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    Pubmed-Is a low FODMAP diet dangerous?

    Related Articles Is a low FODMAP diet dangerous? Tech Coloproctol. 2018 08;22(8):569-571 Authors: Bellini M, Rossi A PMID: 30083779 [PubMed - indexed for MEDLINE] View the full article
  3. Related Articles Pelvic Floor Symptom Related Distress in Chronic Constipation Correlates With a Diagnosis of Irritable Bowel Syndrome With Constipation and Constipation Severity but Not Pelvic Floor Dyssynergia. J Neurogastroenterol Motil. 2019 Jan 31;25(1):129-136 Authors: Singh P, Seo Y, Ballou S, Ludwig A, Hirsch W, Rangan V, Iturrino J, Lembo A, Nee JW Abstract Background/Aims: Although symptoms related to the pelvic floor, such as pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTS), are common in patients with chronic constipation (CC), its impact is not clear. Our aims were to investigate the following (1) compare pelvic floor symptom related dysfunction in irritable bowel syndrome with constipation (IBS-C) and functional constipation (FC), and (2) symptom correlation with findings on anorectal manometry (ARM) and balloon expulsion test. Methods: This was a retrospective analysis of patients with CC undergoing ARM. IBS-C and FC were diagnosed by Rome III criteria. Pelvic Floor Distress Inventory (PFDI-20) was used to measure pelvic floor symptom distress. Constipation Severity Scale was used to assess constipation severity. Results: A total of 107 patients underwent ARM (64 FC, 43 IBS-C). The overall PFDI-20 score in IBS-C was higher compared with FC patients (118.0 vs 79.2, P = 0.001). In those with IBS-C, POP, LUTS, and colorectal symptoms subscales were all higher compared with FC patients ( P < 0.05 for each). On multivariable regression, IBS-C ( P = 0.001) and higher constipation severity ( P = 0.001) were both independently associated with higher PFDI scores. ARM parameters and abnormal balloon expulsion test did not correlate with PFDI scores. Conclusions: Compared with FC patients, those with IBS-C have significantly higher distress from pelvic floor specific symptoms including POP and LUTS. Higher abdominal pain among IBS-C patients did not entirely explain these findings. A diagnosis of IBS-C and higher constipation severity correlated with PFDI-20 scores, but dyssynergia did not. PMID: 30646484 [PubMed] View the full article
  4. Related Articles Effect of a short-term low fermentable oligiosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet on exercise-related gastrointestinal symptoms. J Int Soc Sports Nutr. 2019 Jan 15;16(1):1 Authors: Wiffin M, Smith L, Antonio J, Johnstone J, Beasley L, Roberts J Abstract BACKGROUND: Research has demonstrated that low fermentable oligiosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diets improve gastrointestinal (GI) symptoms in irritable bowel syndrome sufferers. Exercise-related GI issues are a common cause of underperformance, with current evidence focusing on the use of FODMAP approaches with recreationally competitive or highly trained athletes. However, there is a paucity of research exploring the potential benefit of FODMAP strategies to support healthy, recreational athletes who experience GI issues during training. This study therefore aimed to assess whether a short-term LOWFODMAP diet improved exercise-related GI symptoms and the perceived ability to exercise in recreational runners. METHODS: Sixteen healthy volunteers were randomly assigned in a crossover design manner to either a LOWFODMAP (16.06 ± 1.79 g·d- 1) or HIGHFODMAP (38.65 ± 6.66 g·d- 1) diet for 7 days, with a one week washout period followed by a further 7 days on the alternate diet. Participants rated their gastrointestinal symptoms on an adapted version of the Irritable Bowel Syndrome-Severity Scoring System (IBS-SSS) questionnaire before and at the end of each dietary period. Perceived ability to exercise (frequency, intensity and duration) in relation to each dietary period was also rated using a visual analogue scale. Resting blood samples were collected prior to and on completion of each diet to determine plasma intestinal fatty acid binding protein (I-FABP) as a marker of acute GI injury. RESULTS: Overall IBS-SSS score significantly reduced in the LOWFODMAP condition from 81.1 ± 16.4 to 31.3 ± 9.2 (arbitrary units; P = 0.004). Perceived exercise frequency (z = 2.309, P = 0.02) and intensity (z = 2.687, P = 0.007) was significantly improved following a short-term LOWFODMAP approach compared to HIGHFODMAP. No significant differences were reported between dietary conditions for plasma I-FABP (P > 0.05). CONCLUSIONS: A short-term LOWFODMAP diet under free-living conditions reduced exercise-related GI symptoms and improved the perceived ability to exercise in otherwise healthy, recreational runners. These findings may be explained by a reduction in indigestible carbohydrates available for fermentation in the gut. The therapeutic benefits of LOWFODMAP diets in recreational and trained athletes during sustained training periods warrants further investigation. PMID: 30646926 [PubMed - in process] View the full article
  5. Benefit-Risk Assessment of Plecanatide in the Treatment of Chronic Idiopathic Constipation. Drug Saf. 2019 Jan 16;: Authors: Miner PB Abstract Plecanatide, a uroguanylin analog, activates the guanylate cyclase C receptors in the epithelial lining of the gastrointestinal tract in a pH-dependent fashion initiating (1) the conversion of intracellular guanosine triphosphate to cyclic guanosine monophosphate, which increases the activity of the cystic fibrosis transmembrane conductance regulator to increase chloride and bicarbonate secretion into the intestinal lumen and (2) a decrease in activity of the sodium-hydrogen ion exchanger. The resulting ionic shifts cause an increase in lumenal fluid to facilitate digestion. Plecanatide has been approved by the FDA for use in chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation. This manuscript is a critical assessment of the therapeutic efficacy and potential risks associated with the use of plecanatide in CIC. The discussion of CIC as a clinical and investigative disorder focuses on the importance of this problem as well and the difficulties involved in clinical management and scholarly investigation of a symptom arising from multiple pathophysiologic mechanisms. Clinical data from studies of recently approved drugs for CIC are utilized to construct a platform for thoughtful understanding of CIC and of how changes in investigation guidelines influence the interpretation of study data and guide symptom management. Plecanatide is a safe and effective medication for the management of adults with CIC. PMID: 30649746 [PubMed - as supplied by publisher] View the full article
  6. A Breakthrough Research Regarding The Role Of Intestinal Serotonin Transporter (SERT) In Diarrheal Diseases Associated With Infections or Inflammation by Ravinder Gill - Press Release Digital JournalCaused by infectious agents, Diarrheal disease is amongst the leading cause of death in children under 5 years old, and continues to pose a serious health peril ... View the full article
  7. RT @FodyFoods: Our #LowFODMAP snackbars are sweetened with Maple Syrup (low FODMAP natural sweetener), loaded with crunchy nuts fit to @mon… (Feed generated with FetchRSS) View the full article
  8. How to choose a good probiotic for your gut Body and SoulEver wondered why some probiotics need to be refrigerated and others are fine to keep in the pantry? Or whether the strains in your supplements are what your ... View the full article
  9. Yesterday
  10. RT @NIDDKgov: If you have #IBS, dietary changes such as eating more fiber, avoiding gluten, and following a low #FODMAP diet may help treat… (Feed generated with FetchRSS) View the full article
  11. Putting the Genie Back in the Bottle: Addressing Constipation in the Opioid Era HealioHealio Gastroenterology | Approximately 50 million adults in the United States reported experiencing chronic pain in 2016 while 19.6 million U.S. adults reported ... View the full article
  12. 8 Things That Happen Inside Your Body When You're Constipated BustleNot being able to go to the bathroom is frustrating enough, but unfortunately, constipation comes with more than just an inability to go number two. There are a ... View the full article
