Constipation with bloating: a clinical approach

 

Ref

Ann Med. 2026 Jun 19;58(1):2684172. doi: 10.1080/07853890.2026.2684172

Constipation with bloating: a clinical approach to evaluation and management

David J Cangemi a,✉, Adam P Laitman b, Orit Faiman b, Bianca W Chang च

Key Messages

Patients presenting with constipation, with bloating as a predominant symptom, should be evaluated for underlying conditions, including irritable bowel syndrome with constipation (IBS-C), chronic idiopathic constipation (CIC), pelvic floor dysfunction, and microbial overgrowth (e.g. intestinal methanogen overgrowth), among other causes

If food intolerances are suspected, a trial of dietary restriction, such as a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet, can be suggested

Improvement in bloating has been demonstrated in large, randomized trials of several gastrointestinal-targeted pharmacologic therapies (e.g. secretagogues) in patients with IBS-C or CIC

Pelvic floor physical therapy with biofeedback should be considered for patients with dyssynergic defecation

Introduction

Constipation and bloating are common bothersome gastrointestinal (GI) symptoms [1,2]. The estimated 

prevalence of constipation has ranged from 6% to 9% in Asian countries 

to 15% to 17% in Europe and North America [3].

 The estimated prevalence of bloating has ranged from approximately 11% in East Asian countries to approximately 20% in European, Latin American, Middle Eastern, and North American countries [4]. 

Sociocultural factors likely contribute to differences in patient perception of symptoms and reported prevalence rates [3,5].

Constipation and bloating frequently present concurrently [6,7]. 

In a global survey of 51,425 people with nonorganic causes of GI symptoms, approximately one-third of individuals reporting constipation with ≥30% of their bowel movements also reported bloating at least once per week [4].

 Rates of bloating were higher among individuals with irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC), with 71% and 36% of these populations, respectively, reporting bloating at least once weekly [4].

 In another global survey (N = 20,099), among 10,425 (51.9%) individuals who reported having कॉन्स्टीपशन

 in the previous 6 months, 65% reported also having bloating/distention [7]. Of note, a study in Italy of patients with IBS-C (n = 369) or CIC (n = 1834) identified substantially higher bloating prevalence rates of 96% and 91%, respectively, based on a 2-week recall period [1]. 

Although patients may often experience bloating and abdominal distention concurrently, these are distinct phenomena. 

Distension refers to an objective measurable increase in abdominal girth, whereas bloating refers to a subjective sensation of gassiness or fullness/pressure within the abdomen and does not include visible distension [2].

 The underlying pathophysiology of bloating is complex and diverse, as will be discussed latter in the manuscript, whereas abdominal distension may result from an increased volume of gas or stool within the intestines. Abdominophrenic dyssynergia, in which the diaphragm inappropriately contracts and the anterior wall muscles inappropriately relax in response to intestinal gas load, leading to distension, remains an underrecognized cause of abdominal distension, particularly in disorders of gut-brain interaction [8].

 Data have shown that both constipation and bloating impair patient health-related quality of life (QoL) [1,9]. 

Constipation is associated with pronounced detriments to general health, social functioning, 

and mental health, leading to impairments इन

 health-related QoL that are comparable to those associated with chronic diseases, such as diabetes and osteoarthritis [10]. Chronic constipation has been associated with poor QoL and impaired general well-being [11–13],

 with a strong negative correlation between symptom severity and QoL [12]. 

Individuals with CIC experience markedly impaired QoL compared with individuals without constipation [10,14]; likewise, individuals with IBS-C report greater impairments in health-related QoL, work productivity, and activity compared with those without IBS-C [15].

 Notably, patients with bloating have impaired QoL, independent of CIC or IBS-C [1]. In a US survey of patients with IBS-C (n = 328) or CIC (n = 552), bloating was 

reported as a ‘very/extremely bothersome’ symptom in 56% of patients with IBS-C and 46% of patients with CIC (p < 0.03 between the 2 groups) [16]. 

