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  1. Today
  2. BanannaZ

    Ibs D

    Hi, I have a lot of the same problems but without the thyroid issue (that test came back fine for me surprisingly). I came across this post because I was curious about Librax (my doctor’s most recent suggestion for my incurable IBS). Did this help the gas at all for you? That’s my main concern. I’ve tried digestive enzymes to no avail but you can give them a try and see. Takes a few weeks I think to see the full effect apparently but I’ve never seen a difference. Best of luck, hope you’re feeling better since I know this is a very late reply!
  3. @Esjie I feel for you too, it’s very random and I also for some reason get bloated even after I go to the bathroom... you would think that would help. I literally can’t let my body get physically hungry or else it starts freaking out and spazzing / bloating. Recently most food makes me bloated but then sometimes I’ll have a day where I can eat and not feel awful. I’m the same as you, the evenings are the worst!! Sleep helps, it relaxes everything. But then I wake up in the morning and have to get rid of all the gas so it’s just a vicous cycle. Might also try the FODMAP diet again and see... can’t give up because we surely can’t live like this forever!
  4. Yesterday
  5. Isaac

    Does this sound like IBS to you ?

    Thank you for your response. I will take this into consideration too.
  6. Esjie

    Does this sound like IBS to you ?

    Hello Isaac, I am sorry you have all these problems. It is always wise to run a few more tests, just to check if anything else could be causing these issues. Certainly, anxiety can upset the system, and cause bowel changes apart from other symptoms. And of course the symptoms themselves give rise to anxiety. Can you ask your doctor to run some non-invasive tests to start with? That can help eliminate any inflammation etc which might be going on. All it would need is a stool sample. Testing for fecal calprotectin, lactoferrin, and hidden blood will be helpful to start with. If those are all negative, then there is no inflammatory condition. A comprehensive stool test would be better though. That would check for infections and parasites, and possibly gut dysbiosis too.
  7. I have definitely experienced that. I have used a couple of things to calm things down after food poisoning. 1) Probiotic - Visbiome 2) Cholestyramine (Questran) The probiotic seems to help me promote good bacteria to get things back to normal. The cholestyramine is a bile acid sequestran and tends to slow down diarrhea for me. You need a prescription for this and cannot take it with anything else for 2-3 hours after taking it or within 1 hour of taking it. It can be constipating so you have to adjust the dosage. I hope this is helpful.
  8. Isaac

    Does this sound like IBS to you ?

    Thank you for your response. According to the the symptoms described by those who have IBS, I I don't think the cramps or pain that I feel are unbearable. I wouldn't even call it pain. It's more like a an uncomfortable sensation. Anyway, thanks for the advise.
  9. Jeffrey Roberts

    Does this sound like IBS to you ?

    Hello. The yellow bulky stools and experiencing diarrhea and constipation everyday could be IBS; however, you don't seem to complain about abdominal pain which is relieved by the bowel movement which is sometimes an indication of IBS. If the yellow stools are new it could be related to bile acids. It's bile that makes your stools yellow and they are stored in the gallbladder and produced in the liver. There doesn't have to be anything wrong for this to happen, but worth considering. You could take cholestyramine (a powder) which will bind to the excess bile. That should make your bowel movements more normal. It's worth mentioning to your doctor and considering before being labeled with IBS.
  10. Jeffrey Roberts

