Open Access Study Protocol

Functional Bowel Disorders, Psychosocial Correlates and Health-related Quality of Life in a Nigerian Community: Ilisan-Remo Functional Bowel Disorders Project Protocol

Abiodun Christopher Jemilohun, Kolowole Oluseyi Akande, Olufunke Oluwatosin Adeleye, Charles John Elikwu, Oluwatoyin Adetutu Fasesan, Theophilus Oludare Ajiro

International Research Journal of Gastroenterology and Hepatology, Page 1-9

Introduction: Functional bowel disorders are functional gastrointestinal disorders affecting the middle or lower gastrointestinal tract. They occur worldwide and manifest with features of abdominal pain, bloating, distention, and/or bowel habit abnormalities such as diarrhea, constipation, or mixed diarrhea and constipation. Though benign, their interference with the patient’s daily activities constitutes a substantial socioeconomic burden. There is paucity of data concerning the functional bowel disorders and their psychosocial correlates, apart from irritable bowel syndrome, in Nigeria. More especially, these disorders have not been studied with the Rome IV iteration in the country. This study aims at bridging the observed gaps. 

Materials and Methods: The study shall be a descriptive cross-sectional community-based study. The study population shall consist of a cohort of 500 consenting adults aged 18 to 70 years who are residents of Ilisan-Remo, Ogun State, Nigeria. A composite questionnaire consisting of demographic data, medication history, the Rome IV Functional Bowel Disorder questionnaire, the Becks Anxiety, and Depression Inventories, the Pittsburgh Sleep Quality Index, the Early Trauma Inventory-Self Report, Short Form 12, version 2 Health Survey (SF-12v2) questionnaire and other relevant questions shall be used to obtain data from the participants. We shall analyze the data obtained with the IBM- Statistical Package for Social Sciences (SPSS), version 22.

Discussion: The present study would be the first study to investigate a group of FBDs in Nigerian community using the Rome IV criteria. The study would investigate the association between the FBDs and a comprehensive list of prospective risk factors which include anxiety, depression, early trauma exposure, sleep quality, abdominal obesity, cigarette smoking, alcohol consumption, coffee intake, and physical exercise in a Nigerian population. It would also evaluate the health-related quality of life in persons who suffer from the FBDs and help to create awareness of the diseases.

Conclusion: When completed, this study would provide vital information concerning the prevalence, risk factors and health-related quality of life of functional bowel disorders in a black African population.

Open Access Original Research Article

Chemical Content and Antioxidant Potential of Aqueous Extract of Irish Potato Tubers Traditionally Used for Ulcer Treatment in Nigeria

U. Ogbuagu, C. U. Igwe, L. A. Nwaogu, A. I. Airaodion, E. O. Ogbuagu

International Research Journal of Gastroenterology and Hepatology, Page 10-18

Aim: The study evaluated the chemical contents and antioxidant potential of aqueous extract of Irish potato tubers traditionally used for ulcer treatment in Nigeria.

Methods: Freshly harvested Irish potato tubers were purchased from Aba grocery market, Abia State. They were thoroughly washed in running water, peeled, sliced and dried in an oven at 60ºC to a constant weight. The dried potatoes were milled into fine powder (flour) and extracted using water as the solvent. The proximate, mineral, phytochemical and vitamin contents as well as antioxidant potentials were determined using standard methods.

Results: The results of the proximate analysis showed that the extract contain high percentage of carbohydrate (76.39±4.06%) followed by crude fat (11.43±0.75%) while crude protein (0.82±0.07%) is the least nutritional composition.  Magnesium, sodium and iron contents are high in the extract, but calcium and copper were absent. The extract also contain high amounts of phenols (15.54±0.21%), flavonoids (13.03±1.59%), saponins (8.09±0.43%) and alkaloids (4.46±0.91%), but low in antinutrients. Total antioxidant capacity of the extract was 40.16±1.25 mg/AAE/g, with vitamins A, C and E contents being 3.56±0.01 mg/100 g, 61.78±12.48 mg/100 g and 20.39±0.11 µg/100 g respectively.

Conclusion: The results of the present study indicate that Irish potato tubers have high phytochemical content and possess antioxidant potential substantiating its use traditionally in the treatment of stomach ulcers.

Open Access Original Research Article

Duplex Color Doppler Measurement of Hepatic Artery Resistance Index in Evaluation of Severity of Hepatic Steatosis

M. N. Rubaia Islam Bony, Md. Ubaidul Islam, Parbati Devnath, Nahid Safrin, Mahbuba Azim Moonmoon

International Research Journal of Gastroenterology and Hepatology, Page 19-26

Aims: The present study aims to highlight the duplex color doppler measurement of hepatic artery resistance Index in Evaluation of Severity of Hepatic Steatosis.

Introduction: This study was conducted to evaluate the correlation between the severity of fatty liver and the hepatic artery resistance index.

