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Hi , I live in india and have been suffering from IBS C for more than 15 years now. I also have schizophrenia , depression and bipolar. Due to the side effects of anti psychotic medication, I have diabetes, hypothyroidism and cholesterol. In my experience , IBS C has been the toughest to manage as there is no specific time for the washroom cycle, there is incomplete evacuation and chronic daily flatulence. People have mocked me, shamed me and laugh at me in social situations. This affects my mental health. IBS C has crippled my life. I hardly go out, I am divorced and unable to take up a full time job due to this . I have undergone endoscopy , h pylori tests , activated charcoal etc. Last year, I consulted a clinical nutrionist in india who put me on a diet that has reduced the symptoms a little but it's unpredictable. Are there any tips or medicines for this. I have recently consulted a 5th gastroentorlogist who has put me on movicol liquid but it's not helping. I have chia seeds with hemp milk everyday but the cycle is unpredictable. I read about gastropsych as an emerging field , wanted to know if there are any practitioners in India? I have tried reiki, past life regression, inner child healing, hypnotherapy, subconscious healing. I meditate everyday, drink 2 litres of water everyday and do yoga and pranayama regularly. Every morning, I dread the day, dread going out. Please help.

medRxiv. 2023 May 17:2023.05.16.23290065. doi: 10.1101/2023.05.16.23290065. Preprint. ABSTRACT BACKGROUND AND AIMS: Even in the absence of inflammation, persistent symptoms in Crohn's disease (CD) are prevalent and negatively impact quality of life. We aimed to determine whether quiescent CD patients with persistent symptoms ( qCD+symptoms ) have changes in microbial structure and functional potential compared to those without symptoms ( qCD-symptoms ). METHODS: We performed a prospective multi-center observational study nested within the SPARC IBD study. CD patients were included if they had evidence of quiescent disease as defined by fecal calprotectin level < 150 mcg/g. Persistent symptoms were defined by the CD-PRO2 questionnaire. Active CD ( aCD ), diarrhea-predominant irritable bowel syndrome ( IBS-D ), and healthy controls ( HC ) were included as controls. Stool samples underwent whole genome shotgun metagenomic sequencing. RESULTS: A total of 424 patients were analyzed, including 39 qCD+symptoms, 274 qCD-symptoms, 21 aCD, 40 IBS-D, and 50 HC. Patients with qCD+symptoms had a less diverse microbiome, including significant reductions in Shannon diversity ( P <.001) and significant differences in microbial community structure ( P <.0001), compared with qCD-symptoms, IBS-D, and HC. Further, patients with qCD+symptoms showed significant enrichment of bacterial species that are normal inhabitants of the oral microbiome, including Klebsiella pneumoniae (q=.003) as well as depletion of important butyrate and indole producers, such as Eubacterium rectale (q=.001), Lachnospiraceae spp . (q<.0001), and Faecalibacterium prausnitzii (q<.0001), compared with qCD-symptoms. Finally, qCD+symptoms showed significant reductions in bacterial tnaA genes, which mediate tryptophan metabolism, as well as significant tnaA allelic variation, compared with qCD-symptoms. CONCLUSION: The microbiome in patients with qCD+symptoms show significant changes in diversity, community profile, and composition compared with qCD-symptoms. Future studies will focus on the functional significance of these changes. WHAT YOU NEED TO KNOW: Background: Persistent symptoms in quiescent Crohn's disease (CD) are prevalent and lead to worse outcomes. While changes in the microbial community have been implicated, the mechanisms by which altered microbiota may lead to qCD+symptoms remain unclear.Findings: Quiescent CD patients with persistent symptoms demonstrated significant differences in microbial diversity and composition compared to those without persistent symptoms. Specifically, quiescent CD patients with persistent symptoms were enriched in bacterial species that are normal inhabitants of the oral microbiome but depleted in important butyrate and indole producers compared to those without persistent symptoms.Implications for Patient Care: Alterations in the gut microbiome may be a potential mediator of persistent symptoms in quiescent CD. Future studies will determine whether targeting these microbial changes may improve symptoms in quiescent CD. PMID:37292648 | PMC:PMC10246066 | DOI:10.1101/2023.05.16.23290065 View the full article

