Middle East Journal of Digestive Diseases
Volume:9 Issue: 3, Jul 2017

Prevalence of gastroesophageal reflux disease (GERD) is increasing worldwide. We aimed to estimate the prevalence of GERD in Pars Cohort Study (PCS) and to find its correlates.
We used the baseline data from PCS. PCS was conducted in the district of Valashahr in Fars province in southern Iran from 2012 to 2014. 9264 inhabitants who were 40-75 years old, and agreed to participate were enrolled. Data were collected by a structured questionnaire and simple physical examination of all participants.
Generally, 58.50% (95% CI 57.49-59.51) of the participants had GERD and 25.10% (95% CI 24.22-25.99) experienced it at least weekly. Approximately, 32.0%, 52.0%, and 24.4% of the participants reported heart burn sensation, regurgitation, and both symptoms, respectively. Being female (OR: 1.45, 95% CI 1.27-1.65), being older (OR: 1.20, 95% CI 1.06-1.36), being divorced/ widowed/ separated (OR: 1.38, 95% CI 1.01-1.91), and lower education (OR: 1.43, 95% CI 1.02-2.03) were associated with frequent GERD.
GERD is common in PCS and its prevalence is close to that in western countries. Being female, higher age, being divorced/ widowed/ separated, lower education, history of hypertension, anxiety, insomnia, and non-cigarette tobacco smoking were associated with frequent GERD. We are going to investigate the causal relationship between these risk factors and GERD in the next stages of PCS.

Migraine is one of the prevalent headaches. Many of patients with migraine, complain of gastrointestinal symptoms. There is limited studies on relation of gastrointestinal symptoms and migraine headache at population level.
In this population-based study, 1038 subjects older than 15 year from a rural area in Fars province, south of Iran. were investigated for functional gastrointestinal disorders. By cluster random sampling , 160 of these persons invited to receive endoscopy along with histopathology samples of upper gastrointestinal tract. Data were analyzed using Pearson chi-square and Fisher exact.
Mean age of participations were 34.3 years with female to male of 3:1. The prevalence of migraine, irritable bowel syndrome (IBS) , reflux, and dyspepsia were 24.6%, 17.7%, 17.4%, and 32.1%, respectively. There were significant relationship between migraine and functional gastrointestinal diseases (odds ratio of association for migraine with IBS, reflux, and dyspepsia were 3.43, 1.68, and 1.68 with p-valueIn this population based study we found significant association between migraines and gastrointestinal functional disorders including IBS, reflux and dyspepsia. This may have implication in better management of patients with migraine headache.

Pancreatic cancer (PC) is a deadly disease with a 5-year survival of less than 5%. Worldwide PC incidence rates are lower among women than men. While this suggests a protective role for steroid hormones in PC risk, results from epidemiological studies are not consistent.
153 new incident PC cases and 202 controls were recruited from a prospective case–control study, running in a referral center for endoscopic ultrasonography during 2011-2017. A structured valid and reliable questionnaire was used for data collection by a few trained interviewers. Odds ratios and 95% confidence intervals for reproductive factors and PC were estimated using logistic regression methods.
Mean age (SD) of the cases and the controls were 63.18 (11.4) and 63.37 (12.0) years, respectively. Age at menarche, age at menopause, number of parity, gravidity, and abortion were not associated with PC risk.
This study does not support the hypothesis that menstrual and reproductive factors are associated with PC risk.

According to previous studies, probiotic and prebiotic supplementation have desirable effects on glycemic parameters. Thus far, the effect of supplementation on the glycemic parameters and adipokines in non-alcoholic fatty liver disease (NAFLD) has not been assessed. Therefore, the aim of this study was to determine the effects of supplementation with probiotic and prebiotic on adiokines and glycemic parameters in the patients with NAFLD.
In the present randomized, double-blind, placebo-controlled trial, 89 patients with NAFLD were randomly divided into three groups to receive one probiotic capsule 16 g/d maltodextrin (probiotic group) or 16 g/d oligofructose powder one placebo capsule (prebiotic group), and one placebo capsule 16 g/d maltodextrin (control group) for 12 weeks. All the subjects in the study were advised to follow the weight loss diet and physical activity recommendations during the intervention. Fasting blood samples were taken at baseline and after the intervention to measure leptin, adiponectin, insulin, and fasting blood sugar.
At the end of the study, serum concentrations of leptin, insulin, and HOMA-IR decreased significantly in the probiotic and prebiotic groups compared with the control group. Despite the changes within the groups, serum concentrations of adiponectin did not change significantly between the three groups. Also, fasting blood sugar did not change between the groups, but decreased in the prebiotic group. Quantitative insulin-sensitivity check index (QUICKI) increased significantly in probiotic and prebiotic groups compared with the control group.
Probiotic and prebiotic supplementation along with lifestyle intervention has a favorable impact on glycemic parameters and leptin levels compared with lifestyle intervention alone.