Additionally, the frequency of bloating was higher in patients with IBS-C vs CIC (2.8 vs 1.4 mean days/week, p < 0.0001). A systematic literature review of studies of CIC that used validated or disease-specific QoL measures, including the Patient Assessment of Constipation Quality of Life questionnaire, concluded that increased intensity of symptoms of constipation, including bloating, correlated with impaired QoL [17].

Given that constipation and bloating are common symptoms that can occur with a range of medical conditions,

 it is crucial to recognize the underlying condition(s) and tailor therapeutic interventions appropriately. The objective of this narrative review is to highlight key considerations in the evaluation and management of adults with constipation who also have the subjective sensation of bloating as a clinically predominant (i.e. bothersome) symptom.

Onion(Allium cepa) Prebiotic

Ref American Society For Microbiology

(mSystems.) 2024 Dec 23;10(1):e01189-24. doi: 10.1128/msystems.01189-24

The prebiotic potential of dietary onion extracts: shaping gut microbial structures and promoting beneficial metabolites

Yebeen Yoo 1,#, Seongok Kim 1,2,#, WonJune Lee 2, Jinwoo Kim 1,2, Bokyung Son 3, Kwang Jun Lee 4,✉, Hakdong Shin 

 Introduction 

Allium cepa, commonly known as onion, is a bulbous plant that is extensively cultivated worldwide. Compounds from onion have been reported to offer a range of health benefits, including anti-carcinogenic, anti-platelet activity, anti-thrombotic activity, anti-asthmatic, and antibiotic effects (1). These compounds are phytomolecules, including various carbohydrates, polyphenols, dietary fibers, flavonoids, and sulfur compounds 

(2–5). Among them, carborhydrates such as oligosaccharides have gained significant attention for their prebiotic application, as its supplementation has been shown to improve human health disorders, including Chron’s disease, allergen reaction, atopic dermatitis, and intestinal diseases (6–11).

Prebiotics have recently been defined by the International Scientific Association for Probiotics and Prebiotics as “a substrate that is selectively utilized by host microorganisms conferring a health benefit (12).

” Substrates considered prebiotics include non-digestible oligosaccharides, such as fructooligosaccharide (FOS) and galactooligosaccharide, dietary fiber like inulin and pectin, plant-derived polyphenols, and polysaturated fatty acids (12, 13). 

These compounds naturally exist in different dietary food products, including asparagus, sugar beet, garlic, chicory, onion, and other vegetables (14).

 Prebiotics are metabolized by gut microbiota, resulting in the production of beneficial products through microbial cross-feeding, such as short-chain fatty acid and tryptophan-derived metabolites (indolelactate [ILA] and indolepropionate [IPA]). These metabolites have been shown to impact host biological functions, including the maintenance of epithelial barrier integrity, immune modulation, the control of intestinal inflammation, and metabolic disorders (15–23).

The gut microbiota, consisting of 10–100 trillion microorganisms, is considered as an important factor due to its contribution to human health (24). 

The structure of gut microbiota varies significantly among individuals and is influenced by host factors such as age, nationality, gender, and body mass index (BMI) (25). 

These variations have posed challenges in studying the relationships between the human microbiome and health. To address this, recent studies have introduced enterotyping, which categorizes complex human gut microbial communities into three distinct enterotypes based on the predominance of specific genera: Bacteroides (enterotype 1), Prevotella (enterotype 2), and Ruminococcus (enterotype 3), although the classification of enterotype 3 remains controversial (25, 26).

 These enterotypes represent densely populated areas of community composition within a multi-dimensional space, simplifying the complex gut microbial community by minimizing individual variation (25).

 This approach has facilitated deeper exploration of the connections between the human microbiome and various diseases or diets, which has contributed to advances in cancer diagnostics, implications for weight loss, and the development of personalized nutrition plans for obesity management (27–30).

In this study, we demonstrate the potential of dietary onion extract as a prebiotic, 

Allium cepa, commonly known as onion, is a bulbous plant that is extensively cultivated worldwide. Compounds from onion have been reported to offer a range of health benefits, including anti-carcinogenic, anti-platelet activity, anti-thrombotic activity, anti-asthmatic, and antibiotic effects (1). These compounds are phytomolecules, including various carbohydrates, polyphenols, dietary fibers, flavonoids, and sulfur compounds (2–5). Among them, carborhydrates such as oligosaccharides have gained significant attention for their prebiotic application, as its supplementation has been shown to improve human health disorders, including Chron’s disease, allergen reaction, atopic dermatitis, and intestinal diseases (6–11).

