Abstract: ContextIrritable bowel syndrome (IBS), which affects 11% to 14% of the population, is a puzzling condition with multiple models of pathophysiology including altered motility, visceral hypersensitivity, abnormal brain-gut interaction, autonomic dysfunction, and immune activation. Although no conceptual framework accounts for all the symptoms and observations in IBS, a unifying explanation may exist since 92% of these patients share the symptom of bloating regardless of their predominant complaint.Evidence AcquisitionOvid MEDLINE was searched through May 2004 for relevant English-language articles beginning with those related to bloating, gas, and IBS. Bibliographies of pertinent articles and books were also scanned for additional suitable citations.Evidence SynthesisThe possibility that small intestinal bacterial overgrowth (SIBO) may explain bloating in IBS is supported by greater total hydrogen excretion after lactulose ingestion, a correlation between the pattern of bowel movement and the type of excreted gas, a prevalence of abnormal lactulose breath test in 84% of IBS patients, and a 75% improvement of IBS symptoms after eradication of SIBO. Altered gastrointestinal motility and sensation, changed activity of the central nervous system, and increased sympathetic drive and immune activation may be understood as consequences of the host response to SIBO.ConclusionsThe gastrointestinal and immune effects of SIBO provide a possible unifying framework for understanding frequent observations in IBS, including postprandial bloating and distension, altered motility, visceral hypersensitivity, abnormal brain-gut interaction, autonomic dysfunction, and immune activation.

Abstract: OBJECTIVE: Experimental and clinical studies have shown that a novel symbiotic (known as SCM-III) exerts a beneficial effect on gut translocation and local and systemic inflammatory and microbial metabolic parameters. The present investigation was a preliminary trial on the effectiveness of SCM-III for irritable bowel syndrome (IBS). METHODS: Sixty-eight consecutive adult patients with IBS who were free from lactose malabsorption, abdominal surgery, overt psychiatric disorders and ongoing psychotropic drug therapy or ethanol abuse were studied prospectively and divided into 2 groups that were comparable for age, gender, body size, education and pattern of presenting symptoms. The 2 groups were blindly given for 12 weeks either SCM-III 10 mL t.i.d or the same dosage of heat-inactivated symbiotic. RESULTS: Treatment with SCM-III was ‘effective’ or ‘very effective’ in more than 80% of the patients (P < 0.01 vs baseline values and control). Less than 5% reported ‘not effective’ as the final evaluation compared with over 40% of patients in the control group. After 6 weeks of treatment, a significant improvement of pain and bloating was reported in the treatment group compared with control and baseline values. There was also a benefit for bowel habits, mostly for patients with constipation or alternating bowel habits. No overt clinical or biochemical adverse side-effects were recorded. CONCLUSION: Compared with baseline values and the control group, SCM-III resulted in a significant increase in lactobacilla, eubacteria and bifidobacteria, which suggests that some selected IBS patients could benefit substantially from symbiotics, but the treatment may need to be given on a cyclic schedule because of the temporary modification of the fecal flora.

Abstract: The clinical efficacy of probiotics and prebiotics has been proved in several clinical settings. The authors review their proved or potential side effects. Probiotics as living microorganisms may theoretically be responsible for 4 types of side effects in susceptible individuals: infections, deleterious metabolic activities, excessive immune stimulation, and gene transfer. Very few cases of infection have been observed. These occurred mainly in very sick patients who received probiotic drugs because of severe medical conditions. Prebiotics exert an osmotic effect in the intestinal lumen and are fermented in the colon. They may induce gaseousness and bloating. Abdominal pain and diarrhea only occur with large doses. An increase in gastroesophageal reflux has recently been associated with large daily doses. Tolerance depends on the dose and individual sensitivity factors (probably the presence of irritable bowel syndrome or gastroesophageal reflux), and may be an adaptation to chronic consumption.

