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  1. Fructan can cause symptoms in non celiacs ingesting wheat products Another important slide to understand mechanisms why we have symptoms by ingesting wheat and have negative diagnosis of celiac #ACG2019 by @umfoodoc Ironwood Pharmaceuticals, Inc. (IRWD), a GI-focused healthcare company, today announced the presentation of clinical data for linaclotide and MD-7246, as well as results from a survey for patients with persistent gastroesophageal reflux disease (GERD), from Ironwood and its collaborators during the American College of Gastroenterology (ACG) 2019 Annual Scientific Meeting being held in San Antonio, TX, October 25 through October 30, 2019. A linaclotide poster at the meeting was recognized by the ACG as a Presidential Poster Award recipient. Every year less than 5% of accepted abstracts receive this distinction for high quality, novel, unique, and interesting research. The abstract features safety and efficacy data from a Phase II trial of linaclotide in pediatric patients aged six to 17 with functional constipation. Linaclotide, a guanylate cyclase‐C (GC‐C) agonist, is activated by a mechanism pioneered by Ironwood scientists. Phase I data demonstrating the limited effect of MD-7246 on bowel frequency and stool consistency in healthy volunteers will be presented in a poster session. MD-7246, an investigational product, is being evaluated as an oral, intestinal, non-opioid, pain-relieving agent for patients suffering from abdominal pain associated with certain GI diseases, including IBS with diarrhea (IBS-D). MD-7246 is a delayed-release formulation of linaclotide designed to provide targeted delivery of linaclotide to the colon, where the majority of the abdominal pain associated with IBS-D is believed to originate, and to limit fluid secretion in the small intestine resulting in minimal impact on bowel function. Salix Pharmaceuticals to Present New Clinical Data at the American College of Gastroenterology (ACG) Annual Meeting Published: Oct 28, 2019 TRULANCE® (plecanatide) Poster Presentation Recognized with Presidential Poster Award Distinction TRULANCE® (Plecanatide) Darren M. Brenner, MD. "Impact of Plecanatide on Symptoms and Quality of Life for Patients with Chronic Idiopathic Constipation: Analysis of PAC-SYM and PAC-QOL From Two Phase III Clinical Trials." Poster #P0341; Sunday, Oct. 27, 3:30 p.m. – 7:00 p.m. CT; Exhibit Halls 3 and 4 (street level); Recipient of the Presidential Poster Award Gregory Sayuk, MD. "Plecanatide for Patients with Chronic Idiopathic Constipation and Irritable Bowel Syndrome-Constipation: Analysis of Abdominal Bloating from Four Randomized Phase 3 Clinical Trials." Poster #P2157; Tuesday, Oct. 29, 10:30 a.m. – 4:00 p.m. CT; Exhibit Halls 3 and 4 (street level) XIFAXAN® (Rifaximin) Brian Lacy, PhD, MD. "Impact of Colonoscopy Timing on Rifaximin in Patients with Irritable Bowel Syndrome with Diarrhea (IBS-D)." Poster #P2164; Tuesday, Oct. 29, 1:00 p.m. – 2:15 p.m. CT; Exhibit Halls 3 and 4 (street level) PLENVU® (polyethylene glycol 3350, sodium ascorbate, sodium sulfate, ascorbic acid, sodium chloride and potassium chloride for oral solution), also known as NER1006 Michael S. Epstein, MD, FACG; "Electrolyte Shifts of NER1006 Bowel Preparation for Colonoscopy in the Elderly Are Transient and Well-Tolerated." Poster #P0368; Sunday, Oct. 27, 3:30 p.m. – 7:00 p.m. CT; Exhibit Halls 3 and 4 (street level) Michael S. Epstein, MD, FACG, "1 L NER1006 Improves High-Quality Colon Cleansing and Mean Polyp Detection versus Oral Sulfate Solution and 2 L Polyethylene Glycol Plus Ascorbate." Poster #P2030; Tuesday, Oct. 29, 10:30 a.m. – 4:00 p.m. CT; Exhibit Halls 3 and 4 (street level) Michael S. Epstein, MD, FACG; "In Patients with an Overall Cleansing Success the 1L Polyethylene Glycol NER1006 Achieves More High-Quality Cleansed Segments per Patient Than Three Standard Bowel Preparations." Poster #2031; Tuesday, Oct. 29, 10:30 a.m. – 4:00 p.m. CT; Exhibit Halls 3 and 4 (street level) Brooks D. Cash, MD, FACG. "Patient Experience with NER1006 as a Bowel Preparation for Colonoscopy: A Prospective, Multicenter U.S. Survey." Poster #P0372; Sunday, Oct. 27, 3:30 p.m. – 7:00 p.m. CT; Exhibit Halls 3 and 4 (street level) Avoidant/Restrictive Food Intake Disorder May Be Underdiagnosed Gastroenterology patients with avoidant/restrictive food intake disorder (ARFID) are less likely to be taking psychotropic medications, have less-severe body image concerns, and are frustrated with being unable to eat what they want compared with patients without ARFID, according to study findings presented at the American College of Gastroenterology (ACG) 2019 Annual Scientific Meeting and Postgraduate Course. The findings suggest the need to appropriately screen