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  1. Last week
  2. Gut. 2022 May 17:gutjnl-2022-327471. doi: 10.1136/gutjnl-2022-327471. Online ahead of print. ABSTRACT OBJECTIVE: There are altered mucosal functions in irritable bowel syndrome with diarrhoea (IBS-D); ~30% of patients with IBS-D have abnormal bile acid (BA) metabolism (ABAM) and diarrhoea (summarised as BAD). AIM: To compare biochemical parameters, gastrointestinal and colonic transit, rectal sensation and pathobiological mechanisms in IBS-D without ABAM and in BAD (serum 7C4>52 ng/mL). DESIGN: In patients with Rome III criteria of IBS-D, we compared biochemical features, colonic transit, rectal sensation, deep genotype of five BA-related genes, ileal and colonic mucosal mRNA (differential expression (DE) analysis) and stool dysbiosis (including functional analysis of microbiome). Results in BAD were compared with IBS-D without ABAM. RESULTS: Compared with 161 patients with IBS-D without ABAM, 44 patients with BAD had significantly faster colonic transit, lower microbial alpha diversity, different compositional profile (beta diversity) and higher Firmicutes to Bacteroidetes ratio with evidence of decreased expression of bile acid thiol ligase (involved in transformation of primary to secondary BAs) and decreased sulfatases. In BAD (compared with IBS-D without ABAM), terminal ileal biopsies showed downregulation of SLC44A5 (a BA transporter), and ascending colon biopsies showed upregulation in barrier-weakening genes (CLDN2), serine protease inhibitors, immune activation, cellular differentiation and a cellular transporter (FABP6; BA binding). No DE of genes was documented in descending colon biopsies. The two groups had similar rectal sensation. CONCLUSION: Though sharing clinical symptoms with IBS-D, BAD is associated with biological differences and mechanisms that have potential to enhance diagnosis and treatment targeting barrier dysfunction, inflammatory and microbial changes. PMID:35580964 | DOI:10.1136/gutjnl-2022-327471 View the full article
  3. J Gastroenterol Hepatol. 2022 May 17. doi: 10.1111/jgh.15891. Online ahead of print. ABSTRACT BACKGROUND: Irritable bowel syndrome (IBS) is a highly prevalent disorder of gut brain interaction with a multifactorial aetiology. Food trigger avoidance is common among individuals with IBS and exclusion diets are gaining popularity. However, recent guidelines on IBS management cautioned regarding the use of unsupervised dietary therapy with concerns of development of poor eating habits and even nutritional deficiencies. We aimed to review the available literature on the effect of habitual and exclusion diets on micronutrient status as well as the role of micronutrient supplementation in alleviating IBS symptoms. METHODS: Four electronic databases (PubMed, Embase, Cochrane, Web of Science) were searched for articles that reported micronutrient data in patients with IBS. Serum micronutrient levels and dietary intake of micronutrients in patients with IBS were collected. The extracted data were tabulated and organised by micronutrient type to observe for trends. RESULTS: 26 articles were included in this systematic review (12 interventional and 14 observational studies). Studies showed that generally IBS subjects had lower levels of vitamin B2, vitamin D, calcium, and iron at baseline compared to non-IBS subjects. Studies also found that exclusion diets were associated with lower intake of micronutrients especially vitamin B1, B2, calcium, iron, and zinc. There was a lack of interventional studies on micronutrients. CONCLUSION: IBS patients are at risk of developing multiple micronutrient deficiencies that may have both localised gastrointestinal as well as systemic effects. Dietary management of IBS patients should include a proper dietitian review to ensure nutritional adequacy where possible. PMID:35581170 | DOI:10.1111/jgh.15891 View the full article
  4. Earlier