    Please help

    I'm so sorry for what you go through. It sounds miserable. It sounds to me like you are becoming impacted or have some sort of obstruction that then clears. Nausea is felt when the bowel isn't moving so it could be something like this. Liquid stool behind hard stool is typical of this sort of thing. While it could be IBS related, I think you need to get checked out with at least an ultrasound or X-ray to see if you have fecal impaction or you have narrowing of your bowel in a particular region. I would explain your story to a doctor, preferably a gastroenterologist, just like you have described it.
  11. Barley vs. Wheat: What's the Difference? Healthline Wheat and barley have been grown by humans for thousands of years and were one of the earliest plants to be domesticated. Today, they’re two of the major crops in the world used for food and drink production, as well as animal feed. They may look very similar on the surface, but they do have some key differences in terms of how they’re processed and used, their nutrition, and health effects. This article tells you all you need to know about the most important differences between the two grains. View the full article
  12. Hi, I just found out about this forum. I turn 29 in 2 days. I am a college student living in Shanghai, China. It's important to mention that I have generalized anxiety disorder. I have Sleep apnea, so I use a CPAP machine to sleep. After using the machine I lost a lot of weight. I went from 130 kg to 107 in 8 months. My sleep is great every since but I don't know if aerophagia is giving me IBS. My first symptom was a palpitating pain on my lower left back. Even-though the pain was mild, I knew something was wrong. I had never experienced such pain on that area before. After a while, I noticed my urine and stools had a strong smell(a sourish smell.). My stools were now yellow. Sometimes bulky and sometimes watery. Occasionally, I experienced flashing cramps, testicular pain, pain in the tip of my penis, calf pain and a lower back pain that would irradiate to my upper buttocks. The pain was very mild. I could definitely bear the pain, but it made me worry a lot. At first, I thought it was a UTI or kidney stone. After a couple of exams, the Doc said there was nothing wrong with my kidneys, bladder or testicles. I went to the doc a month later again. This time he diagnosed me with IBS. He asked me if I felt particularly stressed lately. Honestly, I didn't feel I was stressed out but deep inside I knew I was dealing with a lot of pressure (Writing my thesis, family problems, quarantine and money.). After the diagnosis, most of my symptoms disappeared without any medication. My urine and stools are not as smelly as before. But my stools are still yellow. I experience diarrhea and constipation everyday. I can see food particles in my stools. I don't have the urge to use the toilet every time. I simply go when I feel I have to. The security officers in my compound check my temperature everyday before I get inside, so I know I have never had high fever. I don't have mucous or blood in my stool. The yellow bulky stools, the occasional watery diarrhea are eally making me anxious. Do I have to live with this for the rest of my life ? If so, how can I make it better? Do you think this could be something else other than IBS?
  13. Are Eggs Okay to Eat if You Have Irritable Bowel Syndrome? Health Essentials from Cleveland Clinic Whether you prefer them sunny side up, hard-boiled or scrambled, you may need to reexamine your relationship with eggs if you have irritable bowel syndrome (IBS). “Eggs can be easy for some but can be a trigger for some IBS symptoms in others,” says gastroenterologist Christine Lee, MD. “It really depends on the person.” View the full article
  14. Claireeee

    Please help

    Hi everyone, apologies if this is a long one and very TMI but I would really appreciate some advice as I feel right at the end of my tether with this. I have suffered with IBS from the age of 17 (I'm 32 now) and it was predominantly IBS-D which seemed to be stress-induced. Over the last couple of years it seems to have changed to IBS-M (mixed) and doesn't seem to have a trigger. It used to be that I'd only have a really bad attack once every few months, but it is getting more and more regular and I can't pinpoint why. I'm here to ask for help with food & diet to stop this from happening if possible. Here are my symptoms: *Almost always happens in the middle of the night, and always after I haven't been able to go to the toilet for a day or two *I wake up with excruciating pain in my lower abdomen, but when I go to the toilet nothing happens *The pain steadily builds to the point I am absolutely saturated in sweat, literally dripping, and need to strip all my clothes off *I feel extremely nauseous (haven't vomited yet but I feel it's on a hair trigger) *The pain is too great to push for a bowel movement, I can't stay upright and collapse to the bathroom floor *I lay there until the nausea & pain lessens a bit and drag myself to the toilet to try again. I honestly just want to die in that moment, the pain and nausea is too great *This happens on a cycle for the next half hour until I'm finally able to have a BM *The BM itself starts off hard with a rush of diarrhea behind it, almost like a cork blocking a bottle *I then have intermittent cramps all night, backwards and forwards to the toilet with a little more diarrhea and gas. *Feel very sore in the abdo area all day after. I would be keen to know if anyone else has similar symptoms with their attacks, and how they cope with it. I'd also like advice on which foods I should eat to stop this bottlenecking from happening, as I think if I can stop the mixed BM's I won't have that horrendous pain experience as it tries to evacuate. I'm willing to overhaul my whole diet if it stops these harrowing attacks. Thank you so much for your help and much love to anyone else suffering 💖
  15. Health Reporter

