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  1. Today
  2. Gut Microbiome: Profound Implications for Diet and Disease. Nutrients. 2019 Jul 16;11(7): Authors: Hills RD, Pontefract BA, Mishcon HR, Black CA, Sutton SC, Theberge CR Abstract The gut microbiome plays an important role in human health and influences the development of chronic diseases ranging from metabolic disease to gastrointestinal disorders and colorectal cancer. Of increasing prevalence in Western societies, these conditions carry a high burden of care. Dietary patterns and environmental factors have a profound effect on shaping gut microbiota in real time. Diverse populations of intestinal bacteria mediate their beneficial effects through the fermentation of dietary fiber to produce short-chain fatty acids, endogenous signals with important roles in lipid homeostasis and reducing inflammation. Recent progress shows that an individual's starting microbial profile is a key determinant in predicting their response to intervention with live probiotics. The gut microbiota is complex and challenging to characterize. Enterotypes have been proposed using metrics such as alpha species diversity, the ratio of Firmicutes to Bacteroidetes phyla, and the relative abundance of beneficial genera (e.g., Bifidobacterium, Akkermansia) versus facultative anaerobes (E. coli), pro-inflammatory Ruminococcus, or nonbacterial microbes. Microbiota composition and relative populations of bacterial species are linked to physiologic health along different axes. We review the role of diet quality, carbohydrate intake, fermentable FODMAPs, and prebiotic fiber in maintaining healthy gut flora. The implications are discussed for various conditions including obesity, diabetes, irritable bowel syndrome, inflammatory bowel disease, depression, and cardiovascular disease. PMID: 31315227 [PubMed - in process] View the full article
  3. Blunted Evoked Prouroguanylin Endocrine Secretion in Chronic Constipation. Clin Transl Gastroenterol. 2019 Jul 17;: Authors: Waldman SA, Tenenbaum R, Foehl HC, Winkle P, Griffin P Abstract OBJECTIVES: Prouroguanylin (ProUGN) in the intestine is cleaved to form uroguanylin (UGN), which stimulates guanylate cyclase C (GUCY2C), inducing cyclic guanosine monophosphate signaling. Paracrine release regulates fluid secretion, contributing to bowel function, whereas endocrine secretion evoked by eating forms a gut-brain axis, controlling appetite. Whereas hormone insufficiency contributes to hyperphagia in obesity, its contribution to the pathophysiology of constipation syndromes remains unexplored. Here, we compared circulating ProUGN and UGN in healthy subjects and in patients with chronic idiopathic constipation (CIC) and patients with irritable bowel syndrome with constipation (IBS-C). METHODS: Circulating ProUGN and UGN levels were measured in 60 healthy subjects, 53 patients with CIC, and 54 patients with IBS-C. After an overnight fast, the participants ingested a standardized meal; blood samples were drawn at fasting and at 30, 60, and 90 minutes thereafter, and hormone levels were quantified by enzyme-linked immunosorbent assay. RESULTS: Fasting ProUGN levels were >30% lower in patients with CIC and those with IBS-C compared with healthy subjects regardless of age, sex, or disease state. After eating, ProUGN levels increased compared with fasting levels, although the rate of change was slower and maximum levels were lower in patients with CIC and those with IBS-C. Similarly, fasting UGN levels were lower in patients with CIC and those with IBS-C compared with healthy subjects. However, unlike ProUGN levels, UGN levels did not increase after eating. DISCUSSION: These observations support a novel pathophysiologic model in which CIC and IBS-C reflect a contribution of ProUGN insufficiency dysregulating intestinal fluid and electrolyte secretion. TRANSLATIONAL IMPACT: This study suggests that CIC and IBS-C can be treated by oral GUCY2C hormone replacement. Indeed, these observations provide a mechanistic framework for the clinical utility of oral GUCY2C ligands like plecanatide (Trulance) and linaclotide (Linzess) to treat CIC and IBS-C. PMID: 31318728 [PubMed - as supplied by publisher] View the full article
  4. Yesterday
