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  1. Yesterday
  2. Microbial dysbiosis in irritable bowel syndrome: A single-center metagenomic study in Saudi Arabia. JGH Open. 2020 Aug;4(4):649-655 Authors: Masoodi I, Alshanqeeti AS, Alyamani EJ, AlLehibi AA, Alqutub AN, Alsayari KN, Alomair AO Abstract Background: The focus of this study was to explore potential differences in colonic mucosal microbiota in irritable bowel syndrome (IBS) patients compared to a control group utilizing a metagenomic study. Methods: Mucosal microbiota samples were collected from each IBS patient utilizing jet-flushing colonic mucosa in unified segments of the colon with distilled water, followed by aspiration, during colonoscopy. All the purified dsDNA was extracted and quantified before metagenomic sequencing using an Illumina platform. An equal number of healthy age-matched controls were also examined for colonic mucosal microbiota, which were obtained during screening colonoscopies. Results: The microbiota data on 50 IBS patients (31 females), with a mean age 43.94 ± 14.50 (range19-65), were analyzed in comparison to 50 controls. Satisfactory DNA samples were subjected to metagenomics study, followed by comprehensive comparative phylogenetic analysis. Metagenomics analysis was carried out, and 3.58G reads were sequenced. Community richness (Chao) and microbial structure in IBS patients were shown to be significantly different from those in the control group. Enrichment of Oxalobacter formigenes, Sutterella wadsworthensis, and Bacteroides pectinophilus was significantly observed in controls, whereas enrichment of Collinsella aerofaciens, Gemella morbillorum, and Veillonella parvula Actinobacteria was observed significantly in the IBS cohort. Conclusion: The current study has demonstrated significant differences in the microbiota of IBS patients compared to controls. PMID: 32782952 [PubMed] View the full article
  3. Nutritional status in irritable bowel syndrome: A North American population-based study. JGH Open. 2020 Aug;4(4):656-662 Authors: Hujoel IA Abstract Background and Aim: Irritable bowel syndrome (IBS) affects 12% of the population, and the evidence supporting current medical interventions is poor. There is increasing focus on the therapeutic benefit of diet and supplementation. We aim to compare dietary composition and hematologic and biochemical markers in those with and without IBS to determine potential targets for therapeutic supplementation. Methods: All 17 national surveys between 1959 and 2019 were screened, and only 1, the Second National Health and Nutrition Examination Survey (NHANES II) (1976-1980), provided comprehensive data on IBS. We performed a cross-sectional analysis of hematologic and biochemical markers and dietary composition of 12 295 individuals, aged 18-74, in NHANES II. Results: Individuals with IBS had significantly higher copper-zinc ratios (1.70 vs 1.55, P = 0.048) and were more likely to have ratios above 1.8 (odds ratio 1.79, 95% confidence interval 1.02-3.13), indicative of underlying copper-zinc imbalance. While more likely to report dietary avoidances, they had no other evidence of nutritional deficiencies. In addition, dietary recall showed that those with IBS consumed more calories (P = 0.02), were more likely to take vitamin supplements (P = 0.003), and that their macro and micronutrient intake was not significantly different. Conclusions: The findings suggest that individuals with IBS should be screened for copper-zinc imbalance. Given zinc's role in the immune system, the "brain-gut" axis, and the gastrointestinal barrier, the identified copper-zinc imbalance may play a role in perpetuating the underlying pathophysiology of IBS. Further studies are needed to investigate this hypothesis and the potential role of therapeutic zinc supplementation. PMID: 32782953 [PubMed] View the full article
  4. Check out the @Stanford_GI YouTube channel #FoodAsMedicine #EatRight https://twitter.com/stanford_gi/status/1293742839336013827 https://t.co/Hqc1WBBFjD (Feed generated with FetchRSS) View the full article
  5. RT @Stanford_GI: Check out our new @YouTube video as a part of the Eating right series on dietary advice for managing #constipation. Our faculty Dr. Neshatian @Leila_Neshatian and dietician Ms. Sun share expert insights on simple steps which can to improve symptoms. https://youtu.be/MKLJfslbMw0 (Feed generated with FetchRSS) View the full article
  6. Google-Participants needed for study into IBS - PerthNow http://dlvr.it/RdXmGt (Feed generated with FetchRSS) View the full article
  7. Last week