Front Med (Lausanne). 2023 May 24;10:1161130. doi: 10.3389/fmed.2023.1161130. eCollection 2023. ABSTRACT About 95% of human body serotonin synthesis occurs in the gastrointestinal tract (GI). Lack of sufficient serotonin levels is thought to play a key role in mood disorders, including anxiety disorders. In this study, we looked at a disorder affecting the GI tract, irritable bowel syndrome (IBS), and aimed to determine whether IBS is differentially associated with anxiety disorders in 252 chronic pain patients in the presence of a history of alcohol use disorders (AUD) given that alcohol is an extremely aggressive substance for the GI mucosa. We found that while the prevalence of IBS was not affected by the presence of AUD in chronic pain patients, IBS had significantly higher comorbidity with anxiety disorders in chronic pain patients with comorbid alcohol use disorders. We argue that these findings highlight mechanistic differences in the comorbidity of anxiety disorders with chronic pain and AUD, implicating a central role for GI problems stemming from chronic alcohol use. The findings may have important implications for the treatment of IBS patients with AUD who commonly present with anxiety disorders which could motivate the continuation of problematic drinking and impede recovery success. We propose that addressing GI problems in patients with AUD may help manage AUD and recovery more effectively. PMID:37293305 | PMC:PMC10244726 | DOI:10.3389/fmed.2023.1161130 View the full article

Ernie Molina is someone who developed IBS after a being placed on antibiotic therapy by his dentist for 6 months after dental implants. His dentist felt that Ernie’s gut discomfort could be managed by eating yogurt. This did not work for Ernie. Before the dental work, Ernie described his health as good and enjoyed a wide variety of foods. This all changed following the antibiotics. Fortunately Ernie’s wife Mary had developed a bar which had few ingredients due to their daughter Lola needing a gentle snack food. When probiotics were added to the bar, Ernie began to return to a normal life. That’s when the Lola Snacks Probiotic Energy Bar took off. In my conversation with Ernie and Mary Molina, Ernie tells his story when and how he was diagnosed with IBS and how he felt after eating the Lola Snacks bars. Mary shares details about how the bar was developed and plans for the future including wide distribution of the bar and an interest in a research clinical trial to understand why Lola Snacks bars eased Ernie’s IBS symptoms. You can find our more information about Lola Snacks at https://lolasnacks.com/ Listen to the podcast: https://www.ibspatient.org/podcasts/ or https://bit.ly/42t3nCY or Say "Play the latest podcast from IBS Chat" from Apple iTunes, Google Play, Alexa or Spotify Not your favorite Podcast app? Listen here: https://pod.link/ibschat

Ok, thank you. I will check it out. BTW, beano and it's generic version from Walmart is still helping her.

Biopsychosoc Med. 2023 Jun 8;17(1):22. doi: 10.1186/s13030-023-00275-4. ABSTRACT BACKGROUND: Irritable bowel syndrome (IBS) and migraines are often comorbid each other. These disorders are likely to be bidirectionally linked through the gut-brain axis and share several underlying mechanisms including central nervous system sensitization. However, quantitative analysis of comorbidity was not reported enough. The aim of this systematic review and meta-analysis was to calculate the present degree of comorbidity of these two disorders. METHODS: A literature search was performed searching for articles describing IBS or migraine patients with the same inverse comorbidity. Pooled odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were then extracted. The total effect estimates were determined and presented by random effect forest plots for the group of articles with IBS patients with migraine and the group of articles on migraine sufferers with comorbid IBS separately. The average results of these plots were compared. RESULTS: The literature search resulted in initial 358 articles and final 22 articles for the meta-analysis. The total OR values obtained were 2.09 [1.79 - 2.43] in IBS with comorbid migraine or headache, 2.51 [1.76 - 3.58] for migraineurs with comorbid IBS and an overall HR of 1 .62 [1.29 - 2.03] was found for cohort studies of migraine sufferers with comorbid IBS. A similar expression of a selection of other comorbidities was found in IBS and migraine patients, especially for depression and fibromyalgia a strong similarity was found in their expression rate. CONCLUSIONS: This systematic review with meta-analysis was the first to combine data on IBS patients with comorbid migraine and migraineurs with comorbid IBS. The fact that closely related existential rates were observed between these two groups should be used as motivation for future research to further investigate these disorders for why this similarity occurs. Mechanisms involved in central hypersensitivity such as genetic risk factors, mitochondrial dysfunction and microbiota are particularly good candidates. Experimental designs in which therapeutic methods for these conditions can be exchanged or combined may also lead to the discovery of more efficient treatment methods. PMID:37291550 | DOI:10.1186/s13030-023-00275-4 View the full article

