فهرست مطالب ترنگ تقوایی

Mahboobe Ebrahimi1,
 Hafez tirgar Fakheri2,
Tarang Taghvaei3,
Iradj Maleki2,
Vahid Hosseini3,
 Arash Kazemi Veisari1,
Zohre Bari1,
Hajar Shokri-Afra4,
Sepehr tirgar Fakheri5

1 Assistant Professor, Gut and Liver Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
2 Professor, Gut and Liver Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
3 Associate Professor, Gut and Liver Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
4 PhD in Clinical Biochemistry, Gut and Liver Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
5 General Physician, Gut and Liver Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran

In the article published in volume 32, issue 209, 2022, the affiliation of Iradj Maleki was published incorrectly, which is now corrected.

Background and

Public vaccination was highly recommended during the COVID-19 pandemic. The lack of evidence-based data made inflammatory bowel disease (IBD) patients hesitant to receive the vaccine. In this study, clinical and laboratory outcomes of COVID-19 vaccination were investigated in patients with IBD.

This retrospective study was conducted on patients with IBD who referred to gastroenterology clinics across Sari during 2021-2022. Patients' information including demographic data and laboratory parameters were recorderd. Clinical outcomes of IBD based on the partial Mayo score in ulcerative colitis and the Harvey-Bradshaw index in Crohn's were compared before vaccination and within three months after receiving the second vaccine.

A total of 111 patients with IBD, including 100 ulcerative colitis patients and 11 Crohn's patients met the inclusion criteria for the study. The two groups were matched for distribution of age, gender, and disease extent. In addition, there was no significant difference between the groups in COVID-19 infection frequency, COVID-19 severity, type of vaccines received, and vaccine injection frequency. No significant differences were observed in clinical outcomes and laboratory parameters between the patients before being vaccinated and after receiving the second dose of vaccine. There were no changes in the type of IBD drugs within three months after getting the second vaccine, except for steroid prescription increase in ulcerative colitis patients (4% vs. 10%, P<0.01). Moreover, a statistically significant correlation was found between steroid necessity and partial Mayo score (r=0.658, P<0.001).

Receiving at least two doses of COVID-19 vaccines did not change the clinical outcomes and laboratory parameters of IBD patients. The results of this study are promising and can reduce possible concerns in IBD patients regarding the use of vaccines against COVID-19.

Autoimmune hepatitis is a chronic liver inflammatory disease of unknown etiology that is more common in women. The goal of this study was to investigate the clinical, histopathological, laboratory, and elastography findings and outcome in patients with autoimmune hepatitis and verifying the factors associated with treatment response in Sari, Iran.

This research is a descriptive study in which demographic, clinical, histopathological, laboratory and elastographic information of 136 autoimmune hepatitis patients referred to Imam Khomeini Hospital and specialized gastrointestinal clinics in Sari during the years 2019-2021 was recorded in a pre-designed questionnaire.

In the study of the relationship between demographic, laboratory, histopathological, elastographic, and clinical factors with response to treatment, only prothrombin time (PT) and platelet (PLT) count had a significant relationship with response to treatment (p < 0.05). In fact, thrombocytopenia and high PT led to poor treatment response and high PT was associated with a higher probability of recurrence. There was also a significant relationship between cirrhosis and non-cirrhosis at the time of diagnosis with response to treatment (p < 0.05). People with cirrhosis experienced less response to treatment. None of the factors mentioned were related to the new cirrhosis (p < 0.05). In the study of the relationship between the results of the initial and subsequent liver fibroscan during the follow-up, the reduction of fibrosis following treatment was clearly seen.

Liver elastography is recommended for fibrosis evaluation during treatment and follow-up.

Clinical trials and meta-analyses have reported about 20% failure rates in first-line Helicobacter pylori (H. pylori) eradication. This reflects the need for effective second-line eradication regimens.
61 patients with H. pylori infection who had failed previous non-bismuth clarithromycin-containing first line therapies entered the study. They were given a 14-day levofloxacin-containing triple regimen consisted of pantoprazole 40 mg, amoxicillin 1gr, and levofloxacin 500mg, each given twice daily. Eight weeks after the treatment, H. pylori eradication was assessed by 14C-urea breath test.
All patients completed the study. The eradication rate was 91.8% (95% confidence interval = 84.9% – 98.6%) by both intention to treat and per-protocol analyses. Side effects of therapy were reported by eight patients (13.1%), but they were severe in only two patients (3.2%).
According to the high H. pylori eradication rate and the very low rate of severe adverse effects, levofloxacin-containing triple therapy seems to be a suitable second-line option in case of previous failure by clarithromycin-containing therapies. We suggest further studies with shorter duration of treatment or lower dose of levofloxacin.

