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  1. Today
  2. Front Psychiatry. 2021 Sep 9;12:673939. doi: 10.3389/fpsyt.2021.673939. eCollection 2021. ABSTRACT Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder, which severely impairs the quality of life of patients. Treatment of refractory IBS patients is needed, but it is not yet widely available. Therefore, we previously developed a Japanese version of cognitive behavioral therapy with interoceptive exposure (CBT-IE) involving 10 face-to-face sessions to treat refractory IBS patients. To disseminate this treatment of IBS in places where therapists are limited, we further developed a hybrid CBT-IE program with complementary video materials that include psychoeducation and homework instructions so that patients can prepare for face-to-face sessions in advance at home and the session time can be shortened, thereby reducing the burden on both patient and therapist. In this study, we conducted a trial to evaluate the feasibility, efficacy, and safety of the hybrid CBT-IE program for Japanese IBS patients. The study was a single-arm, open-label pilot clinical trial. A total of 16 IBS patients were included in the study and 14 patients completed the intervention, which consisted of 10 weekly individual hybrid CBT-IE sessions. We performed an intention to treat analysis. The primary outcome measure for the efficacy of the intervention was a decrease in the severity of IBS symptoms. The feasibility and safety of the intervention were examined by the dropout rate and recording of adverse events, respectively. The dropout rate of the hybrid CBT-IE was comparable to that of our previous CBT-IE with only face-to-face sessions and no adverse events were recorded. The severity of IBS symptoms within-group was significantly decreased from the baseline to mid-treatment [Hedges' g = -0.98 (-1.54, -0.41)], post-treatment [Hedges' g = -1.48 (-2.09, -0.88)], 3-month follow-up [Hedges' g = -1.78 (-2.41, -1.14)], and 6-month follow-up [Hedges' g = -1.76 (-2.39, -1.13)]. Our results suggest that the hybrid CBT-IE is effective and could be conducted safely. To confirm the effectiveness of the hybrid CBT-IE, it is necessary to conduct a multicenter, parallel-design randomized control trial. Clinical Trial Registration: [https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000041376], identifier [UMIN000036327]. PMID:34566709 | PMC:PMC8458884 | DOI:10.3389/fpsyt.2021.673939 View the full article
  3. Long‐term personalized low FODMAP diet improves symptoms and maintains luminal Bifidobacteria abundance in irritable bowel syndrome https://onlinelibrary.wiley.com/doi/10.1111/nmo.14241#.YVEWMBmNJAM.twitter (Feed generated with FetchRSS)View the full article
  4. Increased admissions for eating disorders since pandemic in pediatrics & adults. Clinicians please screen for EDs! One tool for screening: https://www.eat-26.com https://twitter.com/agnesayton/status/1442274508082196480 (Feed generated with FetchRSS)View the full article
  5. RT @jack_turban: New paper shows what many of us have been seeing: eating disorders are getting much worse during the #COVID19 pandemic In this study, medical admissions for restrictive eating disorders doubled #medtwitter #psychtwitter #anorexia https://doi.org/10.1542/peds.2021-052201 (Feed generated with FetchRSS)View the full article
  6. Yesterday
  7. Metabolites. 2021 Sep 9;11(9):612. doi: 10.3390/metabo11090612. ABSTRACT Bile acids are metabolites involved in nutrient absorption and signaling with levels influenced by dietary intake, metabolic processes, and the gut microbiome. We aimed to quantify 23 bile acids in fecal samples to ascertain if concentrations differed between healthy participants and those with functional gut disorders. Fecal bile acids were measured using liquid chromatography-mass spectrometry (LC-MS) in the COMFORT (The Christchurch IBS cohort to investigate mechanisms for gut relief and improved transit) cohort of 250 participants with Rome IV IBS (IBS-constipation (C), IBS-diarrhea (D), IBS-mixed (M)), functional gut disorders (functional constipation (FC), functional diarrhea (FD)) and healthy controls (FC n = 35, FD n = 13, IBS-C n = 24, IBS-D n = 52, IBS-M n = 29, and control n = 97). Dietary information was recorded to ascertain three-day dietary intake before fecal samples