Data Brief. 2023 Jun;48:109287. doi: 10.1016/j.dib.2023.109287. Epub 2023 Jun 1. ABSTRACT The coronavirus disease of 2019 (COVID-19) pandemic created a variety of symptoms from mild to acute in the general population. Additional disease burden was experienced in high-risk populations, such as older adults, people with disabilities or overweight, those from racial and ethnic minority groups, and patients with cancer, chronic kidney, lung or liver disease, or diabetes. Although it is well-known that SARS-CoV-2 mostly affects the respiratory tract, studies have revealed the presence of gastrointestinal (GI) symptoms in those patients diagnosed with COVID-19. The best protection against infection is through receipt of the COVID-19 vaccine, which is associated with a low incidence of adverse events. However, there is limited research on the lesser-known side effects experienced following receipt of the COVID-19 vaccination, amongst healthy and special needs populations. This study investigated the association between the COVID-19 vaccination and, when it occurred, infection, and resulting gastrointestinal (GI) symptomology, focusing on both the general population and on those previously diagnosed with GI disorders, Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD). Through a short, anonymous survey, 215 participants were assessed for acute onset of GI issues and/or worsening of pre-existing GI issues following the receipt of one or more COVID-19 vaccine doses and following contraction of COVID-19 itself, when applicable. All analyses were performed using SAS version 9.4, and prior to study initiation, the study protocol was reviewed and approved as exempt by the Stamford Hospital's Institutional Review Board of record. Data analysis included reporting of demographic variables as well as descriptive statistics regarding side effects experienced after receipt of the COVID-19 vaccine, as well as after contracting COVID-19, if it occurred. To assess for statistically significant differences between the groups, ANOVA was conducted for each survey item. Reporting of results consisted of the mean and standard deviation within each of the groups, and an omnibus p-value less than 0.05 (p <0.05) was considered statistically significant. For the purposes of this report, a greater than 0.50 response difference between highest and lowest mean value will be presented. In the event of a statistically significant omnibus p-value, the Scheffe test was used as the post-hoc procedure. The database created through this research demonstrates the prevalence of post-COVID-19 vaccination side effects and can serve as preliminary data for gaining a better understanding of how both general and populations with a higher disease burden are being affected by the COVID-19 vaccine, booster doses, and incident COVID-19 infection in vaccinated individuals. PMID:37287691 | PMC:PMC10232932 | DOI:10.1016/j.dib.2023.109287 View the full article

Neurogastroenterol Motil. 2023 Jun 8:e14618. doi: 10.1111/nmo.14618. Online ahead of print. ABSTRACT BACKGROUND/PURPOSE: Gastrointestinal (GI) dysmotility is categorized by muscle or nerve dysfunctions in any portion of the GI tract, which leads to abnormalities in GI motor and sensory function. Symptoms may vary depending on the organ affected and can be debilitating. Treatment usually involves diet and lifestyle changes. Pharmacotherapy is limited in effectiveness with various side effects. Transcutaneous electrical stimulation (TES), a noninvasive, needleless technique that provides electrical stimulation using cutaneous non-needle electrodes, has become increasingly popular. It has been shown to be beneficial in treating GI motility disorders. METHODS: This review paper navigates through the different TES techniques, including transcutaneous peripheral nerve (vagal/sacral/tibial nerves) electrical stimulation, transcutaneous electrical acustimulation (stimulation via acupuncture point), transcutaneous interferential current therapy, and transcutaneous electrical nerve stimulation. KEY RESULTS: As we delve deeper, we explore the promising effects of TES on dysphagia, gastroesophageal reflux disease, functional dyspepsia, gastroparesis, postoperative ileus, constipation, and irritable bowel syndrome. The literature at hand speaks volumes about the therapeutic prowess of this noninvasive technique. CONCLUSION & INFERENCES: The time is ripe to evaluate further the full therapeutic potential of TES, a noninvasive, nonpharmaceutical, nonsurgical, and home-based self-administrative technique in managing GI motility disorders. PMID:37288650 | DOI:10.1111/nmo.14618 View the full article