    Pubmed-Health benefits of xylitol.

    Related ArticlesHealth benefits of xylitol. Appl Microbiol Biotechnol. 2020 Jul 07;: Authors: Gasmi Benahmed A, Gasmi A, Arshad M, Shanaida M, Lysiuk R, Peana M, Pshyk-Titko I, Adamiv S, Shanaida Y, Bjørklund G Abstract Many diseases, including caries, chronic inflammatory diseases, diabetes, and obesity, are associated with uncontrolled sugar consumption. Artificial sweeteners are commonly used in food and pharmaceutical industries as sugar substitutes for the prevention of several dental and body diseases; they also have a favorable impact on body weight as they may help to restrict simple sugar consumption. Xylitol is a sugar alcohol that is commonly used as a sweetener. It can be found naturally or artificially prepared mainly from plant materials chemically or by fermentation of hemicelluloses from agricultural biomass by yeast or bacteria strains. This polyol has a significant antiplaque effect on teeth surface and can reduce the gingival inflammation; it is being used as a preventive agent for dental caries due to decreasing the growth levels of pathogenic Streptococcus mutans and Streptococcus sangui at the very early stages. Xylitol can bind with calcium ion leading to consequent remineralization of teeth enamel; it is also able to prevent osteoporosis. This polyol can treat respiratory tract and middle ear diseases due to its antibacterial and anti-inflammatory potential and prevent some diseases which cannot be cured through antibiotics or surgery. Xylitol can reduce constipation, diabetes, obesity, and other body syndromes or illnesses; it has also revealed its stimulating effect on digestion and immune system. However, it can produce some side effects such as irritable bowel syndrome, diarrhea, nephrolithiasis, etc., when consumed in excessive amounts. Different vehicles are used for delivering the xylitol into the human body, but chewing gums occupy a leading position. The present review is devoted to comprehensive analyses of the positive and negative effects of this polyol on human health.Key Points• The health benefits of xylitol are not limited to oral hygiene.• Xylitol efficiently stimulates the immune system, digestion, lipid and bone metabolism.• Xylitol helps in glycemic and obesity control; reduces ear and respiratory infections.• Xylitol treats diseases that cannot be cured through antibiotics or by surgery. PMID: 32638045 [PubMed - as supplied by publisher] View the full article
  16. Recent advances in diagnosis and management of irritable bowel syndrome. Curr Opin Psychiatry. 2020 Jul 06;: Authors: Van den Houte K, Colomier E, Schol J, Carbone F, Tack J Abstract PURPOSE OF REVIEW: This review summarizes recent progress in the diagnosis and management of irritable bowel syndrome, with a focus on dietary and microbiota aspects. RECENT FINDINGS: From a pathophysiological point of view, IBS is a multifactorial condition with both peripheral (transit) as central (visceral hypersensitivity, anxiety, depression) contribution in a cumulative fashion to the symptom pattern and severity. More recently, the focus has shifted to diet and microbiota. The number of dietary options that can be used for IBS and the understanding of determinants of their efficacy is rapidly increasing. Several studies have confirmed the efficacy of the low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet. Sucrose-isomaltase deficiency has emerged as pathogenetic mechanisms in a subset of patients, who do not respond to low FODMAP diet but may respond to starch and sucrose elimination. Herbal remedies, probiotics and secretagogues have been the topic of additional treatment trials. The efficacy of fecal microbiota transplantation in IBS is variable across studies, but donor selection is emerging as a critical factor. SUMMARY: Irritable bowel syndrome has evolved into a disorder of interaction between dietary factors and gut microbiota, with impact on bowel symptoms as well as extra-intestinal, central, symptoms. Dietary adjustments and treatments targeting the gut microbiota are areas of active research and clinical progress. PMID: 32639360 [PubMed - as supplied by publisher] View the full article