  5. Front Hum Neurosci. 2022 Apr 29;16:851586. doi: 10.3389/fnhum.2022.851586. eCollection 2022. ABSTRACT BACKGROUND: The neural activity of irritable bowel syndrome (IBS) patients in the resting state without any intervention has not been systematically studied. The purpose of this study was to compare the resting-state brain functions of IBS patients with healthy controls (HCs). METHODS: The published neuroimage studies were obtained from electronic databases including PubMed, EMBASE, PsycINFO, Web of Science Core, CNKI Database, Wanfang Database, VIP Database, and CBMdisc. Search dates were from inception to March 14th, 2022. The studies were identified by the preidentified inclusion and exclusion criteria. Two independent reviewers compiled the studies and evaluated them for quality and bias. RESULTS: Altogether 22 fMRI studies were included in this review. The risk of bias of the included studies was generally low. The findings indicated that in IBS patients, increased or decreased brain areas were mostly associated with visceral sensations, emotional processing, and pain processing. According to brain network research, IBS may exhibit anomalies in the DMN, CEN, and emotional arousal networks. The fluctuations in emotion (anxiety, sadness) and symptoms in IBS patients were associated with alterations in the relevant brain regions. CONCLUSION: This study draws a preliminary conclusion that there are insufficient data to accurately distinguish the different neurological features of IBS in the resting state. Additional high-quality research undertaken by diverse geographic regions and teams is required to reach reliable results regarding resting-state changed brain regions in IBS. PMID:35572000 | PMC:PMC9105452 | DOI:10.3389/fnhum.2022.851586 View the full article
  6. J Nutr Sci. 2022 Apr 28;11:e31. doi: 10.1017/jns.2022.27. eCollection 2022. ABSTRACT Constipation can greatly impact the quality of life (QoL), which can be relieved by dietary fibres; however, preserving a higher fibre intake remains a challenge. We investigated the effects of a personalised dietary advice (PDA) on fibre intake and mild constipation complaints. A total number of twenty-five adults with mild constipation complaints were included in a 4-week observation period followed by a 4-week personalised intervention. The PDA provided high-fibre alternatives via a web tool. In weeks 1, 4 and 8, dietary intake, constipation complaints and QoL were assessed. Furthermore, participants collected a faecal sample at weeks 1, 4 and 8 to determine microbiota diversity and composition, and short-chain fatty acids (SCFA). Participants completed questions daily for 8 weeks regarding abdominal complaints, stool frequency and stool consistency. Fibre intake in week 8 was significantly higher compared to week 1 (Δ = 5·7 ± 6·7 g, P < 0·001) and week 4 (Δ = 5·2 ± 6·4 g, P < 0·001). Constipation severity and QoL significantly improved at week 8 compared to the observation period (P < 0·001). A higher fibre intake significantly reduced constipation severity (β = -0·031 (-0·05; -0·01), P = 0·001) and the QoL (β = -0·022 (-0·04; -0·01), P = 0·009). Stool consistency (P = 0·040) and abdominal pain (P = 0·030) improved significantly during the intervention period (P = 0·040), but stool frequency did not. Average microbial alpha diversity and composition and SCFA concentrations did not change over time, but indicated individual-specific dynamics. Several SCFAs were associated with constipation complaints. To conclude, a PDA effectively increased fibre intake and subsequently reduced constipation complaints, indicating that guided dietary adjustments are important and feasible in the treatment of mild constipation complaints. PMID:35573462 | PMC:PMC9066321 | DOI:10.1017/jns.2022.27 View the full article
  7. Often IBS and IBD may be confused. So, in light of world IBD day on Thursday (19th of May), we want to share the differences and similarities between the two. Check out the post to learn more: https://www.instagram.com/fodmapfriendlyfoodprogram/ (Feed generated with FetchRSS)View the full article
  8. RT @ibddoctor: The @DDWMeeting online planner is now linked to abstracts, moderators, and session details. Time to start planning your #DDW2022! https://ddw.org/attendee-planning/online-planner/ (Feed generated with FetchRSS)View the full article
  9. Nutrients. 2022 Apr 22;14(9):1755. doi: 10.3390/nu14091755. ABSTRACT A randomized crossover study in eight patients (6 F, age 57 ± 13) with overlapping GERD-IBS (non-constipation) was conducted to evaluate the effects of rice noodle vs. wheat noodle meals for breakfast and lunch on postprandial TLESR, intestinal gas production, and GERD/GI symptoms. Results: Wheat ingestion was significantly associated with more frequent TLESR after lunch than rice (5.0 ± 0.7 vs. 1.9 ± 0.3 times/2 h, p = 0.01). After lunch, wheat ingestion was significantly associated with higher H2 and CH4 levels compared to rice ingestion (p &lt; 0.05), while H2 and CH4 levels before lunch were similar (p &gt; 0.05). The area under curve of H2 concentration until 2 h after lunch significantly correlated with the TLESR