Briefs

Probiotics may help to reduce gut symptoms caused by long-term stress, indicates research published in the journal Gut. The researchers base their findings on analysis of gut tissue taken from rats subjected to either water avoidance stress, which involves placing the rat on a small platform surrounded by water, or sham stress for one hour a day for 10 consecutive days. The stress sessions were designed to mimic psychological stress to produce the type of effects that would be seen in the human gut.

Half the rats were fed drinking water containing probiotic bacteria in the form of Lactobacillus helveticus and Lactobacillus rhamnosus for a period of seven days before and during the stress sessions. Unlike sham stress, brief but repeated water deprivation made the gut “leaky” and boosted the adherence of harmful bacteria to the cells lining the gut wall.

Bacteria were also detected in the mesenteric lymph nodes, which drain fluid coming from the intestine, indicating that bacteria had entered the body and activated the immune system. However, probiotic treatment minimized the changes in chemical signaling and prevented bacterial “stickiness” and movement to the mesenteric lymph nodes.

Chronic stress is known to be implicated in the development of irritable bowel syndrome and in the worsening of symptoms of inflammatory bowel disease, such as Crohn’s disease and ulcerative colitis. It also sensitizes the gut, producing allergies to certain foodstuffs. The authors say that probiotics literally compete for space with harmful bacteria and dampen down inflammatory responses, and as such, offer a potentially promising approach to the management of intestinal problems caused by stress.

BETHESDA, Md. and LINCOLNSHIRE, Ill.— Sucampo Pharmaceuticals, Inc. and Takeda Pharmaceuticals North America, Inc., announce that AmitizaTM (lubiprostone), 24- mcg soft-gel capsules, approved by the Food and Drug Administration (FDA) in January 2006, is now available for the treatment of chronic idiopathic constipation in adults.

Amitiza is the first selective chloride channel activator approved for therapeutic use in chronic idiopathic constipation, a condition that affects both men and women and affects patients over the age of 65 more frequently.

Amitiza works by increasing fluid secretion locally in the small intestine by activating the ClC-2 chloride channel, and thereby increasing the passage of the stool and improving symptoms associated with chronic idiopathic constipation. In clinical trials, 60 percent of patients who used Amitiza experienced a spontaneous bowel movement within the first 24 hours.

OAK BROOK, Ill. — After a year of intense effort, the Task Force on Quality in Endoscopy, a joint effort of the American Society for Gastrointestinal Endoscopy (ASGE) and the American College of Gastroenterology (ACG), has developed quality indicators for the four major endoscopic procedures: colonoscopy, esophagogastroduodenoscopy (EGD, also known as upper endoscopy), endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography (EUS).

The ASGE and the ACG formed the task force to identify objective measures that could be used to define high-quality endoscopic services for the diagnosis and treatment of diseases and conditions of the digestive tract. The task force, led by Douglas O. Faigel, MD, FASGE, Oregon Health & Science University, Portland, and Irving M. Pike, MD, FACG, Gastroenterology Consultants, Virginia Beach, Va., recommends that these guidelines be adopted by facilities where endoscopic procedures are performed.

“We cannot leave the standards-setting to an administrative or regulatory agency with little experience in the practice of endoscopy. It is our responsibility to ensure high-quality care for our patients,” said Robert Hawes, MD, FASGE, ASGE president, professor of medicine at the Digestive Disease Center at the Medical University of South Carolina. The series of papers released on quality indicators for endoscopy were published as a supplement to the April 2006 issue of GIE: Gastrointestinal Endoscopy, the official peer-reviewed publication of ASGE, and within the April 2006 issue of The American Journal of Gastroenterology, the official peer-reviewed publication of ACG.

The Quality Indicators papers serve as a reference for physicians trained in endoscopy who can use the indicators to assess, measure, and improve their performance. “We know that it will not be feasible for the endoscopist to reach 100 percent compliance with every indicator, in every patient, in all cases. We also recognize that there are many areas requiring further study. This effort, however, represents a major commitment within endoscopy to improving the quality of patient care through evidence-based measures,” said Jack A. DiPalma, MD, FACG, ACG president and director of the division of gastroenterology at the University of South Alabama.

“Quality Indicators for Gastrointestinal Endoscopic Procedures” can be accessed at www.asge.org/nspages/practice/patientcare/quality/index.cfm or by calling ASGE at (630) 573-0600, at www.amjgastro.com, or by calling ACG at (301) 263-9000.

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