  17. Bimodal Release Ondansetron Improves Stool Consistency and Symptomatology in Diarrhea-Predominant Irritable Bowel Syndrome: A Randomized, Double-Blind, Trial. Am J Gastroenterol. 2020 Jun 24;: Authors: Plasse TF, Barton G, Davidson E, Abramson D, Kalfus I, Fathi R, Raday G, Harris MS Abstract INTRODUCTION: Previous, small studies have suggested that ondansetron has beneficial effects in diarrhea-predominant irritable bowel syndrome (IBS-D). This randomized, double-blind study evaluated the efficacy and safety of daily 12 mg RHB-102, an investigational bimodal release ondansetron tablet, in IBS-D. METHODS: Men and women with IBS-D by the Rome III criteria, Bristol Stool Scale ≥6 on 2 or more days weekly, and average daily worst pain intensity ≥3/10 were randomized 60:40 to RHB-102 or placebo once daily for 8 weeks. The primary end point was overall stool consistency response for at least 4 of 8 weeks. Secondary end points included overall worst abdominal pain and overall composite response, defined as response on both abdominal pain and stool consistency end points. RESULTS: Overall stool consistency response rates were 56.0% and 35.3% (RHB-102 vs placebo, P = 0.036) and similar among male and female patients. Overall pain response (50.7% vs 39.2%) and composite response rates (40.0% vs 25.5%) favored RHB-102, although these differences were not statistically significant. Stool consistency response rates were enhanced in patients with baseline C-reactive protein above the median (2.09 mg/L), 59.5%, vs 23.1% (P = 0.009). Overall rates of adverse events were similar, with a higher rate of constipation in RHB-102 patients (13.3% vs 3.9%) that resolved rapidly on withholding treatment. DISCUSSION: RHB-102 was effective and safe in the treatment of men and women with IBS-D. Baseline C-reactive protein seemed to be predictive of response. PMID: 32639235 [PubMed - as supplied by publisher] View the full article
  18. Related ArticlesThe association between exposure to childhood maltreatment and the subsequent development of functional somatic and visceral pain syndromes. EClinicalMedicine. 2020 Jun;23:100392 Authors: Chandan JS, Keerthy D, Zemedikun DT, Okoth K, Gokhale KM, Raza K, Bandyopadhyay S, Taylor J, Nirantharakumar K Abstract BACKGROUND: Childhood maltreatment is a global public health issue linked to a vast mortality and morbidity burden. This study builds on current literature to explore the risk of developing central sensitivity syndromes (CSS) (consisting of somatic and visceral pain syndromes) subsequent to childhood maltreatment exposure. METHODS: A retrospective population based open cohort study using the UK primary care database, 'The Health Improvement Network,' between 1st January 1995-31st December 2018. 80,657 adult patients who had experienced childhood maltreatment or maltreatment related concerns (exposed patients) were matched to 161,314 unexposed patients by age and sex. Outcomes of interest were the development of CSS: either somatic (Fibromyalgia, chronic fatigue syndrome, temporomandibular joint disorder, chronic lower back pain, chronic headache, myofascial pain syndrome and restless leg syndrome) or visceral (Interstitial cystitis, vulvodynia, chronic prostatitis and irritable bowel syndrome) in nature. Effect sizes are presented as adjusted incidence rate ratios (aIRR) with confidence intervals (CI). Models were adjusted for the following covariates at cohort entry: age, sex, deprivation, anxiety, depression and serious mental ill health. RESULTS: The average age at cohort entry was 23.4 years and the median follow was 2.2 years. There was an increased risk of developing fibromyalgia (aIRR 2.06; 95% CI 1.71-2.48), chronic fatigue syndrome (1.47; 1.08-2.00), chronic lower back pain (1.99; 1.68-2.35), restless leg syndrome (1.82; 1.41-2.35) and irritable bowel syndrome (1.15; 1.08-1.22) when compared to the unexposed