number (r = 0.69, p = 0.04). Postprandial regurgitation (2.9 ± 1.2 vs. 0.4 ± 0.2), bloating (7.0 ± 0.4 vs. 3.1 ± 0.9), satiety (7.7 ± 0.4 vs. 3.5 ± 0.9), and belching (3.8 ± 1.2 vs. 1.1 ± 0.6) symptom scores were significantly greater after wheat compared to rice noodle ingestion (p &lt; 0.05). Conclusion: Wheat noodle meals, part of a high FODMAP diet, induced a higher frequency of TLESRs, a higher GERD, and higher upper-GI symptom scores than rice noodle meals, part of a low FODMAP diet, in patients with overlapping IBS-GERD. These effects were associated with more intestinal gas production. Thus, a low FODMAP diet may relieve GERD symptoms in GERD patients with overlapping IBS. PMID:35565722 | DOI:10.3390/nu14091755 View the full article
  10. Nutrients. 2022 May 4;14(9):1923. doi: 10.3390/nu14091923. ABSTRACT This review summarizes dietary carbohydrate intolerance conditions and recent advances on the possible role of carbohydrate maldigestion and dietary outcomes in patients with functional bowel disease. When malabsorbed carbohydrates reach the colon, they are fermented by colonic bacteria, with the production of short-chain fatty acids and gas lowering colonic pH. The appearance of diarrhoea or symptoms of flatulence depends in part on the balance between the production and elimination of these fermentation products. Different studies have shown that there are no differences in the frequency of sugar malabsorption between patients with irritable bowel disease (IBS) and healthy controls; however, the severity of symptoms after a sugar challenge is higher in patients than in controls. A diet low in 'Fermentable, Oligo-Di- and Monosaccharides and Polyols' (FODMAPs) is an effective treatment for global symptoms and abdominal pain in IBS, but its implementation should be supervised by a trained dietitian. A 'bottom-up' approach to the low-FODMAP diet has been suggested to avoid an alteration of gut microbiota and nutritional status. Two approaches have been suggested in this regard: starting with only certain subgroups of the low-FODMAP diet based on dietary history or with a gluten-free diet. PMID:35565890 | DOI:10.3390/nu14091923 View the full article
  11. Nutrients. 2022 May 6;14(9):1945. doi: 10.3390/nu14091945. ABSTRACT Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) share common culprit foods and potential pathophysiological factors. However, how diet may contribute to disease course and whether this differs between both entities is unclear. We therefore investigated the association of dietary indices with intestinal inflammation and gastrointestinal symptoms in both IBD and IBS patients. Food frequency questionnaires from 238 IBD, 261 IBS and 195 healthy controls (HC) were available to calculate the overall diet quality by the Dutch Healthy Diet-Index 2015 (DHD-2015) and its inflammatory potential by the Adapted Dietary Inflammatory Index (ADII). Intestinal inflammation and symptoms were evaluated by faecal calprotectin and the Gastrointestinal Symptom Rating Scale, respectively. The DHD-2015 was lower in IBD and IBS versus HC (p &lt; 0.001), being associated with calprotectin levels in IBD (b = -4.009, p = 0.006), and with abdominal pain (b = -0.012, p = 0.023) and reflux syndrome (b = -0.016, p = 0.004) in IBS. ADII scores were comparable between groups and were only associated with abdominal pain in IBD (b = 0.194, p = 0.004). In this side-by-side comparison, we found a lower diet quality that was differentially associated with disease characteristics in IBD versus IBS patients. Longitudinal studies are needed to further investigate the role of dietary factors in the development of flares and predominant symptoms. PMID:35565912 | DOI:10.3390/nu14091945 View the full article
  12. An Expert Explains Why You Shouldn't Hold Back Your Poo ScienceAlert How often should we poo? If you Google this question, you're likely to find an answer along the lines of three times a day to once every three days. But this leaves room for substantial variation. The true answer is: when you feel the urge. View the full article