gastroenterology patients for ARFID and the importance of a using a multidisciplinary treatment approach. >> https://www.consultant360.com/exclusive/gastroenterology/insights-american-college-gastroenterology-2019/avoidantrestrictive-food >> https://www.healio.com/gastroenterology/nutrition/news/online/{eda3e067-5b29-40d5-90bd-8f999c2a1c9f}/avoidant-food-intake-disorder-rarely-connected-with-body-image-concerns Plenary Session at ACG 2019 Conference Reports Unique Blend of HMOs Significantly Improves IBS Symptoms A nationwide multi-center, open label trial on human milk oligosaccharides (HMOs) found that daily intake of a unique formulation of glycans can significantly improve patients' IBS symptoms. “Human Milk Oligosaccharides Improve All the Central Symptoms of Irritable Bowel Syndrome: A Multi-Center, Open Label Trial” will be presented by Magnus Simrén, MD, PhD, Professor and Senior Consultant at the Department of Internal Medicine & Clinical Nutrition for the Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden. Dr. Simrén is also an adjunct professor of medicine at the University of North Carolina School of Medicine in Chapel Hill. Patients were given daily doses of a proprietary blend of HMOs — 2’-FL (2’-fucosyllactose) and LNnT (lacto-N-neotetraose) — found in Holigos® (hōly-gōs) IBS, a medical food to be taken under medical supervision, available without a prescription. The trial results demonstrated significant improvement in overall symptoms (fecal consistency, abdominal pain, and bloating) as well as improved quality of life as measured by IBS Severity Scoring System (IBS-SSS). The findings in this new study support the growing acceptance in the medical community of microbiota-directed therapies, such as the inclusion of prebiotic HMOs in IBS dietary planning. Glycom is a global biotechnology company dedicated to the scientific, clinical, and commercial development of human milk oligosaccharides (HMOs) for a broad range of health applications. Glycom, headquartered in Hørsholm, Denmark, is the world’s leading supplier of HMOs and has a U.S. facility located in Covington, La. Glycom is privately held. For more information about Glycom, visit glycom.com. Additional info from MD Magazine >> https://www.mdmag.com/conference-coverage/acg-2019/human-milk-oligosaccharides-may-help-ease-irritable-bowel-syndrome-symptoms >> https://www.prnewswire.com/news-releases/study-shows-human-milk-oligosaccharides-significantly-improve-ibs-symptoms-300947860.html >> https://www.gastroenterologyadvisor.com/irritable-bowel-syndrome-ibs/effects-of-human-milk-oligosaccharides-on-gastrointestinal-symptoms-in-ibs-qa-with-dr-magnus-simren/ >> https://www.medpagetoday.com/meetingcoverage/acg/83031 Celiac disease patients diet is perceived to be higher burden than patients with HTN, DM2, GERD, IBD or IBS. #ACG2019
  2. Breath tests are used to detect gases which are produced by bacterial fermentation of unabsorbed carbohydrates and then passed through your breath. Breath tests are used in the diagnosis of carbohydrate malabsorption and small intestinal bacterial overgrowth or SIBO. Malabsorption of carbohydrates has been seen as a key trigger of irritable bowel syndrome-type symptoms such as diarrhea or constipation, bloating and excess gas. FoodMarble AIRE is a portable breath test device that can measure gases which might be able to identify which foods you are not absorbing which are causing you IBS-like symptoms. FoodMarble AIRE measures your body’s response to how it digests food by analyzing your breath and giving you immediate results. It also helps you to identify possible trigger components in different foods by tracking and trending your results over time using the smartphone app. The FoodMarble AIRE works by analyzing hydrogen in your breath similar to how labs do it. Listen to our podcast with Aonghus Shortt,PhD Co-Founder & CEO, and Claire Shortt,PhD Chief Scientist from FoodMarble who were my guests while at Digestive Disease Week in San Diego 2019. They explained what was the purpose in creating the AIRE breath test device, how does it work and how this might benefit an IBS sufferer especially when it comes to analyzing foods in a low FODMAP diet. https://www.ibspatient.org/podcasts What's in the box: AIRE portable breast test device: FODMAP Program (optional):