Background and Suitable sedation during gastrointestinal (GI) tract endoscopy leads to the patient’s and the physician’s satisfaction and enhances the quality and the adequacy of the procedure.
In a clinical trial, 140 patients were randomly assigned into two groups in order to compare the adequacy of upper GI tract endoscopy after choosing the type of sedation by either the physician or the patient who were provided with educational pamphlets.
Among 70 patients for whom the type of sedation was chosen by the physician, 15.7% received just local Lidocaine spray, 65.7% received Lidocaine spray intravenous (IV) Midazolam, and 18.5% received Lidocaine spray I.V. Midazolam I.V. Pethidine. No patient needed any change in the dose or type of sedation. From 70 patients in the second group 13 (18.5%) chose just Lidocaine spray, but almost half of these patients could not tolerate the procedure and received I.V. Midazolam. Also, 41 (58.5%) chose Lidocaine spray I.V. Midazolam, but 2 of them received I.V. Pethidine due to intolerance. Furthermore, 16 patients (22.8%) chose Lidocaine I.V. Midazolam I.V. Pethidine, but one of them received I.V. Propofol due to intolerance.
Patient’s right to make decisions is an important issue in choosing the type of sedation for endoscopy, nevertheless, a considerable number of patients cannot make an appropriate decision independently.

Background and Crohn disease (CD) is an autoimmune disorder in which a failure of tolerance to the intestinal antigens plays a pivotal role in the pathogenesis of this disease. Treg cells control immune responses to self and foreign antigens and have an important role in maintaining self-tolerance. In this study we evaluated the frequency of Tregs in the peripheral blood of patients with Crohn disease compared with healthy control group. In a case-control study, 18 patients with Crohn disease and 20 healthy volunteers were enrolled. Blood sampling was done in both patients and controls and peripheral blood mononuclear cells were isolated. Then, the frrequency of CD4+CD25+FoxP3+CD127low/– Tregs and CD4+CD25+FoxP3– activated effector T cells were evaluated by flow cytometry. Data analysis was performed in GraphPad Prism and SPSS. The results showed that the frequency of Treg cells in the peripheral blood of CD patients was significantly lower compared to that of the healthy controls. In addition, a significant decrease in Treg/activated effector T cells ratio was observed in CD patients compared to controls. The results showed that Crohn disease is associated with a decrease in the peripheral blood Tregs pool. Moreover, it seems that the balance between Tregs and effector T cells is disturbed in CD patients.

Ramadan fasting is the implementation of a full and regular body and mental health care، which is considered both. It is scientifically proven that Ramadan fasting not only causes Mental Relaxation، But also Causes Increase in Endorphin hormones، which Helps Recovery Mental condition. These events Cause Relief and increase consciousness in fasting person. The question is fasting is good for health or not. Which patient is able to fast? To answer these questions we decided to review Gastro -intestinal diseases and effect of fasting with them.

Background and Celiac disease (CD) is a genetic disorder that causes inflammation in the lining of the small intestine. Recent literature has shown a relation between inflammatory bowel disease and celiac disease. This study aimed at determining the prevalence of celiac disease in patients with ulcerative colitis (UC). In this cross-sectional study 84 patients (aged 17-79 years of old) with UC underwent screening test for CD. Anti TTG Ab and Total IgA Ab were checked for all patients. The mean age of the patients was 39.26±13.29 years. In all cases Anti TTG and Total IgA Ab were negative. In this study we found no association between CD and UC. However, more studies with larger sample size are recommended to find the exact relation between these diseases.

Undoubtedly, H. pylori is the major human gastric pathogen, which infects the mucosal epithelium in 50% of world population. However, H. pylori infection is relatively prevalent globally; the majority of infected individuals are asymptomatic. The recent epidemiological studies show that the various gastro intestinal complications can be the result of genetic variation in H. pylori strains. To date, different virulence factors had been suggested for H. pylori, but none of them can be a good biomarker for specific gastric disorders. In this review article, we aim to describe a comprehensive view on what we found in H. pylori virulence research in Iran. Hopefully, in parallel with new advances in sequencing systems, we will have better overview of virulence phenomenon of H. pylori in near future.