Abstract: Introduction: The classification of functional dyspepsia into meaningful subgroups remains an important goal. The aim of this investigation was to determine correlations between dyspeptic symptoms with gastric physiology and psychologic distress. Methods: Consecutive patients with functional dyspepsia were evaluated with electrogastrography (EGG), drink test, and solid phase gastric emptying. Subjects also completed the Nepean Dyspepsia Index, Psychologic General Well-Being Index, SCL-90R, and SF-36. Results: Eighty-one patients were evaluated. Gastric emptying was performed in 29 of 81 patients and was abnormal in 21%, but no correlation existed between symptoms and T 1/2 or T LAG . EGG was abnormal in 42% and drink test was abnormal in 40% of patients. Both were significantly associated with nausea but not with other symptoms. Significant correlations existed with 10 of 15 assessed symptoms and various subscales of the SCL-90R. Somatization was associated with abdominal burning, chest pain, abdominal pressure, abdominal discomfort, bad breath, chest burning, excessive fullness, bloating, abdominal pain, and regurgitation. Anxiety was associated with abdominal burning, chest pain, abdominal pressure, and abdominal discomfort. Anger-hostility was associated with abdominal burning and abdominal pressure. Increased interpersonal sensitivity was associated with abdominal burning and chest burning. SCL-90R Global Symptom Score was associated with abdominal burning, chest pain, abdominal discomfort, and bad breath. Conclusions: Abnormal gastric physiology as measured in this study was not associated with symptoms other than nausea. Significant associations existed between measures of psychiatric distress and digestive symptoms. Symptoms in functional dyspepsia had greater associations with psychologic distress than with commonly employed tests of gastric physiology.

Abstract: The patient is a 49-year-old male diagnosed with Crohn’s disease in 1979. He had Crohn’s colitis at that time, and subsequently underwent a total colectomy with end ileostomy for fulminant disease. In 1982 he underwent completion proctectomy, but he had no further surgery related to his Crohn’s disease for the next 18 years. In January 2000, the patient began to have intermittent, crampy abdominal pain, bloating, and decreased ileostomy output, generally related to dietary indiscretion. These episodes of apparent small-bowel obstruction usually resolved within a 24-hour period. A small bowel follow-through study revealed several discrete strictures of the small intestine (Fig. 1). These findings were similar to those seen on a previous study in 1998. There also was involvement of the terminal ileum with fistulization to the skin near his ileostomy. As plans were being made for elective surgery, the patient presented with severe abdominal pain and decreased ostomy output. He was brought to the operating room for abdominal exploration because of this high-grade acute obstruction.

Abstract: The irritable bowel syndrome (IBS) is part of the spectrum of functional bowel disorders characterised by a diverse consortium of abdominal symptoms including abdominal pain, altered bowel function (bowel frequency and/or constipation), bloating, abdominal distension, the sensation of incomplete evacuation and the increased passage of mucus. It is not surprising therefore that no single, unifying mechanism has as yet been put forward to explain symptom production in IBS. The currently favoured model includes both central and end-organ components which may be combined to create an integrated hypothesis incorporating psychological factors (stress, distress, affective disorder) with end-organ dysfunction (motility disorder, visceral hypersensitivity) possibly aggravated by sub-clinical inflammation as a residuum of an intestinal infection. There is currently no universally effective therapy for IBS. Standard therapy generally involves a symptom-directed approach; anti-diarrhoeal agents for bowel frequency, soluble fibre or laxatives for constipation and smooth muscle relaxants and anti-spasmodics for pain. New drug development has focused predominantly on agents that modify the effects of 5-hydroxytryptamine (5-HT) in the gut, principally the 5-HT3 receptor antagonists for painful diarrhoea predominant IBS and 5-HT4 agonists for constipation predominant IBS. More speculative new therapeutic approaches include anti-inflammatory agents, antibiotics, probiotics, antagonists of CCK1 receptors, tachykinins and other novel neuronal receptors.