American Gastroenterological Association-American College of Gastroenterology Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation Chang, Lin MD, AGAF, FACG1,*; Chey, William D. MD, FACG2,*; Imdad, Aamer MBBS, MPH3,*; Almario, Christopher V. MD, MSHPM, FACG4; Bharucha, Adil E. MD5; Diem, Susan MD, MPH6,7; Greer, Katarina B. MD, MS Epi8,9; Hanson, Brian MD6,10; Harris, Lucinda A. MD, FACG11; Ko, Cynthia MD12; Murad, M. Hassan MD13; Patel, Amit MD, FACG14; Shah, Eric D. MD, MBA, FACG2,15; Lembo, Anthony J. MD, FACG16,†; Sultan, Shahnaz MD, MHSc, FACG6,17,† Author Information The American Journal of Gastroenterology ():10.14309/ajg.0000000000002227, May 19, 2023. | DOI: 10.14309/ajg.0000000000002227 Abstract INTRODUCTION: Chronic idiopathic constipation (CIC) is a common disorder associated with significant impairment in quality of life. This clinical practice guideline, jointly developed by the American Gastroenterological Association and the American College of Gastroenterology, aims to inform clinicians and patients by providing evidence-based practice recommendations for the pharmacological treatment of CIC in adults. METHODS: The American Gastroenterological Association and the American College of Gastroenterology formed a multidisciplinary guideline panel that conducted systematic reviews of the following agents: fiber, osmotic laxatives (polyethylene glycol, magnesium oxide, lactulose), stimulant laxatives (bisacodyl, sodium picosulfate, senna), secretagogues (lubiprostone, linaclotide, plecanatide), and serotonin type 4 agonist (prucalopride). The panel prioritized clinical questions and outcomes and used the Grading of Recommendations Assessment, Development, and Evaluation framework to assess the certainty of evidence for each intervention. The Evidence to Decision framework was used to develop clinical recommendations based on the balance between the desirable and undesirable effects, patient values, costs, and health equity considerations. RESULTS: The panel agreed on 10 recommendations for the pharmacological management of CIC in adults. Based on available evidence, the panel made strong recommendations for the use of polyethylene glycol, sodium picosulfate, linaclotide, plecanatide, and prucalopride for CIC in adults. Conditional recommendations were made for the use of fiber, lactulose, senna, magnesium oxide, and lubiprostone. DISCUSSION: This document provides a comprehensive outline of the various over-the-counter and prescription pharmacological agents available for the treatment of CIC. The guidelines are meant to provide a framework for approaching the management of CIC; clinical providers should engage in shared decision making based on patient preferences as well as medication cost and availability. Limitations and gaps in the evidence are highlighted to help guide future research opportunities and enhance the care of patients with chronic constipation. EXECUTIVE SUMMARY Chronic idiopathic constipation (CIC) is a common clinical diagnosis that affects approximately 8%–12% of the US population (1). Nonpharmacological therapies often represent the initial steps in management and may include dietary recommendations (such as increased fluid intake and increased dietary fiber) and behavioral changes (such as exercise). Pharmacological treatment may include the use of over-the-counter (OTC) or prescription medications, such as polyethylene glycol (PEG), secretagogues, or prokinetic agents (2). This joint evidence-based guideline from the American Gastroenterological Association (AGA) and the American College of Gastroenterology (ACG) aims to provide recommendations for the pharmacological management of CIC in adults. >> Read the full Clinical Practice Guideline © 2023 by The American College of Gastroenterology and the American Gastroenterological Association

Struggling with Celiac Disease, leaky gut, food sensitivities or bodywide complaints that you think may originate in your gut? Explore strategies to individualize your diet to attain a healthy and diverse gut microbiome. Also, learn about critical food preparation steps for legumes to minimize gut damage with Vincent Pedre, MD on The Perfect Stool Podcast with host Lindsey Parsons, EdD. Listen below or find the podcast version at: https://link.chtbl.com/theperfectstool-IBS

Not silly for posting. Anyone who visits here knows exactly what you are going through. The way I look at it is that I got through the last "flare up" and I'll get through this one. I take advantage of the good days and tune out the world on the bad days. I understand how this triggers depressive thoughts. You might consider either meeting with a GI Psychologist or investigating the Mahana IBS treatment which is a CBT app for IBS that was FDA approved. It might help you to manage your thoughts that can spiral us into a bad place. P.S. I'm happy to host a live Teams meet-up if you would like to talk anything through. That goes for anyone who is looking for a good listener.