Methodology: A cross-sectional study was conducted in Radiology and Imaging Department, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) among 172 respondents. Purposive sampling technique was applied to select respondents who referred to Radiology and Imaging Department of BIRDEM for ultrasonogram of the upper abdomen and showed fatty infiltration. Fatty infiltration of liver was graded sonographically. The resistance index calculated for each patient was the mean of 3 measurements. Mean resistance index of the hepatic artery was then calculated for each group.

Results: In case of grade 1 (G1) hepato-steatosis patient’s Resistance index (RI) ranges from 0.76-0.85 (mean: 0.78 ± 0.02), grade 2 (G2) hepato-steatosis patient’s Resistance index (RI) ranges from 0.72-0.75 (mean: 0.74 ± 0.01) and grade 3 (G3) hepato-steatosis patient’s Resistance index (RI) ranges from 0.61-0.71 (mean: 0.68 ± 0.03). By hepatic steatosis we mean the abnormal accumulation of fat within the hepatocytes. It is benign as well as reversible condition and most patients are asymptomatic. And usually, if untreated it may progress to steatohepatitis and eventually to cirrhosis.

Conclusion: Hepatic artery resistance index (RI) decreases as the severity of diffuse fatty infiltration increases.

Open Access Original Research Article

In-vitro Anti-Salmonella Activity of Gossypium hirsutum Leaves Extracted with Lime Juice

F. O. Omoya

International Research Journal of Gastroenterology and Hepatology, Page 27-36

Invasive Salmonella infections are responsible for a significant burden of morbidity and mortality worldwide. There has been increase in resistance to anti-typhoid prescription drugs medicinal plants have gained popularity among both urban and rural dwellers in the treatment of not only typhoid fevers but also to treat various ailments. The present study was undertaken to investigate the anti-Salmonella activity of Gossypium hirsutum leaf extract on Salmonella typhi (clinical isolates) using fresh lime juice as an extraction solvent. Extraction of lime juice, bioactive components of the plant leaf and in vitro anti-Salmonella activity of extract were all carried out using standard microbiological methods. Salmonella typhi ATCC 14028 (Type isolates) was used as control. Fourier Transform Infrared Spectrophotometer (FTIR) was used to identify the functional groups in the extract. The result revealed that clinical (mean diameter of inhibition zone 35.10±0.45 mm) and typed (mean diameter of inhibition zone 36.71±0.32 mm) isolates showed highest susceptibility to ciprofloxacin. The crude extract showed an inhibition zone ranging from 24.63±0.11 to 1.43±0.04 mm for clinical and 25.11±0.62 to 1.18±0.31 mm for typed isolates at 600 and 200 mg/mL, respectively. Fourier Transform Infrared Spectrophotometer (FTIR) indicated the presence of various functional groups in the extract such as 1,2,4-trisubstituted arenes, sulfoxide, vinyl ether, phenol, carboxylic acid, conjugated alkene, α, β-unsaturated ester, allene, isothiocyanate and alcohol. The overall results indicated that the extract obtained from G. hirsutum leaves using a lime juice has the potential for an effective treatment of salmonellosis, including typhoid fevers. However, it is necessary to ascertain the safety of this extract in vivo in further studies.

Open Access Original Research Article

A Randomized Controlled Trial of Anoscopy and Manual Abdominal Compression to Increase Patient Comfort after Colonoscopy

Gulhan Kanat Unler, Huseyin Savas Gokturk, Aydın Karakoca

International Research Journal of Gastroenterology and Hepatology, Page 37-41

Background/Aim: Colonoscopy may be associated with pain due to distension of colonic mesentery and air insufflation into the colonic lumen, although Sedo-analgesia may increase the tolerability of the procedure. This randomized, prospective, controlled study based on our clinical observations aimed to explore the sustainability of comfort provided by intraoperative sedation by allowing gas discharge via anoscopy while patients were still sedated. 

Methods: The patients that underwent colonoscopy for colorectal cancer screening were considered for this study and a total of 100 patients were (61 male and 39 female) were included in this study. Colonoscopy procedures were carried out by two experienced endoscopists who are adequately trained. Following the colonoscopy, 50 patients in the study group were administered a disposable anoscope with sterile, water-soluble, lubricant gel while the effect of sedation was still maintained. Endoscopist compressed four abdominal quadrants for 5 seconds to evacuate gas and reduce distension during anoscopy. The anoscope was then removed and the patients were woken from anesthesia. The patients in the control group did not undergo anoscopy following a colonoscopy.

Results: Both groups were similar in terms of sex distribution, presence of polyps, procedural time, and midazolam and propofol doses. Only age was greater in the study group. Significant differences were detected between the mean pain scores of each of the three measurements (p<0.05). The anoscopy group had a significantly lower mean pain score.

Conclusion: Our study showed that pain and bloating were reduced at the end of the procedure and and 24th hours after the procedure when anoscopy was performed following a colonoscopy. Anoscopy group also had a higher proportion of patients accepting a repeat procedure (p<0.05). Even if not used on a routine basis, anoscopy may be used in select patients with excess distension after the colonoscopy procedure.