Abstract: When no organic cause for dyspepsia is found, the condition generally is considered to be functional, or idiopathic. Nonulcer dyspepsia can cause a variety of symptoms, including abdominal pain, bloating, nausea, and vomiting. Many patients with nonulcer dyspepsia have multiple somatic complaints, as well as symptoms of anxiety and depression. Extensive diagnostic testing is not recommended, except in patients with serious risk factors such as dysphagia, protracted vomiting, anorexia, melena, anemia, or a palpable mass. In these patients, endoscopy should be considered to exclude gastroesophageal reflux disease, peptic or duodenal ulcer, and gastric cancer. In patients without risk factors, consideration should be given to empiric therapy with a prokinetic agent (e.g., metoclopramide), an acid suppressant (histamine-H2 receptor antagonist), or an antimicrobial agent with activity against Helicobacter pylori. Treatment of patients with H. pylori infection and nonulcer dyspepsia (rather than peptic ulcer) is controversial and should be undertaken only when the pathogen has been identified. Psychotropic agents should be used in patients with comorbid anxiety or depression. Treatment of nonulcer dyspepsia can be challenging because of the need to balance medical management strategies with treatments for psychologic or functional disease.

Abstract: Non-ulcer dyspepsia (NUD), gastro-esophageal reflux disease (GERD), gastritis, diabetic gastroparesis and functional dyspepsia are commonly encountered disorders of gastric motility in clinical practice. Prokinetic drugs such as metoclopramide, domperidone, cisapride, mosapride etc. are the mainstay of therapy in these disorders. These drugs are used to relieve symptoms such as nausea, vomiting, bloating, belching, heartburn, epigastric discomfort etc.

Abstract: Systemic sclerosis (SSc) is a clinically heterogeneous disorder which affects the skin and internal organs such as the gastrointestinal tract, lungs, heart, and kidneys. Small bowel disease can present with a wide variety of symptoms, including intermittent bloating, abdominal cramps, chronic diarrhoea and, in a minority of patients, malabsorption.1 Coeliac disease (CD) is a malabsorptive disorder resulting from inflammatory injury to the mucosa of the small intestine after the ingestion of wheat gluten. As CD has an immunological basis, an association between CD and other autoimmune disorders, such as type 1 diabetes mellitus and autoimmune thyroiditis, is not uncommon.2,3 We describe here a patient with SSc and insulin dependent diabetes mellitus in whom a diagnosis of CD was made at the age of 49. …

Abstract: Eosinophilic gastritis is related to eosinophilic gastroenteritis, varying only in regards to the extent of disease and small bowel involvement. Common symptoms reported are similar to our patient's including: abdominal pain, epigastric pain, anorexia, bloating, weight loss, diarrhea, ankle edema, dysphagia, melaena and postprandial nausea and vomiting. Microscopic features of eosinophilic infiltration usually occur in the lamina propria or submucosa with perivascular aggregates. The disease is likely mediated by eosinophils activated by various cytokines and chemokines. Therapy centers around the use of immunosuppressive agents and dietary therapy if food allergy is a factor. The patient is a 31 year old Caucasian female with a past medical history significant for ulcerative colitis. She presented with recurrent bouts of vomiting, abdominal pain and chest discomfort of 11 months duration. The bouts of vomiting had been reoccurring every 7–10 days, with each episode lasting for 1–3 days. This was associated with extreme weakness and cachexia. Gastric biopsies revealed intense eosinophilic infiltration. The patient responded to glucocorticoids and azathioprine. The differential diagnosis and molecular pathogenesis of eosinophilic gastritis as well as the molecular effects of glucocorticoids in eosinophilic disorders are discussed. The patient responded to a combination of glucocorticosteroids and azathioprine with decreased eosinophilia and symptoms. It is likely that eosinophil-active cytokines such as interleukin-3 (IL-3), granulocyte macrophage colony stimulating factor (GM-CSF) and IL-5 play pivotal roles in this disease. Chemokines such as eotaxin may be involved in eosinophil recruitment. These mediators are downregulated or inhibited by the use of immunosuppressive medications.

