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  1. DDW Study Sees Better Outcomes With Multidisciplinary Approach to Functional GI Disorders Many patients say their functional gastrointestinal disorders improve with a combination of adjunctive strategies, including dietary changes and biofeedback. Now they have some rigorous evidence to back up those beliefs. A prospective randomized trial found that a multidisciplinary approach “was superior for global symptoms, improvement in specific functional symptoms, psychological state, quality of life, and cost” to care from a gastroenterologist alone, said Chamara Basnayake, MBBS, a consult
  2. DISTINCT BRAIN-GUT MICROBIOME ALTERATIONS IN FEMALE IBS SUBJECTS: AN ANALYSIS OF FUNCTIONAL BRAIN NETWORKS AND FECAL AMINO-ACID METABOLITES Author(s): Vadim Osadchiy1, Emeran A. Mayer1, Kan Gao1, Jennifer S. Labus1, Bruce D. Naliboff1, Lin Chang1, Jonathan P. Jacobs1, Arpana Gupta1 Background: Evidence from preclinical and clinical studies suggests that alterations in brain-gut-microbiome (BGM) interactions play an important role in the pathogenesis of irritable bowel syndrome (IBS). Here, we use a systems biology approach, leveraging neuroimaging and fecal metabolite data to charac
  3. ASSOCIATION OF FECAL MICROBIOME WITH RESILIENCE IN IRRITABLE BOWEL SYNDROME PATIENTS COMPARED TO HEALTHY CONTROLS Author(s): Wendi LeBrett1, Swapna Mahurkar-Joshi1, Jennifer S. Labus1, Bruce D. Naliboff1, Arpana Gupta1, Jonathan P. Jacobs1, Kirsten Tillisch1, Lisa A. Kilpatrick1, Emeran A. Mayer1, Lin Chang1 Introduction: Evidence supports that irritable bowel syndrome (IBS) is a disorder of brain-gut microbiome interactions that affect the community structure and function of the gut microbiota and may modulate gastrointestinal function. IBS patients have been shown to ha
  4. HIGH STRESS REACTIVITY IS ASSOCIATED WITH SHIFTS IN IBS PHENOTYPE AND MICROBIOME COMPOSITION/FUNCTION Author(s): Jonathan P. Jacobs1,2,3, Venu Lagishetty1, Cathy Liu1,2, Jennifer S. Labus1,2, Lin Chang1,2, Arpana Gupta1,2, Kirsten Tillisch1,2,3, Emeran A. Mayer1,2 Background and Aims: Irritable bowel syndrome (IBS) is associated with perturbation of the brain-gut-microbiome (BGM) axis including alteration of CNS structure/connectivity, visceral sensitivity, and gut microbiome composition/function. We hypothesized that heightened reactivity to stressors would affect IBS phenotyp
  5. GASTROENTEROLOGISTS’ PRESCRIBING PATTERNS AND COMFORT-LEVEL VARY ACROSS DIFFERENT CLASSES OF CENTRAL NEUROMODULATORS FOR TREATMENT OF IBS Author(s): Wendi LeBrett1, Benjamin Nulsen1,Douglas Drossman2, Lin Chang1 INTRODUCTION: Central neuromodulators (CN) are increasingly being recommended for treatment of IBS. However, gastroenterologists (GIs) may not be fully familiar with their different mechanisms of action and side effect profiles, and may vary in their comfort level when prescribing them. Therefore, we administered a survey of GIs to compare variations in prescription p
  6. FACTORS AFFECTING CENTRAL NEUROMODULATOR USE BY GASTROENTEROLOGISTS IN THE TREATMENT OF IBS: RESULTS OF A NATIONAL SURVEY Author(s): Benjamin Nulsen1, Wendi LeBrett1, Douglas A. Drossman2, Lin Chang1 INTRODUCTION: Central neuromodulators (CN), including antidepressants and other CNS-targeted medications, are an effective treatment for irritable bowel syndrome (IBS). Little is known about factors that might affect gastroenterologists’ (GIs) prescribing patterns for these medications in their IBS patients. The aims of our study were to measure the use of CN by GIs in the Uni