  8. Brain-Gut Connection: How Emotions Affect Your Gut | Shape Shape Magazine It would be easy to blame all of your stomach issues on a weak digestive system. Diarrhea? Definitely last night's socially distanced BBQ. Bloated and gassy? Thank that extra cup of coffee this a.m. Sure, what you consume can and does affect your gut. But (!!) have you ever stopped to think that there might be more to your stomach issues that have nothing at all do with the stomach itself? Many of the commonly-experienced tummy troubles can actually stem from your head. Just think: How many times have you had an emotionally fraught day and your stomach paid the price? "The mind and body are intimately connected," says Paraskevi Noulas, Psy.D., clinical assistant professor in the Department of Psychiatry at NYU Grossman School of Medicine. "It's funny how we separate the two sometimes and think that issues of the mind are totally separate and independent and vice versa. Your body and mind are one unit; it's like one big spider web and each piece relate to the other. Your gut, in particular, has a direct path to your brain. That's why when we're upset, the first physical sensation is first and foremost in our gut." View the full article
  9. Participants needed for study into IBS PerthNow PARTICIPANTS are needed for an ECU study investigating whether fibre can improve gut health, mental wellbeing and sleep for people with irritable bowel syndrome (IBS). Globally, the condition affects 11 per cent of adults, with 40 per cent having an associated mental health issue such as depression and anxiety, and 33 per cent reporting sleep problems. The study, led by PhD candidate Tina Yan from ECU’s School of Medical and Health Sciences, aims to evaluate the effects of the supplement Fibre-fix (a combination of dietary fibre) on gut health, sleep, quality of life and mental health of IBS sufferers on a low FODMAP diet. “People with IBS have an oversensitive gut, which causes many digestive symptoms such as recurrent stomach pain, bloating, flatulence, constipation and diarrhoea,” Ms Yan said “One solution to IBS is a low FODMAP diet, which can help control IBS symptoms.” View the full article
  10. Functional gastrointestinal disorders in inflammatory bowel disease: Time for a paradigm shift? World J Gastroenterol. 2020 Jul 14;26(26):3712-3719 Authors: Vasant DH, Ford AC Abstract Recent advances in biological therapies have revolutionalised and redefined treatment targets in inflammatory bowel disease (IBD). There is now a stronger emphasis on achieving the more stringent therapeutic goals of mucosal and histological healing, rather than clinical remission alone. Consequently, the treatment of refractory "functional" gastrointestinal symptoms, often attributed as the aftermath of previous inflammation, has recently become more prominent in quiescent disease. With further expected advances in anti-inflammatory treatments on the horizon, the burden of such symptoms in quiescent disease, which have been relatively neglected, is set to become an even bigger problem. In this article, we highlight the current state of research and understanding in this field, including recent developments and clinical practice guidelines on the diagnosis and management of functional gastrointestinal symptoms, such as irritable bowel syndrome and functional anorectal and pelvic floor disorders, in patients with quiescent IBD. These disorders are not only highly prevalent in these patients, they are often misdiagnosed, and are difficult to treat, with very few evidence-based therapies. Moreover, they are associated with substantial impairment in quality-of-life, considerable morbidity, and psychological distress. There is therefore an urgent need for a change in emphasis towards earlier recognition, positive diagnosis, and targeted treatment for patients with ongoing functional gastrointestinal symptoms in the absence of active IBD. This article also highlights the need for further research to develop much needed evidence-based therapies. PMID: 32774052 [PubMed - as supplied by publisher] View the full article
  11. GI symptoms linked to behavioral problems in children, especially those with autism EurekAlert A new UC Davis Health study found that common gastrointestinal (GI) symptoms such as diarrhea, constipation and bloating are linked to troubling sleep problems, self-harm and physical complaints in preschool children. According to the study, published Aug. 6 in Autism Research, these GI symptoms are much more common and potentially disruptive in young kids with autism. "Clinicians and parents need to be aware of the high occurrence of GI problems in kids with autism," said Bibiana Restrepo, assistant clinical professor of pediatrics and first author on the study. "This study highlights the link between GI symptoms and some problematic behaviors we see in preschool-aged children." View the full article
