gastroenterology clinic: a prospective study conducted in a Canadian gastroenterology clinic.

    Brahmania, Mayur / Young, Madison / Muthiah, Chetty / Ilnyckyj, Alexandra / Duerksen, Donald / Moffatt, Dana C

    Canadian journal of gastroenterology & hepatology

    2015  Volume 29, Issue 7, Page(s) 363–368

    Abstract: Background: There is little literature regarding how a gastroenterology trainee affects a patient's interpretation of care during outpatient clinic visits. Improving patient satisfaction is desirable and benefits may include enhanced patient compliance ... ...

    Abstract Background: There is little literature regarding how a gastroenterology trainee affects a patient's interpretation of care during outpatient clinic visits. Improving patient satisfaction is desirable and benefits may include enhanced patient compliance as well as providing trainees with areas for improvement.
    Objectives: To evaluate patient satisfaction in an outpatient gastroenterology clinic when seen by a trainee and attending physician versus an attending physician alone. The secondary objective was to evaluate physician characteristics that play a role in creating a positive clinical experience.
    Methods: A randomized prospective survey study was conducted over an 11-month period (July 2012 to June 2013) at St Boniface Hospital (Winnipeg, Manitoba). Two gastroenterology fellows (postgraduate year 4 and 5) and nine internal medicine residents (postgraduate year 1 to 3) comprised the 'trainee' role, while three academic clinicians comprised the 'attending' role. Patients included individuals seen for an initial consultation and were >18 years of age.
    Results: A total of 211 patients comprised the final study group, with 118 in the attending group and 93 in the trainee group. In univariate analysis, patients more often had a very good experience when seen by an attending physician alone versus a trainee and attending physician (73% versus 56%; P=0.016); however, on multivariate analysis, there was no significant difference in patient satisfaction (OR 0.89; P=0.931). Physician factors found to be associated with high patient satisfaction on multivariate analysis included: addressing all patient concerns (OR 27.56; P=0.021); giving the patient a preliminary diagnosis (OR 78.02; P=0.006); and feeling the physician was thorough (OR 72.53; P=0.029).
    Conclusions: The present study did not reveal a difference in patient satisfaction if a patient sees an attending physician alone or with a trainee. Moreover, to improve patient satisfaction in a gastroenterology clinic, physicians should address all patient concerns, provide a preliminary diagnosis and appear to be thorough in their assessment. Further work to increase patient awareness on the role of residents in teaching hospitals is warranted to further promote careers in gastroenterology.
    MeSH term(s) Adolescent ; Adult ; Aged ; Ambulatory Care/psychology ; Ambulatory Care Facilities/statistics & numerical data ; Female ; Gastroenterology/education ; Humans ; Internal Medicine/education ; Internship and Residency ; Male ; Manitoba ; Medical Staff, Hospital/psychology ; Middle Aged ; Outpatients/psychology ; Patient Satisfaction ; Prospective Studies ; Young Adult
    Language English
    Publishing date 2015-05-21
    Publishing country Egypt
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2762182-0
    ISSN 2291-2797 ; 1916-7237 ; 0835-7900
    ISSN (online) 2291-2797 ; 1916-7237
    ISSN 0835-7900
    DOI 10.1155/2015/429405
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Management of acute bleeding upper gastrointestinal ulcers in the era of endoscopic and intravenous proton pump inhibitor therapy.

    Ilnyckyj, Alexandra / Mathew, George

    Canadian journal of gastroenterology = Journal canadien de gastroenterologie

    2005  Volume 19, Issue 3, Page(s) 157–159

    Abstract: Background: Despite advances in therapy, the morbidity and mortality of gastrointestinal bleeding remains high. A review of current practice patterns was undertaken in St Boniface General Hospital, Winnipeg, Manitoba to assess the standard of care ... ...