  13. Nutr Hosp. 2022 May 12. doi: 10.20960/nh.04044. Online ahead of print. ABSTRACT BACKGROUND: latest studies have shown that vitamin D deficiency is related to the occurrence of irritable bowel disease (IBS), and taking vitamin D as a supplement can alleviate the symptoms of irritable bowel disease. However, clinical treatment of irritable bowel disease with vitamin D is controversial. OBJECTIVE: we conducted a meta-analysis of all clinical trials to evaluate the associations between vitamin D and irritable bowel disease. METHODS: we screened all randomized controlled trials that were published before December 20, 2021 from the following databases: Medline, Web of Science, China National Knowledge Infrastructure (CNKI), Cochrane Central, and Clinical Trial. We used RevMan 5.4.1 and Stata 16.1 to analyze the relevant data. The standardized mean difference (SMD) with 95 % confidence interval (95 % CI) was used to report effect sizes. Serum vitamin D concentration, risk of vitamin D deficiency among patients with IBS, Symptom Severity Score (SSS), and Quality of Life (QoL) score are the main endpoint outcomes in this study. RESULTS: data from twelve clinical trials with 1331 IBS patients were included. Patients with IBS have relatively low vitamin D levels in their serum. Vitamin D supplementation improves the Quality of Life (QoL) score but has no significant effect on the Symptom Severity Score (SSS). CONCLUSIONS: vitamin D deficiency is associated with the pathogenesis of irritable bowel syndrome. Serum vitamin D levels decreased in patients with irritable bowel syndrome, and vitamin D supplementation could improve patient quality of life. PMID:35546472 | DOI:10.20960/nh.04044 View the full article
  14. Dtsch Med Wochenschr. 2022 Apr;147(10):595-604. doi: 10.1055/a-1554-1739. Epub 2022 May 11. ABSTRACT Approximately 50 % of chronic gastrointestinal symptoms in primary care can be attributed to functional gastrointestinal disorders (FGID). The most frequent gastrointestinal disorders are functional dyspepsia and irritable bowel syndrome. FGID are heterogenous with regards to the amount of symptoms and associated patient's impairment as well as to the underlying pathophysiological mechanisms. The biopsychosocial model of FGID assumes that biological, psychological and social factors interact in the predisposition to and in the initiation and course of FGID. The Rome Foundation defines FGID as disorders of the brain-gut interaction.Some physicians are hesitant to diagnose FGID due to the lack of specific biomarkers and/or structural changes in the gastrointestinal tract. In addition, some FGID to not respond well to conventional medications. Some patients are reluctant to accept the diagnosis of a FGID because they are afraid that a serious somatic disease has been missed and/or to be diagnosed as mentally ill.The use of interdisciplinary evidence-based guidelines for diagnosis and management of FGID can increase the certainty of diagnosis and the therapeutic options for physicians. In addition, these guidelines include recommendations how to explain the disorder and the management to the patient to establish a trustful doctor-patient relationship.FGID are diagnosed by the history of a typical cluster of symptoms and by guideline - recommended exclusion of somatic gastrointestinal disorders. FGID should be managed according to the main symptoms, the associated impairment and patients' preferences in a graduated approach by education and by dietary, pharmacological and psychological treatments. PMID:35545068 | DOI:10.1055/a-1554-1739 View the full article
  15. Airplane bloat: why am I so bloated on planes? Stylist Magazine We all think we’ll feel our best when we’re on holiday, finally away from our laptop screens and the stresses of everyday life. But more often than not, our feel-good trips are scuppered by bloating. It starts on the flight to the destination of our dreams and can impact our care-free attitude upon landing. If you’ve ever felt your gut balloon when you are on a plane, you’ll be relieved to know that it’s not just you. ‘Mile high IBS’ is a very common phenomenon. View the full article
  16. Probiotic Improves Symptoms of Irritable Bowel Syndrome Medscape A randomized study in France demonstrated that a 30-day treatment with the probiotic Bifidobacterium longum 35624 resulted in a significant improvement in symptoms for approximately two thirds of patients with irritable bowel syndrome (IBS). This improvement was also seen in patients who had the most severe symptoms at baseline. In addition, patients reported that their quality of life was better after the treatment. View the full article