  5. I am reaching out for some guidance as I have struggled for over 20 years with constipation. I currently experience incomplete evacuation and have very little rectal sensation. This seems an odd symptom, but when I am unable to evacuate completely, I get a pain and cracking in my right neck, shoulder and arm. I am currently 45 and in otherwise good health. I had a large cyst on my bile duct and gall bladder removed at age 14. I am currently seeing a neurogastro doctor at Mass General, but we still have not figured out the issue. Below is a list of what I am taking. I am curious as to why I cannot fully evacuate. I can often get the stool to my left side, but getting the last batch of watery stool out is a struggle. Noted below-I use about 30 glycerine suppositories and 2-3 stimulant biscodyl suppositories daily. Without these, I would hardly go to the bathroom at all. Happy to answer other questions as I am in great need of help. The current regimen takes about 3 hours per morning. What I am taking daily: Linzess 290 (doc prescribed) Cymbalta (doc prescribed to tone down nerves in gut) 4 Dr. Schultz Formula 1 stimulant laxatives 1 mag glycinate 2 triphala around 30 glycerine suppositories 2-3 stimulant biscodyl suppositories
  6. Roostertails12

    My story.

    I’ll try to make this short, started with acid reflux in 2003 i was 19 and was dipping a can every 2 days till I was 29. I stopped due to my brother getting diagnosed with pancreatic cancer and passed away at 34. I am 34 as of today . His passing started to make me hyper aware of my own symptoms other than acid reflux.. I have always had a mild urgency of bowel movements for years didn’t really know what was going on. , there was never any blood so I dismissed it . I was taking a ppi in the morning for years and then started to get breakthrough symptoms . This was in 2014 so I started taking 2 one in the morning one in the evening . Brother passes in 2015 and I go into full hypochondriac mode worrying about every pain I endure ...so I start to get physicals done , blood work done and full abdominal ultrasounds done. Everything coming back normal . I finally get referred to a gastro in 2017 and have an endoscopy done and changes my meds because the ppi I had been using was causing me pain everywhere . Changing worked for about a month and then pain came back and would have to switch again ..... after the endoscopy I was Basically was told that there is a lot of reflux , stomach inflammation and well as Esophageal inflammation . Biopsies done on throat , stomach and upper bowel . All came back with non cancerous and no pre cancerous conditions . About a year later i see my gi again because of severe alternating bouts with d and c and the feeling of a golf ball in my rectum he says ibs .... He tells me fiber is the answer. Fiber slightly worked . Kept everything solid for the most part. He told me the conjunction of the 2 diseases Is really hard to manage and will take time .... now I have ever changing symptoms . Sharp pain , dull pain upper , lower, mid , in my back sometimes. Also had a weird bout with yellow Diarrhea a while back about 3 weeks ago for about 3 days. I feel like I have constant trapped wind and my abdomen is always very tight very smelly frequent gas at times. .... eating actually feels ok ... discomfort happens about 3-4hours later but never fully goes away . This is new been happening for a few weeks now . Feels like muscle cramps but not spastic . Had full blood work done about a month ago everything metabolic turned out good , I’m active and train 5 times a week . And that’s really the only time I feel normal . Sorry for the long story . I’m sure I missed something .only thing else I can add is y latest ultrasound was last November and everything was normal won’t have more blood work done till November. Any input or questions are welcome.. thank you
  7. Irritable bowel syndrome: how can symptoms and quality of life be improved with diet? Curr Opin Clin Nutr Metab Care. 2019 Jul 10;: Authors: Guerreiro M, Sousa Guerreiro C, Cravo M Abstract PURPOSE OF REVIEW: This article aims to review the current scientific evidence of dietary approaches to control the symptoms of irritable bowel syndrome (IBS). RECENT FINDINGS: In the last decade, there was an important evolution in the study of the low fermentable oligo, di, mono-saccharides and polyols (FODMAP) diet (LFD). Current scientific evidence suggests a significant efficacy in the overall control of symptoms. LFD seems to be effective in improving quality of life. Recent studies suggest that LFD is effective and nutritionally well tolerated also in the long term, and longer adherence may contribute to greater effectiveness in improving depression. There is insufficient scientific evidence for the recommendation of gluten exclusion in IBS therapy, and some authors still suggest that the efficacy of this approach results from the limited ingestion of fructans. There is a promising efficacy of pre, pro, and symbiotic supplements, but there is no consensus on the most appropriate and effective strains in each case. SUMMARY: Given the poor evidence and the pathophysiological variability of IBS, the interest of each therapeutic option should be always evaluated individually. Nevertheless, LFD is currently the dietary approach with a higher degree of scientific evidence. PMID: 31313689 [PubMed - as supplied by publisher] View the full article