Prebiotics have recently been defined by the International Scientific Association for Probiotics and Prebiotics as “a substrate that is selectively utilized by host microorganisms conferring a health benefit (12).” Substrates considered prebiotics include non-digestible oligosaccharides, such as fructooligosaccharide (FOS) and galactooligosaccharide, dietary fiber like inulin and pectin, plant-derived polyphenols, and polysaturated fatty acids (12, 13). These compounds naturally exist in different dietary food products, including asparagus, sugar beet, garlic, chicory, onion, and other vegetables (14). Prebiotics are metabolized by gut microbiota, resulting in the production of beneficial products through microbial cross-feeding, such as short-chain fatty acid and tryptophan-derived metabolites (indolelactate [ILA] and indolepropionate [IPA]). These metabolites have been shown to impact host biological functions, including the maintenance of epithelial barrier integrity, immune modulation, the control of intestinal inflammation, and metabolic disorders (15–23).

The gut microbiota, consisting of 10–100 trillion microorganisms, is considered as an important factor due to its contribution to human health (24). The structure of gut microbiota varies significantly among individuals and is influenced by host factors such as age, nationality, gender, and body mass index (BMI) (25). These variations have posed challenges in studying the relationships between the human microbiome and health. To address this, recent studies have introduced enterotyping, which categorizes complex human gut microbial communities into three distinct enterotypes based on the predominance of specific genera: Bacteroides (enterotype 1), Prevotella (enterotype 2), and Ruminococcus (enterotype 3), although the classification of enterotype 3 remains controversial (25, 26). These enterotypes represent densely populated areas of community composition within a multi-dimensional space, simplifying the complex gut microbial community by minimizing individual variation (25). This approach has facilitated deeper exploration of the connections between the human microbiome and various diseases or diets, which has contributed to advances in cancer diagnostics, implications for weight loss, and the development of personalized nutrition plans for obesity management (27–30).

In this study, we demonstrate the potential of dietary onion extract as a prebiotic, highlighting its significant impact on gut microbial composition and its ability to enhance the production of beneficial metabolites such as butyrate and IPA/ILA.

MATERIALS AND  its significant impact on gut microbial composition and its ability to enhance the production of beneficial metabolites such as butyrate and IPA/ILA

कांद्याच्या अर्काची प्रीबायोटिक क्षमता

 

संदर्भ: अमेरिकन सोसायटी फॉर मायक्रोबायोलॉजी

(एमसिस्टम्स.) २०२४ डिसेंबर २३; १०(१):e०११८९-२४. doi: १०.११२८/एमसिस्टम्स.०११८९-२४

आहारातील कांद्याच्या अर्काची प्रीबायोटिक क्षमता: आतड्यातील सूक्ष्मजीवांच्या संरचनेला आकार देणे आणि फायदेशीर मेटाबोलाइट्सना प्रोत्साहन देणे

येबीन यू १,#, सेओंगोक किम १,२,#, वॉनजून ली २, जिनवू किम १,२, बोक्यंग सोन ३, क्वांग जून ली ४,✉, हाकडोंग शिन १,२,✉

संपादक: अवियाजा लायबर्थ हॉप्टमन५

सारांश

कांदा ही एक सुप्रसिद्ध भाजी आहे जी आरोग्यासाठी विविध फायदे देते. या अभ्यासात, इन विट्रो फेकल इनक्युबेशन मॉडेल आणि मेटाबोलॉम विश्लेषणाचा वापर करून, कांद्याच्या अर्काचा आतड्यातील मायक्रोबायोमवर होणारा परिणाम तपासला आहे.

 १९ निरोगी दात्यांकडून विष्ठेचे नमुने गोळा करण्यात आले आणि कांद्याच्या अर्काच्या उपस्थितीत किंवा अनुपस्थितीत २४ तास उबवण्यात आले.

