Aim: To explore the preparedness of adult student nurses in relation to providing gastrointestinal care once qualified. Background: With an estimated 6.5 million adults in the UK experiencing with some form of bowel problem (NHS England, 2019), bowel care is a fundamental area of nursing that is frequently overlooked. The pre-registration nursing curriculum ( NMC, 2018 ) within the UK is well-placed to equip students to become confident and proficient upon qualification, ensuring the provision and delivery of safe, compassionate, person-centred care. There is limited evidence specific to GI care; preparedness is largely inferred from broader studies. Method: With identified keywords, a structured database search took place resulting in the selection of 12 primary research papers deemed relevant to this review. Findings: A thematic analysis led to the identification of 5 themes; teaching methods, exposure to practice, students’ sense of preparedness, gaps in education practice and coping strategies. Conclusion: This literature highlights the preparedness of student nurses, contributing valuable insights by incorporating their perspective on pre-registration education for GI care. However, no direct evidence on nurses’ GI preparedness was found. Further research is needed to explore how GI education is integrated into pre-registration programmes and its impact on students’ ability to apply theory to practice.
Background: Hemorrhoids and anal fissures are common anorectal disorders with multifactorial etiologies. This study aimed to assess the prevalence and associated factors of these conditions in patients referred for colonoscopy. Methods: In this cross-sectional study, 536 individuals aged 35–70 years undergoing colonoscopy at Razi Hospital in Rasht, Iran, were enrolled. Patients with a history of inflammatory bowel disease, malignancy, or colectomy, and pregnant women were excluded. Colonoscopic findings were assessed by a gastroenterologist and confirmed histologically. Demographic, lifestyle, and anthropometric data were collected, including age, sex, education, habitat, BMI, WHR, physical activity, smoking, and alcohol use. Logistic regression was used to identify factors associated with hemorrhoids and fissures. Results: Hemorrhoids were diagnosed in 55.8% and fissures in 17.9% of participants. Higher education levels (university: OR=0.39, 95% CI: 0.17–0.89) and rural residence (OR=0.68, 95% CI: 0.46–1.00) were inversely associated with hemorrhoids. Anal fissures were significantly associated with younger age (OR=0.98, 95% CI: 0.96–1.00), higher education (diploma: OR=0.44, university: OR=0.31), and low WHR (OR=0.29, 95% CI: 0.14–0.62). Other factors such as sex, BMI, smoking, and physical activity showed no significant associations. Conclusion: Education level, age, and WHR were independently associated with anorectal conditions. These findings suggest the importance of socioeconomic and metabolic factors in the prevention and management of hemorrhoids and fissures and warrant further prospective studies.
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by systemic inflammation and progressive joint destruction. Recent evidence implicates the gut microbiota as a critical factor in RA pathogenesis through mechanisms such as intestinal barrier disruption, molecular mimicry, and immune modulation. This review examines the emerging role of gut dysbiosis in RA development and progression, highlighting how imbalances in microbial communities may trigger or exacerbate autoimmune responses via increased intestinal permeability, shared epitopes, and Th17/Treg cell dysregulation. Particular attention is given to the therapeutic potential of postbiotics as novel interventions in RA. Postbiotics, including short-chain fatty acids (SCFAs), exopolysaccharides, and microbial-derived vitamins, exhibit anti-inflammatory, immunoregulatory, and barrier-protective effects with favorable safety profiles. These compounds influence immune tolerance, modulate cytokine production, and reinforce gut integrity, offering promising microbiome-targeted strategies for managing RA. This review advocates for the continued investigation of postbiotics as adjunct or alternative therapeutics in autoimmune diseases, especially RA.
