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Pubmed-Factors Associated With Efficacy of Cognitive Behavior Therapy vs Education for Patients With Irritable Bowel Syndrome.

Jan 8, 2019
Related Articles Factors Associated With Efficacy of Cognitive Behavior Therapy vs Education for Patients With Irritable Bowel Syndrome. Clin Gastroenterol Hepatol. 2018 Oct 26;: Authors: Lackner JM, Jaccard J, IBS Outcome Study Research Group Abstract 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 positive outcome. We sought to identify pretreatment baseline characteristics that associate with symptom improvement in patients who received empirically validated regimens of cognitive behavior therapy (CBT) or IBS education. METHODS: We analyzed data from the IBS Outcome Study, in which 436 patients with IBS (average age, 41 years; 80% female) were randomly assigned to groups that received to 4 or 10 weeks of cognitive behavior therapy or education. Baseline data were collected from all participants on sociodemographic and clinical features and comorbidities. Interaction analyses used a modified linear probability model with Huber-White robust estimators to identify baseline factors that moderated as a function of treatment condition symptom improvement based on the IBS-version of the Clinical Global Impressions-Improvement Scale. RESULTS: Whether the primary outcome of IBS symptom improvement was rated by patients or physician assessors blind to treatment 2 weeks after it ended, higher percentages of patients had symptom improvement after CBT compared with EDU among those with low levels of trait anxiety (71.3% vs 34.9%; P<.05) or anxiety sensitivity (71.7% vs 38.6%; P<.05) and for those with baseline typical levels of trait anxiety (66.0% vs 47.1%; P<.05) or anxiety sensitivity (66.3% vs 47.1%; P<.05). For patients with high trait anxiety or anxiety sensitivity, the difference in percentage of responders to CBT vs EDU was non-significant for trait anxiety (60.6% vs 59.2%) and anxiety sensitivity (60.9% vs 55.9%). If patients scored at or below 22 on the Trait Anxiety Inventory, CBT had a statistically significant advantage over EDU. If patients scored at or below 29 on the Anxiety Sensitivity Inventory, there was a statistically significant advantage for CBT vs EDU. CONCLUSION: In analyses of outcomes of patients with treatment-refractory IBS, baseline levels of trait anxiety and anxiety sensitivity (fear of arousal symptoms) were associated with improved gastrointestinal symptoms following CBT compared to IBS education. These findings and approaches might be used to optimize selection of treatment for patients with IBS. PMID: 30613000 [PubMed - as supplied by publisher] View the full article

Pubmed-Close association between abnormal expressed enzymes of energy metabolism and diarrhea-predominant irritable bowel syndrome.

Jan 8, 2019
Close association between abnormal expressed enzymes of energy metabolism and diarrhea-predominant irritable bowel syndrome. Chin Med J (Engl). 2019 Jan 03;: Authors: Zhang CY, Yao X, Sun G, Yang YS Abstract BACKGROUND: Irritable bowel syndrome (IBS) is one of the most common functional intestinal diseases, but its pathogenesis is still unknown. The present study aimed to screen the differentially expressed proteins in the mucosa of colon between IBS with diarrhea (IBS-D) patients and the healthy controls. METHODS: Forty-two IBS-D patients meeting the Rome III diagnostic criteria and 40 control subjects from July 2007 to June 2009 in Chinese PLA General Hospital were enrolled in the present study. We examined the protein expression profiles in mucosa of colon corresponding to IBS-D patients (n = 5) and controls (n = 5) using 2-dimensional gel electrophoresis (2-DE) and mass spectrometry (MS). Secondly, Western blot and immunohistochemical analysis were carried out to validate the screened proteins in 27 IBS-D patients and 27 controls. Thirdly, high-performance liquid chromatography (HPLC) was further carried out to determine ATP concentration in the mucosa of colon between 10 IBS-D patients and 8 controls. Comparisons between 2 groups were performed by Student's t-test or Mann-Whitney U-test. RESULTS: Twelve differentially expressed proteins were screened out. The α-enolase (ENOA) in the sigmoid colon (0.917 ± 0.007 vs 1.310 ± 0.100, t = 2.643, P = 0.017) and caecum (0.765 ± 0.060 vs 1.212 ± 0.122, t = 2.225, P = 0.023), Isobutyryl-CoA dehydrogenase (ACAD8) in the sigmoid colon (1.127 ± 0.201 vs 1.497 ± 0.392, t = 7.093, P = 0.008) of the IBS-D group were significantly lower while acetyl-CoA acetyltransferase (CT) in the caecum (2.453 ± 0.422 vs 0.931 ± 0.652, t = 8.363, P = 0.015) and ATP synthase subunit d (ATP5H) in the sigmoid (0.843 ± 0.042 vs 0.631 ± 0.042, t = 8.613,P = 0.007) of the IBS-D group was significantly higher, compared with the controls. The ATP concentration in the mucosa of the sigmoid colon in IBS-D group was significantly lower than that of control group (0.470 [0.180, 1.360] vs 5.350 [2.230, 7.900], U = 55, P < 0.001). CONCLUSIONS: Many proteins related to energy metabolism presented differential expression patterns in the mucosa of colon of the IBS-D patients. The abnormalities in energy metabolism may be involved in the pathogenesis of IBS which deserves more studies to elucidate.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0. PMID: 30614852 [PubMed - as supplied by publisher] View the full article