आतड्यांतील सूक्ष्मजीवांमधील व्यक्ती-व्यक्तींमधील भिन्नता कमी करण्यासाठी, आम्ही मूळ विष्ठेतील सूक्ष्मजीवांवर आधारित एन्टेरोटायपिंगचा वापर केला: यामध्ये बॅक्टेरॉइड्स-प्रबळ प्रकार (एन्टेरोटाइप बी) असलेले १४ विषय आणि प्रिव्होटेला-प्रबळ प्रकार (एन्टेरोटाइप पी) असलेले ५ विषय होते. बॅक्टेरॉइड्स- आणि प्रिव्होटेला-प्रबळ दोन्ही प्रकारांमध्ये, उपचार न केलेल्या नियंत्रण गटाच्या तुलनेत कांद्याने उपचार केलेल्या गटात अल्फा विविधता लक्षणीयरीत्या कमी झाली होती. तथापि, भारित युनिफ्रॅक अंतरावर आधारित जिवाणू समुदायांमध्ये लक्षणीय संरचनात्मक फरक दिसून आले. विशेषतः, एन्टेरोटाइप बी मध्ये कांद्याच्या अर्काला प्रतिसाद म्हणून बिफिडोबॅक्टेरियम_३८८७७५, फिकॅलिबॅक्टेरियम आणि फ्युसिकेटनिबॅक्टर यांसारखे शॉर्ट-चेन फॅटी ऍसिड (SCFA) तयार करणारे जीवाणू अधिक प्रमाणात आढळले.

शिवाय, एन्टेरोटाइप बी मध्ये कांद्याने उपचार केलेल्या गटात ब्युटिरेट उत्पादनाशी संबंधित जनुके लक्षणीयरीत्या अधिक प्रमाणात आढळली. समृद्ध टॅक्सा आणि अंदाजित चयापचय मार्गांशी सुसंगतपणे, कांद्याने उपचार केलेल्या गटात SCFAs आणि त्यांचे संबंधित मेटाबोलाइट्स लक्षणीयरीत्या समृद्ध झाले होते. याव्यतिरिक्त, नियंत्रण गटाच्या तुलनेत कांद्याने उपचार केलेल्या गटात ट्रिप्टोफॅन चयापचयातून मिळणारे मेटाबोलाइट्स, ज्यात इंडोललॅक्टेट (ILA) आणि इंडोलप्रोपियोनेट (IPA) यांचा समावेश आहे, अनुक्रमे ४-पट आणि ३२-पट वाढले होते. इन विट्रो वाढ चाचण्यांमध्ये कांद्याच्या अर्काच्या उपस्थितीत लॅक्टोबॅसिली स्ट्रेन्समध्ये वाढ दिसून आली.

 या परिणामांमधून असा पुरावा मिळतो की कांद्याचा अर्क आतड्यातील सूक्ष्मजीवांची रचना बदलून आणि एससीएफए (शॉर्ट-चेन फॅटी ऍसिड (एससीएफए) तयार करणारे जीवाणू) व इंडोल डेरिव्हेटिव्ह्ज यांसारख्या फायदेशीर मेटाबोलाइट्सच्या उत्पादनास चालना देऊन, तसेच प्रोबायोटिक्सच्या वाढीस चालना देऊन, आश्वासक प्रीबायोटिक्स म्हणून काम करू शकतो.

Dietary onion Prebiotic

 

Ref American Society For Microbiology

(mSystems.) 2024 Dec 23;10(1):e01189-24. doi: 10.1128/msystems.01189-24

The prebiotic potential of dietary onion extracts: shaping gut microbial structures and promoting beneficial metabolites

Yebeen Yoo 1,#, Seongok Kim 1,2,#, WonJune Lee 2, Jinwoo Kim 1,2, Bokyung Son 3, Kwang Jun Lee 4,✉, Hakdong Shin 1,2,✉

Editor: Aviâja Lyberth Hauptmann5

ABSTRACT

Onions are well-known vegetables that offer various health benefits. This study explores the impact of onion extracts on gut microbiome using an in vitro fecal incubation model and metabolome analysis.