Metabolic disorders such as dyslipidemia and insulin resistance are associated with progression of non alcoholic fatty liver disease (NAFLD) and can lead to cardiovascular problems، the most common cause of death in these patients. The amount and composition of dietary fat are influential factors for blood lipid and glucose levels. The aim of this study was to assess the effects of virgin olive oil on serum lipid and glucose levels in the NAFLD patients on weight loss diets. This 12 week-clinical trial was carried out on 50 patients with non-alcoholic fatty liver). Subjects were randomly assigned into groups A (receiving the equivalent of 20% of total daily energy requirement from olive oil) or B (receiving their normal consumption of oil. At the beginning and end of the study، dietary intakes، anthropometric parameters، fasting plasma glucose and lipid levels were measured. At the end of the study، as compared to commonly used oil، olive oil resulted in significant reductions of serum triglycerides (P<0. 05)، and TG/HDL-C ratio [identified as an atherogenic index and a powerful predictor of cardiovascular disease risk] (P<0. 05). Consuming a diet rich in virgin olive oil along with a slight weight loss in NAFLD patients، can be effective in the treatment and prevention of the consequences of cardiovascular complications of this disease.

Background and The aim of this study was to compare the proportion of natural killer (NK) and natural killer T (NKT)-like cells in dyspeptic disorders caused by Helicobacter pylori (H. pylori). In a case-control study, 27 patients with gastric cancer (GC), 25 patients with peptic ulcer (PUD), and 22 patients with non-ulcer dyspepsia (NUD) were enrolled. After endoscopic diagnosis, the proportions of NK cells subsets (CD3-CD56+ and CD3-CD16+), as well as NKT-like cells (CD3+CD56+) in peripheral blood were determined by flow cytometry. The frequency of CD8+ and CD8– NK cell subsets were also determined. H. pylori infection was confirmed in all study subjects using the rapid urease test and histopathology. The frequencies of CD3-CD16+ NK, CD3-CD56+ NK, and CD3+CD56+ NKT-like cells in patients with gastric cancer infected by H. pylori were significantly lower than those in patients with non-ulcer dyspepsia (P < 0.001, P = 0.050, and P = 0.020, respectively). However, these cell populations showed no significant difference between the PUD and NUD groups. Further analysis showed that high numbers of CD8– NK cells in the blood were CD56+ and CD16+ phenotypes. This study showed decreased numbers of NK and NKT-like cell populations in patients with gastric cancer compared to those with non-ulcer dyspepsia. It is thus suggested that these cells may limit the prolonged inflammation by H. pylori, which, in turn, reduce the risk of gastric cancer.

Background and Colonoscopy is an invasive short-lasting procedure causes the patient's considerable pain, discomfort and anxiety. Therefore, various types of sedation and analgesia techniques have been used during the procedure. The aim of this study was to compare the quality of sedation/analgesia of propofol-fentanyl and midazolam-meperidine combinations in patients undergoing elective colonoscopy. Eighty-three patients scheduled for elective colonoscopy under sedation were enrolled in this randomized double-blind study. In propofol-fentanil group, patients received fentanyl (1 µg/kg) and propofol (0.5 mg/kg) followed by an infusion of 25 µg/kg/min. Group midazolam-meperidine received meperidine (0.7 mg/kg) with midazolam (0.03 mg/kg). The assessment included measurements of quality of sedation, heart rate, blood pressure, oxygen saturation, and evaluation of the recovery time. The systolic blood pressure, heart rate, and percent of blood oxygen saturation (SPO2) remined stable during the procedure. Sedation level was higher in propofol-fentanil group. Recovery time was 12.68 ± 4.90 and 25.75 ± 2.07 minutes in the propofol-fentanil and midazolam-meperidine groups, respectively (P = 0.023). Propofol-fentanil can provide better sedation, satisfaction and analgesia than midazolam-meperidine during colonoscopy. Therefore, it can be recommend in patients scheduled for elective colonoscopy.

