Browsing by Author "Tack, Jan"

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    International consensus on the diagnosis and management of dumping syndrome
    (Nature Publishing group, 2020-05-26) Scarpellini, Emidio; Arts, Joris; Karamanolis, George; Laurenius, Anna; Siquini, Walter; Suzuki, Hidekazu; Ukleja, Andrew; Van Beek, Andre; Vanuytsel, Tim; Bor, Serhat; Ceppa, Eugene; Di Lorenzo, Carlo; Emous, Marloes; Hammer, Heinz; Hellström, Per; Laville, Martine; Lundell, Lars; Masclee, Ad; Ritz, Patrick; Tack, Jan; Surgery, School of Medicine
    Dumping syndrome is a common but underdiagnosed complication of gastric and oesophageal surgery. We initiated a Delphi consensus process with international multidisciplinary experts. We defined the scope, proposed statements and searched electronic databases to survey the literature. Eighteen experts participated in the literature summary and voting process evaluating 62 statements. We evaluated the quality of evidence using grading of recommendations assessment, development and evaluation (GRADE) criteria. Consensus (defined as >80% agreement) was reached for 33 of 62 statements, including the definition and symptom profile of dumping syndrome and its effect on quality of life. The panel agreed on the pathophysiological relevance of rapid passage of nutrients to the small bowel, on the role of decreased gastric volume capacity and release of glucagon-like peptide 1. Symptom recognition is crucial, and the modified oral glucose tolerance test, but not gastric emptying testing, is useful for diagnosis. An increase in haematocrit >3% or in pulse rate >10 bpm 30 min after the start of the glucose intake are diagnostic of early dumping syndrome, and a nadir hypoglycaemia level <50 mg/dl is diagnostic of late dumping syndrome. Dietary adjustment is the agreed first treatment step; acarbose is effective for late dumping syndrome symptoms and somatostatin analogues are preferred for patients who do not respond to diet adjustments and acarbose.
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    Prolonged Gastrointestinal Manifestations After Recovery From COVID-19
    (Elsevier, 2023) Elmunzer, B. Joseph; Palsson, Olafur S.; Forbes , Nauzer; Zakaria , Ali; Davis, Christian; Canakis, Andrew; Qayed, Emad; Bick, Benjamin; Pawa, Swati; Tierney, William M.; McLeod, Caroline G.; Taylor, Jason; Patel, Harsh; Mendelsohn, Robin B.; Bala, Gokul; Sloan, Ian; Merchant, Ambreen A.; Smith, Zachary L.; Sendzischew Shane, Morgan A.; Aroniadis, Olga C.; Ordiah, Collins O.; Ruddy, Johannah M.; Simren, Magnus; Tack, Jan; Drossman, Douglas; Medicine, School of Medicine
    Background & Aims Acute enteric infections are well known to result in long-term gastrointestinal (GI) disorders. Although COVID-19 is principally a respiratory illness, it demonstrates significant GI tropism, possibly predisposing to prolonged gut manifestations. We aimed to examine the long-term GI impact of hospitalization with COVID-19. Methods Nested within a large-scale observational cohort study of patients hospitalized with COVID-19 across North America, we performed a follow-up survey of 530 survivors 12–18 months later to assess for persistent GI symptoms and their severity, and for the development of disorders of gut-brain interaction (DGBIs). Eligible patients were identified at the study site level and surveyed electronically. The survey instrument included the Rome IV Diagnostic Questionnaire for DGBI, a rating scale of 24 COVID-related symptoms, the Gastrointestinal Symptoms Rating Scale, and the Impact of Events–Revised trauma symptom questionnaire (a measure of posttraumatic stress associated with the illness experience). A regression analysis was performed to explore the factors associated with GI symptom severity at follow-up. Results Of the 530 invited patients, 116 responded (52.6% females; mean age, 55.2 years), and 73 of those (60.3%) met criteria for 1 or more Rome IV DGBI at follow-up, higher than the prevalence in the US general population (P < .0001). Among patients who experienced COVID-related GI symptoms during the index hospitalization (abdominal pain, nausea, vomiting, or diarrhea), 42.1% retained at least 1 of these symptoms at follow-up; in comparison, 89.8% of respondents retained any (GI or non-GI) COVID-related symptom. The number of moderate or severe GI symptoms experienced during the initial COVID-19 illness by self-report correlated with the development of DGBI and severity of GI symptoms at follow-up. Posttraumatic stress disorder (Impact of Events–Revised score ≥33) related to the COVID-19 illness experience was identified in 41.4% of respondents and those individuals had higher DGBI prevalence and GI symptom severity. Regression analysis revealed that higher psychological trauma score (Impact of Events–Revised) was the strongest predictor of GI symptom severity at follow-up. Conclusions In this follow-up survey of patients 12–18 months after hospitalization with COVID-19, there was a high prevalence of DGBIs and persistent GI symptoms. Prolonged GI manifestations were associated with the severity of GI symptoms during hospitalization and with the degree of psychological trauma related to the illness experience.