group, whereas no statistical association was seen with the development of temporomandibular joint disorder (1.00; 0.88-1.13), chronic headache (1.04; 0.59-1.86), interstitial cystitis (1.19; 0.51-2.74), vulvodynia (0.65; 0.34-1.26), chronic prostatitis (0.34; 0.07-1.77) and myofascial pain syndrome (0.88; 0.36-2.14). Outcome numbers were low, most likely, due to the rarity of visceral conditions (aside from irritable bowel syndrome). The association between a history of childhood maltreatment and CSS were mainly observed in somatic CSS. INTERPRETATION: The debilitating effects of CSS carry a substantial physical, psychological and economic burden to both the individuals who are diagnosed with them and the health services who serve them. Primary prevention approaches targeting childhood maltreatment as well as secondary preventative approaches should be considered to minimise the associated burden of CSS. PMID: 32637892 [PubMed] View the full article
  19. Related ArticlesRisk of irritable bowel syndrome in patients who underwent appendectomy: A nationwide population-based cohort study. EClinicalMedicine. 2020 Jun;23:100383 Authors: Yang CY, Wu MC, Lin MC, Wei JC Abstract Background: Appendectomy is one of the most common surgical procedures; however, the possible long-term consequences have not been fully explored. The appendix has been associated with microflora of the gut and immune functions. However, literature examining the relationship between prior appendectomy and the risk of irritable bowel syndrome (IBS) is lacking. The aim of this study was to evaluate the risk of irritable bowel syndrome for patients who underwent appendectomy by using a nationwide longitudinal population-based cohort. Methods: Data from this study was collected from Taiwan's National Health Insurance Research Database (NHIRD), a population-based database. We identified 12,760 patients who underwent appendectomy between January 1, 2000 and December 31, 2012. A total of 9236 patients who had appendectomy (case group) were randomly matched with 9236 patients who had not undergone appendectomy (control group) in a ratio of 1:1 by means of propensity scores. The hazard ratio (HR) of IBS was calculated by multiple Cox regression. Furthermore, sensitivity test and stratified analysis were performed. Findings: The incidence rate of IBS was 51.30 per 10,000 person-years in patients having appendectomy, more than the 35.28 per 10,000 person-years in patients not having appendectomy. Patients who underwent appendectomy had 1.46-fold risk of IBS compared to patients not having appendectomy (HR, 1.46; 95% CI, 1.24-1.72). Stratified analysis revealed that the higher HR of 1.55 (95% CI, 1.18-2.04) in patients <40 years old, and particularly within the first 5 years follow-up period of undergoing appendectomy. In addition, patients diagnosed with fibromyalgia had a greater risk of suffering IBS after appendectomy (HR, 1.41; 95% CI, 1.04-1.92). Interpretation: Patients with appendectomy have a higher incidental risk of IBS than the control population. The risk is higher for patients under 40 years old and those who received appendectomy within 5 years. Physicians could take this into consideration for treatment plans of patients who have underwent this surgery. Further research on the pathogenesis of this association is required. Funding: This work was supported by grants from the Ministry of Health and Welfare, Taiwan (MOHW108-TDU-B-212-133004), China Medical University Hospital, Academia Sinica Stroke Biosignature Project (BM10701010021), MOST Clinical Trial Consortium for Stroke (MOST 108-2321-B-039-003-), Tseng-Lien Lin Foundation, Taichung, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan. PMID: 32637891 [PubMed] View the full article