Pubmed-Altered Brain Structure and Functional Connectivity and its Relation to Pain Perception in Girls with Irritable Bowel Syndrome.

Jan 8, 2019
Altered Brain Structure and Functional Connectivity and its Relation to Pain Perception in Girls with Irritable Bowel Syndrome. Psychosom Med. 2018 Nov 19;: Authors: Bhatt RR, Gupta A, Labus JS, Zeltzer LK, Tsao JC, Shulman RJ, Tillisch K Abstract OBJECTIVE: Imaging studies in adults with IBS have shown both morphological and resting state (RS) functional connectivity (FC) alterations related to cortical modulation of sensory processing. Since analogous differences have not been adequately investigated in children, this study compared gray matter volume (GMV) and RS-FC between girls with IBS and healthy controls (HC), and tested the correlation between brain metrics and laboratory-based pain thresholds (Pth). METHODS: Girls with Rome III criteria IBS (N=32) and matched HCs (N=26) were recruited. In a subset of patients, Pth were determined using a thermode to the forearm. Structural and RS scans were acquired. A voxel-based general linear model, adjusting for age, was applied to compare differences between groups. Seeds were selected from regions with group GMV differences for a seed-to-voxel whole-brain RS-FC analysis. Significance for analyses were considered at p<.05 after controlling for false discovery rate. Significant group differences were correlated with Pth. RESULTS: Girls with IBS had lower GMV in the thalamus, caudate nucleus (CaN), nucleus accumbens, anterior mid-cingulate (aMCC), and dorsolateral prefrontal cortex (dlPFC). They also exhibited lower RS-FC between the aMCC and the precuneus, but greater connectivity between the CaN and precentral gyrus. Girls with IBS had higher Pth with a moderate effect size (t(22.81) = 1.63, p = 0.12, d = 0.64) and lower thalamic GMV bilaterally was correlated with higher Pth (left: r=-.62, p(FDR)=.008; right: r=-.51, p(FDR)=.08). CONCLUSION: Girls with IBS had lower GMV in the PFC, basal ganglia, and aMCC, as well as altered functional connectivity between multiple brain networks, suggesting that structural changes related to IBS occur early in brain development. Girls with IBS also showed altered relationships between pain sensitivity and brain structure. PMID: 30615602 [PubMed - as supplied by publisher] View the full article

Pubmed-Negative Events During Adulthood are Associated With Symptom Severity and Altered Stress Response in Patients With Irritable Bowel Syndrome.