were collected. Fecal bile acid concentrations, predominantly primary bile acids, were significantly different between all functional gut disorder participants and healthy controls (CDCA p = 0.011, CA p = 0.003) and between constipation (FC + IBS-C) and diarrhea (FD + IBS-D) groups (CDCA p = 0.001, CA p = 0.0002). Comparison of bile acids between all functional groups showed four metabolites were significantly different, although analysis of combined groups (FC + IBS-C vs. FD + IBS-D) showed that 10 metabolites were significantly different. The bile acid profiles of FD individuals were similar to those with IBS-D, and likewise, those with FC were similar to IBS-C. Individuals with a diarrhea phenotype (FD + IBS-D) had higher concentrations of bile acids compared to those with constipation (FC + IBS-C). Bile acid metabolites distinguish between individuals with functional gut disorders and healthy controls but are similar in constipation (or diarrhea) whether classified as IBS or not. PMID:34564428 | DOI:10.3390/metabo11090612 View the full article
  8. Last week
  9. ‘Oatrepreneur’ Kathryn develops new Nuttin’ But to help her IBS Belfast News Letter Lisburn mum creates tasty support for strengthening our immune system and helping digestive health problems The busy mum of one in Lisburn has created Nuttin’ But, a small enterprise specialising in convenient oat-based and gluten-free breakfast pots and immune cereal bars with a unique bio-culture to promote digestive health. The natural products are also now on the shelves of retailers here and in Britain including WH Smyth. View the full article
  10. Endomicroscopy Fails to Detect Wheat Sensitivity in IBS Patients MedPage Today Diagnostic accuracy of confocal laser endomicroscopy (CLE) was too low to identify wheat sensitivities in non-celiac irritable bowel syndrome (IBS) patients, according to a prospective multicenter study. The method accurately detected wheat sensitivity in only about half of the individuals who responded to a gluten-free diet at 2 months (51.4% sensitivity, 97.5% CI 38.7-63.9%), reported Christian Bojarski, MD, of Charité–Universitätsmedizin Berlin in Germany, and colleagues. View the full article
  11. Int J Psychophysiol. 2021 Sep 21:S0167-8760(21)00884-9. doi: 10.1016/j.ijpsycho.2021.09.006. Online ahead of print. ABSTRACT Debate continues as to whether an attentional bias towards threat displayed by sufferers of functional gastrointestinal disorders (FGIDs) is conscious and, thus, more amenable to change through psychological therapy. We compared the amplitudes of early (unconscious) and later (conscious) electroencephalographic (EEG) event-related potentials following silent reading of symptom-related, emotionally neutral, and emotionally negative nouns across two participant groups: 30 female FGID-sufferers who met diagnostic criteria for irritable bowel syndrome or functional dyspepsia, and 30 female healthy controls. Analogous indices based on alpha desynchronization were also examined, as were correlations between the EEG-based indices and a range of psychosocial variables. FGID-sufferers displayed marginally significantly higher occipital EPN amplitudes for all nouns, indicating marginally higher levels of unconscious attention in the task. FGID-sufferers also displayed, for negative as compared to neutral nouns, significantly lower central N400 amplitudes indicative of higher conscious attention. The result was only apparent in post-hoc pairwise comparisons, however. Uniquely among FGID-sufferers, central N400 was strongly negatively correlated with a range of negative psychosocial traits and states. The findings provide preliminary evidence of hypervigilance to general (as opposed to symptom-specific) threat among FGID-sufferers. Amidst concerns over Type I error, recommendations are made for fine-tuning the operationalisation of unconscious and conscious attentional bias in this population. PMID:34560170 | DOI:10.1016/j.ijpsycho.2021.09.006 View the full article