Background and Ulcerative colitis (UC), a subtype of inflammatory bowel diseases (IBD), is an immune-mediated chronic intestinal condition. Changes in the copper (Cu) and zinc (Zn) concentrations have been reported previously in IBD. Due to controversial results, the aim of this study was to evaluate and compare serum and urine levels of Zn and Cu in patients with UC and control group. This case-control study was conducted on 50 patients with UC and 49 healthy volunteers. Urine and venous blood samples were collected from patients and healthy volunteers and separated serum and urine samples were kept at -20oC. Levels of Zn and Cu were measured in blood serum and urine using atomic absorption spectrophotometry. Data were analyzed then. Mean serum levels of Zn and Cu in patients with UC were 72.6 ± 15.2 and 138.3 ± 42.6 μg/dl, respectively; the values in normal individuals were 104.0 ± 37.9 and 110.0 ± 38.5 μg/dl, respectively. Mean urine levels of Zn and Cu in UC patients were 128.7 ± 37.5 and 8.7 ± 2.3 μg/dl, respectively; in normal individuals, the values were 109.0 ± 34.0 and 4.1 ± 1.5 μg/dl, respectively. The differences between the two groups were significant (P < 0.01). In patients, the overall mean Zn concentration in serum was lower and in urine was greater than the controls. The serum and urine Cu concentrations were higher in those with UC. According to the results, trace element levels such as Zn and Cu in patients with UC are subjects to change. As UC is an inflammatory disease and Cu levels are increased during inflammation, serum and urinary Cu levels were higher. The decrease in serum and increase urinary Zn in patients with UC is debatable. So, for future studies, Zn supplementation and examining mucosal healing process is suggested.

Background and

Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of increased liver enzymes. The world population are suffering from NAFLD (30% in IRAN, 20% - 40% in western countries, and 5% - 30% in Asia-Pacific). The prevalence of NAFLD is higher in hyperlipidemic, diabetic and obese people. This study assessed the preventive effect of sylmarin on the progression of NAFLD/NASH.

This clinical trial was performed in 41 patients with NAFLD referring to gastrointestinal clinics in Sari. The patients were randomly divided into case and control groups. The case group was treated with a tablet containing 140 mg silymarin twice a day for six months and the control group was given placebo for the same period. The data was analyzed using independent t-test, paired t-test and Chi-Square in SPSS.

At the end of the treatment period the improvement of steatosis in sonography was more significant in case group (P= 0.03). Liver enzymes reduced significantly in silymarin group compared to other group (P= 0.002 for ALT and P= 0.01 for AST).

In this study sylmarin reduced the liver enzymes in the intervention group. Therefore, it could be of great benefit in the treatment of NAFLD.

Crohn disease (CD) and ulcerative colitis (UC), collectively known as inflammatory bowel disease (IBD), are chronic illnesses that affect predominately the gastrointestinal tract. The pathogenesis and etiology remain unclear but the importance of environmental factors, in particular diet, is evidenced by the increased incidence rates of the recent decades that genetic inheritance cannot account for. In particular, the quantity of fatty acid consumption has been consistently linked with IBD risk. While several studies have investigated the connections between diet, etiology, signs and symptoms associated with IBD, very few have explored the relationship between disease state and specific fatty acid intake in the pediatric IBD population. In this cross-sectional study, 65 patients that all patients had colit ulcerative and it hadn’t passed more than 6 months of their desease. And also 137 healthy individual that matched for age, sex, contraceptive pills and smoking with patients. all participants in the study were recruited from Sari hospital. dietary record was used through mechanized food frequency questionnaire(MFFQ). A logistic regression and liner regression analysis was carried out to correlate disease severity with the dietary intake of omega 3, omega 6 fatty acid, omega 6/3 ratio. The findings showed that the highest quartile of intake of omega 6/3 fatty acid was associated with an increase risk of ulcerative colitis (OR, 3/48 95% CI, 1/43-8/45, P= 0/006) with a significant trend across quartiles (OR 1/09, Pt=0/008). highest quartile of intake of omega-6 fatty acid intake also was associated with increase the risk of ulcerative colitis)OR, 2/16 95% CI, 0/91-5/1, P=0/07) with a significant trend across quartiles (OR 1/02, Pt=0/08). also highest quartile of intake of omega-3 fatty acid was associated with a reduce risk of ulcerative colitis (OR, 0/43 95%CI, 0/15-1/21, P=0/11) but, this rate was not statistically significant (OR 0/17, Pt =0/94). While the western diet has high ratio of omega6 than omega 3,several studies, including this study show that increasing the ratio of omega 6/3 in the diet may also resulted in an increased incidence of many chronic disease like IBD. Overall, the findings obtained in the present study emphasizes the importance of choosing an appropriate dietary pattern that includes a good ratio of omega 6/3.