  20. Related ArticlesThe Effectiveness of Synbiotic Preparation Containing Lactobacillus and Bifidobacterium Probiotic Strains and Short Chain Fructooligosaccharides in Patients with Diarrhea Predominant Irritable Bowel Syndrome-A Randomized Double-Blind, Placebo-Controlled Study. Nutrients. 2020 Jul 05;12(7): Authors: Skrzydło-Radomańska B, Prozorow-Król B, Cichoż-Lach H, Majsiak E, Bierła JB, Kosikowski W, Szczerbiński M, Gantzel J, Cukrowska B Abstract The purpose of the randomized double-blind placebo-controlled trial was to assess the effectiveness of synbiotic preparation containing probiotic Lactobacillus rhamnosus FloraActive™ 19070-2, Lactobacillus acidophilus DSMZ 32418, Bifidobacterium lactis DSMZ 32269, Bifidobacterium longum DSMZ 32946, Bifidobacterium bifidum DSMZ 32403 and fructooligosaccharides in adult patients with diarrhea-dominant IBS (IBS-D). The study included eighty patients with moderate and severe IBS-D who were randomized to receive synbiotics or placebo for eight weeks. Finally, a total of sixty-eight patients finished the study. The primary endpoints included the assessment of the symptoms' severity with IBS symptom severity scale (IBS-SSS), an improvement of IBS global symptoms with Global Improvement Scale (IBS-GIS) and adequate relief of symptoms after four and eight weeks of therapy. Secondary endpoints, which were collected by telephone interviewers three times a week included the assessment of individual IBS symptoms and adverse events. Synbiotic treatment in comparison to placebo significantly improved IBS-GIS (p = 0.043), and IBS-SSS score inducing a decrease in the total IBS-SSS (p = 0.042) and in domain-specific scores related to flatulence (p = 0.028) and bowel habit (p = 0.028) after four and eight weeks. Patients treated with synbiotics reported in weekly observations a significant amelioration in a feeling of incomplete bowel movements, flatulence, pain, stool pressure and diarrheal stools compared to those receiving placebo. There were no differences in adverse events between both groups. Concluding, the multi-strain synbiotic preparation was associated with a significant improvement in symptoms in IBS-D patients and was well-tolerated. These results suggest that the use of synbiotics offers a benefit for IBS-D patients. [Clinicaltrials.gov NCT04206410 registered 20 December 2019]. PMID: 32635661 [PubMed - in process] View the full article
  21. Last week
  22. I’m actually dealing with the exact same thing right now but no nausea or vomiting. I’ve been dealing with it since March. All started to get worse when I started working from home. I feel like it’s probably something I did in the office that I’m not doing now but I’ve had my IBSD under control for years and now I’m having the terrible pain and constipation and I feel like I have to go to the bathroom a lot but can’t. I’m finding that I’m experiencing different pains that are hard to fully pinpoint but some pains are Gas and I’m treating it with gas x and some appear to be intestines and I’m treating those with Tagamet. Neither has given me bad side effects like the ones my dr wanted to put me on. I’m currently shopping for a new gastro because the one I have now is just a pill pusher of expensive meds I do have a thought for you. Does she drink coffee or anything with caffeine each day? Sent from my iPhone using Tapatalk
  23. A few years a go I had a problem with my bowels for several weeks and the doc told me to take Align and it helped. Didn't have any side effects, thank goodness. I told my mom that she should call her doctor first and see what he says before she takes it. Hopefully it won't give her gas and heartburn as that is part of her problem. Unfortunately, she had another bout today with vomiting but after that felt much better. It seems that she gets lower abdominal cramps and she says it feels like she has to go to the bathroom and that's how all this starts. For the past 6 weeks this has been happening every 2 weeks, but before that she would go without episodes for several months. I don't know if this is IBS or not, but it sure does seem like it. Todays episode wasn't as bad because usually each episode would knock her out for several hours and today she just felt very tired before the episode, but after it happened felt ok.