  13. Related Articles The role of a sequencing-based clinical intestinal screening test in patients at high-risk for Clostridium difficile and other pathogens: a case report. J Med Case Rep. 2019 Jan 15;13(1):9 Authors: Hitschfeld M, Tovar E, Gupta S, Bik EM, Palmer C, Hoaglin MC, Almonacid DE, Richman J, Apte ZS Abstract BACKGROUND: Hospitalization and antibiotic treatment can put patients at high risk for Clostridium difficile infection, where a disturbance of the gut microbiome allows for Clostridium difficile proliferation and associated symptoms, including mild, moderate, or severe diarrhea. Clostridium difficile infection is challenging to treat, often recurrent, and leads to almost 30,000 annual deaths in the USA alone. Here we present a case where SmartGut™, an at-home, self-administered sequencing-based clinical intestinal screening test, was used to identify the presence of Clostridium difficile in a patient with worsening diarrhea. Identification of this pathogen and subsequent treatment led to a significant improvement in symptoms. CASE PRESENTATION: The patient is a 29-year-old white woman with a history of severe irritable bowel syndrome with diarrhea, hemorrhoidectomy, and anal sphincterotomy complicated by a perianal fistula and perirectal abscesses that required extended courses of broad-spectrum antibiotics. In June 2016, she developed intermittent Clostridium difficile infections, which required continued antibiotic use. Months later she used an at-home, self-administered, intestinal microbial test, the first of which was negative for the presence of Clostridium difficile, but it detected the relative abundance of microbes associated with irritable bowel syndrome outside the healthy reference ranges. In the subsequent 2 months after the negative Clostridium difficile result, her gastrointestinal symptoms worsened dramatically. A second microbiome test resulted in a positive Clostridium difficile finding and continued abnormal microbial parameters, which led the treating physician to refer her to a gastroenterologist. Additional testing confirmed the presence of Clostridium difficile with a toxin-positive strain. She received treatment immediately and her gastrointestinal symptoms improved significantly over the next week. CONCLUSIONS: This case report suggests that more frequent DNA testing for Clostridium difficile infections may be indicated in patients that are at high-risk for Clostridium difficile infection, especially for patients with irritable bowel syndrome, and those who undergo gastrointestinal surgery and/or an extended antibiotic treatment. This report also shows that such testing could be effectively performed using at-home, self-administered sequencing-based clinical intestinal microbial screening tests. Further research is needed to investigate whether the observations reported here extrapolate to a larger cohort of patients. PMID: 30642394 [PubMed - in process] View the full article
  14. Low-FODMAP Diet Is Associated With Improved Quality of Life in IBS Patients-A Prospective Observational Study. Nutr Clin Pract. 2019 Jan 15;: Authors: Kortlever TL, Ten Bokkel Huinink S, Offereins M, Hebblethwaite C, O'Brien L, Leeper J, Mulder CJJ, Barrett JS, Gearry RB Abstract BACKGROUND: The low fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) diet is effectively manages irritable bowel syndrome (IBS) symptoms. Long-term low-FODMAP studies rarely report quality of life (QoL). We aimed to determine the effect of low-FODMAP diet on long-term QoL, gastrointestinal (GI) and non-GI symptoms in IBS patients. METHODS: A prospective observational study of IBS patients referred for low-FODMAP dietary advice was performed. The primary outcome of QoL and secondary outcomes of GI symptoms, anxiety/depression, fatigue, sleep quality, and happiness were obtained at baseline, 6 weeks (T6), and 6 months (T26). RESULTS: 111 patients were recruited. 91.0%, 71.6%, and 50.5% of participants completed baseline, T6, and T26 assessments, respectively. There were significant improvements in QoL from baseline at T6 and T26 (both P < 0.001). Significant reductions were seen in GI symptoms at T6 and T26 (both P < 0.001), fatigue at T6 and T26 (both P < 0.003), and anxiety at T6 and T26 (both P < 0.007), compared with baseline. A significant reduction was seen for depression (P < 0.010) from baseline at T26, and a significant increase was seen for both happiness and vitality (both P < 0.04) from baseline at T26. There was a significant correlation between GI symptom response and change in QoL, anxiety, depression, and fatigue (all P < 0.034). CONCLUSION: Low-FODMAP diet was associated with improved long-term QoL and GI symptoms, reduced fatigue and anxiety/depression, and increased happiness and vitality. These data support a wider range of benefits for IBS patients consuming a low-FODMAP diet. PMID: 30644587 [PubMed - as supplied by publisher] View the full article