  17. Neurogastroenterol Motil. 2022 May 9:e14391. doi: 10.1111/nmo.14391. Online ahead of print. ABSTRACT BACKGROUND: Previously, we used latent class analysis (LCA) to identify novel subgroups in people with irritable bowel syndrome (IBS). There are four other functional bowel disorders that, although characterized as discrete disorders, overlap considerably with, and fluctuate to, IBS. These might instead be conceptualized as a milder form of IBS. We explored this hypothesis using LCA in a cohort of people with non-IBS functional bowel disorders. METHODS: We collected demographic, symptom, and psychological health data from 1375 adults in the community who self-identified as having IBS and identified individuals meeting Rome IV criteria for any non-IBS functional bowel disorder. We performed LCA to identify specific subgroups (clusters). We followed participants up at 12 months to reassess gastrointestinal and psychological heath and also gather data about healthcare utilization and impact of symptoms. KEY RESULTS: 811 people met Rome IV criteria for IBS and 558 Rome IV criteria for another functional bowel disorder (76 (5.5%) functional constipation; 198 (14.5%) functional diarrhea; 129 (9.5%) functional abdominal bloating or distension; and 155 (11.4%) unspecified functional bowel disorder). LCA in these 558 people identified five clusters defined by a combination of gastrointestinal symptoms and the extent of psychological co-morbidity. However, correlation between these clusters and the Rome IV functional bowel disorder diagnoses was poor and 75% of people were classified as having mild IBS using our previous IBS-derived model. By 12 months, one-third of people had fluctuated and met criteria for IBS. Clusters with high psychological burden had a poorer prognosis, with higher rates of medical consultation, medication use, and greater impact of symptoms on daily life. CONCLUSIONS AND INFERENCES: The functional bowel disorders may be better characterized as a spectrum of IBS rather than separate disorders. Adopting this pragmatic stance may help to simply diagnosis, treatment, and recruitment of patients to research trials. PMID:35531932 | DOI:10.1111/nmo.14391 View the full article
  18. World allergy week begins this Friday! Food intolerance is related to IBS. It can develop as a result of IBS, but a food allergy is often inherited or genetic in nature. To learn the difference between the three head over to our blog! https://fodmapfriendly.com/blogpost/foodallergy/ (Feed generated with FetchRSS)View the full article
  19. RT @Rajan___Singh: I'm excited to share our research at the 5th Annual Conference of the Indian Motility & Functional Diseases Association#7th-8thMay2022 Extremely thankful to Prof. Uday Ghoshal for the invitation to deliver a talk🙏 Exciting theme "GI Motility & DGBIs: From Clinics To Innovation" (Feed generated with FetchRSS)View the full article
  20. Nutr J. 2022 May 5;21(1):24. doi: 10.1186/s12937-022-00777-x. ABSTRACT BACKGROUND: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder involving gut-brain interactions with limited effective treatment options. Vitamin D deficiency is commonly observed in patients with IBS, but whether vitamin D supplementation ameliorates IBS is controversial in randomized controlled trials. The present systematic review and meta-analysis explored the efficacy of vitamin D supplementation in patients with IBS. METHODS: We performed a systematic search of potentially relevant publications from PubMed, EMBASE, the Cochrane Central Register of Controlled Studies and the Web of Science up until January 2022. We assessed the weighted mean difference (WMD) and 95% confidence interval (95% CI) of the IBS severity scoring system (IBS-SSS), IBS quality of life (IBS-QoL) and IBS total score (IBS-TS) before and after vitamin D supplementation intervention. RESULTS: We included four randomized, placebo-controlled trials involving 335 participants. The differences in IBS-SSS score between participants in the intervention group and the placebo group increased after intervention (WMD: -55.55, 95% CI: -70.22 to -40.87, I2 = 53.7%, after intervention; WMD: -3.17, 95% CI: -18.15 to 11.81, I2 = 0.0%, before intervention). Participants receiving vitamin D supplementation showed greater improvement in IBS-SSS after intervention than participants receiving placebo treatment (WMD: -84.21, 95% CI: -111.38 to -57.05, I2 = 73.2%; WMD: -28.29, 95% CI: -49.95 to -6.62, I2 = 46.6%, respectively). Vitamin D supplementation was also superior to placebo in IBS-QoL improvement (WMD: 14.98, 95% CI: 12.06 to 17.90, I2 = 0.0%; WMD: 6.55, 95% CI: -2.23 to 15.33, I2 = 82.7%, respectively). Sensitivity analyses revealed an unstable pooled effect on IBS-TS in participants receiving vitamin D supplementation. Therefore, we did not evaluate the efficacy of vitamin D intervention in IBS-TS. CONCLUSIONS: This systematic review and meta-analysis suggested that vitamin D supplementation was superior to placebo for IBS treatment. PMID:35509010 | DOI:10.1186/s12937-022-00777-x View the full article