  24. It could. Everyone reacts to probiotics differently though. I did Culturelle and had to go off of it. I got terrible gas and heartburn from it. I hear great things about Florastor. If you do see a reaction know that you can also open up the capsules and do less. You can mix it with almost anything. Most people see the adverse reactions in the first few weeks to first month. You’ll read other people on here that say they didn’t work for them though. I do far have not gone back on them. Sent from my iPhone using Tapatalk
  25. Due to the number of foods that make up our diet, particularly when we include packaged foods, there will come a time when a food you would like to include in your diet is not listed in the app. So what can you do? Find out here: http://ow.ly/RJZ250ArqwP (Feed generated with FetchRSS) View the full article
  26. Thank you! She is on a few meds but this problem started a few years before she started taking the medications. I told her to try Align probiotic, what do you think of that? Could it help?
  27. I have suffered from IBS-D for about 30 years and recently has a bout of food poisoning. Thought it was just a severe IBS or gastro to didn’t go to hospital as soon as I should have. 5 weeks later my IBS-D is in overdrive and I am reacting to anything I eat (pain, diarrhea,nausea) Has anyone else experienced this and did things settle eventually?
  28. Related ArticlesWheat Sensitivity and Functional Dyspepsia: A Pilot, Double-Blind, Randomized, Placebo-Controlled Dietary Crossover Trial with Novel Challenge Protocol. Nutrients. 2020 Jun 30;12(7): Authors: Potter MDE, Duncanson K, Jones MP, Walker MM, Keely S, Talley NJ Abstract Introduction: Functional dyspepsia (FD), characterised by symptoms of epigastric pain or early satiety and post prandial distress, has been associated with duodenal eosinophilia, raising the possibility that it is driven by an environmental allergen. Non-coeliac gluten or wheat sensitivity (NCG/WS) has also been associated with both dyspeptic symptoms and duodenal eosinophilia, suggesting an overlap between these two conditions. The aim of this study was to evaluate the role of wheat (specifically gluten and fructans) in symptom reduction in participants with FD in a pilot randomized double-blind, placebo controlled, dietary crossover trial. Methods: Patients with Rome III criteria FD were recruited from a single tertiary centre in Newcastle, Australia. All were individually counselled on a diet low in both gluten and fermentable oligo-, di-, mono-saccharides, and polyols (FODMAPs) by a clinical dietitian, which was followed for four weeks (elimination diet phase). Those who had a >30% response to the run-in diet, as measured by the Nepean Dyspepsia Index, were then re-challenged with 'muesli' bars containing either gluten, fructan, or placebo in randomised order. Those with symptoms which significantly reduced during the elimination diet, but reliably reappeared (a mean change in overall dyspeptic symptoms of >30%) with gluten or fructan re-challenge were deemed to have wheat induced FD. Results: Eleven participants were enrolled in the study (75% female, mean age 43 years). Of the initial cohort, nine participants completed the elimination diet phase of whom four qualified for the rechallenge phase. The gluten-free, low FODMAP diet led to an overall (albeit non-significant) improvement in symptoms of functional dyspepsia in the diet elimination phase (mean NDI symptom score 71.2 vs. 47.1, p = 0.087). A specific food trigger could not be reliably demonstrated. Conclusions: Although a gluten-free, low-FODMAP diet led to a modest overall reduction in symptoms in this cohort of FD patients, a specific trigger could not be identified. The modified Salerno criteria for NCG/WS identification trialled in this dietary rechallenge protocol was fit-for-purpose. However, larger trials are required to determine whether particular components of wheat induce symptoms in functional dyspepsia. PMID: 32629906 [PubMed - in process] View the full article
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