  15. Diverticular disease and posture during defecation : a prospective comparative study. Acta Gastroenterol Belg. 2018 Oct-Dec;81(4):490-495 Authors: Ozturk O, Koklu H, Akbal E, Aksoy EK, Altan E, Basar O, Yuksel O, Arslan S, Koklu S Abstract BACKGROUND AND STUDY AIMS: Although several factors are thought to be responsible for the development of colonic diverticulosis (CD), the underlying pathogenesis is still obscure and needs clarification. The aim of this study was to determine the prevalence, location and clinical features of CD and especially to detect whether there is an association between CD and postures during defecation. PATIENTS AND METHODS: This prospective study enrolled 757 patients. The subjects were divided into two groups as a diverticulosis group (D group, n:95) and non-diverticulosis group (non-D group, n:662). RESULTS: The median patient age was 54.9±13.2 years. CD frequency was 12.5% (n:95). The most commonly involved part of the colon was the sigmoid colon (56.8%). Diverticula location was on the left in 45.3% (n:43), on the right in 24.2% (n:23) and on both sides of the colon in 30.5% (n:29). Patients in the D group were older (p<0.001) and were predominantly female (p:0.04). The frequency of sitting during defecation (Western type toilet) was higher in the D group compared to the non-D group (72.2% vs 53.5%; p:0.007). The use-time of a Western-type toilet was longer in the D group compared to the non-D group (p:0.04). In multivariable logistic regression analysis, age and toilet type were independent risk factors for the development of diverticulosis. CONCLUSION: Sitting during defecation seems to increase the risk of CD. PMID: 30645917 [PubMed - in process] View the full article
  16. New Test for IBS-D Uses Autoimmune Biomarker Gastroenterology & Endoscopy NewsBased on the science behind a new diagnostic test, diarrhea-predominant irritable bowel syndrome appears to be an autoimmune process in at least some ... View the full article
  17. Last week
  18. Here’s why high-fiber diets are all the rage—and how to beat the bloat Well+GoodF-Factor founder Tanya Zuckerbrot and wellness expert Lindsey Elmore explain how to beat the bloat on a high-fiber diet. View the full article
  19. Lactobacillus acidophilus: Health benefits and sources Medical News TodayLactobacillus acidophilus is a common probiotic that is available as a dietary supplement and is an ingredient in yogurts and other fermented foods. Research ... View the full article
  20. Dietary fiber is associated with a number of health benefits. But how much should you include in your daily diet? @medpagetoday shares new research that daily intake of 30 g or more/day can help guard against certain chronic health conditions at https://www.medpagetoday.com/cardiology/prevention/77419 (RSS generated with FetchRss) View the full article
  21. RT @Jeff_Lackner: #CBT treatment for IBS developed by @UBuffalo researchers just received empirically validated treatment designation by @A… (RSS generated with FetchRss) View the full article
  22. RT @HealioGastro: ICYMI: @umfoodoc recently spoke with us and offered some advice o ways to bridge the patient education gap in chronic con… (RSS generated with FetchRss) View the full article
  23. Irritable Bowel Syndrome Symptoms And Cures Glamour UKNutritional health coach Madeleine Shaw shares her top tips for coping with IBS. View the full article
  24. Related Articles Sleep Quality of Functional Gastrointestinal Disorder Patients in Class-Three Hospitals: A Cross-Sectional Study in Tianjin, China. Biomed Res Int. 2018;2018:3619748 Authors: Zhao W, Jin H, Xu M, Wang D, Liu Y, Tang Y, Zhang Q, Hua J, Wang B Abstract Background: Functional gastrointestinal disorder (FGID) patients are influenced by anxiety, depression, and low sleep quality, which reduce the quality of their life. However, epidemiological data on the quality of sleep in FGID patients were lacking. This study aims to explore the sleep quality and influencing factors of the sleep quality in FGID patients. Methods: 1200 subjects, diagnosed as FGID in one of the six class-three hospitals in Tianjin, China, from January to December 2014, were recruited. The information about demographic information, the severity of clinical