    Abstract Background: Despite advances in therapy, the morbidity and mortality of gastrointestinal bleeding remains high. A review of current practice patterns was undertaken in St Boniface General Hospital, Winnipeg, Manitoba to assess the standard of care provided.
    Objective: To determine whether upper gastrointestinal bleeding (UGIB) attributable to a single acute ulcer is treated appropriately with respect to local therapy, acid suppression and Helicobacter pylori status.
    Methods: A retrospective chart review identified patients with consecutive acute UGIB attributable to a single gastric or duodenal ulcer presenting to a tertiary care centre over a six-month period. The lesions were classified as high- or low-risk based on endoscopic appearance. Local care of the ulcer, acid suppressive therapy and management of H. pylori were determined by reviewing pertinent chart materials. Appropriate care was defined for all three end points a priori using literature-supported standards of care.
    Results: Fifty-five patients who met study criteria were identified. Twenty-six of 55 (47%) and 29 of 55 (52%) lesions were considered to be low- and high-risk respectively. Of the high-risk lesions, two of 29 received no local therapy, 24 of 29 received adrenaline injection and two had an endoclip placed. Of the 27 patients whose lesions were treated, 16 received thermal coagulation. Twenty-five of 29 (88%) received intravenous proton pump inhibitors. Thirty-three of 55 (55%) patients did not have H. pylori status considered in their management.
    Conclusion: Weaknesses in the management of UGIB were identified, particularly with respect to addressing the role of H. pylori. Fragmentation and compartmentalization of patient care may be important contributing factors.
    MeSH term(s) Acute Disease ; Gastrointestinal Hemorrhage/microbiology ; Gastrointestinal Hemorrhage/therapy ; Gastroscopy ; Helicobacter Infections/complications ; Helicobacter Infections/diagnosis ; Helicobacter pylori ; Humans ; Injections, Intravenous ; Peptic Ulcer/microbiology ; Peptic Ulcer/therapy ; Practice Patterns, Physicians' ; Proton Pump Inhibitors ; Retrospective Studies
    Chemical Substances Proton Pump Inhibitors
    Language English
    Publishing date 2005-03-11
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 639439-5
    ISSN 1916-7237 ; 0835-7900
    ISSN (online) 1916-7237
    ISSN 0835-7900
    DOI 10.1155/2005/741576
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: A population-based study of breastfeeding in inflammatory bowel disease: initiation, duration, and effect on disease in the postpartum period.

    Moffatt, Dana C / Ilnyckyj, Alexandra / Bernstein, Charles N

    The American journal of gastroenterology

    2009  Volume 104, Issue 10, Page(s) 2517–2523

    Abstract: Objectives: We aimed to assess breastfeeding practices and the impact of breastfeeding on disease flare during the postpartum year in inflammatory bowel disease (IBD).: Methods: Women of childbearing age from 1985 to 2005 were identified from the ... ...

    Abstract Objectives: We aimed to assess breastfeeding practices and the impact of breastfeeding on disease flare during the postpartum year in inflammatory bowel disease (IBD).
    Methods: Women of childbearing age from 1985 to 2005 were identified from the University of Manitoba IBD Research Registry. Questionnaires were completed regarding pregnancy and the postpartum period. Data for initiation and duration of breastfeeding were compared with population-based regional data.
    Results: Of 204 eligible women, 132 (64.7%) responded to the survey, yielding information on 156 births. Breastfeeding was initiated in 83.3% of women with IBD (n=132), 81.9% of Crohn's disease patients (CD, n=90), and 84.2% of ulcerative colitis patients (UC, n=39) vs. 77.1 % in the general population (P>0.05 for all). Of women with IBD, 56.1% breastfed for >24 weeks vs. 44.4% of controls (P=0.02). The rate of disease flare in the postpartum year was 26% for those who breastfed vs. 29.4% in those who did not (P=0.76) in CD and 29.2% vs. 44.4% (P=0.44) in UC. The odds ratio of disease flare postpartum for those who breastfed vs. those who did not was 0.58 (95% CI: 0.24-1.43), 0.84 (0.19-9.87), and 0.51 (0.12-2.2) for IBD total, CD, and UC, respectively. Risk of disease flare was not related to age at pregnancy, duration of disease, or socioeconomic status.
    Conclusions: Women with IBD are as likely as the general population to breastfeed their infants. Breastfeeding is not associated with an increased risk of disease flare and may even provide a protective effect against disease flare in the postpartum year.
    MeSH term(s) Adolescent ; Adult ; Breast Feeding ; Chi-Square Distribution ; Female ; Humans ; Infant, Newborn ; Inflammatory Bowel Diseases/complications ; Manitoba ; Postpartum Period ; Pregnancy ; Registries ; Risk ; Statistics, Nonparametric ; Surveys and Questionnaires
    Language English
    Publishing date 2009-10
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.1038/ajg.2009.362
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Acceptance of colonoscopy requires more than test tolerance.