Abstract: Tegaserod is a drug in a new class of compounds called aminoguanidine indoles and is structurally similar to serotonin (5-HT) with modifications that make the drug selective for the 5-HT(4) receptor Tegaserod has a stimulatory effect on gastrointestinal (GI) motility that has been demonstrated in animal studies and in healthy adults Tegaserod also increases GI secretion and reduces rectal sensitivity Tegaserod is currently approved by the FDA for the treatment of women with constipation-predominant irritable bowel syndrome (C-IBS) Eight large Phase III clinical trials involving > 5000 IBS patients support the clinical efficacy of tegaserod in this group of patients Patients who were treated with tegaserod had an overall improvement in IBS symptoms (Subject's Assessment of Global Relief) as well as in secondary end points, such as abdominal pain and discomfort, stool consistency, change in bowel movements and relief of bloating Tegaserod was well-tolerated The most common adverse reaction in clinical trials was diarrhoea, which was usually temporary and mild, although severe diarrhoea requiring hospitalisation has been rarely (< 1%) reported

Abstract: The post-withdrawal characteristics of tegaserod treatment in patients with irritable bowel syndrome with constipation remain undefined.

Abstract: OBJECTIVE To determine the efficacy and tolerability of tegaserod in the treatment of symptoms of irritable bowel syndrome (IBS) IBS-C patients. DESIGN An open label (quasi interventional) study. PLACE AND DURATION OF STUDY Patients were enrolled between October 2000 and August 2001 at 4 centres (AKUH, Karachi; Mayo Hospital, Lahore; PIMS, Islamabad; Hayatabad Teaching Complex, Peshawar). PATIENTS AND METHODS Tegaserod was administered in a dose of 6 mg (twice-a-day) orally for a period of 6 weeks. Symptoms were assessed before and during treatment using a questionnaire. RESULTS The mean age of patients was 37.5 years and 81(69.2%) were males. The study enrolled 117 patients and 101 patients completed the study. Number of bowel movements, symptoms of straining at defecation, stool consistency, bloating, urgency and abdominal pain improved significantly following treatment (p<0.05). Analysis of data in both genders separately showed statistically significant improvement in symptoms of urgency, straining at defecation, abdominal pain and number of bowel movements following treatment. Side effects of diarrhoea and vertigo (6 and 1 patients respectively) necessitating discontinuation of treatment were infrequent. CONCLUSION Tegaserod given in a dose of 6 mg b.d. is effective and well tolerated in IBS-C patients. It is equally effective in males and females in relieving the symptoms of abdominal pain, bloating, straining at defecation as well as increased in the mean number of bowel movements per week.

Abstract: Functional abdominal bloating is a condition dominated by a feeling of abdominal fullness or bloating and without sufficient criteria for another functional gastrointestinal disorder. The currently used therapeutic approaches aim to reduce the volume of intestinal gas, thus increasing intestinal gas elimination or reducing its production. Some promising results have been obtained by the use of prokinetics, such as tegaserod and Prostigmine, and by the use of nonabsorbable antibiotics, such as rifaximin. Another therapeutic approach is represented by the administration of probiotics to modify the composition of colonic flora and thus the production of intestinal gas. The authors recently studied the effect of LGG, which proved to be more effective than placebo in reducing the severity of symptoms.