  12. How food might lead to IBS symptoms Gut Microbiota for Health Emerging evidence is showing that a one-size-fits-all treatment for irritable bowel syndrome (IBS) may not be feasible. That is mainly due to the complex etiology of IBS, with multiple environmental triggers leading to gastrointestinal symptoms and impaired quality of life. Diet is one of the major culprits of the symptoms reported by patients. For instance, gastrointestinal symptoms related to food are reported by 84% of patients with IBS, and are especially true for foods containing incompletely absorbed carbohydrates and fat. View the full article
  13. GI Genius offers a better way to diagnose and treat DGBIs. Use it as a learning tool to refine your knowledge and help more people. https://bit.ly/32D9nxD (Feed generated with FetchRSS) View the full article
  14. #lowFODMAP swaps! 👏 Easy ways to adapt high #FODMAP recipes to low FODMAP by swapping out a few ingredients with similar flavours rather than avoiding the recipe all together! (Feed generated with FetchRSS) View the full article
  15. Cannabis and the Gastrointestinal Tract. J Pharm Pharm Sci. 2020;23:301-313 Authors: Cohen L, Neuman MG Abstract Cannabis has been used for its medicinal purposes since ancient times. Its consumption leads to the activation of Cannabis receptors CB1 and CB2 that, through specific mechanisms can lead to modulation and progression of inflammation or repair. The novel findings are linked to the medical use of Cannabis in gastrointestinal (GI) system. PURPOSE: The objective of the present paper is to elucidate the role of Cannabis consumption in GI system. An additional aim is to review the information on the function of Cannabis in non-alcoholic fatty liver disease (NAFLD). METHODS AND RESULTS: This review summarizes the recent findings on the role of cannabinoid receptors, their synthetic or natural ligands, as well as their metabolizing enzymes in normal GI function and its disorders, including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) and possible adverse events. The synergism or antagonism between Cannabis' active ingredients and the "entourage" plays a role in the efficacy of various strains. Some elements of Cannabis may alter disease severity as over-activation of Cannabis receptors CB1 and CB2 can lead to changes of the commensal gut flora. The endocannabinoid system (ECS) contributes to gut homeostasis. The ability of ECS to modulate inflammatory responses demonstrates the capacity of ECS to preserve gastrointestinal (GI) function. Alterations of the ECS may predispose patients to pathologic disorders, including IBD. Clinical studies in IBD demonstrate that subjects benefit from Cannabis consumption as seen through a reduction of the IBD-inflammation, as well as through a decreased need for other medication. NAFLD is characterized by fat accumulation in the liver. The occurrence of inflammation in NAFLD leads to non-alcoholic-steatohepatitis (NASH). The use of Cannabis might reduce liver inflammation. CONCLUSIONS: With limited evidence of efficacy and safety of Cannabis in IBD, IBS, and NAFLD, randomized controlled studies are required to examine its therapeutic efficacy. Moreover, since long term use of the plant leads to drug use disorders the patients should be followed continuously. PMID: 32762830 [PubMed - as supplied by publisher] View the full article
  16. Patient-Specific Stress-Abdominal Pain Interaction in Irritable Bowel Syndrome: An Exploratory Experience Sampling Method Study. Clin Transl Gastroenterol. 2020 Jul;11(7):e00209 Authors: Vork L, Keszthelyi D, van Kuijk SMJ, Quetglas EG, Törnblom H, Simrén M, Aziz Q, Corsetti M, Tack J, Mujagic Z, Leue C, Kruimel JW, Masclee AAM Abstract INTRODUCTION: Gastrointestinal symptoms in irritable bowel syndrome (IBS) have been correlated with psychological factors using retrospective symptom assessment. However, real-time symptom assessment might reveal the interplay between abdominal and affective symptoms more reliably in a longitudinal perspective. The aim was to evaluate the association between stress and abdominal pain, using the Experience Sampling Method (ESM) as a real-time, repeated measurement method. METHODS: Thirty-seven patients with IBS (26 women; mean age 36.7 years) and 36 healthy controls (HC; 24 women; mean age 31.1 years) completed an electronic ESM during 7 consecutive days. Abdominal pain and stress were scored on an 11-point Numeric Rating Scale at a maximum of 10 random moments each day. RESULTS: Abdominal pain scores were 2.21 points higher in