    Condon, Amanda / Graff, Lesley / Elliot, Lawrence / Ilnyckyj, Alexandra

    Canadian journal of gastroenterology = Journal canadien de gastroenterologie

    2008  Volume 22, Issue 1, Page(s) 41–47

    Abstract: Background: Colon cancer screening, including colonoscopy, lags behind other forms of cancer screening for participation rates. The intrinsic nature of the endoscopic procedure may be an important barrier that limits patients from finding this test ... ...

    Abstract Background: Colon cancer screening, including colonoscopy, lags behind other forms of cancer screening for participation rates. The intrinsic nature of the endoscopic procedure may be an important barrier that limits patients from finding this test acceptable and affects willingness to undergo screening. With colon cancer screening programs emerging in Canada, test characteristics and their impact on acceptance warrant consideration.
    Objectives: To measure the acceptability of colonoscopy and define factors that contribute to procedural acceptability, in relation to another invasive gastrointestinal scope procedure, gastroscopy.
    Patients and methods: Consecutive patients undergoing a colonoscopy (n=55) or a gastroscopy (n=33) were recruited. Their procedural experience was evaluated and compared pre-endoscopy, immediately before testing and postendoscopy. Questionnaires were used to capture multiple domains of the endoscopy experience and patient characteristics.
    Results: Patient scope groups did not differ preprocedurally for general or procedure-specific anxiety. However, the colonoscopy group did anticipate more pain. Those who had a gastroscopy demonstrated higher preprocedural acceptance than those who had a colonoscopy. The colonoscopy group had a significant decrease in scope concerns and anxiety postprocedurally. As well, they reported less pain than they anticipated. Regardless, postprocedurally, the colonoscopy group's acceptance did not increase significantly, whereas the gastroscopy group was almost unanimous in their test acceptance. The best predictor of pretest acceptability of colonoscopy was anticipated pain.
    Conclusions: The findings indicate that concerns that relate specifically to colonoscopy, including anticipated pain, influence acceptability of the procedure. However, the experience of a colonoscopy does not lead to improved test acceptance, despite decreases in procedural anxiety and pain. Patients' preprocedural views of the test are most important and should be addressed directly to potentially improve participation in colonoscopy.
    MeSH term(s) Adult ; Anxiety ; Colonoscopy/psychology ; Female ; Gastroscopy/psychology ; Humans ; Male ; Middle Aged ; Outpatients/psychology ; Pain Measurement ; Patient Acceptance of Health Care ; Stress, Psychological ; Surveys and Questionnaires
    Language English
    Publishing date 2008-01-22
    Publishing country Canada
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639439-5
    ISSN 1916-7237 ; 0835-7900
    ISSN (online) 1916-7237
    ISSN 0835-7900
    DOI 10.1155/2008/107467
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Sexual abuse in irritable bowel syndrome: to ask or not to ask -- that is the question.

    Ilnyckyj, Alexandra / Bernstein, Charles N

    Canadian journal of gastroenterology = Journal canadien de gastroenterologie

    2002  Volume 16, Issue 11, Page(s) 801–805

    Abstract: Background: Irritable bowel syndrome (IBS) is a common and costly disorder in Canada. The paucity of medical treatment underscores the importance of examining every element of the management approach. Data exist supporting an increased prevalence of ... ...