  8. Review article: the incidence and risk factors for irritable bowel syndrome in population-based studies. Aliment Pharmacol Ther. 2019 Jul 17;: Authors: Creed F Abstract BACKGROUND: In the absence of prior gastrointestinal infection, the risk factors for irritable bowel syndrome (IBS) are not well established. AIM: To identify the incidence and risk factors for IBS in general population samples METHODS: Narrative review of population-based studies. Electronic databases were searched using the keywords "incidence," "onset," "epidemiology," "population," "risk factors" with "irritable bowel syndrome" with subsequent hand searching. Inclusion criteria were: population-based, adults, prospective design (including retrospective case cohorts), clinical or research diagnosis of IBS and exclusion of individuals who had IBS prior to recruitment. RESULTS: Of 1963 papers, 38 were included; all provided data on risk factors, 27 reported incidence. The median incidence of physician-diagnosed IBS in 19 general population cohorts was 38.5 per 10 000 person-years (interquartile range = 20-45.3). In 14 cohorts with specific medical disorders, median incidence was 92 per 10 000 person-years (IQR: 73.9-119). Apart from gastroenteritis, the most common risk factors were other medical disorders, female sex, age (both young and old), anxiety and depression, life events/stress, frequent healthcare use, pain and sleep disorders. The results were conflicting for alcohol consumption, smoking and BMI. Incidence rates were similar in different countries but risk factors differed. CONCLUSIONS: Incidence rates were generally lower than previous estimates reflecting physician-diagnosed IBS. The results highlight the importance of other medical and psychosocial problems in the onset of IBS in addition to prior gastrointestinal infections. Aetiological research could be enhanced by studying the underlying mechanisms relating to all of these risk factors. PMID: 31313850 [PubMed - as supplied by publisher] View the full article
  9. Last week
  10. Faecal microbiota transplantation for diarrhoea-predominant irritable bowel syndrome: a double-blind, randomised, placebo-controlled trial The LancetFaecal microbiota transplantation (FMT) has shown promise in alleviating the symptoms of irritable bowel syndrome (IBS); however, controlled data on this ... View the full article
  11. Have you been avoiding eating out while on a #lowFODMAP diet? We have shared tips on our blog so that you don’t miss out on the fun of socialising over food! Link here: https://www.monashfodmap.com/blog/eating-out-on-low-fodmap-diet/ (Feed generated with FetchRSS) View the full article
  12. Studies offer conflicting evidence on probiotics for CDI prevention HealioInfectious Diseases in Children | Although guidelines do not recommend probiotics for the prevention of Clostridioides difficile infection, or CDI, researchers ... View the full article
  13. FMT Benefits for IBS Care Are Inconclusive MD MagazineNew evidence from a cumulative RCT analysis suggests irritable bowel syndrome patients do not definitively benefit from FMT treatment. View the full article
  14. Jeffrey Roberts

    IBSD

    While stress is a component of everyone's life, IBS is really not a stress disorder. I assume you were taking an antibiotic for your UTI. If that was within the last 3-6 months, it's possible to have an overgrowth of Clostridium Difficile, a nasty bacteria. Has your doctor considered that? With C. Difficile You might have diarrhea often which has a strong odour and your stools might have yellow mucous. You use a stool test to confirm it. Ironically, treatment is with a different antibiotic. Other than that, you have gone through a lot and your gut has taken quite a hit. While maybe not in an infectious state, it might need some care until it returns to normal. You might consider looking at the low FODMAP diet for foods that may not be as gassy or could contribute to diarrhea. You might also add some probiotics to your diet to see if that settles it down. I hope this is helpful.