patients with IBS compared with those in HC (P < 0.001), whereas stress levels did not differ significantly (B: 0.250, P = 0.406). In IBS, a 1-point increase in stress was associated with, on average, 0.10 points increase in abdominal pain (P = 0.017). In HC, this was only 0.02 (P = 0.002). Stress levels at t = -1 were not a significant predictor for abdominal pain at t = 0 in both groups, and vice versa. DISCUSSION: Our results demonstrate a positive association between real-time stress and abdominal pain scores and indicate a difference in response to stress and not a difference in experienced stress per se. Furthermore, an in-the-moment rather than a longitudinal association is suggested. This study underlines the importance of considering the individual flow of daily life and supports the use of real-time measurement when interpreting potential influencers of abdominal symptoms in IBS. PMID: 32764210 [PubMed - as supplied by publisher] View the full article
  17. Recent study using faecal microbiota transplant #FMT as treatment #IBS - Interesting research with more work in the field needed. What are your thoughts on faecal transplants in #IBS? https://pubmed.ncbi.nlm.nih.gov/32681922/ (Feed generated with FetchRSS) View the full article
  18. In #CTGJournal: Managing Chronic Diarrhea From a Gut Microbiota-Bile Acid Perspective Zhao, et al. ➡️ http://bit.ly/2XHKr4C http://clintranslgastro.com (Feed generated with FetchRSS) View the full article
  19. FoodMarble AIRE portable breath test device review – A breath of fresh air for checking digestive issues The Gadgeteer I have celiac disease, an autoimmune condition that requires I eat a gluten-free diet or suffer potentially life-threatening illness. Many celiac sufferers react to other foods, especially dairy, so I was intrigued at the opportunity to review FoodMarble, an easy-to-use handheld device that helps people identify foods to which their bodies respond badly. Think gas, bloating, discomfort and diarrhea, though I prefer not to. View the full article
  20. Does propolis affect the quality of life and complications in subjects with irritable bowel syndrome (diagnosed with Rome IV criteria)? A study protocol of the randomized, double-blinded, placebo-controlled clinical trial. Trials. 2020 Aug 05;21(1):698 Authors: Miryan M, Alavinejad P, Abbaspour M, Soleimani D, Ostadrahimi A Abstract BACKGROUND: Irritable bowel syndrome (IBS) is one of the most frequent and recurrent gastrointestinal diseases. However, up to now, no pharmacological agent has been approved to treat IBS. Emerging evidence showed that inflammation has a vital role in enhancing nervous system sensitivity and perception of abdominal pain in subjects with IBS. Propolis is an herbal substance with a broad spectrum of antioxidants, anti-inflammatory, and prebiotic properties, which might exert beneficial effects to reduce the severity of IBS. The current clinical trial aims to evaluate the efficacy of propolis supplementation on IBS. METHODS: This single-center, randomized, double-blind, placebo-controlled clinical trial will be performed to evaluate the effect of propolis supplementation in adult patients with IBS diagnosed with Rome IV criteria. Fifty-two eligible patients will randomly be allocated to receive a propolis tablet (450 mg, containing 100 mg polyphenol compounds) or identical placebo, twice daily for 6 weeks. The primary outcome of the trial is an improvement in IBS severity from baseline to the sixth week of intervention. The secondary outcomes include the change in weight, waist circumference, and IBS quality of life. We will use the paired sample t test or Mann-Whitney U test for the within-group comparison and independent sample t test or Wilcoxon rank-sum and chi-square test or Fisher's exact test for the between-group comparison. Besides, a multivariable-adjusted mean effect will be computed using the ANCOVA test. DISCUSSION: We hypothesize that propolis supplementation would be useful for treating IBS through its antioxidants, anti-inflammatory, and prebiotic properties. This trial will show the results of propolis supplementation, whether positive or negative, on IBS. If the current trial confirms our hypothesis, propolis supplementation can be a new choice in adjunctive therapy of IBS. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20190708044154N1. Registered on 26 December 2019. Updated on 13 February 2020. https://en.irct.ir/trial/40983 SPONSOR: Tabriz University of Medical Sciences, Tabriz, Iran. PMID: 32758282 [PubMed - in process] View the full article
  21. Google-What Causes Bloating? How to Get Rid of Bloated Stomach - Parade http://dlvr.it/RdDRkg (Feed generated with FetchRSS) View the full article