Gastric cancer is one of the most common diseases of digestive system with a low 5-year survival rate and metastasis is the main cause of death. Multi-factors, such as changes in molecular pathways and deregulation of cells are involved in the disease development. Epidermal growth factor receptor pathway (EGFR) which is associated with cell proliferation and survival can influence cancer development. EGFR function is governed by its genetic polymorphism; thus, we aimed to study the tyrosine kinase domain gene mutations of the receptor in patients with gastric cancer. In this experimental study, 123 subjects (83 patients with gastric cancer and 40 normal subjects) were investigated in north of Iran for EGFR gene polymorphisms during 1 year. Genomic DNA was extracted by DNA extraction kit according to the manufacture's protocol. Polymerase chain reaction single-stranded conformation polymorphism (PCR-SSCP) and silver staining were performed for investigating EGFR gene polymorphisms. The participants included 72 men and 44 women. Gene polymorphism in exon 18 was present in 10% of the study population but SSCP pattern in exon 19 did not show different migrate bands neither in patients nor in normal subjects. It seems that screening for tyrosine kinas gene polymorphism of epidermal growth factor receptor in patients with gastric cancer and use of tyrosine kinas inhibitors could be useful in the prevention of disease progress and improvement of treatment process for a better quality of life in these patients.

Background and Gastric cancer has been considered as the second lethal cancer throughout the world and the incidence of this cancer in Ïran is 25 cases out of 10000 people per year. Ïnterleukin-11 (ÏL-11)، a member of ÏL-6 family، might have played some role in developing gastric cancer via activation of the JÂK/STÂT signaling pathway. Ïn this study، the level of ÏL-11 gene expression was determined in gastric biopsy specimens of patients with and without gastric cancer. Ïn this case-control study، biopsy specimens were collected from Ïmam Khomeini Hospital and Tooba Çlinic in Sari. Based on the histopathologic and endoscopic assessments، patients were divided into two groups of gastric cancer patients (n=45) and those without gastric cancer (n=45). To determine the level of gene expression of ÏL-11، SYBR Green Real-time PÇR method was employed. The obtained data were analyzed using RËST 2008 and SPSS16. The histopathology of the biopsy specimens were determined as intestinal adenocarcinoma (93. 4%)، diffused adenocarcinoma (4. 4%)، and carcinoid tumor (2. 2%). The level of ÏL-11 gene expression was significantly higher in gastric cancer samples compared to non-cancer gastric individuals (P<0. 05); moreover، no change in the expression of this gene in the digestive complication patients (non-cancer) was observed. Çonclusion: Ït is suggested that ÏL-11 has relationship with developing gastric cancer and it likely acts in the process of tumor creation، proliferation and survival by increasing the anti-apoptotic activity.

Introduction & Hepatitis C viruses (HCVs), which is an enveloped RNA cense positive, are classified into six major genotypes and multiple subtypes. Infection with this virus has been found to be a major cause of liver disease. Also, HCV infection is quite high among chronic hemodialysis patients. The purpose of the present study was to compare the genotypes of HCV and associated risk factors in hemodialysis patients with positive HCV non uremic patients. Sera sample were taken from population consisted of 113 non uremic patients and uremic ones with HCV who referred to Imam Khomeini nephrology clinic and Sari and Ghaemshahr Dialysis Centers: Case group was consisted of 55 patients with positive HCV hemodialysis disease. The control group consisted of 58 patients suffering from non-uremic positive HCV. Samples were tested with improved Real-Time PCR technique using the appropriate kit. In this study, the mean age of case group was 44.88±14.6 and for the control group was 46.73±11.9. Considering the sex of participants, 23 (41.8%) were female patients and 32 (58.2%) were in the case group while 13 female (22.4%) and 45 male (77.6%) were in the control group. The most common genotype of HCV in case group was 1a-b (72.7%) and in control group was 3a (50%). Significant differences (p<0.05) were seen in HCV genotypes between two case and control groups. BUN and Cratinin in hemodialysis patients showed observable differences in comparison to control group (p<0.05), while PTT, AST, ACT in control group were higher in compare with hemodialysis patients (P < 0.05). This study showed that the hepatitis C virus genotype and its associated risk factors in hemodialysis patients and non uremic patients is different.