  15. Review article: biological mechanisms for symptom causation by individual FODMAP subgroups - the case for a more personalised approach to dietary restriction. Aliment Pharmacol Ther. 2019 Jul 15;: Authors: Wang XJ, Camilleri M, Vanner S, Tuck C Abstract BACKGROUND: Due to the paucity of targeted therapy for irritable bowel syndrome (IBS), many patients turn to dietary modifications for symptom management. The combination of five subgroups of poorly absorbed and rapidly fermented carbohydrates-fructans, galacto-oligosaccharides, lactose, excess fructose and polyols-are thought to trigger gastrointestinal symptoms and are referred to collectively as "FODMAPs". AIMS: To examine the biological plausibility and mechanisms by which foods high in specific FODMAP subgroups cause symptoms, and to use this information to explore the possibility of targeting select dietary components to allow for a more personalised approach to dietary adjustment METHODS: Recent literature was analysed via search databases including Medline, PubMed and Scopus. RESULTS: Lactose, fructans and galacto-oligosaccharides have strong biologic plausibility for symptom generation due to lack of hydrolases resulting in distention from osmosis and rapid fermentation. However, excess fructose and polyols may only cause symptoms in specific individuals when consumed in high doses, but this remains to be established. There is evidence to suggest that certain patient characteristics such as ethnicity may predict response to lactose, but differentiation of other subgroups is difficult prior to dietary manipulation. CONCLUSIONS: While some clear mechanisms of action for symptom generation have been established, further research is needed to understand which patients will respond to specific FODMAP subgroup restriction. We suggest that clinicians consider in some patients a tailored, personalised "bottom-up" approach to the low-FODMAP diet, such as dietary restriction relevant to the patients' ethnicity, symptom profile and usual dietary intake. PMID: 31309595 [PubMed - as supplied by publisher] View the full article
  16. Total Bilirubin Is Associated with Small Intestinal Bacterial Overgrowth in Diarrhea Predominant Irritable Bowel Syndrome. Ann Clin Lab Sci. 2019 May;49(3):344-352 Authors: Kim SY, Seo YS, Lee ES, Kim KN Abstract BACKGROUND: Small intestinal bacterial overgrowth (SIBO) associated with irritable bowel syndrome (IBS) can cause microscopic mucosal inflammation and oxidative damage. Bilirubin is a marker of oxidant stress that is responsible for anti-oxidative activities. The objective of this research was to determine whether or not total bilirubin is associated with SIBO according to IBS subtypes. MATERIALS AND METHODS: We retrospectively reviewed the charts of patients who showed IBS symptoms with documented results of lactulose breath test for SIBO. Multivariate models were used in order to assess the relationship of total bilirubin with SIBO according to IBS subtypes. In addition, we observed changes in total bilirubin when SIBO was treated with rifaximin in the relevant IBS subtype. RESULTS: The total bilirubin level of subjects with SIBO was significantly higher than it was in those without. An examination according to IBS subtype groups showed that total bilirubin was independently associated with SIBO only in the subjects with diarrhea-predominant IBS subtype (OR: 2.723, 95% CI: [1.303-5.692], p<0.001). Additionally, a decrease in total bilirubin level and overall improvement of abdominal symptoms were observed following rifaximin treatment. CONCLUSIONS: These findings suggest that total bilirubin levels may provide additional information regarding the presence of SIBO in diarrhea-predominant IBS patients. PMID: 31308034 [PubMed - in process] View the full article