  7. TREATMENT EXPECTANCY FOR GI SYMPTOM IMPROVEMENT AND MOTIVATION IMPACTS THE QUALITY OF THE THERAPEUTIC ALLIANCE WITH IBS PATIENTS Author(s): Brian M. Quigley1, Christopher Radziwon1, Alison Vargovich1, Jeffrey M. Lackner1 Background: In the absence of a satisfactory medical treatment, the development of the therapeutic alliance between IBS patients and their provider is deemed critical to managing IBS patients (e.g., Drossman, 2006). The therapeutic alliance refers to the quality and nature of the patient–provider relationship, their collaborative interactions, and the emo
  8. FACTORS ASSOCIATED WITH EFFICACY OF COGNITIVE BEHAVIOR THERAPY VS EDUCATION FOR PATIENTS WITH IRRITABLE BOWEL SYNDROME Author(s): Jeffrey M. Lackner1, James Jaccard2, Rebecca S. Firth1, Susan S. Krasner1, Frank A. Hamilton3, Laurie Keefer4, Chang-Xing Ma1, Christopher Radziwon1, Michael D. Sitrin1, Darren M. Brenner4, Gregory D. Gudleski1, Leonard A. Katz1 Background & Aims: Among patients with irritable bowel syndrome (IBS), it would be helpful to identify those most likely to respond to specific treatments, yet few factors have been identified that reliably predict p
  9. DO I REALLY HAVE TO DO MY HOMEWORK?: THE RELATIONSHIP BETWEEN HOMEWORK COMPLIANCE AND GI SYMPTOM IMPROVEMENT FOLLOWING COGNITIVE BEHAVIORAL THERAPY (CBT) FOR IRRITIBLE BOWEL SYNDROME Author(s): Sarah Mason1, Christopher Radziwon1, Brian M. Quigley1, Gregory D. Gudleski1, Alison Vargovich1, Ashlye Borden1, Jeffrey M. Lackner1 Background: In the absence of a medical cure, treatment guidelines for irritable bowel syndrome (IBS) emphasize behavioral self-management that is designed to teach patients a set of skills for controlling and/or reducing refractory GI symptoms (e.g.,
  10. NUTRITIONAL IMPLICATIONS RELATED TO FOLLOWING A LOW FODMAP DIET IN CHILDREN WITH IBS Author(s): Ann R. McMeans1, Rebecca B. Cappello1, Kristi L. King1, Zoe Carbo1, Gabrielle Kane1, Margaret Heitkemper2, Rona L. Levy2, Robert J. Shulman1, Bruno P. Chumpitazi1 Background: A low fermentable oligosaccharide disaccharide monosaccharide and polyol (FODMAP) diet may ameliorate irritable bowel syndrome (IBS) symptoms. Though the low FODMAP diet is focused on restricting fermentable carbohydrates, whether it affects intake of calories, macronutrients, micronutrients, and whether it affects
  11. UTILITY OF A CONSUMER-FRIENDLY PORTABLE HYDROGEN BREATH ANALYSER DEVICE FOR MONITORING COLONIC FERMENTATION AND SENSATION IN RESPONSE TO SUPPLEMENTAL FIBER Author(s): Claire Shortt1, Niall McGovern1, Eoghan Lafferty1, Pankaj J. Pasricha2 BACKGROUND: Fermentation of soluble fibers by fecal microbiota is vital for colonic health and leads to production of hydrogen (H2) and other volatiles. On the other hand, excessive or aberrant fermentation is associated with gastrointestinal distress. There are currently no practical methods for monitoring fermentation in the gut. To address this n
  12. PREDICTING TREATMENT RESPONSE TO THE LOW FODMAP DIET IN IBS: THE ROLE OF ILLNESS PERCEPTIONS Author(s): Lauren Manning1, Jessica Biesiekierski1, Lukas Van Oudenhove2,3 Background The low fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet has shown efficacy in irritable bowel syndrome (IBS) at the group level, but not all patients respond to the treatment. Predictors of treatment response at the individual subject level are lacking. We aimed to investigate baseline illness perceptions as predictors of treatment response and their cross-sectional asso