Abstract: We hypothesized that functional anal incontinence with no structural explanation comprises distinct pathophysiologic subgroups that could be identified on the basis of the predominant presenting bowel pattern. Consecutive patients (n = 80) were prospectively grouped by bowel symptoms as 1) incontinence only, 2) incontinence + constipation, 3) incontinence + diarrhea, and 4) incontinence + alternating bowel symptoms. The Hopkins Bowel Symptom Questionnaire, the Symptom Checklist 90-R, and anorectal manometry were completed. Significant group differences were found between subcategories of incontinent patients on the basis of symptoms. Abdominal pain was more frequent in patients with altered bowel patterns. Patients with alternating symptoms reported the highest prevalence of abdominal pain, rectal pain, and bloating. Basal anal pressures were significantly higher in alternating patients (P = 0.03). Contractile pressures in the distal anal canal were diminished in the incontinent-only and diarrhea groups (P = 0.004). Constipated patients with incontinence exhibited elevated thresholds for the urge to defecate (P = 0.027). Dyssynergia was significantly more frequent in patients with incontinence and constipation or alternating bowel patterns. Distinct patterns of pelvic floor dysfunction were identified in patient subgroups with anal incontinence, based on the presence or absence of altered bowel patterns. Physiologic assessments suggested different pathophysiologic mechanisms among the subgroups. The evaluation of patients with fecal incontinence should consider altered bowel function.

Abstract: Activation of serotonin 5-HT 4 receptors has been proposed as treatment for irritable bowel syndrome, a common, complex and distressing gastrointestinal disorder. Abnormal intestinal motility and sensitivity in irritable bowel syndrome patients can result in diarrhea, constipation, abdominal pain, bloating, headache and fatigue; these and other symptoms can lead to exacerbation of psychological stress, which may in turn induce further physiological abnormalities and patient discomfort. The serotonin agonist tegaserod binds with high affinity to 5-HT 4 receptors and has demonstrated potent pharmacological effects on the mid- and distal gut. Tegaserod has been safely employed in clinical trials where it has demonstrated efficacy in normalizing intestinal function, thereby improving irritable bowel syndrome symptoms.

Abstract: Introduction: The study was undertaken to test a hypothesis of coexistence and causality between abdominal and recto-anal symptoms and physical signs. Material and methods: A random sample of 251 patients was drawn from 645 referred patients from 12th September 1988 to 19th January 1999. Nineteen selected symptoms were recorded; abdominal palpation and ano-rectoscopy were with special reference to identify faecal reservoirs. Barium enema was used to demonstrate colon pathology. After a combined prokinetic regimen, symptoms and signs were reassessed. The study was observational and factor analysis was used to explore the data together with testing after cross tabulations. Results: One hundred and fiftynine patients were female (63%); neither bloating (64%), abdominal pressure (60%) and pain (26%) nor right iliac fossa tenderness (58%) and faecal mass (42%) and meteorism (33%) were related to age. Patients with additional diverticula and haemorrhoids were significantly older than patients without these lesions. Bloating was found together with a reservoir of faeces in ano-rectum in 62% of patients and 51% had haemorrhoids grade 2 or more and 50% had bloating, faeces in rectum and a right sided palpable abdominal mass (additional faecal reservoir). Among 17 factors explaining 68% of the variance in 45 variables, frequent abdominal and ano-rectal symptoms and physical signs showed substantial correlations to nine factors, indicating that they belong to the same underlying condition. A malignant tumour was found in four patients, polyps in 20 patients, and in 105 patients left sided diverticula were present. After a prokinetic regimen was conducted the dominant symptoms and signs were reduced significantly. Conclusions: Collectively, the data showed significant correlations between abdominal and anorectal symptoms and signs. Additional faecal reservoirs were demonstrated in the right colon and the rectum, irrespective of defaecation daily. This hidden constipation (faecal retention) gives rise to bloating, pain and right iliac fossa tenderness and mass, and defaecation disorders (functional faecal retention) which was confirmed by a significant reduction in symptoms and physical signs after a propulsive regimen. Also, over the years, the state of hidden constipation seems to bear a cumulative risk of developing organic diseases like diverticula, polyps, haemorrhoids and malignancy. Dan Med Bull 2004;51:422-5.