 Fecal samples were collected from 19 healthy donors and incubated in the presence or absence of onion 

extracts for 24 h. To reduce inter-individual variability 

in the gut microbiome, we employed enterotyping

 based on baseline fecal microbiota: 14 subjects with a Bacteroides-dominant type (enterotype B) and 5 subjects 

with Prevotella-dominant type (enterotype P). Alpha diversity was significantly reduced in the onion-treated group compared to the non-treated control group in both Bacteroides- and Prevotella-dominant types. However, significant structural differences in bacterial communities were observed based on weighted UniFrac distance. Notably, short-chain fatty acid (SCFA)-producing bacteria, such as Bifidobacterium_388775, Feacalibacterium, and Fusicatenibacter, were overrepresented in response to onion extracts in enterotype B. 

Furthermore, genes related to butyrate production were significantly overrepresented in the onion-treated group within enterotype B. Consistent with the enriched taxa and the predicted metabolic pathways, SCFAs and their related metabolites were significantly enriched in the onion-treated group. Additionally, tryptophan metabolism-derived metabolites, including indolelactate (ILA) and indolepropionate (IPA), were elevated by 4- and 32-fold, respectively, in the onion-treated group compared to the control group. In vitro growth assays showed an increase in lactobacilli strains in the presence of onion extracts.

 These results provide evidence that onion extracts could serve as promising prebiotics by altering gut microbial structure and promoting the production of beneficiary metabolites, including SCFAs( short-chain fatty acid (SCFA)-producing bacteria)

 and indole derivatives, and enhancing the growth of probiotics.

तरुण कोरियन प्रौढांमधील GERD

 

कोरियन जर्नल ऑफ कम्युनिटी न्यूट्रिशन लोगो

कोरियन जे कम्युनिटी न्यूट्रिशन. २०२४ ऑक्टोबर ३१; २९(५):३९६–४०५. doi: १०.५७२०/kjcn.२०२४.०००११

तरुण कोरियन प्रौढांमधील गॅस्ट्रोएसोफेजियल रिफ्लक्स डिसीजची लक्षणे आणि आहार व जीवनशैली वर्तणूक यांच्यातील संबंध: एक प्राथमिक क्रॉस-सेक्शनल अभ्यास

सोहेउन शिम १,*, जोंग-ह्वा चोई २,*, यंग-रॅन हेओ ३,†

सारांश

उद्दिष्टे

गॅस्ट्रोएसोफेजियल रिफ्लक्स डिसीज (GERD) ही एक वैद्यकीय स्थिती आहे जी पोटातील किंवा लहान आतड्यातील (duodenal) घटकांच्या उलट प्रवाहामुळे (reflux) अन्ननलिकेच्या ऊतींचे नुकसान झाल्यामुळे होते.

अलीकडे GERD च्या रुग्णांची संख्या वाढत असल्याचे दिसून आले आहे; तथापि, या लोकसंख्येवर, विशेषतः तरुण प्रौढांवर, संशोधनाचा अभाव आहे.  या अभ्यासाचा उद्देश तरुण कोरियन प्रौढांमधील GERD लक्षणांशी संबंधित आहारविषयक आणि जीवनशैली घटकांचा शोध घेणे हा होता.

प्रस्तावना

गॅस्ट्रोएसोफेजियल रिफ्लक्स डिसीज (GERD) म्हणजे पोटातील किंवा लहान आतड्यातील (ड्यूओडेनम) घटकांच्या उलट प्रवाहामुळे (रिफ्लक्समुळे) अन्ननलिकेच्या ऊतींना होणाऱ्या नुकसानाशी संबंधित लक्षणांचा संच [1].