Colorectal cancer (CRC) is a common cancer that results in outstanding morbidity and mortality worldwide. DNA methylation is one of the most important epigenetic events that is thought to occur during the early stages of oncogenic transformation especially in CRC. The aim of this study was to investigate whether hypermethylation of bone morphogenetic protein 3 (BMP3) in tissue samples is implicated in Iranian patients with CRC.
From fresh frozen tissue samples of 30 patients with CRC, the DNA was isolated, treated with sodium bisulfite and analyzed by methylation-specific polymerase chain reaction with primers specific for methylated or unmethylated promoter sequences of the BMP3 gene. Demographic characteristics of the patients including age, sex, tumor grade, location, stage, and TNM classification were evaluated and the relationship between hypermethylation of the gene and clinicopathological features was analyzed.
Methylation of the BMP3 promoter was often present in the DNA extracted from the tumoral tissues. A sensitivity of 56.66% and specificity of 93.3% were attained in the detection of colorectal neoplasia.
We assumed that solely BMP3 methylation analysis in our population is not sufficient to select the gene as a screening biomarker and it should be considered in combination with other markers to screen for detection of colorectal cancer.

This study was done to define some epidemiological aspects of inflammatory bowel disease (IBD), and to describe its characteristics in west of Iran.
In this descriptive study all patient with the diagnosis of IBD who were visited in university‐affiliated medical centers, between 2014 and 2015 were recruited. Their demographic characteristics, disease-related manifestations, complications, disease course and their chief complaints were analyzed.
Of 156 referred individuals, 153 patients had ulcerative colitis (UC) and 3 patients had Crohn’s diseases (CD). The mean age of the patients at diagnosis was 35.69±12.35 (range: 17-80) years with the most common age group of 25-35 years and slight female predominance (51.9%). More urban patients were registered (90.4%) and 57% had high school or upper education. Positive family history of the disease was in 25.6% and 66.6% had four or more family members. Furthermore, 51.9% had left sided colitis and 40.4% had pancolitis with bloody diarrhea (79.5%) and abdominal pain (68.6%) as the most common manifestations.
36.5% had other autoimmune diseases. Multiple flare was seen in 47.4%, most commonly due to drug discontinuation (26.28%). Hospital admission was reported in 34.6%. History of contraceptive pill use was in 38.8% of the female patients.
The demographic and clinical manifestations of IBD are usually the same as other developing countries; however, the rarity of CD is eminent. Although the accurate epidemiological characteristic of IBD in Iran is still obscure, it is not a rare disease as previously thought and it seems that gradual reception of a western lifestyle may be linked to the ongoing rise in IBD.

A young man was admitted due to gastrointestinal obstruction and was diagnosed as having cocoon peritonitis secondary to perforated appendicitis. He suffered from small intestine partial obstruction because of multiple adhesion bands whose obstructive symptoms completely resolved after single balloon enteroscopy. So balloon enteroscopy could be offered as a therapeutic option for partial small intestine obstruction.

Peutz-Jeghers syndrome (PJS) is characterized by scattered black pigmentations on fingers and lips and multiple polyps in the gastrointestinal tract. Patients with PJS often have severe complications secondary to multiple large polyps. Herein, we presented a young woman complicated with a large polyp in her colon without any clinical symptoms. We also emphasized the necessity of early diagnosis and treatment of multiple polyps in such patients.

A 67-year-old man presented with generalized abdominal pain, abdominal distension, and inability of defecation and gas passage, which persisted for two months. The pain was constant, which was first appeared in the epigastric and right upper quadrant (RUQ) regions but gradually became generalized. The pain intensified by bending and eating food while alleviated by lying. The patient complained of constipation, weight loss, and loss of appetite. He also reported a few times of vomiting after eating. He had no diarrhea, fever, icterus, dysuria, hematuria, shortness of breath, and coughing. There was no blood in the stool.

We are extremely grateful for the communication of acceptance received regarding the letter to the editor dated 03.06.2017. Please find attached the revised letter to the editor as per the recommended suggestions.
In a brief report on “Correlation between cut-off level of tissue transglutaminase antibody and Marsh classification” published in October 2016 by Azita Ganji et al, the role of Immunoglobulin A- tissue transglutaminase (IgA- tTG) has been adequately explained. However, certain discrepancies have been noticed.