  21. Therap Adv Gastroenterol. 2022 Apr 29;15:17562848221092596. doi: 10.1177/17562848221092596. eCollection 2022. ABSTRACT INTRODUCTION: Linaclotide, a guanylate cyclase C agonist that improves the symptoms of irritable bowel syndrome with predominant constipation (IBS-C), has been recently approved for IBS-C treatment. This study aimed to report real-world data on linaclotide treatment in China. METHODS: This was a prospective multicentre study of the effectiveness of linaclotide treatment in patients with IBS-C from 10 primary medical institutions. Changes in defecation, abdominal symptoms, the IBS symptom severity scale (IBS-SSS), IBS quality of life questionnaire (IBS-QOL), Zung Self-Rating Anxiety Scale and Self-Rating Depression Scale in patients were evaluated to determine the drug's clinical efficacy and safety. RESULTS: We enrolled 97 patients (mean age: 52.39 ± 13.99 years), 55 of whom were women (56.7%). In terms of efficacy, the number of the patients' defecation per week and Bristol stool form scale scores significantly increased at week 4 and week 12 compared with the values at the baseline. The baseline average IBS-SSS score was 211.01 ± 81.23. Of the patients, 24 had severe IBS-C, and their IBS-SSS scores at week 4 (51.81 ± 54.42) and week 12 (9.3 ± 30.39) significantly decreased and showed a pronounced improvement. The IBS-QOL total scores at week 4 and week 12 gradually decreased compared with that at the baseline and the QOL significantly improved. Treatment satisfaction rate was 79.3% in week 4 and 100% in week 12, showing a gradually increased satisfaction and significant differences. However, 11 cases (11.3%) had diarrhoea. CONCLUSION: Linaclotide has proved to be a safe and effective drug to improve IBS-C symptoms and severity. PMID:35509427 | PMC:PMC9058335 | DOI:10.1177/17562848221092596 View the full article
  22. Am J Gastroenterol. 2022 May 4. doi: 10.14309/ajg.0000000000001812. Online ahead of print. ABSTRACT There has been a dramatic increase in clinical studies examining the relationship between disorders of gut-brain interactions (DGBI) and symptoms evoked by food ingestion in the upper and lower GI tract, but study design is challenging to verify valid endpoints. Consequently, mechanistic studies demonstrating biological relevance, biomarkers and novel therapeutic targets are greatly needed. This review highlights emerging mechanisms related to nutrient sensing and tasting, maldigestion, physical effects with underlying visceral hypersensitivity, allergy and immune mechanisms, food - microbiota interactions and gut-brain signaling, with a focus on patients with functional dyspepsia and irritable bowel syndrome. Many patients suffering from DGBI exhibit these mechanism(s) but which ones and which specific properties may vary widely from patient to patient. Thus, in addition to identifying these mechanisms and the need for further studies, biomarkers and novel therapeutic targets are identified that could enable enriched patient groups to be studied in future clinical trials examining the role of food in the generation of gut and non-gut symptoms. PMID:35506862 | DOI:10.14309/ajg.0000000000001812 View the full article
  23. Dig Dis Sci. 2022 May 4. doi: 10.1007/s10620-022-07516-6. Online ahead of print. ABSTRACT MicroRNAs (miRNAs) are tiny (20-24 nucleotides long), non-coding, highly conserved RNA molecules that play a crucial role within the post-transcriptional regulation of gene expression via sequence-specific mechanisms. Since the miRNA transcriptome is involved in multiple molecular processes needed for cellular homeostasis, its altered expression can trigger the development and progression of several human pathologies. In this context, over the last few years, several relevant studies have demonstrated that dysregulated miRNAs affect a wide range of molecular mechanisms associated with irritable bowel syndrome (IBS), a common gastrointestinal disorder. For instance, abnormal miRNA expression in IBS patients is related to the alteration of intestinal permeability, visceral hyperalgesia, inflammatory pathways, and pain sensitivity. Besides, specific miRNAs are differentially expressed in the different subtypes of IBS, and therefore, they might be used as biomarkers for precise diagnosis of these pathological conditions. Accordingly, miRNAs have noteworthy potential as theragnostic targets for IBS. Hence, in this current review, we present an overview of the recent discoveries regarding the clinical relevance of miRNAs in IBS, which might be useful in the future for the development of miRNA-based drugs against this disorder. PMID:35507132 | DOI:10.1007/s10620-022-07516-6 View the full article