आरोग्य विमा पुनरावलोकन आणि मूल्यांकन सेवेच्या [2] बिग डेटा विश्लेषणानुसार,

GERD (कोड: K21) च्या एकूण रुग्णांची संख्या 2019 मधील 4.58 दशलक्ष वरून 2021 मध्ये 4.86 दशलक्ष पर्यंत अंदाजे 6.1% ने वाढली. याव्यतिरिक्त, याच कालावधीत 20 ते 20 वयोगटातील रुग्णांची संख्या 389,162 वरून 467,973 पर्यंत आणि 30 ते 30 वयोगटातील रुग्णांची संख्या 532,964 वरून 574,936 पर्यंत वाढली,

परिणामी 2019 ते 2021 पर्यंत वार्षिक प्रादुर्भावात अनुक्रमे अंदाजे 20.3% आणि 7.8% वाढ झाली. 40 ते 50 वयोगटातील आणि 60 व त्याहून अधिक वयाच्या व्यक्तींमध्ये प्रादुर्भावाचे प्रमाण 20 ते 30 वयोगटाच्या तुलनेत अनुक्रमे सुमारे 11% आणि 14% असे सातत्याने जास्त होते.  हे उच्च दर स्थिर राहिले असले तरी, २०-३० वयोगटातील तरुणांमध्ये याचे प्रमाण हळूहळू वाढताना दिसत आहे [2]. त्यामुळे, या तरुण लोकसंख्येमध्ये GERD ची काळजी आणि प्रतिबंधासाठीच्या धोरणांवर पुढील अभ्यासाची आवश्यकता आहे.

जीईआरडी (GERD) मुख्यत्वे स्फिंक्टरमधील (sphincter) विकृतीमुळे होतो, जो पोटातील अन्ननलिकेत परत येण्यापासून रोखण्यासाठी पोट आणि अन्ननलिका घट्ट करतो; दाब कमी होणे, पोटातील अन्नपदार्थ वाढणे, आणि पोटातील दाब वाढणे हे देखील या आजाराशी संबंधित असल्याचे ज्ञात आहे. छातीत जळजळ आणि ॲसिड रिफ्लक्स ही जीईआरडीची वैशिष्ट्यपूर्ण लक्षणे आहेत, आणि काही रुग्णांना असामान्य पोटदुखी, अपचन, मळमळ, पोट फुगणे आणि ढेकर येणे यांचा अनुभव येतो [3]. जीईआरडीवरील उपचारांचा उद्देश वेदना कमी करणे, ॲसिड रिफ्लक्स कमी करणे, जखमा भरणे आणि गुंतागुंत व पुनरावृत्ती टाळणे हा असतो. रुग्णाचा वैद्यकीय इतिहास आणि तीव्रता लक्षात घेऊन, जीवनशैलीत बदल आणि औषधोपचार या दोन टप्प्यांत उपचारात्मक पद्धती अवलंबल्या गेल्या [4]. प्रोटॉन पंप इनहिबिटर हे जीईआरडीसाठी प्राथमिक औषध आहे; तथापि, काही रुग्ण उपचारांना प्रतिसाद देत नाहीत आणि अनेक उपचारात्मक चाचण्या घेण्यात आल्या आहेत. जीईआरडी सहजपणे पुन्हा उद्भवतो परंतु तो अल्सर, बॅरेटची अन्ननलिका (Barrett’s esophagus) आणि पुढे कर्करोगापर्यंत वाढू शकतो.  म्हणून, GERD च्या उपचारासाठी आणि प्रतिबंधासाठी जीवनशैली, आहाराच्या सवयी आणि औषधोपचारांमध्ये बदल करणे आवश्यक आहे [5].

पूर्वीच्या अभ्यासातून असे दिसून आले आहे की, सिगारेट ओढणे आणि मद्यपान यांसारख्या अनेक जीवनशैलीच्या सवयींमुळे अन्ननलिकेच्या स्फिंक्टरवरील दाब कमी होतो. मद्यपानाचा संबंध रिफ्लक्सची लक्षणे वाढण्याशी आणि अन्ननलिकेचा जठरातील आम्लाशी संपर्क वाढण्याशी आहे [6]. GERD ची लक्षणे तंबाखूच्या सेवनाशी देखील संबंधित आहेत [7, 8]. आहाराच्या सवयींचा GERD शी लक्षणीय संबंध आहे, ज्यामध्ये कॅफीनयुक्त पेये, कार्बोनेटेड सोडा, चरबीयुक्त पदार्थ, चॉकलेट आणि आंबट व तिखट पदार्थांच्या सेवनाचा समावेश आहे [9].