Hi, JenniferLyn, I totally get it. I’ve been dealing with regular flare ups for over 2 years and it has made my depression much worse. Today’s episode is side by side with a sinus infection and I’m at a complete loss. Crying, feeling out of control of my own body. I used to be able to push through physical pain. Since turning 50, its like I can’t catch a break. You’re not alone in your suffering! Thinking of you, sending positive vibes. Ursula

I have nothing good to say about today or how I’m feeling. IBS triggers my depression. I feel alone and helpless. I know there will be better days to come, but then its just a waiting game for the next flare up. Just looking to reach out to people who understand the pain. I sound so dramatic and feel silly for posting this. But, it is what it is. Thanks for listening!

Oh dear. I understand how anxious this can make you. If this is out of the ordinary for you then it really sounds like it might be infectious or viral related. Imodium will stop things up pretty good. Mebeverine could also do the same. I think you have to wait this out and drink plenty of fluids and walk to get your bowels moving again. If not moving over the next 24 hrs you could try using some MiraLax (US-name). If the diarrhea comes back on its own and this isn't usual for you, you might have your doctor test for an infection by doing some stool cultures. It isn't "IBS" until you have a repeated pattern for some time.

Hi, I am 56 and have severe GAD and health anxiety. Last Wednesday I had multiple loose stools until lunch time ish probably about 8-10 times. The next day I had a normal morning one and then two urgent ones after eating with slight cramping. This happened the next 2 days. I took an 3 immodium during Saturday and things settled. But I haven’t had a bowel movement since apart from a small sticky bit today. My stomach is gurgling and I have quite smelly glass and wind. I also took some mebeverine for about 3 days that I had been prescribed for IBS once before. I have got myself into such a state I’m scared to go to the loo and scared if I can’t go to the loo. My anxiety is in overdrive and I can’t think logically about this. Please help.

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Front Pharmacol. 2023 May 22;14:1131354. doi: 10.3389/fphar.2023.1131354. eCollection 2023. ABSTRACT Background and study aims: The feasibility and barriars of escitalopram use in patients with functional gastrointestinal disorders (FGIDs) are still debated. We aimed to evaluate the feasibility, safety and efficacy and barriars of escitalopram use in managing FGIDs in the Saudi population. Patients and Methods: We included 51 patients who received escitalopram for irritable bowel syndrome (n = 26), functional heartburn (n = 10), globus sensation (n = 10) or combined disorders (n = 5). We used an irritable bowel syndrome-severity scoring system IBS-SSS), GerdQ questionnaire and Glasgow Edinburg Throat Scale (GETS) to assess disease severity change before and after treatment. Results: The median age was 33 years (25th- 75th percentiles: 29-47), and 26 (50.98%) were males. Forty-one patients experienced side effects (80.39%), but most side effects were mild. The most common side effects were drowsiness/fatigue/dizziness (54.9%), xerostomia (23.53%), nausea/vomiting (21.57%) and weight gain (17.65%). IBS-SSS was 375 (255-430) and 90 (58-205) before and after treatment, respectively (p < 0.001). GerdQ score was 12 (10-13) before treatment and 7 (6-10) after treatment (p = 0.001). GETS score before treatment was 32.5 (21-46) and after treatment became 22 (13-31) (p = 0.002). Thirty-five patients refused to take the medications, and seven patients discontinued the medication. Possible causes of the poor compliance were fear of the medications and not being convinced of taking psychiatric medications for functional disorders (n = 15). Conclusion: Escitalopram could be a safe and effective treatment for functional gastrointestinal disorders. Targeting and managing factors leading to poor compliance could further improve the treatment outcome. PMID:37284319 | PMC:PMC10240913 | DOI:10.3389/fphar.2023.1131354 View the full article