  22. What Causes Bloating? How to Get Rid of Bloated Stomach Parade “Ugh, I feel like I’m going to explode.” Sound familiar? We’ve all been there—those feelings of being too full, tight or swollen in the stomach, sometimes accompanied by flatulence, burping and rumbling sensations. Sometimes the cause of your stomach bloating is obvious (hello loaded cheese fries), but sometimes it’s not. Although occasional stomach bloating is very common and usually resolves with simple changes to diet and lifestyle, it’s possible that it could be a sign of a more serious health issue. So when that feeling of uncomfortable fullness strikes, here are some ways to identify what’s causing it so that you can keep it at bay. View the full article
  23. Yes, constipation can cause nausea — here's why it happens and how to treat it - Insider INSIDER Constipation is a common digestive problem that involves the inability to pass stool. Occasionally, constipation is accompanied by feelings of nausea, and the urge to vomit. If you've ever wondered why you might feel nauseous while constipated, here is how it happens. Why constipation can make you nauseous The main symptom of constipation is the inability to evacuate stool more than three times a week. It can also involve straining while passing stool, having lumpy or hard stool, or needing to use your fingers to remove stool from your anus. "In general, it's recommended to empty your bowels at least once every two to three days. Once you've gone four days or more without having a bowel movement, something has gone wrong. It's at this time you can expect unpleasant symptoms like nausea to occur," says Bryan Curtin, M.D., MHSc, a gastroenterologist at Mercy Medical Center in Baltimore, Maryland. View the full article
  24. Earlier
  25. ModifyHealth Secures $2 Million Series A Investment To Fuel Growing Demand for Medically-Tailored Meals and Support PRNewswire ATLANTA, Aug. 7, 2020 /PRNewswire/ -- ModifyHealth, a nationwide provider of gut-friendly, Low-FODMAP and gluten-free meals today announced the closing of $2 million in Series A funding led by Nashville Capital Network (NCN). The partnership with NCN will support ModifyHealth's continued growth of its category-leading 'food as medicine' solutions and further expansion of its nationwide operations to deliver meaningful patient outcomes. Recommended by GI providers and dietitians alike, ModifyHealth's home-delivered meals, dietitian support, and digital health solutions deliver evidenced-based treatments for GI conditions such as Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD), SIBO, and celiac disease. View the full article
  26. Enlightening the Frontiers of Neurogastroenterology Through Optogenetics. Am J Physiol Gastrointest Liver Physiol. 2020 Aug 05;: Authors: Johnson AC, Louwies T, Ligon CO, Greenwood-Van Meerveld B Abstract Neurogastroenterology refers to the study of the extrinsic and intrinsic nervous system circuits controlling the gastrointestinal (GI) tract. Over the past 5-10 years there has been an explosion in novel methodologies, technologies and approaches that offer great promise to advance our understanding of the basic mechanisms underlying GI function in health and disease. This review focuses on the use of optogenetics combined with electrophysiology in the field of neurogastroenterology. We discuss how these technologies and tools are currently being used to explore the brain-gut axis and debate the future research potential and limitations of these techniques. Taken together, we consider that the use of these technologies will enable researchers to answer important questions in neurogastroenterology through fundamental research. The answers to those questions will shorten the path from basic discovery to new treatments for patient populations with disorders of the brain-gut axis affecting the GI tract such as irritable bowel syndrome (IBS), functional dyspepsia, achalasia, and delayed gastric emptying. PMID: 32755304 [PubMed - as supplied by publisher] View the full article