  3. Chey: non-celiac responders to gluten is a subset group of patients Chey: Numerous RCT’s (randomized control trials) for low FODMAP most consistently for pain and bloating Chey: low FODMAP diet real live data is different than clinical trials as we don’t know long term elimination and reintroduction Chey: FODMAP Elimination is the beginning, not the end! Great message for all these doctors to hear. It’s a *process*, not just a list of low-FODMAP foods. See https://www.ibspatient.org/lowfodmap/ for more info. Chey: Can we utilize the microbiome to indicate who will do well on the low FODMAP diet for IBS? Chey: Fecal microbiome predicts IBS patients response to a low FODMAP diet Chey: Congenital Sucrase-isomaltese deficiency (CSID) is under diagnosed in IBS-D patients Chey: Supplementation (prebiotic) had same response as low FODMAP diet. Suggest that it might be beneficial in some patients eg: Glutamine for PI-IBS (post infectious IBS) Chey: Dietary manipulation is a critical part of the treatment strategy in patients with IBS. Food is complicated. Caterina Oneto: Several trials have shown the benefit of low #FODMAP diet in #IBS . Mechanism not entirely clear, but we do know that the low FODMAPs diet is associated with a) decreased total bacterial abundance and b) increased microbial diversity Premysl Bercik: Bacterial production of histamine may be an important factor in mechanism behind the benefit of a low FODMAP diet in reducing pain in IBS Shanti Eswaran: Reports lower response to low FODMAP diet in IBS patients with sucrase isomaltase gene defects. Something to consider in low FODMAP Diet non-responders.
  4. Kat

    FODMAP Gifts

    I have been following the low FODMAP diet for nearly 2 years now and have had times in my life where it has felt really difficult and other times it has been easier. One of the hardest times was over Christmas; people tried to include me and buy me treats that were gluten and lactose free but many of these products were still high FODMAP so not only was I deprived but also now in an even more awkward situation. That's why I've decided to start making Low FODMAP foodie gift box. Whether you are looking to treat yourself or you're after some gift ideas you can rest assured that all items are safe for events elimination phase. For more information on what's inc!used and how to order, take a look at my finder https://www.fiverr.com/swain326/create-a-low-fodmap-gluten-free-lactose-free-gift-box-hamper-12fa
  5. The Low FODMAP Diet: Elimination is the Beginning NOT the End The team at Monash University in Australia, led by Professor Peter Gibson MD, developed the low FODMAP diet. In its strictest sense it is not so much a diet as it is a diagnostic tool for helping to determine whether foods in your diet are involved in contributing to your gastrointestinal symptoms. Some IBS sufferers have unfortunately been using the low FODMAP diet as a forever elimination diet whereas it was designed to be a three phase process. Taking on the three phase diet process by yourself is not recommended. An experienced FODMAP Dietitian is your best ally for using this diet as a diagnostic tool for symptoms. >> Read More
  6. Martin Burridge

    My IBS success story

    My IBS symptoms started in October 2014.I had constipation, burping and excruciating pain under my ribs.I lost 35 pounds (15.8kg) in weight because I basically stopped eating due to the pain. I was off work for 2 months and spent the best part of 8 months in my bedroom. It was May 2015 before I was diagnosed as having IBS. In June 2015 I discovered the FODMAP diet and started by reducing all FODMAP groups. The symptoms reduced 90% within days. In the next few months I discovered my trigger groups were O (inc. wheat, onion, garlic,sweetcorn,brocolli) and M (inc .apples, pears and anything containing glucose fructose syrup). Over the next year I found my tolerance to O and M foods gradually improved but I still had to limit foods that were very high in these FODMAPs. (wheat, onions and garlic in particular), Then I decided to introduce a potent probiotic that did well in independent clinical trials. Its called VSL3 and it is very expensive. To save cost I only took half the dose but mixed it in a relatively cheap probiotic yogurt drink called Actimel. I took the VSL3 first thing in the morning before eating. This is because stomach acid is low at this point which gives the probiotic bacteria the best chance of surviving and reaching the bowel. This seemed to speed up my recovery and I was been able to eat wheat, garlic, onion and foods containing glucose fructose syrup in surprisingly large amounts without any symptoms. There is no instant cure for IBS. I believe it is predominantly a problem of bacterial species mix in the bowel. Changing the species mix in the bowel does not happen overnight. Both the foods we eat and some probiotics can change the mix but there is no magic formula that fits everyone. For me the mix of the FODMAP diet and VSL3 seems to have brought my IBS to an end. The key to defeating IBS is understanding it. I learnt a lot about IBS from my experience so have shared it in a blog to help others who suffer this awful condition. You can view the blog here.
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