याव्यतिरिक्त, जलद खाणे आणि अति खाणे यामुळे जठरातील आम्लाचा अतिरिक्त स्राव होऊ शकतो, ज्यामुळे अन्ननलिकेच्या श्लेष्मल त्वचेला नुकसान पोहोचते आणि GERD होतो [10].

GERD शी संबंधित अस्वास्थ्यकर जीवनशैली आणि आहाराच्या सवयी तरुण लोकसंख्येमध्ये दिसून येतात.  २०२१ च्या राष्ट्रीय आरोग्य आणि पोषण तपासणी सर्वेक्षण अहवालानुसार, २०-३० वयोगटातील अंदाजे ६४% लोक महिन्यातून किमान एकदा मद्यपान करत होते, जे संपूर्ण वयोगटात सर्वाधिक होते [११]. याव्यतिरिक्त, त्या तरुण प्रौढांपैकी २०% सध्या तंबाखूचे सेवन करतात (ज्यामध्ये त्यांच्या आयुष्यात पाच किंवा अधिक सिगारेटची पाकिटे ओढणाऱ्यांचा समावेश आहे) आणि हे प्रमाण संपूर्ण लोकसंख्येत सर्वाधिक होते [११]. तरुण लोकसंख्या जास्त प्रमाणात चरबीयुक्त पदार्थ (उदा. रामेन, तळलेले चिकन/स्ट्रिप्स), मिठाई, कार्बोनेटेड पेये आणि कॉफी यांचे सेवन करत होती, ज्यामुळे अन्ननलिकेच्या खालच्या स्फिंक्टरवरील (LES) दाब कमी होतो आणि शिवाय, त्यांच्या आहाराच्या गुणवत्तेचा निर्देशांक लोकसंख्येत सर्वात कमी होता [११, १२]. ही आहाराची सवय GERD च्या जोखमीच्या घटकांपैकी एक असू शकते, तरीही बहुतेक अभ्यास रुग्णालयांमध्ये केस-कंट्रोल स्टडी डिझाइनवर आधारित केले गेले आहेत [७, १३, १४]. २०-३० वयोगटातील अशा तरुण प्रौढांविषयी आणि सामान्य लोकसंख्येविषयीचे संशोधन मर्यादित आहे.

म्हणून, या अभ्यासाचा उद्देश तरुण कोरियन प्रौढांमधील GERD ची लक्षणे, जीवनशैली आणि आहाराच्या सवयी यांच्यातील संबंध तपासणे हा होता.

या अभ्यासात ग्वांगजू महानगरात राहणाऱ्या तरुण कोरियन लोकांचे विश्लेषण करून 1) प्रश्नावलीचा वापर करून GERD प्रकरणांचे प्रमाण आणि 2) GERD च्या विविध प्रकारांनुसार (फेनोटाइप्सनुसार) जीवनशैली, आहाराच्या सवयी आणि आहारातील फरक निश्चित करण्यात आले.

हा अभ्यास तरुण कोरियन प्रौढांमधील GERD च्या प्रतिबंध आणि व्यवस्थापनासाठी जीवनशैली आणि आहाराच्या सवयी समजून घेण्यासाठी प्राथमिक पुरावे प्रदान करतो.

Gerd and dietary life style behavior Korian

 Ref

Korean Journal of Community Nutrition logo

Korean J Community Nutr. 2024 Oct 31;29(5):396–405. doi: 10.5720/kjcn.2024.00011

Associations between the symptoms of gastroesophageal reflux disease and dietary and lifestyle behavior among young Korean adults: a preliminary cross-sectional study

Soheun Shim 1,*, Jeong-Hwa Choi 2,*, Young-Ran Heo 3,†

Abstract

Objectives

Gastroesophageal reflux disease (GERD) is a clinical condition caused by esophageal tissue damage 

resulting from the reflux of stomach or duodenal contents. An increasing number of GERD cases have been reported recently; however, research on this population, especially young adults, is lacking. This study aimed to investigate the dietary and lifestyle factors associated with GERD symptoms in young Korean adults.