  24. Perspectives on Leadership, Education and the Future of Clinical Care in IBS with Lin Chang, MD Healio In this podcast episode, Lin Chang, MD, vice-chief of Vatche and Tamar Manoukian Division of Digestive Diseases, discusses her path to GI, her interest in IBS and some of the newest therapies coming down the pipe and more. Intro :02 Welcome to this episode of Gut Talk :22 About Chang :28 The interview :46 Where did you grow up? :49 Who are your early role models?3:50 How far along in college were you before you decided to apply for medical school? 4:58 How did you get interested in GI? 5:32 What advice would you give to the residents and fellows that you interact with in that regard? 8:42 As you started your career you weren’t necessarily thinking that you were going to be a clinical/academic icon … didn’t you start mostly as a clinician? 11:56 Early on when we started working together … you were the only woman in the room. How were you able to break through that glass ceiling and get into the room? 17:38 What advice do you give your fellows who want to get more involved? 22:12 How did you get interested in a condition like IBS? 24:02 Could you explain to our listeners what it means by the biopsychosocial model when referring to IBS? 26:21 Do you think that, in actuality, these could be completely separate diseases? 29:03 Discussion on the layers of IBS 32:26 Do you mind summarizing your key takeaways from an American Gastrological Association clinical practice update on the role of diet in patients with IBS? 38:03 Another document we’re working on right now is the first joint society (AGA, ACG) clinical practice guideline on treatment of chronic constipation … would you like to say a couple words about that one? 42:04 What does your future look like? What are you thinking is next for Lin Chang? 44:39 In your role as program director, what are the trends that you’ve noticed amongst trainees? 46:46 What are you most excited about with regards to the newer therapies and treatment paradigms, the new care delivery models that are on the horizon to help patients with IBS? 49:13 Lin, this has been a great discussion 51:00 Thanks for listening 51:37 Lin Chang, MD, is the vice-chief of Vatche and Tamar Manoukian Division of Digestive Diseases, program director of the UCLA GI Fellowship Program and the co-director of the G. Oppenheimer Center for Neurobiology of Stress and Resilience. We’d love to hear from you! Send your comments/questions to guttalkpodcast@healio.com. Follow us on Twitter @HealioGastro@sameerkberry @umfoodoc View the full article
  25. Dig Dis Sci. 2022 May 3. doi: 10.1007/s10620-022-07500-0. Online ahead of print. ABSTRACT BACKGROUND: Irritable bowel syndrome (IBS) is a heterogeneous disease, which is closely related to environmental factors and gut microbiota. OBJECTIVE: To study gut microbiota in IBS-D of Han nationality in Southwest China and explore its relationship with environmental factors. METHODS: One hundred and twenty cases of IBS-D and 63 cases of HCs were recruited; baseline data such as age, height, and weight were collected. HAMA, HAMD, IBS-SSS, IBS-QOL, and laboratory tests were performed. Feces were collected for 16S rDNA sequencing. Then, the differences of gut microbiota were analyzed and looked for biomarkers of each. FAPROTAX was used to predict the functional differences of gut microbiota. Spearman analysis was conducted between the phylum level and environmental factor. RESULTS: There were significant differences in daily life between IBS-D and HCs, especially in the spicy taste. The scores of HAMA and HAMD, urea, and transaminase in IBS-D were significantly higher than those of HCs. The richness of gut microbiota in IBS-D was significantly lower than that of HCs, as well as the beta diversity, but not diversity. The biomarkers of IBS-D were Prevotella, Clostridiales, and Roseburia, and the biomarkers of HCs were Veillonellaceae, Bacteroides coprocola, and Bifidobacteriales. The functions of gut microbiota in IBS-D were significantly different from HCs. Correlation analysis showed that multiple gut microbiota were closely related to HAMA, IBS-SSS, IBS-QOL, inflammatory indexes, and liver enzymes. CONCLUSION: There are significant differences in richness of gut microbiota, flora structure, and flora function between IBS-D and HCs in Southwest China. These differences may be closely related to environmental factors such as eating habits, living habits, and mental and psychological factors. CLINICAL TRIAL REGISTRATION: The trial was registered and approved in China Clinical Trial Registry (Registration No. ChiCTR2100045751). PMID:35503487 | DOI:10.1007/s10620-022-07500-0 View the full article
