Oral glutamine supplementation in Inflammatory Bowel Disease patients: Quality of life matters
Bibliographic record
Abstract
Ulcerative colitis (UC) and Crohn's disease (CD) are inflammatory bowel diseases (IBD), which mostly appear in a relapsing remitting form. During acute episodes, patients' quality of life is often highly deteriorated, as bloody diarrhea and abdominal pain are common symptoms. Despite improvements in diagnostic and therapeutic strategies, the treatment of IBD is still unsatisfactory, as conventional therapy to induce and maintain remission mainly works in a symptomatic style, merely suppressing the immune response. Within nutritional therapy, L-glutamine (GLN) is a promising candidate to exert a protective function on altered intestinal mucosa. In this randomized, double-blind, placebo-controlled pilot study, we investigated the effects of an 8-week application of a GLN-containing oral nutrition supplement in 22 corticosteroid-treated IBD patients (8 UC, 14 CD) with moderate and severe inflammatory episodes, on health-related quality of life, judged by the intestinal bowel disease questionnaire (IBDQ, ©McMaster University, Canada) and on disease activity, measured by the Crohn's disease activity index (CDAI) and the colitis activity index (CAI), respectively. Patients received either an oral nutritional supplement containing 10 grams of GLN, vitamins, electrolytes and trace elements or an equal composition devoid of GLN (placebo). IBDQ, CAI, CDAI, and the amount of required corticosteroids were assessed at baseline, and after 2, 4, 6, 8, and 12 weeks of investigational product administration. For group comparisons of metric and ordinal variables the Mann-Whitney-U-test was used. All tests are two-tailed with a confidence level of 95%; no adjustment for the type-I-error was made. 18 of the 22 recruited patients completed the study according to the protocol. Although there were no marked group differences in the overall IBDQ-score, the bowel sub-score, reflecting bowel specific issues, improved more in the GLN group than in the placebo group (after 8 weeks: p= .032). This observation was similar for UC and CD patients. Presumably due to the low numbers of patients, the clear tendencies towards a GLN-specific IBDQ bowel sub-score improvement could be reproduced only partially in the disease-specific scores (CDAI, CAI). Regarding corticosteroid medication during GLN-application, no relevant differences were seen in both, duration and quantity of corticosteroid-usage. The application of GLN in IBD-patients tends to improve the healthrelated quality of life, and might exert beneficial effects on disease activity. However, as the results of our study are merely descriptive, follow-up studies with higher case numbers and a confirmatory design are needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".