Cureus. 2023 May 5;15(5):e38567. doi: 10.7759/cureus.38567. eCollection 2023 May. ABSTRACT Background Irritable bowel syndrome (IBS) is a chronic condition characterized by persistent abdominal pain or discomfort and impaired bowel function. Symptoms often vary in onset and severity, are worse during flare-ups, and affect the patient's quality of life. A positive diagnosis of IBS based on clinical symptoms may lead to a better outcome. There are different diagnostic criteria like Kruis score, Manning criteria, Rome I, II, III, and IV criteria, and each new one addresses the deficiencies of the previous ones. We analyze the effectiveness of the most commonly used diagnostic criteria associated with clinical examinations and laboratory tests in treating IBS in these studies. Methodology This is a retrospective study in which data from IBS subjects were collected by simple random sampling and compared using Manning criteria, Kruis score, and Rome IV criteria. Laboratory tests included complete blood count (CBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Results Of the 130 patients, IBS is more prevalent in adults aged 30-50 years, with a male predominance. The Kruis score outperformed the Manning criterion in distinguishing between organic bowel disease and IBS. This, together with the Rome IV criteria, increases the likelihood of identifying IBS. Conclusions Differentiating IBS from functional and organic gastrointestinal problems is critical. Irritable bowel syndrome can be diagnosed using symptom-based diagnostic criteria. Clinical observation and physical examination should be supplemented with laboratory indicators. PMID:37284405 | PMC:PMC10239547 | DOI:10.7759/cureus.38567 View the full article

Some BIG news abut pasta and FODMAP friendly. If you are like me where a large quantity of pasta is challenging due to bloating and cramping, this simple experiment and observaton might give you more opportunity to enjoy pasta. If you boil pasta, let it cool and then heat it up again, there appears to be less high FODMAP in the pasta. Read about it here: https://fodmapfriendly.com/blogpost/pasta/

I have read about Pelvic Floor Dyssynergia for many years; however, I am no expert. I think the key thing is to find a center that knows how to manage this in a gastroenterology vs a gynecological fashion. Biofeedback might be helpful initially vs any type of surgery.

Hi to whoever is reading this, I think I'm just now finding out a huge problem of mine is Pelvic Floor Dyssynergia. Does anyone else experience these two together? Advice?

Front Immunol. 2023 May 18;14:1136343. doi: 10.3389/fimmu.2023.1136343. eCollection 2023. ABSTRACT OBJECTIVE: Whether fecal microbiota transplantation (FMT) in patients with irritable bowel syndrome (IBS) is effective in improving outcomes remains controversial. We assessed the safety and efficacy of FMT for patients with IBS. METHODS: In this systematic review and meta-analysis, we searched PubMed, Embase, Web of Science, the Cochrane Library, the clinicaltrials.gov and International Clinical Trials Registry Platform (ICTRP) up to February 25, 2022, updated to March 28, 2023. Randomized controlled trials (RCTs) compared the stool and capsule FMT with placebo in patients with IBS were included. Two authors independently assessed study eligibility, extracted the data, and assessed risk of bias. We did meta-analysis with RevMan, and the Stata software was used for sensitivity analysis and meta-regression. The GRADE system was used to assess the quality of evidences. Mean difference (MD) or standardized Mean difference (SMD) with 95% CI for continuous data, and risk ratios (RR) with 95% CI for dichotomous data were used with random-effects models. The primary outcomes included the clinical response rate and IBS-SSS score. This study is registered with PROSPERO: CRD42022328377. RESULTS: Nineteen reports from nine RCTs were included finally. Compared with the placebo, a single stool FMT could significantly decrease the IBS-SSS score at 1 month (MD=-65.75, 95%CI [-129.37, -2.13]), 3 months (MD=-102.11, 95% CI [-141.98, -62.24]), 6 months (MD=-84.38, 95%CI [-158.79, -9.97]), 24 months (MD=-110.41, 95%CI [-145.37, -75.46]), and 36 months (MD=-104.71, 95%CI [-137.78, -71.64]). It also could improve the clinical response rate at 3 months (RR=1.91, 95% [1.12, 3.25]), 24 months (RR=2.97, 95% [1.94, 4.54]), and 36 months (RR=2.48, 95% [1.65, 3.72]), and increase the IBS-QoL score at 3 months, 24 months, and 36 months. FMT did not increase the serious adverse event. The risk of bias was low, and the quality of evidence based on GRADE system was moderate in the stool FMT group. However, we did not find positive effect of capsule FMT on patients with IBS based on the current available data. CONCLUSION: A single stool FMT is effective and safe for patients with IBS. However, some factors may affect the effectiveness of FMT, and the relationship between the gut microbiome and the effect of FMT for IBS is still unclear. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD42022328377. PMID:37275867 | PMC:PMC10234428 | DOI:10.3389/fimmu.2023.1136343 View the full article