  27. Beneficial Effects of a Low-Nickel Diet on Relapsing IBS-Like and Extraintestinal Symptoms of Celiac Patients during a Proper Gluten-Free Diet: Nickel Allergic Contact Mucositis in Suspected Non-Responsive Celiac Disease. Nutrients. 2020 Jul 29;12(8): Authors: Borghini R, De Amicis N, Bella A, Greco N, Donato G, Picarelli A Abstract BACKGROUND AND AIM: Nickel (Ni)-rich foods can induce allergic contact mucositis (ACM) with irritable bowel syndrome (IBS)-like symptoms in predisposed subjects. Ni ACM has a high prevalence (>30%) in the general population and can be diagnosed by a Ni oral mucosa patch test (omPT). Many celiac disease (CD) patients on a gluten-free diet (GFD) often show a recrudescence of gastrointestinal and extraintestinal symptoms, although serological and histological remission has been achieved. Since a GFD often results in higher loads of ingested alimentary Ni (e.g., corn), we hypothesized that it would lead to a consequent intestinal sensitization to Ni in predisposed subjects. We wanted to (1) study Ni ACM prevalence in still symptomatic CD patients on a GFD and (2) study the effects of a low-Ni diet (LNiD) on their recurrent symptoms. MATERIAL AND METHODS: We recruited 102 consecutive CD patients (74 female, 28 male; age range 18-65 years, mean age 42.3 ± 7.4) on a GFD since at least 12 months, in current serological and histological remission (Marsh-Oberhuber type 0-I) who complained of relapsing gastrointestinal and/or extraintestinal symptoms. INCLUSION CRITERIA: presence of at least three gastrointestinal symptoms with a score ≥5 on the modified Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. EXCLUSION CRITERIA: IgE-mediated food allergy; history of past or current cancer; inflammatory bowel diseases; infectious diseases including Helicobacter pylori; lactose intolerance. All patients enrolled underwent Ni omPT and followed a LNiD for 3 months. A 24 symptoms questionnaire (GSRS modified according to the Salerno Experts' Criteria, with 15 gastrointestinal and 9 extraintestinal symptoms) was administered at T0 (free diet), T1 (GFD, CD remission), T2 (recurrence of symptoms despite GFD), and T3 (GFD + LNiD) for comparisons. Comparisons were performed using Wilcoxon signed-rank test. RESULTS: Twenty patients (all female, age range 23-65 years, mean age 39.1 ± 2.9) out of 102 (19.6%) were finally included. All 20 patients enrolled (100%) showed positive Ni omPT, confirming an Ni ACM diagnosis. A correct GFD (T0 vs. T1) induced the improvement of 19 out of the total 24 (79.2%) symptoms, and 14 out of 24 (58.3%) were statistically significant (p-value < 0.0083 according to Bonferroni correction). Prolonged GFD (T1 vs. T2) revealed the worsening of 20 out of the total 24 (83.3%) symptoms, and 10 out of 24 (41.7%) were statistically significant. LNiD (T2 vs. T3) determined an improvement of 20 out of the total 24 (83.4%) symptoms, and in 10 out of 24 (41.7%) symptoms the improvement was statistically significant. CONCLUSIONS: Our data suggest that the recrudescence of gastrointestinal and extraintestinal symptoms observed in CD subjects during GFD may be due to the increase in alimentary Ni intake, once gluten contamination and persisting villous atrophy are excluded. Ni overload can induce Ni ACM, which can be diagnosed by a specific Ni omPT. Improvement of symptoms occurs after a proper LNiD. These encouraging data should be confirmed with larger studies. PMID: 32751300 [PubMed - in process] View the full article
  28. Herbal Therapies in Functional Gastrointestinal Disorders: A Narrative Review and Clinical Implication. Front Psychiatry. 2020;11:601 Authors: Kim YS, Kim JW, Ha NY, Kim J, Ryu HS Abstract The pathophysiology of functional gastrointestinal disorders (FGIDs) is still unclear and various complex mechanisms have been suggested to be involved. In many cases, improvement of symptoms and quality of life (QoL) in patients with FGIDs is difficult to achieve with the single-targeted treatments alone and clinical application of these treatments can be challenging owing to the side effects. Herbal preparations as complementary and alternative medicine can control multiple treatment targets of FGIDs simultaneously and relatively safely. To date, many herbal ingredients and combination preparations have been proposed across different countries and together with a variety of traditional medicine. Among the herbal therapies that are comparatively considered to have an evidence base are iberogast (STW-5) and peppermint oil, which have been mainly studied and used in Europe, and rikkunshito and motilitone (DA-9701), which are extracted from natural substances in traditional medicine, are the focus of this review. These herbal medications have multi-target pharmacology similar to the etiology of FGIDs, such as altered intestinal sensory and motor function, inflammation, neurohormonal abnormality, and have displayed comparable efficacy and safety in controlled trials. To achieve the treatment goal of refractory FGIDs, extensive and high quality studies on the pharmacological mechanisms and clinical effects of these herbal medications as well as efforts to develop new promising herbal compounds are required. PMID: 32754057 [PubMed] View the full article
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