  12. Clin Nutr. 2021 Sep 9;40(10):5365-5372. doi: 10.1016/j.clnu.2021.09.002. Online ahead of print. ABSTRACT BACKGROUND & AIMS: Wheat contains several components, including gluten and fructan, that may be associated with gastrointestinal symptoms (GI) in irritable bowel syndrome (IBS). The aims of the study were to determine the average daily intake of gluten, investigate the association of gluten and GI symptoms, as well as the association between fructan and GI symptoms in IBS subjects. METHODS: We assessed dietary intake, including total energy, and calculated average gluten and fructan intake in this 4-day food diary study. The subjects reported GI symptoms using the validated Gastrointestinal Symptom Rating Scale-IBS (GSRS-IBS). RESULTS: In total, 147 IBS subjects (116 females) were included in this study. The median (IQR) intake of gluten was 11.0 (7.5-15.4) (range: 0.6-52.1) g/day, and this intake was significantly higher for males (16.2 (11.5-18.8), g/day) compared with females (10.3 (7.3-13.2), g/day) (P ≤ 0.001). For analyses purposes, the subjects were stratified in tertiles of gluten intake. Median (IQR) overall GI symptom severity (GSRS-IBS) was significantly worse for the subjects with the lowest (52 (45-57)) and intermediate gluten intake (51 (43-58)), compared with the highest gluten intake (45 (37-50), P ≤ 0.05, and P ≤ 0.01 respectively). In addition, caloric intake was significantly lower in subjects with the lowest (1905 ± 446, kcal/day) and intermediate gluten intake (1854 ± 432, kcal/day), compared with subjects with the highest gluten intake (2305 ± 411, kcal/day), P < 0.001 for both. Analyses of the stratified fructan tertiles resulted in no significant differences in GSRS-IBS. CONCLUSIONS: The mean intake of gluten varies substantially among subjects with IBS, and IBS subjects with more severe GI symptoms have lower intake of gluten and calories. TRIAL REGISTRY: (http://www.clinicaltrials.gov): Registered under Clinical Trial number NCT02970591. PMID:34560607 | DOI:10.1016/j.clnu.2021.09.002 View the full article
  13. Front Med (Lausanne). 2021 Sep 7;8:665520. doi: 10.3389/fmed.2021.665520. eCollection 2021. ABSTRACT Fecal microbiota transplantation has been primarily investigated as a therapeutic tool for a number of gut disorders. Optimistic results from clinical studies on Clostridium difficile infection, inflammatory bowel disease and irritable bowel syndrome have stimulated the expansion of possible indications in which FMT might represent a game changing approach. Microbial dysbiosis was shown in a number of non-gastrointestinal disorders. Moreover, FMT was proven to be effective in therapy of numerous animal models of disease. However, only a proportion of these disorders have been addressed in clinical studies using FMT. These include obesity, non-alcoholic fatty liver disease, cardiovascular inflammation and neurological disorders such as autism, depression and Parkinson's disease. Results from preclinical and clinical studies also outlined possible molecular mechanisms that contribute to alleviation of the disease. These range from increasing the circulating levels of microbial metabolites (trimethylamine N-oxide, lipopolysaccharide, short chain fatty acids) to stimulation of the enteric nervous system. Several methodological shortcomings are still to be addressed; however, positive results of the clinical studies indicate that further investigation of FMT as a therapeutic tool for non-gastrointestinal disorders can be expected in upcoming years. PMID:34557498 | PMC:PMC8452915 | DOI:10.3389/fmed.2021.665520 View the full article
  14. Can Cannabis Help Your Gut? | Time TIME When Joe Silverman developed Crohn’s disease at age 21, the symptoms started out mild. While the sight of blood in his stools initially freaked him out, what really bothered him was the frequent abdominal pain and bloating that occurred as his condition progressed to moderate and then severe. Dietary changes didn’t make a difference, so he began taking prescription oral anti-inflammatory drugs that are often used to treat certain bowel diseases, which alleviated but didn’t eliminate his discomfort. He started using prescription steroid suppositories to cope with flare-ups of the inflammatory bowel disease. View the full article
