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    Effectiveness of senna in treating chronic constipation in geriatric patients presenting to the emergency department: a randomized, double-blind, multicenter study
    (Turkish Geriatrics Society, 2024) Sanalp Menekşe, Tuğba; Sarıtaş, Ayhan; Güçlü Utlu, Sibel; Akan, Ayşe Şule; Tekin, Erdal; Ergin, Mustafa
    Chronic constipation is prevalent in the geriatric population. Undiagnosed and untreated constipation can lead to complications and decreased health-related quality of life. The aim of this study was to compare the therapeutic effectiveness of senna alone with a combination of bisacodyl and senna in patients diagnosed with chronic constipation. Materials and Method: This prospective, multicenter, double-blind, randomized controlled trial included patients aged 65 years and older who presented to the emergency department with chronic constipation, diagnosed according to the Rome IV criteria, between July and October 2023. Patients were randomly assigned to either the senna group (20 mg sennoside B) or the senna + bisacodyl group (3 mg sennoside B + 5 mg bisacodyl). Participants took the drugs twice daily for 28 days. The Constipation Scoring System and Patient Assessment of Constipation Quality of Life scores were calculated before and after treatment for each patient. Results: The study included 105 patients, with 54 in the senna group and 51 in the senna + bisacodyl group. There was a statistically higher need for dose reduction because of drug side effects in the senna + bisacodyl group compared with the senna group (p=0.026). Following treatment, the senna group had a higher score on the Constipation Scoring System and Patient Assessment of Constipation Quality of Life compared with the senna + bisacodyl group, and the difference was statistically significant (p<0.001, p=0.012). Conclusion: In geriatric patients, short-term treatment of chronic constipation with senna is more effective than senna+bisacodyl regarding constipation severity and quality of life.
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    The correlation between systemic immune-inflammatory index and helicobacter pylori infection and its severity
    (Galenos Publishing House, 2025) Ordu, Melike; Öztürk, Gülfidan; Ergin, Mustafa
    The systemic immune-inflammatory index (SII), derived from routine hemogram parameters, has recently emerged as a novel marker reflecting the balance between host immune status and inflammatory burden and may offer information about the severity of Helicobacter pylori (H. pylori) associated gastric inflammation. We investigated whether there was a correlation between H. pylori inflammation, its severity, and this index. Methods: This single-center, retrospective study was conducted between January and December 2021. A total of 1137 H. pylori-positive and 401 H. pylori-negative patients who underwent upper gastrointestinal endoscopy were included. Participants were grouped based on gastric tissue activity and chronicity scores, which reflect the histological severity of inflammation and mononuclear infiltration, respectively, as defined by the updated Sydney system. The SII and other inflammatory markers were statistically compared between groups. Correlation analysis was also performed to evaluate the relationship between histological severity and inflammatory parameters. Results: Lymphocyte, neutrophil, platelet, SII, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were compared between the groups. No significant differences were observed. There was no significant difference in terms of the SII and other parameters in the H. pylori (+) group when the “1(+)” and “2(+) and 3(+)” subgroups were compared. No significant relationship was found between tissue activity and chronicity score values and inflammatory markers. Conclusion: No correlation was found between the presence and severity of H. pylori and the SII. This is the first study to compare inflammatory markers in the blood with activity and chronicity findings in the tissue.
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    The Effects of Positioning During Colonoscopy on Efficacy and Post-procedure Comfort
    (AVES, 2025) Ergin, Mustafa; Ergin, Gülencan Yumuşak; Kıvrakoğlu, Fatih; İbiş, Mehmet
    There are studies with different results on improving effectiveness and patient comfort by increasing lumen distention through positioning during colonoscopy. In our study, we aimed to compare colonoscopy outcomes and post-procedural patient comfort in the left-lateral and right-lateral positions. Materials and Methods: A total of 231 patients who underwent screening colonoscopy were included. Patients were randomized to either the left-lateral or the right-lateral position. Patient age, sex, comorbidities, body mass index (BMI) values, times to reach the cecum, ileum intubation rates, total procedure times, and colonoscopy findings were compared. Pain and discomfort after the procedure were evaluated and compared with the visual analog scale (VAS) scores at 30 minutes, 6 hours, and 24 hours. Results: Colonoscopy was performed in the left-lateral position in 129 patients and in the right-lateral position in 102. The distributions of age, sex, comorbidities, and BMI values were similar in both groups. The time to reach the cecum and the total procedure time were similar in both groups. There were no significant differences in the findings detected by colonoscopy. There was no significant difference in the post-procedural VAS scores. Conclusion: This study failed to show a difference in colonoscopy outcomes and postprocedural discomfort between the left- and right lateral positions.