Jan 8, 2019
Negative Events During Adulthood are Associated With Symptom Severity and Altered Stress Response in Patients With Irritable Bowel Syndrome. Clin Gastroenterol Hepatol. 2019 Jan 04;: Authors: Parker CH, Naliboff BD, Shih W, Presson AP, Videlock EJ, Mayer EA, Chang L Abstract BACKGROUND & AIMS: Irritable bowel syndrome (IBS) is a stress-sensitive disorder associated with dysregulation of the hypothalamic-pituitary-adrenal pathway. We studied the cumulative effect of events during adulthood on this pathway in patients with IBS. METHODS: We studied 129 patients with IBS, based on Rome III criteria (mean age 28.1 years, 66% women), and 108 healthy individuals (controls; mean age 29.8 years, 60% women) who completed the Life Experiences Survey from August 2013 to September 2017. Data were collected on the presence and effects of events since age 18, IBS severity scores, and IBS-related quality of life. For a subset of subjects, we measured serum cortisol and adrenocorticotropic hormone (ACTH) production in response to administration of corticotrophin-releasing factor and ACTH. RESULTS: Compared with controls, patients with IBS perceived more adulthood life events as negative and had a significantly higher negative life event impact score (14.17±12.04 vs 10.83±9.98; P=.022). In patients with IBS, the presence of more-negatively perceived adulthood life events was associated with worse IBS symptom severity (β=1.53, 95% CI, 0.21-2.84; P=.025) and IBS-related quality of life (β=-0.70; 95% CI, -1.02 to -0.38; P<.001). Negatively perceived adulthood life events were associated with reduced production of ACTH in response to corticotrophin-releasing factor in patients with IBS compared with controls (P<.05). CONCLUSION: In a study of more than 200 subjects, we associated more-negatively perceived events during adulthood with an increased risk for IBS, worse symptom severity and quality of life, and a dysregulated stress response. Understanding the effects of events that cause stress in adults and their perceived effects on IBS may help guide disease management. PMID: 30616026 [PubMed - as supplied by publisher] View the full article

Google-Add-On Fecal Transplant Curbs Recurrent C. Diff - MedPage Today

Jan 7, 2019
Add-On Fecal Transplant Curbs Recurrent C. Diff MedPage TodayMore than doubled resolution rate with antibiotic alone. View the full article

Google-Ironwood to Get New CEO, Current CEO to Head Latest Spinoff - Nasdaq

Jan 7, 2019
Ironwood to Get New CEO, Current CEO to Head Latest Spinoff NasdaqIronwood Pharmaceuticals, Inc. 's IRWD board announced the appointment of chief executive officers ("CEO") for the two new companies that will emerge ... View the full article

Pubmed-Changes in Fecal Calprotectin After Rifaximin Treatment in Patients With Nonconstipated Irritable Bowel Syndrome.

Jan 7, 2019
Changes in Fecal Calprotectin After Rifaximin Treatment in Patients With Nonconstipated Irritable Bowel Syndrome. Am J Med Sci. 2019 Jan;357(1):23-28 Authors: Lee SH, Kim CR, Kim KN Abstract BACKGROUND: Fecal calprotectin, an indicator of colonic inflammation, is associated with nonconstipated irritable bowel syndrome. Rifaximin is an antibiotic used to treat nonconstipated irritable bowel syndrome. We performed a retrospective review of patient charts to investigate the changes in fecal calprotectin levels and intestinal symptoms following treatment with rifaximin in patients with nonconstipated irritable bowel syndrome with elevated fecal calprotectin. METHODS: This study included 198 patients presenting with gastrointestinal complaints consistent with Rome III criteria for irritable bowel syndrome. We treated them with rifaximin for 4-12 weeks, until fecal calprotectin levels were normalized, and divided these into 4-, 8-, and 12-week groups according to the treatment period. Fecal calprotectin levels and gastrointestinal symptoms were assessed following rifaximin therapy. RESULTS: A total of 162 subjects achieved normalized fecal calprotectin values. Of these, most patients who used rifaximin for 8 or 12 weeks showed a significant improvement in gastrointestinal symptoms by the fourth week of treatment, and gradually improved symptoms after 4 weeks. Fecal calprotectin levels were reduced with concomitant improvement of clinical symptoms. In addition, 36 patients who had elevated fecal calprotectin even after 12 weeks of rifaximin treatment showed a gradual reduction in gastrointestinal symptoms and fecal calprotectin during the course of treatment for 12 weeks. CONCLUSIONS: These findings suggest that fecal calprotectin might be a useful biomarker for measuring the effect of rifaximin therapy in nonconstipated irritable bowel syndrome patients with elevated fecal calprotectin values. PMID: 30611316 [PubMed - in process] View the full article