  15. Front Med (Lausanne). 2021 Sep 6;8:622029. doi: 10.3389/fmed.2021.622029. eCollection 2021. ABSTRACT Aims: To compare the effects of Ayurvedic and conventional nutritional therapy in patients with irritable bowel syndrome (IBS). Methods: Sixty-nine patients with IBS were randomized to Ayurvedic (n = 35) or conventional nutritional therapy according to the recommendations of the German Nutrition Society including the low-FODMAP diet (n = 34). Study visits took place at baseline and after 1, 3, and 6 months. The primary outcome was IBS symptom severity (IBS-SSS) after 3 months; secondary outcomes included stress (CPSS), anxiety and depression (HADS), well-being (WHO-5) and IBS-specific quality of life (IBS-QOL). A repeated measures general linear model (GLM) for intent-to-treat-analyses was applied in this explorative study. Results: After 3 months, estimated marginal means for IBS-SSS reductions were 123.8 [95% confidence interval (95% CI) = 92.8-154.9; p < 0.001] in the Ayurvedic and 72.7 (95% CI = 38.8-106.7; p < 0.001) in the conventional group. The IBS-SSS reduction was significantly higher in the Ayurveda group compared to the conventional therapy group (estimated marginal mean = 51.1; 95% CI = 3.8-98.5; p = 0.035) and clinically meaningful. Sixty-eight percentage of the variance in IBS-SSS reduction after 3 months can be explained by treatment, 6.5% by patients' expectations for their therapies and 23.4% by IBS-SSS at pre-intervention. Both therapies are equivalent in their contribution to the outcome variance. The higher the IBS-SSS score at pre-intervention and the larger the patients' expectations, the greater the IBS-SSS reduction. There were no significant group differences in any secondary outcome measures. No serious adverse events occurred in either group. Conclusion: Patients with IBS seem to benefit significantly from Ayurvedic or conventional nutritional therapy. The results warrant further studies with longer-term follow-ups and larger sample sizes. Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT03019861, identifier: NCT03019861. PMID:34552937 | PMC:PMC8450363 | DOI:10.3389/fmed.2021.622029 View the full article
  16. Dtsch Med Wochenschr. 2021 Oct;146(19):1243-1248. doi: 10.1055/a-1331-6478. Epub 2021 Sep 22. ABSTRACT IRRITABLE BOWEL SYNDROME: WHAT IS NEW?: The following refers only to irritable bowel syndrome (IBS) in adults. The new guideline includes a separate section on IBS for paediatric patients. Irritable bowel syndrome (IBS) presents as a heterogeneous picture with chronic abdominal complaints related to the bowel. These are usually accompanied by changes in bowel movements and lead to impaired quality of life. The genesis is multifactorial and there are complex underlying pathophysiological mechanisms associated with IBS. Thus, disturbances in various components of the gut-brain axis and the increasing importance of the microbiome can be identified. Various psychological comorbidities also play a role. DIAGNOSTICS: The diagnosis is made by a thorough anamnesis and symptom-oriented exclusion of important differential diagnoses. A subdivision into different subtypes depending on the main symptoms is beneficial for the further management of IBS patients. The diagnosis of IBS should be made as early as possible after reliable exclusion of the important differential diagnoses. If diarrhoea dominates as a symptom, a detailed differential diagnosis and functional diagnosis should be carried out. THERAPY: There is no proven causal and no established standard therapy. Due to the variable genesis and symptom manifestation of IBS, a broad spectrum of therapy options results, whereby there is no individual prediction regarding effectiveness and therefore every therapy is initially probationary. Symptom-independent general therapies that can be used for all subtypes include dietary methods (e. g. the low-FODMAP diet), probiotics, psychotherapy methods and complementary medicine. The choice of symptom-dependent drug treatments is made according to the subtype/main symptom. In the case of diarrhoea, bile acid binders, the non-absorbable antibiotic rifaximin or, in individual cases, 5-HT3-antagonists can be used in addition to loperamide. In constipation, prucalopride and linaclotide have value in addition to the use of soluble fibre and macrogol/other laxatives. For abdominal pain/cramps, studies show good results for spasmolytics, especially peppermint oil, and for tricyclic-type antidepressants. For the main symptom of flatulence, probiotics, rifaximin and especially the low-FODMAP diet can show positive results in studies. PMID:34553347 | DOI:10.1055/a-1331-6478 View the full article