INTRODUCTION

Gastroesophageal reflux disease (GERD) is defined as a set of symptoms associated with tissue damages in the esophagus caused by the reflux of the stomach or duodenal contents [1]. 

According to big data analyses of the Health Insurance Review and Assessment Service [2], 

the total number of cases of GERD (code: K21) increased by approximately 6.1% from 4.58 million in 2019 to 4.86 million in 2021. Additionally, the number of patients in their 20s increased from 389,162 to 467,973, and those in their 30s rose from 532,964 to 574,936 during the same period, 

resulting in annual prevalence increase of approximately 20.3% and 7.8%, respectively from 2019 to 2021. The prevalence rates among individuals in their 40s–50s and those aged 60 and older were consistently higher, 

around 11% and 14%, respectively, compared to the 20s–30s group. While these higher rates remained stable, the prevalence in the younger group, in their 20s–30s, has shown a gradual upward trend [2]. Therefore, further

 studies on the strategies for GERD care and prevention in this young population are required.

GERD is mainly caused by abnormalities in the

 sphincter that tightens the stomach and esophagus to prevent the reflux of stomach contents into the esophagus; a decrease in pressure, an increase in stomach contents, and an increase in pressure inside the stomach and abdominal pressure are also known to be associated with the disease. Heartburn and acid reflux are typical symptoms of GERD, and some patients experience atypical abdominal pain, indigestion, nausea, bloating, and belching [3]. Treatment of GERD aims to relieve pain, reduce acid reflux, heal wounds, and prevent complications and recurrence. Therapeutic approaches were performed in two steps, lifestyle modification and medication, considering the patient’s medical history and severity [4]. Proton pump inhibitors are the primary medication for GERD; however, some patients do not respond to treatment, and multiple therapeutic trials have been conducted. GERD easily recurs but can progress to ulcers, Barrett’s esophagus, and further malignancy. Therefore, changes in lifestyle, dietary behavior, and medications are essential for the treatment and prevention of GERD [5].

Earlier studies suggested that several lifestyle habits, including cigarette smoking and alcohol consumption, 

lower the pressure on the esophageal sphincter. Alcohol consumption is associated with increased

 reflux symptoms and esophageal exposure to 

gastric acid [6]. The symptoms of GERD are also associated with tobacco use [7, 8]. Dietary behavior is significantly associated with GERD, including consumption of 

caffeinated drinks, carbonated soda, fat-rich foods, chocolate, and sour and savory foods [9].

 Additionally, eating fast and overeating can lead to

 excessive secretion of stomach acid, which damages the esophageal mucosa, leading to GERD [10].

Unhealthy lifestyles and dietary habits related to GERD are evident in younger population. According to 2021 the National Health and Nutrition Examination Survey reports, approximately 64% of people in their 20s–30s had alcohol at least once a month, which was the highest in the entire age group [11]. Additionally, 20% of those young adults are currently smoking tobacco (including those who smoked five or more packs of cigarettes in their lifetime) and this ratio was the highest among the entire population [11]. The young population also had more fatty foods (e.g. ramen, fried chicken/strips), sweets, carbonated drinks, and coffee, which lower the pressure on the lower esophageal sphincter (LES), and further their dietary quality index scored lowest in the population [11, 12]. This dietary behavior could be one of the risk factors of GERD, yet majority of studies performed in the hospital based with a case-control study design [7, 13, 14]. Research regarding such young adults in their 20-30s and general population is limited.

Therefore, this study aimed to examine the association between GERD symptoms, lifestyle, and dietary behaviors in young Korean adults. This study analyzed young Koreans living in Gwangju Metropolitan City to ascertain 1) the prevalence of GERD cases using a questionnaire and 2) the differences in lifestyle, dietary behavior, and intake between GERD phenotypes. This study provides preliminary evidence for understanding lifestyle and dietary behaviors for the prevention and management of GERD in 

young Korean adults.

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