Abstract: Irritable bowel syndrome represents a common gastrointestinal disorder that significantly impacts patients' lives. It is defined by Rome II criteria and characterized by abdominal pain and bloating associated with changes in bowel habit. Visceral hypersensitivity is currently considered a biological marker for the disease. Current therapeutic treatments include the use of fiber supplements, antidiarrheal agents, laxatives, antispasmodics, tricyclic antidepressants and serotonergic agents. Through a proper understanding of the diagnostic criteria, pathophysiology and treatment options, this disorder can be treated effectively in many patients.

Abstract: marginally better than those who received ranitidine Conclusions: The frequency of functional dyspepsia in childhood reached a percentage of 70% The majority of patients exhibited mild disease manifestations whereas the most frequent symptoms of the condition were nausea, vomiting, belching, bloating and postprandial fullness Therapeutically, cisapride seemed to be superior to acidreducing drugs but in a non significant manner

Abstract: Amongst many studies on the textural, mineralogical and physical changes during biscuit firing of whiteware bodies, this paper attempts to investigate the bloating behaviour of a commercial bone china body during biscuit firing. In order to achieve this, representative test samples were shaped by uniaxial pressing and biscuit fired at various temperatures for different heating rates and soaking times. The resultant microstructures were investigated using XRD and SEM techniques. A special etching technique was also used in order to observe the microstructural evolution of the body with changing firing regime. Introduction Bone china is a highly specialized product and is the basis of the world’s most attractive and expensive type of tableware. The important characteristics of bone china are strength, whiteness, translucency and resonance. Its production is, however, considerably difficult due to various technological limitations such as lack of plasticity in the body mix, large firing shrinkage and a very short vitrification range of the body, which is generally of the order of 15° to 25°C. If the firing temperature is over the firing range, then the ware bloats, resulting in a growth of closed pores, a reduction in bulk density and general increase in size. Thus, the maximum biscuit firing temperature and soaking time are critical and need to be carefully controlled if losses are to be avoided. In addition, overfiring is a waste of energy. A typical unfired bone china body contains about 35 % porosity, all of which is interconnected, i.e. open. When it is fully matured, the open porosity will be less than 1 %, preferably below 0.5 %, but there will be a residue of closed pores giving a true porosity of about 8-10 % [1]. Several authors have recently investigated the microstructural development of bone china body during biscuit firing [2-5]. On the other hand, the bloating behaviour of bone china has little been studied. A possible mechanism for bloating is the evolution of gas or vapour at the vitrification temperature of the body. According to Cartwright, Webster and Roberts [6] this could be due to thermal decomposition of one or more of the raw materials (or an impurity in the raw material), reaction between two or more of the body components or evolution of gases dissolved in the glassy phase of the body. They showed that the bloating of a bone china could be substantially suppressed by increasing the calcination temperature of bone and as a result the vitrification range could be extended. This study aims to investigate the bloating behaviour of bone china depending on the heating rate, maximum biscuit firing temperature and soaking time. Experimental Procedures A spray dried bone china body (Grade: BCG 400) for the present study was kindly supplied by Jesse Shirley & Son