  17. In a large US database encompassing >53 million patients over >20 years, patients with IBS are at least 4 times more likely to have a Mast cell disorders than the general population. 👇🏼 https://twitter.com/john_damianosmd/status/1440761482518548486 (Feed generated with FetchRSS)View the full article
  18. J Gastrointestin Liver Dis. 2021 Sep 21;30(3):334-338. doi: 10.15403/jgld-3828. ABSTRACT BACKGROUND AND AIMS: Irritable bowel syndrome (IBS) is a chronic condition, with a relatively high prevalence and represents a burden for the healthcare budgets. Knowing the prevalence of IBS is important for scientific and practical estimation of its impact. The recent Rome IV global study has shed light on the prevalence of IBS in many countries, but reports are lacking from other countries. The aim of this study was to assess the prevalence of IBS in Albania, a country from which we do not have relevant information. METHOD: A prospective study was carried out in order to find out the prevalence of IBS in Albania. The target population was a sample of at least 500 Albanian adults (from a population of 2.2 million adults in this country. The questionnaires were distributed to the general population through three University centers from different areas of the country, through family doctors, chosen randomly, and by door to door by volunteer medical students. The questionnaires were self-completed by the participants and included 29 items: biographical data, IBS symptoms based on the Rome IV criteria, the symptoms that accompany IBS and the quality of life (QoL). The prevalence of IBS in the studied population, the sex ratio, the subtypes of IBS and the prevalence of different symptoms were calculated. RESULTS: We sent out 550 questionnaires and we received answers from 502 subjects (response rate 91%, 312 females, median age: 42 years). IBS was present in 43 cases (8.6%), without gender predominance. The IBS subtypes had the following values: IBS-C 58%, IBS-D 28% and IBS-M 14%. Women had a relatively higher risk for subtype IBS predominant constipation (OR=1.13, 95%CI: 0.32-3.95, p=0.84) but men appeared to be more prone to IBS predominant diarrhea (OR=1.3, 95%CI: 0.33-5.08, p=0.7). The most affected age was over 50 years and the least affected was between 18-30 years. Bloating was present in 81.4% of IBS respondents. The pain significantly influenced the daily activity in IBS: OR=12.9:1 (95% CI: 6.18-27.31, p<0.0001). Education seems to be an important risk factor; people with only middle school education or less had an OR=4.5 (95% CI: 2-10.54, p=0.0003) of developing IBS than people with a higher education. CONCLUSIONS: These are the first reported data on IBS in Albania. IBS in Albania is of 8.6%, more than the average data in the Rome IV global study, but in the range obtained from other studies. The most common type is IBS-C; there is no gender predominance; it is more common in less educated persons; the influence of pain on daily activity is higher in IBS. PMID:34551031 | DOI:10.15403/jgld-3828 View the full article
  19. Minerva Gastroenterol (Torino). 2021 Sep 22. doi: 10.23736/S2724-5985.21.02957-0. Online ahead of print. ABSTRACT INTRODUCTION: Studies have suggested an association between ischemic colitis and irritable bowel syndrome (IBS) although the results were inconsistent. This systematic review and meta-analysis were performed to comprehensively examine the association between IBS and ischemic colitis by identifying all available cohort and case-control studies and combining their effect estimates together. EVIDENCE ACQUISITION: EMBASE, MEDLINE and Google Scholar databases were systematically reviewed up to June 2020. Eligible study had to be either cohort or case-control studies that evaluated whether patients with IBS have a higher risk of ischemic colitis than individuals without IBS. Point estimates and standard errors from each eligible study were combined together using the generic inverse variance method of DerSimonian and Laird. EVIDENCE SYNTHESIS: The systematic review identified three cohort and eight case-control studies. The pooled analysis found a significantly higher risk of ischemic colitis among patient with IBS with the pooled odds ratio of 2.50 (95% CI, 2.00 - 3.14; I2 57%). Funnel plot was relatively symmetric and was not suggestive of presence of publication bias. CONCLUSIONS: A significantly increased risk of ischemic colitis among patients with IBS was observed in this systematic review and meta-analysis. PMID:34547858 | DOI:10.23736/S2724-5985.21.02957-0 View the full article