  13. HYPERACTIVITY AND AGGRESSION ARE ASSOCIATED WITH AUTONOMIC NERVOUS SYSTEM DYSFUNCTION IN CHILDREN WITH FUNCTIONAL ABDOMINAL PAIN DISORDERS Author(s): Miranda A. van Tilburg3, Robert Burr2, Margaret Heitkemper2, Joan M. Romano2, Robert J. Shulman1, Rona L. Levy2 BACKGROUND: Functional Abdominal Pain Disorders (FAPDs) are posited to be caused by brain-gut dysfunction, such as altered responses to stress through hyperarousal of the autonomic nervous system. The aim of this study was to examine if autonomic nervous system function is associated with psychological symptoms in children wi
  14. FREQUENCY AND INTENSITY OF GASTROINTESTINAL SYMPTOMS RELATED TO FERMENTABLE CARBOHYDRATES IN SUBJECTS SELF- REPORTED MILK INTOLERANT Author(s): Sophia E. Martinez Vazquez1, Jose M. Remes Troche2, Jose R. Nogueira3, Ramon Carmona Sanchez8, María E. Icaza Chávez4, Maria V. Bielsa5, Alejandra Noble-Lugo6, Ricardo Raña-Garibay6, Guillermo R. Aceves-Tavares7, Enrique Coss-Adame1, Luis Uscanga1 Background: Many patients with chronic gastrointestinal disorders relate their symptoms with foods containing milk and dairy products and they avoid them without any test confirming lactose maldige
  15. SLEEP PARASOMNIAS ARE ASSOCIATED WITH AUTONOMIC NERVOUS SYSTEM DYSFUNCTION IN CHILDREN WITH FUNCTIONAL ABDOMINAL PAIN DISORDERS Author(s): Miranda A. van Tilburg2, Robert Burr3, Jennifer Cowie-Jansen1, Mariella M. Self1, Margaret Heitkemper3, Joan M. Romano3, Rona L. Levy3, Robert J. Shulman1 BACKGROUND: Disturbed sleep has been found in children with Functional Abdominal Pain Disorders (FAPDs). Physiological hyperarousal of the autonomic nervous system (ANS) during sleep may contribute to both disturbed sleep as well as pain. The aim of the current ongoing pilot study wa
  16. IMPACT OF PARENTAL ILLNESS AND INJURY ON PEDIATRIC DISORDERS OF GUT-BRAIN INTERACTION Background: Disorders of gut-brain interaction (DGBI) have been associated with psychosocial stressors in children. Parental injuries and illnesses (PII) are known stressors which impact children’s health. We hypothesized that PII would be associated with increased healthcare and prescription use for DGBIs.Methods: A self-controlled case-control study using Military Health System Data evaluated the rate of DGBI visits and odds of prescription use before and after a PII. Children ages 3-16 with a military
  17. GUT DYSBIOSIS INDUCED BY CIRCADIAN RHYTHM DISRUPTION PROMOTES VISCERAL HYPERSENSITIVITY: MEDIATION BY DEGRADATION OF COLONIC MUCUS BARRIER AND LPS ENDOTOXEMIA Author(s): Xiaomin Hu1, Shi-Yi Zhou1, Yawen Zhang1, Weiyang Zheng1, Merritt Gillilland1, Chung Owyang1 Clinical studies suggest that time-shift workers have increased incidence of IBS. We and others have shown that circadian rhythm disruption is associated with gut dydbiosis. We hypothesize that circadian rhythm disruption modulates visceral hypersensitivity (VH) by promoting the growth of mucolytic bacteria resulting in incre
  18. EFFECTS OF SHORT-TERM PPI INTAKE ON PRODUCING SIBO AND BOWEL SYMPTOMS. A STUDY IN HEALTHY VOLUNTEERS Author(s): Cristina Durán Rosas1, Bryan A. Priego Parra1, Lydia A. Mercado2, Eliana C. Morel Cerda1, Carlos Arturo Aquino-Ruiz1, Arturo Triana-Romero1, Mercedes Amieva-Balmori1, Federico B. Roesch Dietlen1, Jose Antonio Velarde Ruiz Velasco2, Jose M. Remes Troche1 Background: Currently, proton pump inhibitors (PPIs) are one of the most commonly prescribed drugs in the primary care setting and have great benefit for patients with acid related disease. Although PPIs are genera
  19. PILOT STUDY TO DETERMINE FERMENTABILITY AND TOLERABILITY OF ARTIFICIAL SWEETENERS IN HEALTHY CONTROLS AND IRRITABLE BOWEL SYNDROME PATIENTS Author(s): Amit Gupta1, Jason Baker1, Jeremy Farida1, Emily Haller1, Lydia Watts1, Moira Armstrong1, Gabrielle Ezell1, William D. Chey1 Background: Sugar substitutes (SS) are a popular means of reducing caloric intake. Two popular SS are sucralose/maltodextrin (Splenda) and stevia extract/dextrose (Stevia in the Raw). SS have been touted as non-fermentable by humans, and thus, devoid of gastrointestinal (GI) symptoms though little data sup