  26. Am J Physiol Gastrointest Liver Physiol. 2022 May 3. doi: 10.1152/ajpgi.00063.2022. Online ahead of print. ABSTRACT BACKGROUND & AIMS: Altered mucosal functions are documented in jejunal or colorectal mucosa from patients with IBS. AIM: To quantify ileal, ascending and rectosigmoid colon mucosal expression of genes in IBS-diarrhea (D) and IBS-constipation (C). METHODS: 44 patients with IBS-D, 30 with IBS-C, and 30 healthy volunteers underwent colonoscopic ileal, ascending and rectosigmoid colon biopsies. Biopsies were stored in RNAlater at -80˚C, purified with on-column DNase, cDNA libraries prepared from 100-200ng of total RNA, sequenced on Illumina NovaSeq{trade mark, serif} 6000, and analyzed on Illumina's RTA version 3.4.4. Normalized mRNA expression was obtained using MAP-RSeq bioinformatics pipeline. Differential expressions in the groups (Log2 Fold change) were measured using the bioinformatics package edgeR 2.6.2, corrected for false discovery rate (PADJ <0.05). RESULTS: There were 30 females with IBS-C, and 31 females and 13 males with IBS-D. In IBS-D and IBS-C, there were differential expressions of 181 genes in ascending colon and 199 genes in rectosigmoid colon. The majority were gene upregulations in IBS-D with functions reflecting activation of inflammation genes, TRPV1 (visceral hypersensitivity) and neurotransmitters/receptors (purinergic, GABA, cannabinoid). Although gene differential expressions in ascending and rectosigmoid colon mucosa of the 2 groups were different, the diverse upregulated genes involved immune functions, receptors, transmitters, ion channels, and transporters. Conversely, there was reduced expression of PI15 and PI16 genes that inhibit proteases. CONCLUSION: In patients with IBS-D and IBS-C, differential expressions of genes related to immune, transmitter, nociceptive, protease inhibition, channel, and transporter functions suggest opportunities to reverse the pathobiology and treat patients with IBS. PMID:35502856 | DOI:10.1152/ajpgi.00063.2022 View the full article
  27. Front Public Health. 2022 Apr 15;10:864721. doi: 10.3389/fpubh.2022.864721. eCollection 2022. ABSTRACT BACKGROUND: Irritable bowel syndrome (IBS) has become a common public health issue among university students, impairing their physical and mental health. This meta-analysis aimed to examine the pooled prevalence of IBS and its associated factors among Chinese university students. METHODS: Databases of PubMed, EMBASE, MEDLINE (via EBSCO), CINAHL (via EBSCO), Wan Fang, CNKI and Weipu (via VIP) were systematically searched from inception date to May 31, 2021. Meta-analysis was performed using random-effects models. Meta-regression and subgroup analysis were used to detect the potential source of heterogeneity. KEY RESULTS: A total of 22 cross-sectional studies (14 were in Chinese and 8 were in English) with 33,166 Chinese university students were included. The pooled prevalence of IBS was estimated as 11.89% (95% CI = 8.06%, 16.35%). The prevalence was 10.50% (95% CI = 6.80%, 15.87%) in Rome II criteria, 12.00% (95% CI = 8.23%, 17.17%) in Rome III criteria, and 3.66% (95% CI = 2.01%, 6.60%) in Rome IV criteria. The highest prevalence of IBS was 17.66% (95% CI = 7.37%, 36.64%) in North China, and the lowest was 3.18% (95% CI = 1.28%, 7.68%) in South China. Subgroup analyses indicated that gender, major, anxiety and depression symptoms, drinking and smoking behaviors were significantly associated with the prevalence of IBS. Meta-regression analyses suggested that region influenced prevalence estimates for IBS. CONCLUSIONS AND INFERENCES: This meta-analysis illustrated that IBS is very common in Chinese university students. Regular screening, effective prevention, and appropriate treatments should be implemented to reduce the risk of IBS in this population. More future studies should be conducted in Northeastern and Southwestern parts of China. PMID:35493361 | PMC:PMC9051230 | DOI:10.3389/fpubh.2022.864721 View the full article
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