  20. RT @DrTiffTaft: If you haven’t checked out @Christi32501837 Christine Rich’s book “Chronic” go now and get a copy. It’s an incredibly authentic look at life with #IBD https://twitter.com/christi32501837/status/1437099003645210640 (Feed generated with FetchRSS)View the full article
  21. Chin J Integr Med. 2021 Sep 21. doi: 10.1007/s11655-021-3521-4. Online ahead of print. ABSTRACT Irritable bowel syndrome (IBS) is a common refractory disease. Chinese medicine (CM) has remarkable efficacy and advantages on the treatment of IBS. This review summarized the articles focusing on the treatment of IBS with CM to sum up the latest treatment methods for IBS and the underlying mechanisms. Literature analysis showed that prescriptions, acupuncture, and moxibustion are the primary methods of CM treatment for IBS. The potential mechanism centers on the regulation of the enteric nervous system, the alleviation of visceral hypersensitivity, the stability of intestinal flora, and the regulation of the immune system. PMID:34546535 | DOI:10.1007/s11655-021-3521-4 View the full article
  22. Gut. 2021 Sep 20:gutjnl-2021-325181. doi: 10.1136/gutjnl-2021-325181. Online ahead of print. ABSTRACT OBJECTIVE: A considerable proportion of patients with irritable bowel syndrome (IBS) may be wheat-sensitive and respond to a gluten-free diet (GFD) although they do not have coeliac disease. However, a diagnostic test for wheat sensitivity (WS) is missing. Our study evaluated the diagnostic accuracy (sensitivity and specificity) of confocal laser endomicroscopy (CLE) for the identification of WS as primary outcome. DESIGN: In this prospective, double-blind diagnostic study 147 non-coeliac patients fulfilling the Rome III criteria for IBS were tested by CLE for duodenal changes after wheat (index test), soy, yeast or milk exposure. Patients with IBS responding to 2 months of GFD were classified as having WS (reference test) using response criteria recommended by regulatory bodies for pharmaceutical trials of patients with IBS. After 2 months, CLE results were unblinded and patients were advised to exclude those food components that had led to a positive CLE reaction. The clinical response was assessed at follow-up after 6 and 12 months. RESULTS: Of 130 patients who completed the study per protocol, 74 (56.9%) responded to GFD and were classified as WS after 2 months, and 38 of these 74 patients were correctly identified by CLE (sensitivity 51.4%; 97.5% CI: 38.7% to 63.9%). A total of 38 of 56 patients without WS were correctly identified by CLE (specificity 67.9%; 97.5% CI: 52.9% to 79.9%). At 6 months follow-up, CLE correctly identified 49 of 59 food-sensitive patients (sensitivity 83.1%; 97.5% CI: 69.9% to 91.3%) but specificity was only 32% (97.5% CI: 15.7% to 54.3%). CONCLUSION: In light of the high proportion of patients with IBS responding to GFD, the diagnostic accuracy of CLE is too low to recommend widespread use of this invasive procedure. TRAIL REGISTRATION NUMBER: This study was registered as clinical trial in the German Registry for Clinical Studies (DRKS00010123). PMID:34544843 | DOI:10.1136/gutjnl-2021-325181 View the full article
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  24. William Chey, MD: Treating Gastrointestinal Diseases With Diet MD Magazine Diet might be just as important a treatment for gastrointestinal disorders like irritable bowel syndrome (IBS) as any medication is. And until recently the advice on diet was a little unclear as there were very few studies proved the value in diet and specifics in diet for this patient population. But recently there has been more evidence-based research proving the value in diet in not only preventing gastrointestinal disorders, but also aiding patients who have been diagnosed with diseases like IBS. An example of a diet that has value in this target population is the FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet. This diet values whole grains, fruits, vegetables, and lean proteins like chicken and fish, while eliminating the processed sugars and sweeteners that are prevalent in many diets today. One of the biggest advocates for this diet for patients with gastrointestinal disorders is William Chey, MD, professor of gastroenterology and nutrition sciences at Michigan Medicine at the University of Michigan. Chey joined the DocTalk Podcast to discuss how diets like FODMAP can be beneficial for IBS patients and how should patients view food trends to avoid falling for faulty information. He also explained how the COVID-19 pandemic may have been good for some diets, while bad for others. View the full article