  17. GHSR-1 agonist sensitizes rat colonic intrinsic and extrinsic neurons to exendin-4: A role in the manifestation of postprandial gastrointestinal symptoms in irritable bowel syndrome? Neurogastroenterol Motil. 2019 Jul 16;:e13684 Authors: Buckley MM, O'Brien R, Buckley JM, O'Malley D Abstract BACKGROUND: Patients with irritable bowel syndrome (IBS) may experience postprandial symptom exacerbation. Nutrients stimulate intestinal release of glucagon-like peptide 1 (GLP-1), an incretin hormone with known gastrointestinal effects. However, prior to the postprandial rise in GLP-1, levels of the hunger hormone, ghrelin, peak. The aims of this study were to determine if ghrelin sensitizes colonic intrinsic and extrinsic neurons to the stimulatory actions of a GLP-1 receptor agonist, and if this differs in a rat model of IBS. METHODS: Calcium imaging of enteric neurons was compared between Sprague Dawley and Wistar Kyoto rats. Colonic contractile activity and vagal nerve recordings were also compared between strains. KEY RESULTS: Circulating GLP-1 concentrations differ between IBS subtypes. Mechanistically, we have provided evidence that calcium responses evoked by exendin-4, a GLP-1 receptor agonist, are potentiated by a ghrelin receptor (GHSR-1) agonist, in both submucosal and myenteric neurons. Although basal patterns of colonic contractility varied between Sprague Dawley and Wister Kyoto rats, the capacity of exendin-4 to alter smooth muscle function was modified by a GHSR-1 agonist in both strains. Gut-brain signaling via GLP-1-mediated activation of vagal afferents was also potentiated by the GHSR-1 agonist. CONCLUSIONS & INFERENCES: These findings support a temporal interaction between ghrelin and GLP-1, where the preprandial peak in ghrelin may temporarily sensitize colonic intrinsic and extrinsic neurons to the neurostimulatory actions of GLP-1. While the sensitizing effects of the GHSR-1 agonist were identified in both rat strains, in the rat model of IBS, underlying contractile activity was aberrant. PMID: 31311066 [PubMed - as supplied by publisher] View the full article
  18. Gina F

    IBSD

    I was told by my PC that I’ve got IBSD. She says it can be caused by stress. I AM a very anxious person and lately have been through some medical issues such as Shingles, UTI, trapezius spasm and now hip bursitis. The last week I’ve been waking in the morning with lots of gas and then diarrhea. It also happens awhile after dinner. I’m not sure if it can be stress related although my doctor seems to say yes. Any advice would help. Thank you all.
  19. The Chart I Made to Explain the Types of Bloating I Experience Yahoo NewsA woman creates the "Swall" chart to explain the different kinds of bloating she experiences due to irritable bowel syndrome. View the full article
  20. Jeffrey Roberts

    New member, looking for answers to my symptoms

    There's a lot to your story and while your symptoms have lasted for 12 months, it's not possible for anyone other than a physician to make a diagnosis. I think it is good that your family doctor has referred you to a GI Doctor for further investigation.