Ltd. (England) (see Table 1). It was uniaxially pressed in a 20 mm diameter stainless steel die by means of a hand-operated hydraulic press at a suitable pressure. Following the pressing, the bone china pellets were placed in a drying oven at around 110°C for at least 24 hours until they reached a constant mass. Three groups of biscuit firings were carried out under laboratory conditions. For the first group of firings, three different steady firing rates to three different peak temperatures Key Engineering Materials Online: 2004-05-15 ISSN: 1662-9795, Vols. 264-268, pp 1717-1722 doi:10.4028/www.scientific.net/KEM.264-268.1717 © 2004 Trans Tech Publications Ltd, Switzerland All rights reserved. No part of contents of this paper may be reproduced or transmitted in any form or by any means without the written permission of Trans Tech Publications Ltd, www.scientific.net. (Semanticscholar.org-13/03/20,18:13:59) for a fixed soaking time were employed. In the second group, only soaking time was changed for a fixed heating rate and firing temperature. In the last group, the firings were achieved in a range of 1000° to 1350°C at a heating rate of 120°C for one hour soaking. Values of bulk density and apparent porosity of the representative samples were measured using the water immersion method based on the Archimedes’ principle. Prior to SEM studies, XRD was used for the qualitative determination of the crystalline phases present in the fired samples. This was performed using a Rigaku based diffractometer (Rint 2200, Japan). The X-ray scan was made over a range of 2θ values of 5° to 80°. Both chemical and thermal etching of the relevant polished surfaces were also carried out. Prior to SEM investigation, the samples were gold coated to prevent charging. A Cam Scan analytical scanning electron microscope was employed in both secondary (SE) and back scattered (BE) imaging modes. Table 1. Chemical analysis of the bone china body Oxide SiO2 Al2O3 CaO MgO K2O Na2O P2O5 Fe2O3 TiO2 LOI wt, % 33.2 12.9 25.9 0.72 1.64 1.27 19.5 0.24 0.05 4.51 Results and Discussion Table 2 gives some of the fired characteristics of the bone china body biscuit fired at three different steady firing rates to three different peak temperatures for one hour soaking. As can be seen, the best physical properties were obtained at 1240°C for a heating rate of 120°C/h. Higher heating rates did not, however, result in the same degree of densification at this temperature. High apparent porosity and corresponding low bulk density values obtained for the firings at 1220°C indicate that the samples were under fired. But, the decrease in the bulk density for the firings at 1260°C for all heating rates shows that the samples were overfired at this temperature, being almost regardless of the heating rate. Table 2. The change in the physical properties of the bone china body with the heating rate and maximum biscuit firing temperature (I. group) 120°C/h 180°C/h 240°C/h Biscuit firing temperature (°C) Bulk density (g/cm 3 ) Apparent porosity (%) Bulk density (g/cm 3 ) Apparent porosity (%) Bulk density (g/cm 3 ) Apparent porosity (%) 1220 2.53±0.03 1.47±0.02 2.51±0.2 1.43±0.02 2.51±0.05 1.50±0.03 1240 2.58±0.03 ≤0.5 2.54±0.02 ≤0.5 2.52±0.05 ≤0.5 1260 2.50±0.03 ≤0.5 2.50±0.03 ≤0.5 2.46±0.03 ≤0.5 The variation in the values of bulk density and apparent porosity with the increase in the soaking time for the bone china samples biscuit fired at a heating rate of 120°C/h to 1240°C is presented in Table 3. It is clear that any further increase above one hour in the soaking time resulted in bloating. Table 3. The physical properties of the bone china body biscuit fired at 1240°C for different soaking times (II. group) Soaking time (h) Bulk density, g/cm 3 Apparent porosity, % *True density, g/cm 3 Relative density, % 1 2.58±0.03 ≤0.5 2.82 91.5 3 2.48±0.04 ≤0.5 2.82 87.9 5 2.47±0.02 ≤0.5 2.82 87.6 * provided by the supplier 1718 Euro Ceramics VIII