    Abstract Background: Irritable bowel syndrome (IBS) is a common and costly disorder in Canada. The paucity of medical treatment underscores the importance of examining every element of the management approach. Data exist supporting an increased prevalence of abuse among individuals with IBS. Importantly, the pathophysiology underlying the link between abuse and IBS is increasingly understood. Treatment recommendations by opinion leaders support an abuse inquiry. However, many clinicians view abuse inquiry as an ethical dilemma.
    Method: Canadian gastroenterologists were surveyed to determine current practice patterns and to identify barriers to inquiry. Barriers cited by clinicians were explored within an ethical context.
    Results: Abuse inquiry is not universally practised in Canada. Fifty-four per cent of the membership of Canadian Association of Gastroenterologists responded to the survey. They reported inquiring into abuse histories in approximately 50% of patients with IBS. The frequency of inquiry declined when male patients were considered. The primal barriers cited were time constraints (25%), personal comfort with abuse issues (25%) and lack of resources for addressing the abuse (33%). Importantly, only a minority (10%), cited abuse history as irrelevant to the management of the patient.
    Interpretation: Physicians identify significant barriers to pursuing an inquiry into abuse. However, a minority cited 'clinical irrelevance' as a primal barrier, the implicit statement being that the abuse history has clinical relevance. This view is consistent with opinion leaders and published treatment recommendations. Therefore, by not inquiring into the abuse history, physicians are not fulfilling their ethical responsibility to the patient. Physicians need to resolve their barriers to inquiry. Furthermore, they need to familiarize themselves with treatment recommendations and include this review in their consultation.
    MeSH term(s) Canada ; Colonic Diseases, Functional/diagnosis ; Colonic Diseases, Functional/etiology ; Colonic Diseases, Functional/psychology ; Female ; Gastroenterology/ethics ; Gastroenterology/statistics & numerical data ; Health Care Surveys/statistics & numerical data ; Humans ; Male ; Physician's Role/psychology ; Physician-Patient Relations/ethics ; Practice Patterns, Physicians'/ethics ; Practice Patterns, Physicians'/statistics & numerical data ; Risk Factors ; Sex Offenses/ethics ; Sex Offenses/psychology ; Sex Offenses/statistics & numerical data
    Language English
    Publishing date 2002-10-25
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 639439-5
    ISSN 1916-7237 ; 0835-7900
    ISSN (online) 1916-7237
    ISSN 0835-7900
    DOI 10.1155/2002/245256
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Canadian physicians' choices for their own colon cancer screening.

    Raza, Mamoon / Bernstein, Charles Noah / Ilnyckyj, Alexandra

    Canadian journal of gastroenterology = Journal canadien de gastroenterologie

    2006  Volume 20, Issue 4, Page(s) 281–284

    Abstract: Introduction: Compliance with colorectal cancer (CRC) screening in Canada is low. The aim of the present survey was to determine whether Canadian physicians older than 50 years were pursuing colon cancer screening. Specifically, physicians were asked to ...

    Abstract Introduction: Compliance with colorectal cancer (CRC) screening in Canada is low. The aim of the present survey was to determine whether Canadian physicians older than 50 years were pursuing colon cancer screening. Specifically, physicians were asked to identify their modality of choice and identify their barriers to screening.
    Methods: Surveys were mailed to members, older than 50 years, of the Canadian Association of Gastroenterology, the Society of Obstetricians and Gynaecologists of Canada, the Canadian Society of Internal Medicine, the Canadian Psychiatric Association and the Canadian Association of Radiologists.
    Results: Of 2,807 surveys, 46% were returned. Screening for CRC was reported by 53% of respondents. The Canadian Association of Radiologists members (61%) and the Canadian Association of Gastroenterology members (61%) were more likely to be screened than other specialties (P<0.01 and P<0.05, respectively). Members of the Society of Obstetricians and Gynaecologists of Canada (44%) were least likely to be screened (P<0.001). Men (P<0.001) and Ontario physicians (P<0.01) were more likely to be screened than women and Canadian physicians from other provinces, respectively. Colonoscopy (56%) was the most common screening modality used, followed by fecal occult blood testing (27%). Respondents who had not been screened cited a lack of personal time (47%) and insufficient data to warrant screening (14%).
    Discussion: More than one-half of all respondents were screened for CRC. Colonoscopy is the most common screening modality used. Lack of time is the most common reason cited for not participating in CRC screening.
    MeSH term(s) Aged ; Attitude to Health ; Canada/epidemiology ; Colonoscopy ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/epidemiology ; Female ; Humans ; Incidence ; Male ; Mass Screening/methods ; Middle Aged ; Physicians ; Risk Factors ; Surveys and Questionnaires
    Language English
    Publishing date 2006-03-31
    Publishing country Canada
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639439-5
    ISSN 1916-7237 ; 0835-7900
    ISSN (online) 1916-7237
    ISSN 0835-7900
    DOI 10.1155/2006/969832
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Post-traveler's diarrhea irritable bowel syndrome: a prospective study.