Google-Is A Hormone Imbalance Causing Your Gut Issues? Here's How Estrogen Is Linked To Constipation - mindbodygreen.com

Jan 7, 2019
Is A Hormone Imbalance Causing Your Gut Issues? Here's How Estrogen Is Linked To Constipation mindbodygreen.comThe connection between estrogen and constipation, including how to relieve it. View the full article

Twitter-Why Is Packing A Healthy Lunch For Work So Hard? We Asked The Pros To Solve All Your Problems by @sproutedroutes https://t.co/1zORdBKaQY via @mindbodygreen

Jan 6, 2019
Why Is Packing A Healthy Lunch For Work So Hard? We Asked The Pros To Solve All Your Problems by @sproutedroutes https://www.mindbodygreen.com/articles/easy-work-lunch-ideas-how-to-pack-a-healthy-work-lunch via @mindbodygreen (RSS generated with FetchRss) View the full article

Google-Ironwood Pharmaceuticals Appoints Michael Shetzline, MD, Ph.D. as Chief Medical Officer - Associated Press

Jan 6, 2019
Ironwood Pharmaceuticals Appoints Michael Shetzline, MD, Ph.D. as Chief Medical Officer Associated PressCAMBRIDGE, Mass.--(BUSINESS WIRE)--Jan 6, 2019--Ironwood Pharmaceuticals, Inc. (NASDAQ: IRWD) today announced that Michael Shetzline, M.D., Ph.D., ... View the full article

Twitter-3 STEP FODMAP DIET Starting the Low FODMAP diet? You need to read this! https://t.co/X40TJMcaz6 https://t.co/jqeatt2CLb

Jan 6, 2019
3 STEP FODMAP DIET Starting the Low FODMAP diet? You need to read this! https://bit.ly/2AogDyo (RSS generated with FetchRss) View the full article

Twitter-RT @RuchiMathurMD: Two new studies show gut microbiome variance is related to immigration to the US and departure from a hunter-gatherer li…

Jan 5, 2019
RT @RuchiMathurMD: Two new studies show gut microbiome variance is related to immigration to the US and departure from a hunter-gatherer li… (RSS generated with FetchRss) View the full article

Twitter-Dietary Emulsifiers - what are they are do they affect our gut? Read a recent review written by our colleague Dr Emma Halmos on dietary emulsifiers here: https://t.co/cLGD5hWdpH

Jan 5, 2019
Dietary Emulsifiers - what are they are do they affect our gut? Read a recent review written by our colleague Dr Emma Halmos on dietary emulsifiers here: https://bit.ly/2By7QcS (RSS generated with FetchRss) View the full article

Twitter-RT @BuildUpRDNs: Save the DATE! @KateScarlata_RD takes over our FB page for a Facebook Live 1/11 at 12nET all about IBS and the #Fodmap die…

Jan 4, 2019
RT @BuildUpRDNs: Save the DATE! @KateScarlata_RD takes over our FB page for a Facebook Live 1/11 at 12nET all about IBS and the #Fodmap die… (RSS generated with FetchRss) View the full article

Google-The Difference Between a Food Allergy and Food Intolerance - Food & Wine

Jan 4, 2019
The Difference Between a Food Allergy and Food Intolerance Food & WineWondering about the deal with food allergies vs. food intolerances? Here, experts explain why it's crucial to know the difference. View the full article

Pubmed-Depression Promotes the Onset of Irritable Bowel Syndrome through Unique Dysbiosis in Rats.