  21. Use of Eluxadoline in IBS-D MD MagazineMD Magazine. Mark Pimentel, MD: Let's switch gears. Let's talk about eluxadoline. Bill, you have some experience with the product but also, perhaps, in the ... View the full article
  22. Stratifying Patients With IBS-C to the Appropriate Agent Pharmacy TimesFollowing their discussion of available agents for irritable bowel syndrome with constipation (IBS-C), the panel considers how to optimally stratify patients. View the full article
  23. Effectiveness of mesalazine to treat irritable bowel syndrome: A meta-analysis. Medicine (Baltimore). 2019 Jul;98(28):e16297 Authors: Zhang FM, Li S, Ding L, Xiang SH, Zhu HT, Yu JH, Xu GQ Abstract AIM: Accumulating evidence has explored the effect of mesalazine on irritable bowel syndrome (IBS). However, these studies remain inconsistent. Thus, a meta-analysis was conducted to estimate the role of mesalazine on IBS. METHODS: PubMed, Medline, Embase, Web of Science, and the Cochrane Library Database were searched for all relevant randomized, controlled, blinded trials on mesalazine in patients with IBS between January 1980 and October 2018. All statistical analyses were performed using Revman 5.3 software. A fixed-effects model was adopted, 95% confidence intervals for SMD was calculated. Heterogeneity was evaluated by χ test and I statistic. RESULTS: Five studies involving 387 participants were finally included in this meta-analysis. The results showed that the SMD for clinical efficacy on abdominal pain in IBS patients treated with mesalazine in comparison to placebo was 0.19 (95% CI = -0.01 to 0.39, P = .06), which was statistically non-significant but clinically important. For beneficial effect of abdominal bloating, the SMD was 0.05 (95% CI = -0.20 to 0.30, P = .70), which was statistically non-significant. In regard to clinical efficacy on defecation frequency per day, the results revealed that the SMD was 0.29 (95% CI = -0.14 to 0.73, P = .18), which was statistically non-significant but clinically important. As for beneficial effect of general well-being, we found that the SMD was 0.41 (95% CI = -0.75 to 1.58, P = .49), which was statistically non-significant. With respect to stool consistency, the SMD was 0.01 (95% CI = -0.31 to 0.33, P = .96), which was statistically non-significant. For the effect of defecation urgency severity in IBS patients treated with mesalazine in comparison to placebo, we detected a surprising result with an SMD of 0.54 (95% CI = 0.05-1.04, P = .03), which was statistically significant. There was no significant difference between mesalazine group and placebo group on total mucosal immune cell counts of the patients with IBS with an SMD of -1.64 (95% CI = -6.17 to 2.89, P = .48) and there was also no significant difference in adverse reactions between two groups with an SMD of 1.05 (95% CI = 0.76-1.46 P = .77). CONCLUSION: Mesalazine is not superior to placebo in relieving clinical symptoms of abdominal pain, abdominal bloating, and general well-being of IBS and has no advantage of reducing defecation frequency per day and immune cell infiltration and improving stool consistency though without adverse reactions of mesalazine compared with placebo. For defecation urgency severity, placebo is even superior to mesalazine for IBS patients. Thus, mesalazine might be a cost burden to patients without providing good effectiveness. In view of the small sample size of the current study and the differences in every experimental designs, this study has high heterogeneity and requires subsequent verification. PMID: 31305414 [PubMed - in process] View the full article
  24. Health sequelae of human cryptosporidiosis-a 12-month prospective follow-up study. Eur J Clin Microbiol Infect Dis. 2019 Jul 14;: Authors: Carter BL, Stiff RE, Elwin K, Hutchings HA, Mason BW, Davies AP, Chalmers RM Abstract To investigate long-term health sequelae of cryptosporidiosis, with especial reference to post-infectious irritable bowel syndrome (PI-IBS). A prospective cohort study was carried out. All patients with laboratory-confirmed, genotyped cryptosporidiosis in Wales, UK, aged between 6 months and 45 years of age, over a 2-year period were contacted. Five hundred and five patients agreed to participate and were asked to complete questionnaires (paper or online) at baseline, 3 and 12 months after diagnosis. The presence/absence of IBS was established using the Rome III criteria for different age groups. Two hundred and five of 505 cases completed questionnaires (40% response rate). At 12 months, over a third of cases reported persistent abdominal pain and diarrhoea, 