Helicobacter pylori iceA gene has been reported to be a genetic marker for the development of peptic ulcer in western populations. The aim of this study was to investigate the prevalence of iceA genotypes and their relationship with peptic ulcer in Iran. This observational study was carried out on 75 patients. Biopsy specimens were evaluated for the presence of Helicobacter pylori through rapid urease test. GlmM gene and iceA1 and iceA2 genotypes allelic verification and variation culture were determined via PCR. In this study, iceA1 and iceA2 alleles were identified in peptic ulcer disease (PUD) patients. IceA1 genotype (64%) was more prevalent than iceA2 (21.3%). IceA1 strains were more observable in patients with PUD. No significant relationships were seen between iceA genotypes and the clinical outcomes following infection (p= 0.71). This study revealed a significant two-tailed correlation between iceA genotypes and PUD occurrence. The results indicate that iceA1 gene can be used as a reliable marker in predicting the clinical outcomes of Helicobacter pylori infection. Therefore, further in-vitro and in-vivo investigations are needed for reaching general consensus in this regard.

In this study a 31 y/o woman who was housewife, came from Mazandaran and lived in Behshahr is presented. Patient's complaints were diarrhea, bloating, abdominal pain and weight loss. Abdominal radiography showed loop dilatation. In primary Para clinic assessments she had Alb: 2.8, Ca: 6.4, P: 2.3 and PTH: 201. Considering malabsorption in early evaluation, upper endoscopy was done. Intestinal folds were disappeared in second and third part of duodenum in endoscopic view and duodenal biopsy was done. Then pathological assessment revealed a large accumulation of intraepithelial lymphocytes and obvious villus atrophy that was accordant to celiac sprue. She was advised to be on gluten free diet. After about 1 month, She was referred because of sever lower extremities edema. Serum albumin was checked that was 2. Enlarged mesenteric lymph nodes were detected in sonography. Considering non- responding treatment, IHC staining of intestinal biopsy was performed with celiac sprue complication suspicion. Therefore the patient was referred to chemotherapy center with the diagnosis of T-cell lymphoma following celiac sprue. She was spent 6 course chemotherapy with CHOP regimen and radiotherapy.

This is a clinical trial regarding the comparative effect of two drugs in COPD patients. The drugs were Salbutamol and Ipratropoim bromide that are being used commonly in the treatment of COPD. Salbotamol is less expensive in Iran and more available than Ipratropim. We chose 16 patients which were referred to Pulmonary Clinic in ImamHospital, Sari. The Pulmonary function test was done for each patient prior and after administering 200 µg salbotamol and 36 µg Atrovent in 0.5 ml within a one and two hour period. Then, comparison was made regarding the results of FVC and FEV1, with paired T- test and SPSS. We found no difference between the effects of these two drugs.

Presentations of Irritable Bowel Syndrome (IBS) is influenced by numerous cultural, racial and social factors. Some evidences indicate that psycho-education can potentially improve the Quality Of Life (QOL) in these patients. The aim of this study was to evaluate the effects of psycho-education on the QOL in a sample of Iranian patients with IBS.&nbsp;

Method and Materials: 

This clinical trial was conducted on 44 patients who were randomly assigned to an experiment group and a control one. The two groups were matched for age, sex, level of education, job status and level of stress. The control group received only drug therapy while the case group participated in a three-session educational program as well. The content of educations included information about anatomy of the intestines, pathopysiology of IBS and potential causes of symptom aggravation, as well as stress manage-ment and problem solving skills training. The QOL Short Form scale for IBS patients (IBS QOL-SF36) were administerd to both groups before the first and one month after the last session of psycho-education. Data were analysed using T-student and Chi-square tests running SPSS-10 software.

The mean age of the control and the case group was 33.5&plusmn;8 and 37.5&plusmn;10 years respectively. Most of the patients in both groups were female, married and urban resident, with no significant differences in this regards. There was also no significant difference between the two groups regarding the mean scores of IBS-QOL-SF36.&nbsp;

In the short term follow up psycho-education was not effective in improving the QOL in patients with IBS. A long-