  25. Front Med (Lausanne). 2021 Sep 1;8:646658. doi: 10.3389/fmed.2021.646658. eCollection 2021. ABSTRACT Background: The influence of daily life exposure on the gastrointestinal tract is not fully understood. This study aimed to examine associations between functional gastrointestinal symptoms and sociodemographic status and lifestyle habits in the general population. Methods: The Malmö Offspring Study (MOS) included 2,648 participants from the general population who had answered a questionnaire about sociodemographic status, lifestyle habits, medical health, and self-reported irritable bowel syndrome (IBS). The visual analog scale for IBS (VAS-IBS) was completed to assess gastrointestinal symptoms the past 2 weeks. Subjects with organic gastrointestinal diseases were excluded. Presence of self-reported IBS and gastrointestinal symptoms the past 2 weeks were used as dependent variables to study the associations with age, sex, body mass index, education, occupation, marital status, smoking, snuff using, alcohol drinking frequency, alcohol amount per drinking occasion, physical activity at work, and physical activity during leisure time, using logistic regression and generalized linear model. Results: Self-reported IBS was associated with gastrointestinal symptoms the past 2 weeks (p < 0.001). There was an association between IBS and female sex (p < 0.001), former smoking (p < 0.001), present smoking (p < 0.001), and an inverse association with drinking 3-4 standard glasses per occasion (p = 0.038). Gastrointestinal symptoms were associated with age 50-59 years (p = 0.009), ≥60 years (p = 0.004), female sex (p < 0.001), studying (p = 0.036), unemployment (p = 0.009), former smoking (p = 0.001), and present smoking (p = 0.012). In men, IBS was associated with middle-age and both IBS and gastrointestinal symptoms were associated with unemployment (p < 0.001 and p = 0.001, respectively). In women, IBS was associated with present smoking (p = 0.022), and gastrointestinal symptoms were associated with former smoking and inversely associated with higher age (p = 0.006) and intermediate physical activity at work (p = 0.008). No associations were found with BMI, education, marital status, or snuff using. Conclusion: Self-reported IBS in the general population shows strongest association with female sex and smoking, whereas gastrointestinal symptoms also are associated with unemployment and inversely associated with higher age. In men, both IBS and gastrointestinal symptoms are associated with unemployment. In women, both IBS and gastrointestinal symptoms are associated with smoking, whereas symptoms are inversely associated with higher age and intermediate physical activity. PMID:34540857 | PMC:PMC8440854 | DOI:10.3389/fmed.2021.646658 View the full article
  26. Front Neurosci. 2021 Sep 3;15:721822. doi: 10.3389/fnins.2021.721822. eCollection 2021. ABSTRACT BACKGROUND AND PURPOSE: The appearance and aggravation of diarrhea-predominant irritable bowel syndrome (IBS-D) have proven to be closely related to psychosocial factors. We aimed to measure altered spontaneous brain activity and functional connectivity (FC) in patients with IBS-D using resting-state functional magnetic resonance imaging (RS-fMRI) and to analyze the relationship between these parameters and emotional symptoms. METHODS: Thirty-six adult IBS-D patients and thirty-six demographic-matched healthy controls (HCs) underwent RS-fMRI scans. After processing RS-fMRI data, the values of the amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) of the two groups were compared. The abnormal regions were selected as the regions of interest to compare whole-brain seed-based FC between the groups. The relationships between RS-fMRI data and mood and gastrointestinal symptoms were analyzed using correlation and mediation analyses. RESULTS: Compared