28% reported joint pain and 26% reported fatigue. At both 3 and 12 months, the proportion reporting fatigue and abdominal pain after Cryptosporidium hominis infection was statistically significantly greater than after C. parvum. Overall, 10% of cases had sufficient symptoms to meet IBS diagnostic criteria. A further 27% met all criteria except 6 months' duration and another 23% had several features of IBS but did not fulfil strict Rome III criteria. There was no significant difference between C. parvum and C. hominis infection with regard to PI-IBS. Post-infectious gastrointestinal dysfunction and fatigue were commonly reported after cryptosporidiosis. Fatigue and abdominal pain were significantly more common after C. hominis compared to C. parvum infection. Around 10% of people had symptoms meriting a formal diagnosis of IBS following cryptosporidiosis. Using age-specific Rome III criteria, children as well as adults were shown to be affected. PMID: 31302785 [PubMed - as supplied by publisher] View the full article
  25. Relative Efficacy of Tegaserod in a Systematic Review and Network Meta-analysis of Licensed Therapies for Irritable Bowel Syndrome with Constipation. Clin Gastroenterol Hepatol. 2019 Jul 11;: Authors: Black CJ, Burr NE, Ford AC PMID: 31302307 [PubMed - as supplied by publisher] View the full article
  26. Chemical synthesis of 7α-hydroxycholest-4-en-3-one, a biomarker for irritable bowel syndrome and bile acid malabsorption. Steroids. 2019 Jul 11;:108449 Authors: Offei SD, Arman HD, Yoshimoto FK Abstract 7α-Hydroxy-cholest-4-en-3-one is a biomarker for bile acid loss, irritable bowel syndrome, and other diseases associated with defective bile acid biosynthesis. Furthermore, 7α-hydroxy-cholest-4-en-3-one is the physiological substrate for cytochrome P450 8B1 (P450 8B1 or CYP8B1), the oxysterol 12α-hydroxylase enzyme implicated in obesity and cardiovascular health. We report the chemical synthesis of this physiologically important oxysterol beginning with cholesterol. The key feature of this synthesis involves a regioselective C3-allylic oxidation of a 3-desoxy-Δ4-7α-formate steroid precursor to form 7α-formyloxy-cholest-4-en-3-one, which was saponified to yield 7α-hydroxy-cholest-4-en-3-one. PMID: 31302111 [PubMed - as supplied by publisher] View the full article
  27. American Gastroenterological Association Guideline on Mild-to-Moderate Ulcerative Colitis on the Laboratory Evaluation of Functional Diarrhea and Diarrhea-Predominant Irritable Bowel Syndrome in Adults (IBS-D). Gastroenterology. 2019 Jul 11;: Authors: Smalley W, Falck-Ytter C, Carrasco-Labra A, Wani S, Lytvyn L, Falck-Ytter Y PMID: 31302098 [PubMed - as supplied by publisher] View the full article
  28. Related Articles Mitochondrial function - gatekeeper of intestinal epithelial cell homeostasis. Nat Rev Gastroenterol Hepatol. 2018 08;15(8):497-516 Authors: Rath E, Moschetta A, Haller D Abstract The intestinal epithelium is a multicellular interface in close proximity to a dense microbial milieu that is completely renewed every 3-5 days. Pluripotent stem cells reside at the crypt, giving rise to transient amplifying cells that go through continuous steps of proliferation, differentiation and finally anoikis (a form of programmed cell death) while migrating upwards to the villus tip. During these cellular transitions, intestinal epithelial cells (IECs) possess distinct metabolic identities reflected by changes in mitochondrial activity. Mitochondrial function emerges as a key player in cell fate decisions and in coordinating cellular metabolism, immunity, stress responses and apoptosis. Mediators of mitochondrial signalling include molecules such as ATP and reactive oxygen species and interrelate with pathways such as the mitochondrial unfolded protein response (MT-UPR) and AMP kinase signalling, in turn affecting cell cycle progression and stemness. Alterations in mitochondrial function and MT-UPR activation are integral aspects of pathologies, including IBD and cancer. Mitochondrial signalling and concomitant changes in metabolism contribute to intestinal homeostasis and regulate IEC dedifferentiation-differentiation programmes in the context of diseases, suggesting that mitochondrial function as a cellular checkpoint critically contributes to disease outcome. This Review highlights mitochondrial function and MT-UPR signalling in epithelial cell stemness, differentiation and lineage commitment and illustrates mitochondrial function in intestinal diseases. PMID: 29844587 [PubMed - indexed for MEDLINE] View the full article
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