Abstract: Irritable bowel syndrome (IBS) is the most common gastrointestinal (GI) disorder seen by healthcare professionals, yet, effective treatment is lacking. The aim of this study was to explore the effects of osteopathic treatment on IBS. Two IBS patients were recruited and received osteopathic treatment over four consecutive weeks at Victoria University Osteopathic Medicine Clinic. The patients were assessed by the Bowel Symptom Scale (BSS) at the pre, mid and post treatment points. Subjects showed varied results throughout the study, however by the end of the study both patients showed a decrease in their overall severity of symptoms. Improvements did occur in the patients' individual presenting symptoms, where abdominal pain, bloating and diarrhoea were all reduced. The preliminary data of two patients indicates that osteopathic treatment may help. However, the results are inconclusive due to an insufficient patient population and inadequate study design. This highlights the need for further research of a larger scale, longer-term , randomised, controlled study. This minor thesis was written by a post-graduate student as part of the requirements of the Master of Health Science (Osteopathy) program.

Abstract: Background : The Aim of study is to identify specific subjective symptoms for gastroesophageal reflux disease (GERD), GERD proportion in ulcer like dyspepsia and the correlation between specific subjective symptoms for GERD and endoscopic examination Result in ulcer like dyspepsia Methods : A cross-sectional study was conducted in 67 patients with ulcer like dyspepsia. The patient’s history of illness was taken, and physical and endoscopic examinations were performed. A questionnaire on dyspepsia symptoms was completed. Data analysis was performed to identify the correlation between subjective symptoms and endoscopic examination results using chi-square test. T test was performed to determine the correlation between dyspepsia scores and endoscopic results. Result : Subjective symptoms that correlated with endoscopic results were severe epigastric pain (p=0.080) and the absence of bloating (p=0.055). Dyspepsia scores did not correlate with endoscopic examination results (p=0.725). Conclusion : Specific subjective symptoms for GERD in clinical dyspepsia-like ulcer were severe epigastric pain and absence of bloating. The proportion of such symptoms in ulcer like dyspepsia could assist clinical diagnosis of GERD. Keywords : GERD, symptom, dyspepsia

Abstract: Compositions and methods for providing relief from pain and/or discomfort associated with gastrointestinal disorders, including, for example, bloating, crying, gas, cramping, regurgitation, diarrhea and gastrointestinal pain, associated with colic comprising, at least one antiflatulent, at least one histamine H1-receptor antagonist, and optionally,one or more prebiotic and/or one or more probiotic.

Abstract: Nissen fundoplication remains one of the three most common major surgical procedures performed in infants and children. However, despite its unquestioned value in preventing reflux and emesis, fundoplication is far from being an uncomplicated procedure. Dyspeptic symptoms such as fullness, early satiety, abdominal pain, or bloating may occur in up to 30% of patients who undergo surgery [4].

Abstract: The importance of gastrointestinal motility and gut perception in medicine has been long recognized. Physiologically, these key functions ensure normal unperceived feeding and digestion, crucial aspects of health and wellbeing. Conversely, pathophysiological disturbances may produce digestive symptoms, which are common in the general population and may range from the simply annoying to the incapacitating. In fact, major disturbances may lead to malnourishment, metabolic imbalance and general deterioration of the body. Altered normal gut motility may also disrupt gut homeostasis, induce changes in the gut flora and facilitate bacterial translocation from the intestine to other viscera (Fig. 1). Clinical recognition of gastrointestinal motility and perception disorders is largely based on the anatomic localization of their symptomatic expression (1-4). Thus, dysphagia, reflux symptoms and chest pain are normally associated with esophageal or gastroesophageal disturbances. Upper abdominal pain or discomfort, early satiety, nausea and vomiting, and other dyspeptic-like symptoms are usually ascribed to dysfunction of the stomach and/or upper small bowel. Bloating is a somewhat mysterious symptom that may be generated by motor/sensorial disturbances throughout the gastrointestinal tract. Diarrhea and/or constipation usually result from small bowel and/or colonic disorders. Ano-rectal symptoms usually derive from dysfunction of the pelvic floor, distal colon or sphincteric structures. Traditionally, clinical conditions were divided into somatic gastrointestinal motility disorders: achalasia, gastroparesis, chronic intestinal pseudo-obstruction and so on, and functional disorders: dyspepsia, irritable bowel syndrome and a myriad of clinical syndromes and descriptions. The distinction between both groups was largely based on whether a propulsive failure was or not demonstrated by conventional imaging tests. Thus, a patient with recurrent abdominal pain and distension could be categorized either as a chronic intestinal pseudoobstruction (if dilated loops of bowel were visualized on Xrays) or irritable bowel syndrome (if nothing obviously abnormal was found). Application of more sophisticated and discriminating diagnostic tests (intestinal manometry, barostat, etc.) and histology increasingly showed that Gastrointestinal motility and perception disorders re-visited