with HCs, IBS-D patients showed increased ALFF in the right cerebellum posterior lobe, the right lingual gyrus/calcarine, the right postcentral gyrus, the right superior frontal gyrus (SFG), and middle frontal gyrus (MFG), with decreased ALFF in the right inferior parietal lobule, the right striatum, the right anterior cingulated cortex, the right insula, the right hippocampus, the right thalamus, the right midbrain, and the left precuneus. IBS-D patients showed increased ReHo in the bilateral lingual gyrus/calcarine, the bilateral SFG, the right MFG, and the right postcentral gyrus, with decreased ReHo in the orbital part of the left inferior frontal gyrus and the right supplementary motor area. Patients showed enhanced FC between the left precuneus and the bilateral orbitofrontal cortex (OFC). There was a positive correlation between increased ALFF values in the right midbrain and anxiety-depression symptoms in IBS-D patients, and the mediating effect of gastrointestinal symptoms indirectly caused this correlation. CONCLUSION: IBS-D patients had dysregulated spontaneous activity and FC in regions related to pain regulation and emotional arousal involved in prefrontal-limbic-midbrain circuit and somatosensory processing. The development of mood disorders in IBS-D patients may be partly related to the dysfunction of components in the dopamine pathway (especially the midbrain, OFC) due to visceral pain. PMID:34539337 | PMC:PMC8446353 | DOI:10.3389/fnins.2021.721822 View the full article
  27. Neurogastroenterol Motil. 2021 Sep 17:e14265. doi: 10.1111/nmo.14265. Online ahead of print. ABSTRACT BACKGROUND: Mounting evidence supports a mechanistic association between irritable bowel syndrome (IBS) symptoms and mast cell hyperactivity. Yet, association between IBS and mast cell disorders (MCDs) has not been studied. We examined this association using two large databases and verified with manual chart review. METHODS: The IBM Watson Health Explorys database (Somers, NY), an aggregate of electronic health record (EHR) data from over two dozen US healthcare systems, and Epic's SlicerDicer tool, a self-service tool containing de-identified data from the Epic EHR, were used to identify patients with IBS and MCDs. Patients with organic gastrointestinal disease or diseases associated with secondary mast cell hyperproliferation were excluded. Results were verified with manual chart review from two academic centers. KEY RESULTS: Up to 4% of IBS patients had a comorbid MCD. IBS was strongly associated with all MCDs. The strongest association was between IBS and mast cell activation syndrome (OR 16.3; 95% CI 13.1-20.3). Odds ratios for IBS+urticaria, IBS+idiopathic urticaria, IBS+non-malignant mastocytosis, and IBS+mast cell malignancy ranged from 4.5 to 9.9. Patients from each of these overlap cohorts were predominantly female, and the overlap occurred with all IBS subtypes. Thorough endoscopic evaluation and comorbid mood disorders and migraines are more common in the overlap cohorts than in IBS alone. CONCLUSIONS/INFERENCES: In a large US database encompassing >53 million patients over >20 years, patients with IBS are at least 4 times more likely to have a MCD than the general population. Further study of mast cell involvement in the pathogenesis of IBS is warranted. PMID:34535952 | DOI:10.1111/nmo.14265 View the full article
  28. Dr. Drossman and @JohannahRuddy will be answering your questions on “Gut Feelings” in a live webinar on Oct 7th. Claim your spot today! #GutFeelings #AuthorChat https://loom.ly/jzQV1Q4 (Feed generated with FetchRSS)View the full article
  29. Autonomic Dysfunction Linked to Chronic Constipation Gastroenterology & Endoscopy News Patients with chronic refractory constipation appear to have heightened activity in their sympathetic nervous system and reduced activity in their parasympathetic nervous system, researchers have found. While tests like colonic manometry can assess colon function, the added measure of extrinsic nerve dysfunction can give clinicians a more comprehensive picture of a patient’s pathology and also guide individualized therapy, said Jan D. Huizinga, PhD, a professor of medicine and biomedical sciences at McMaster University in Hamilton, Ontario, and co-author of the study. View the full article
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