Int J Nanomedicine. 2023 May 30;18:2839-2853. doi: 10.2147/IJN.S402871. eCollection 2023. ABSTRACT BACKGROUND: Berberine (BR) shows promise as a candidate for treating irritable bowel syndrome with diarrhea (IBS-D). However, the undesired physicochemical properties and poor oral absorption limit its clinical translation. A ketogenic diet (KD) can induce intestinal overexpression of cannabidiol (CB) receptors, which may offer a potential target for IBS-D-specific delivery of BR. METHODS: The microemulsions loaded with BR and decorated with cannabidiol (CBD/BR-MEs) were developed through a one-step emulsion method. The pharmaceutical behaviors of the CBD/BR-MEs were measured using dynamic light scattering and high-performance liquid chromatography. The efficacy of the anti-IBS-D therapy was evaluated by assessing fecal water content, Bristol score, and AWR score. The intestinal permeability were assessed through immunofluorescent staining of CB1 and ZO-1, respectively. The signaling of CREB/BDNF/c-Fos was also studied along with immunofluorescent and immunohistochemical examination of brain sections. RESULTS: The CBD/BR-MEs, which had a particle size of approximately 30 nm and a surface density of 2% (wt%) CBD, achieved greater than 80% (wt%) encapsulation efficiency of BR. The pharmacokinetics performance of CBD/BR-MEs was significantly improved in the KD-fed IBS-D rats than the standard diet-fed ones, which is highly related to intestinal expression of CB1 receptors. The treatment with CBD/BR-MEs and KD exhibited evident comprehensive advantages over the other groups in terms of anti-IBS-D efficacy. CBD/BR-MEs and KD synergistically decreased intestinal permeability. Moreover, the treatment with CBD/BR-MEs and KD not only blocked the CREB/BDNF/c-Fos signaling in the brain but also decreased the levels of neurotrophic factors, neurotransmitters, and inflammatory cytokines in the serum of IBS-D model rats. CONCLUSION: Such a design represents the first attempt at IBS-D-targeted drug delivery for improved oral absorption and efficacy through KD-induced target exposure, which holds promising potential for the treatment of IBS-D. PMID:37273286 | PMC:PMC10239260 | DOI:10.2147/IJN.S402871 View the full article

You Don't Walk Alone: A Partnership of Care Between Patients and Providers Working Together Created for World IBS Day 2023 on April 19, 2023 in partnership with Tuesday Night IBS >> Watch here

Dr. Mark Pimentel is a professor of medicine and gastroenterology at Geffen School of Medicine UCLA and associate professor of medicine at Cedars-Sinai Medical Center, Los Angeles. He is also the executive director of the Medically Associated Science and Technology (MAST) Program at Cedars-Sinai, https://csmast.com. A pioneering expert in irritable bowel syndrome (IBS), Dr. Pimentel's research led to the first-ever blood tests for IBS, https://ibssmart.com. Dr. Pimentel has served as a principal investigator for numerous clinical investigations of IBS and the relationship between gut flora composition and human disease. Dr. Pimentel is a diplomate of the American Board of Internal Medicine, a fellow of the Royal College of Physicians and Surgeons of Canada, and a member of the American Gastroenterological Association, the American College of Gastroenterology, and the American Neurogastroenterology and Motility Society. Pam Emmer is a GI motility patient who has overcome SIBO, small intestinal bacterial overgrowth. She has been a patient advocate, fundraiser and cheer leader for Cedar Sinai Medical Center in LA and the Mast Program for almost 10 years. Pam and I met with Dr. Pimentel at DDW 2023 in Chicago where we spoke about intestinal methane overgrowth, how to use prokinetics, motility and pooping - what's the difference, biomarkers for malabsorption and its relationship to SIBO and upcoming clinical trials for the MAST program. Find Pam Emmer at: Website: https://lifeaftersibo.com Facebook: https://www.facebook.com/lifeaftersibo Twitter: https://twitter.com/lifeaftersibo Instagram: https://www.instagram.com/lifeafter_sibo Listen to the podcast: https://www.ibspatient.org/podcasts/ or https://bit.ly/3WKoLCr or Say "Play the latest podcast from IBS Chat" from Apple iTunes, Google Play, Alexa or Spotify Not your favorite Podcast app? Listen here: https://pod.link/ibschat