Background Accurate preoperative staging is essential in rectal cancer, particularly in patients managed without neoadjuvant therapy, where initial magnetic resonance imaging findings directly inform surgical decision-making. Evidence describing magnetic resonance imaging–pathology concordance in this specific clinical context remains limited. Methods This single-centre retrospective service evaluation included consecutive patients with rectal adenocarcinoma who underwent primary surgery without neoadjuvant therapy between June 2022 and August 2025. Preoperative pelvic MRI staging (T stage, nodal status, and extramural venous invasion) was compared with postoperative histopathology. Concordance, rates of over and understaging, and diagnostic performance metrics were calculated. Given the small sample size, results are descriptive. Results Twenty-nine patients were included. Magnetic resonance imaging correctly staged T category in 62% and nodal status in 55% of cases. For distinguishing ≥T3 disease (n=27), sensitivity was 64.3% (95% CI 38.8–83.7), specificity 76.9% (95% CI 49.7–91.8), and overall accuracy 70.4% (95% CI 51.5–84.1). Nodal staging showed poor sensitivity at 18.2% (95% CI 5.1–47.7) with accuracy of 55.2% (95% CI 37.5–71.6). EMVI concordance was limited, with both false-positive and false-negative Magnetic resonance imaging assessments observed. Conclusions In this small single-centre retrospective cohort, magnetic resonance imaging demonstrated moderate performance for T staging but limited reliability for nodal and EMVI assessment in rectal cancer patients undergoing primary surgery without neoadjuvant therapy. These findings support cautious interpretation of magnetic resonance imaging staging in early disease and highlight the need for improved standardisation and larger prospective studies.
Roux-en-Y gastric bypass has emerged as an effective treatment for severe obesity, with biliopancreatic limb length playing a crucial role in the procedure's success. This review explores the significance of biliopancreatic limb length in gastric bypass surgery outcomes, particularly its impact on weight loss, nutritional status, and resolution of obesity-related comorbidities. While there is no universal consensus on the optimal method for determining biliopancreatic limb length, the trend is towards a more personalised approach that considers multiple patient factors and surgical considerations. Ongoing research aims to provide more evidence-based guidelines for optimal limb length determination in Roux-en-Y gastric bypass surgery. This review discusses factors influencing biliopancreatic limb length decision making, including body mass index, comorbidities, age, and nutritional status. Longer biliopancreatic limbs may enhance weight loss and metabolic benefits but increase the risk of nutritional deficiencies, while shorter biliopancreatic limbs may reduce malabsorption risks but potentially limit weight loss outcomes. The final decision on biliopancreatic limb length often involves carefully balancing potential benefits and risks for each patient. Surgeons must consider the patient's overall health status, risk factors for nutritional deficiencies, likelihood of compliance with post-operative supplementation regimens, and long-term weight loss goals. Additionally, the combined length of the biliopancreatic limbs and Roux limb must be considered to ensure an adequate common channel length for nutrient absorption.
Dysbiosis of gut microbiota has been increasingly acknowledged as a significant factor in the development of inflammatory bowel disease and colorectal cancer. Changes in the composition and functioning of the gut microbial community can result in chronic inflammation and encourage tumour formation in the colorectal region. This review outlines the current understanding of gut microbiota changes linked to inflammatory bowel disease and colorectal cancer and examines treatment strategies aimed at restoring microbial balance. In particular, the authors emphasise the potential of probiotics and fecal microbiota transplantation as promising methods to modify the gut ecosystem, reduce inflammation and enhance clinical outcomes. The effectiveness, mechanisms and challenges associated with these approaches are discussed, underscoring their importance in disease prevention and management. Additional research is necessary to refine these treatments and fully understand their long-term effects.
This study aimed to examine the association between support garment use, comfort, and early stoma complications among individuals living with a stoma. This descriptive and comparative study was conducted with 132 adults who had undergone stoma surgery at least one month prior. Data were collected through face to face interviews using a patient identification and stoma complications follow up form and the General Comfort Questionnaire–Short Form. Descriptive statistics and comparative analyses were performed to evaluate differences between individuals who used support garments and those who did not. Among the participants, 25.8% reported using support garments, most commonly stoma belts (70.5%). No statistically significant differences were observed between support garment users and non users in terms of demographic or clinical characteristics. Early stoma complications, including irritant dermatitis, parastomal hernia, and mucocutaneous separation, did not differ significantly between the groups. The overall mean comfort score was high (Mean = 4.55, SD = 0.86). Participants who used support garments both during the day and at night reported higher comfort scores than those who used them only during the day; however, these differences did not reach statistical significance. Support garment use was not associated with statistically significant differences in comfort levels or early stoma complications. Nevertheless, when appropriately selected and used, support garments may contribute to perceived security and physical comfort as part of individualized stoma care. These findings support a tailored rather than a routine approach to support garment recommendations in clinical practice.