    Ilnyckyj, Alexandra / Balachandra, Brinda / Elliott, Lawrence / Choudhri, Shurjeel / Duerksen, Donald R

    The American journal of gastroenterology

    2003  Volume 98, Issue 3, Page(s) 596–599

    Abstract: Objective: Anecdotal evidence suggests that irritable bowel syndrome (IBS) can develop after an episode of traveler's diarrhea (TD). This observation supports a contemporary paradigm proposed for the etiology of IBS and may have important implications ... ...

    Abstract Objective: Anecdotal evidence suggests that irritable bowel syndrome (IBS) can develop after an episode of traveler's diarrhea (TD). This observation supports a contemporary paradigm proposed for the etiology of IBS and may have important implications for public health strategies aimed at preventing TD. This study aimed to determine the incidence of IBS in people experiencing TD.
    Methods: A total of 109 healthy adults traveling outside of Canada or the United States were identified and enrolled in a prospective, cohort field study. GI symptoms before and after travel were assessed using the Rome I criteria. Travel diaries and questionnaires were used to assess for TD.
    Results: The incidence of TD in the study cohort was 44%. Among those experiencing TD, the incidence of IBS was 4.2%. In those not experiencing TD, the incidence of IBS post-travel was 1.6% (relative risk = 2.5, 95% CI = 0.2-27.2, p = 0.41, ns). There was no significant difference in the incidence of IBS between the exposed and nonexposed groups.
    Conclusions: This study does not support a large association between TD and an increased risk of developing IBS. A small increase in relative risk may have been undetected because of the size of the study.
    MeSH term(s) Adult ; Aged ; Canada/epidemiology ; Colonic Diseases, Functional/epidemiology ; Colonic Diseases, Functional/etiology ; Developing Countries ; Diarrhea/complications ; Diarrhea/etiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Prospective Studies ; Risk Assessment ; Risk Factors ; Travel
    Language English
    Publishing date 2003-02-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.1111/j.1572-0241.2003.07297.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Microbial overgrowth in water perfusion equipment for esophageal/rectal motility.

    Alfa, Michelle J / Ilnyckyj, Alexandra / MacFarlane, Nila / Preece, Vivienne / Allford, Sandra / Fachnie, Beth

    Gastrointestinal endoscopy

    2002  Volume 55, Issue 2, Page(s) 209–213

    Abstract: Background: There are few data on microbial levels in water used during the assessment of GI motility. Patients undergoing such procedures may be ingesting water with unacceptably high levels of bacteria.: Methods: Samples of water from the reservoir ...

    Abstract Background: There are few data on microbial levels in water used during the assessment of GI motility. Patients undergoing such procedures may be ingesting water with unacceptably high levels of bacteria.
    Methods: Samples of water from the reservoir and tubing from water perfusion motility equipment were taken and quantitatively assessed to determine the concentration of viable aerobic and facultative microorganisms. Interventions were evaluated to determine which reprocessing schedule ensures absence of overgrowth by microbes within the system during storage.
    Results: Bacterial overgrowth can occur in manometry systems with bacterial levels of greater than 10(4) colony-forming units (cfu)/mL in the water from both the reservoir and the tubing. Organisms detected included Serratia marcescens, Burkholderia species, and other gram-negative nonfermentors. Eradication of these organisms was difficult, and the only intervention that consistently ensured bacterial water levels below 200 cfu/mL (i.e., within potable water guidelines) was retrofitting of the pump/tubing with new components combined with a monthly hydrogen peroxide decontamination protocol and a daily drying protocol.
    Conclusions: The entire tubing path of motility equipment must be stored dry to prevent microbial overgrowth. Additionally, implementation of a motility equipment quality assurance program with water testing 3 to 4 times per year is recommended to ensure that overgrowth is not a problem.
    MeSH term(s) Bacteriological Techniques ; Biofilms ; Colony Count, Microbial ; Cross Infection/microbiology ; Cross Infection/prevention & control ; Cross Infection/transmission ; Disinfection ; Equipment Contamination ; Gastrointestinal Motility/physiology ; Humans ; Manometry/instrumentation ; Perfusion ; Risk Assessment ; Water Microbiology
    Language English
    Publishing date 2002-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 391583-9
    ISSN 1097-6779 ; 0016-5107
    ISSN (online) 1097-6779
    ISSN 0016-5107
    DOI 10.1067/mge.2002.121339
    Database MEDical Literature Analysis and Retrieval System OnLINE

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