  20. SAFETY AND EFFICACY EVALUATION OF PLECANATIDE FOR THE TREATMENT OF CHRONIC IDIOPATHIC CONSTIPATION AND IRRITABLE BOWEL SYNDROME-CONSTIPATION IN PATIENTS AGED 65 YEARS OR OLDER Author(s): Stacy B. Menees1, Jonathan Rosenberg2, Reema Patel3, William D. Chey4 Introduction: Chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C) are common functional gastrointestinal disorders that likely represent a spectrum of disease. The prevalence of constipation-related complaints tends to increase with age. There are limited data regarding safety and eff
  21. PROBIOTICS FOR THE PREVENTION OF CLOSTRIDIUM DIFFICILE INFECTION AMONG PATIENTS UNDERGOING ANTIBIOTIC THERAPY Author(s): Alina Popescu1, Camelia G. Foncea1, Raluca Lupusoru1, Mirabela M. Topan1, Radu Cotrau1, Tudor V. Moga1, Andrada-Patricia Belintan1, Mirela Danila1, Roxana Sirli1, Ioan Sporea1 Background and Aim: Clostridium difficile infection (CDI), is the leading cause of antibiotic-associated diarrhea (AAD), a disease which increased in incidence and severity over the last years. Antibiotics exposure is considered the most significant risk factor for CDI among eldery and hospi
  22. EPIDEMIOLOGY OF PSYCHIATRIC DISORDERS IN IRRITABLE BOWEL SYNDROME IN THE UNITED STATES BETWEEN 2014 AND 2019: A POPULATION-BASED NATIONAL STUDY Author(s): Fangyuan Jin-Dominguez1, Emad Mansoor1, Richard C. Wong1, Gregory S. Cooper1 Background Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder. Although dysregulation of the gut-brain axis has been proposed and generally well accepted as one of the etiologies of IBS, there are still a lack of studies with a large sample size to describe the correlation between IBS and psychiatric co-morbidi
  23. USEFULNESS OF FECAL CALPROTECTIN IN PRIMARY CARE. NON-INVASIVE APPROACH FOR THE FRAMING OF INTESTINAL DISEASES Author(s): Florenzo Moccia2, Alberto Barchi2, Marilisa Franceschi3, Michele Russo2, Chiara Miraglia2, Antonio Ferronato2, Antonio Antico5, Maria Piera Panozzo5, Gianluca Baldassarre3, Antonio Tursi6, Giovanni Brandimarte4, Lorella Franzoni1, Pellegrino Crafa2, Francesco Di Mario2 Introduction and Aim: Faecal Calprotectin (FC) is a marker of intestinal inflammation. Many studies show the usefulness of FC as a diagnostic tool in IBD in gastroenterology; there are, inst
  24. THE CLINICAL OUTCOMES OF CLOSTRIDIUM DIFFICILE INFECTION IN IRRITABLE BOWEL SYNDROME PATIENTS: THE US NATIONWIDE ANALYSIS 2004-2014 Author(s): Abdullah Sohail1, Ahmad Khan1, Zunaira Mahmood1, Shailendra Singh1 Clostridium difficile infection (CDI) is a healthcare-related diarrheal infection associated with increased morbidity and mortality. CDI clinical outcomes in irritable bowel syndrome (IBS) patients have not much studied. Both IBS and CDI can present with a similar clinical picture. Data on the nationwide trends and associated mortality in IBS is limited. We sought to es
  25. CANNABIS USE IS ASSOCIATED WITH REDUCED 30-DAY READMISSION AMONG HOSPITALIZED PATIENTS WITH IRRITABLE BOWEL SYNDROME: A NATIONWIDE ANALYSIS Author(s): Catherine Choi1, Marwan S. Abougergi2,3, Heather Peluso4, Preet Patel1, Nikolaos Pyrsopoulos1 Background: Recent studies demonstrated the biological roles of endocannabinoid system in the gastrointestinal tract, and therefore cannabinoid receptors are the potential therapeutic targets for the gastrointestinal tract disorders. We hypothesize that cannabis use is associated with better control of irritable bowel syndrome (IBS)
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