Jan 4, 2019
Related Articles Depression Promotes the Onset of Irritable Bowel Syndrome through Unique Dysbiosis in Rats. Gut Liver. 2018 Dec 24;: Authors: Takajo T, Tomita K, Tsuchihashi H, Enomoto S, Tanichi M, Toda H, Okada Y, Furuhashi H, Sugihara N, Wada A, Horiuchi K, Inaba K, Hanawa Y, Shibuya N, Shirakabe K, Higashiyama M, Kurihara C, Watanabe C, Komoto S, Nagao S, Kimura K, Miura S, Shimizu K, Hokari R Abstract Background/Aims: Although studies using conventional animal models have shown that specific stressors cause irritable bowel syndrome (IBS), it is unclear whether depression itself causes IBS. Our aim was to establish a rat model to determine if depression itself promotes the onset of IBS and to elucidate the role of gut microbiota in brain-gut axis pathogenesis during coincident depression and IBS. Methods: Rat models of depression were induced using our shuttle box method of learned helplessness. Visceral hypersensitivity was evaluated by colorectal distension (CRD) to diagnose IBS. Gut microbiota compositions were analyzed using high-throughput sequencing. In the subanalysis of rats without depression-like symptoms, rats with posttraumatic stress disorder (PTSD) were also examined. Results: The threshold value of CRD in depressed rats was significantly lower than that in control rats. Microbial community analysis of cecal microbiota showed that the relative abundance of Clostridiales incertae sedis, the most prevalent microbe, was significantly lower in depressed rats than in control rats. The distribution pattern of the microbiota clearly differed between depressed rats and control rats. Neither visceral hypersensitivity nor the composition of gut microbiota was altered in rats with PTSD-like phenotypes. Conclusions: Our rat model of depression is useful for clarifying the effect of depression on IBS and suggests that depression itself, rather than specific stressors, promotes the onset of IBS. Further, we provided evidence that various psychiatric diseases, viz. depression and PTSD, are associated with unique gut microbiota profiles, which could differentially affect the onset and progression of coincident IBS. PMID: 30602220 [PubMed - as supplied by publisher] View the full article

Google-Against cramps, constipation, loss of memory: the miracle weapon of Magnesium acts - The Dickinson Daily News

Jan 3, 2019
Against cramps, constipation, loss of memory: the miracle weapon of Magnesium acts The Dickinson Daily Newsmore Recently, Magnesium was considered “only” as a mineral that relieves it is effective against nocturnal leg cramps and muscle pain. In the meantime, it ... View the full article

Twitter-RT @JohannahRuddy: @RomeGastroPsych @RomeFoundation @drlauriekeefer @umfoodoc @IFFGD @DDrossman @FGIFYI @DrvanTilburg @DrTiffTaft @Jules_Ga…

Jan 3, 2019
RT @JohannahRuddy: @RomeGastroPsych @RomeFoundation @drlauriekeefer @umfoodoc @IFFGD @DDrossman @FGIFYI @DrvanTilburg @DrTiffTaft @Jules_Ga… (RSS generated with FetchRss) View the full article

Google-Unjustifiably maligned celery - Southside Times

Jan 3, 2019
Unjustifiably maligned celery Southside TimesBy Wendell Fowler. In the Mediterranean, crunchy celery has been cultivated and used as food and medicine for millennia. Although, in America celery, meh, ... View the full article

Google-Urovant Sciences Initiates Patient Enrollment in Phase 2a Clinical Trial for Vibegron in Patients with Abdominal Pain Due to Irritable Bowel Syndrome - Business Wire

Jan 3, 2019
Urovant Sciences Initiates Patient Enrollment in Phase 2a Clinical Trial for Vibegron in Patients with Abdominal Pain Due to Irritable Bowel Syndrome Business WireBASEL, Switzerland & IRVINE, Calif.--(BUSINESS WIRE)--Urovant Sciences (Nasdaq: UROV), a clinical-stage biopharmaceutical company focused on ... View the full article

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