symptoms, psychological status (Zung self-rating depression scale), and sleep quality (evaluated with Pittsburgh sleep quality index) was gathered. Results: The questionnaires from 1117 participants were collected including 920 of functional dyspepsia (FD) patients, 77 of irritable bowel disease (IBS) patients, 26 of functional constipation (FC) patients, and 94 other FGID patients. The results showed that morbidity rate for FD patients who had sleep disorders was higher than those who suffered from IBS or FC (P < 0.001). The proportion of elderly patients suffering from low sleep quality was higher than that of middle-aged and young patients (P < 0.001). The binary logistic regression analysis showed that age, education, and the severity of FGID symptom were influencing factors for poor sleep quality in FGID patients. Conclusion: The issue of poor sleep quality in FGID patients in Tianjin area is prominent, and elderly patients suffer lower sleep quality than other FGID patients. Age, education, and the severity of FGID symptoms are critical influencing factors which result in a drop-in sleep quality. PMID: 29977909 [PubMed - indexed for MEDLINE] View the full article
  25. Related Articles Factors associated with more frequent diagnostic tests and procedures in patients with irritable bowel syndrome. Therap Adv Gastroenterol. 2019;12:1756284818818326 Authors: Lacy B, Ayyagari R, Guerin A, Lopez A, Shi S, Luo M Abstract Background: Irritable bowel syndrome (IBS) reduces quality of life and burdens healthcare systems. This study identified factors associated with frequent use of IBS diagnostic tests and procedures. Methods: Using a United States claims database (2001-2012), tests and procedures in IBS patients occurring in the 2-year study period (12 months before/following the first IBS diagnosis) were analyzed: endoscopy, GI transit testing, anorectal procedures, and radiologic imaging. Patients were classified based on test/procedure frequency (3+, 1-2, or 0). Multivariate logistic regression identified factors associated with more frequent tests/procedures. Results: Among 201,322 IBS patients, 41.7% had 3+ tests/procedures, 35.1% had 1-2, and 23.3% had 0. Patients with more tests/procedures were older [mean age 50.6 (3+ group), more likely to be female and had more comorbidities, including anxiety, depressive disorders, and somatization. Dyspepsia [odds ratio (95% confidence interval): 1.80 (1.72-1.87)], interstitial cystitis [1.60 (1.45-1.77)], gastroesophageal reflux disease [1.59 (1.55-1.63)], constipation [1.50 (1.45-1.54)], and dyspareunia [1.38 (1.25-1.52)] were significantly associated with more tests/procedures (3+ versus 1-2), while anxiety, depressive disorders, and somatization were not. Patients with more frequent specialist visits [emergency department (ED; 1.10 (1.09-1.11)) and gastroenterologists (1.26 (1.26-1.27))] or at least one GI-related ED visit or inpatient admission [1.95 (1.86-2.04) and 3.67 (3.48-3.87), respectively] were more likely to have more tests/procedures (all p < 0.05). Conclusions: Test frequency in patients with IBS is strongly associated with demographic and clinical characteristics, especially comorbid conditions related to IBS. Presence of common overlapping comorbid conditions should increase clinicians' confidence in making the diagnosis of IBS, thus curtailing redundant testing and reducing healthcare costs. PMID: 30636972 [PubMed] View the full article
  26. Ironwood Pharmaceuticals Announces Approval of LINZESS® (linaclotide) in China for the Treatment of Adults with IBS-C Business WireIronwood Pharmaceuticals, Inc. (Nasdaq: IRWD), a commercial biotechnology company, today announced that the National Medical Products Administration ( View the full article
  27. Patients to take part in landmark irritable bowel syndrome trial Hospital Healthcare EuropeSheffield Teaching Hospitals NHS Foundation Trust has been named as one of 20 UK sites involved in a landmark trial assessing whether a drug commonly ... View the full article
  28. Clinical Trial Testing Fecal Microbiota Transplant for Recurrent Diarrheal Disease Begins National Institutes of HealthA research consortium recently began enrolling patients in a clinical trial examining whether fecal microbiota transplantation (FMT) by enema—putting stool from ... View the full article
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