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Ask the Doctor: stomach ulcers, eczema, and arthritis WNDU-TV Full coverage View the full article
Diagnostic Potential of Systemic Eosinophil-Associated Cytokines and Growth Factors in IBD. Gastroenterol Res Pract. 2018;2018:7265812 Authors: Neubauer K, Matusiewicz M, Bednarz-Misa I, Gorska S, Gamian A, Krzystek-Korpacka M Abstract Despite the acknowledged contribution of eosinophils to the disease pathogenesis, available data on cytokines closely related to the peripheral eosinophils in inflammatory bowel disease (IBD) are scattered. We assessed the concentrations of eosinophil-associated cytokines and growth factors in the group of 277 individuals (101 patients with Crohn's disease (CD), 77 with ulcerative colitis (UC), 16 with irritable bowel syndrome (IBS), and 83 healthy controls) and referred to IBD activity and the levels of hsCRP. As compared to IBS patients or healthy controls, patients with CD had significantly higher levels of IL5, IL8, IL12(p70), GM-CSF, and TNFα and patients with UC, the levels of eotaxin, IL4, IL5, IL8, IL12(p70), IL13, GM-CSF, and TNFα were also higher. As compared to CD patients, patients with UC had significantly higher levels of eotaxin, IL4, IL5, IL8, and IL1. In turn, the concentrations of hsCRP were significantly higher in CD than UC. Except for IL13, all cytokines and hsCRP positively correlated with CDAI. In UC, a positive correlation with MDAI was observed for hsCRP, GM-CSF, IL12(p70), and IFNγ and a negative one for IL8. The concentrations of hsCRP, GM-CSF, IFNγ, IL12(p70), and RANTES were higher in UC patients with active than inactive disease whereas those of IL8 and TNFα were significantly lower. Eotaxin, determined individually or in a panel with IFNγ and hsCRP, showed fair accuracy in differentiating CD from UC. If confirmed on a larger representation of IBS patients, IL8 might support differential diagnosis of organic and functional conditions of the bowel. GM-CSF, in turn, demonstrated to be an excellent indicator of bowel inflammation and may be taken into consideration as a noninvasive marker of mucosal healing. In summary, eosinophil-associated cytokines are elevated in IBD, more pronouncedly in UC, and may support the differential diagnosis of IBD and aid in monitoring of mucosal healing. PMID: 30147719 [PubMed] View the full article
Pubmed-The Geometry of Emotions: Using Chakra Acupuncture and 5-Phase Theory to Describe Personality Archetypes for Clinical Use.
The Geometry of Emotions: Using Chakra Acupuncture and 5-Phase Theory to Describe Personality Archetypes for Clinical Use. Med Acupunct. 2018 Aug 01;30(4):167-178 Authors: Chase CR Abstract Background: The 5-Phase theory of Traditional Chinese Medicine has been an integral part of medical acupuncture for 2000 years. The research of John R. Cross PhD, PhDAc, has resulted in a further evolution of the 5-Phase theory to include the Ayurvedic chakra energy centers. By using chakras, a clinician can appreciate the integration of human organ systems, the neuroendocrine system, and personality attributes (both positive and negative) associated with each chakra. Objective: To create personality archetypes from chakras that have practical clinical value. Design: By assigning chakras to the 5-Phase elements on a pentagon per Dr. Cross, it was possible to connect a series of negative or positive emotions, from one to another, using the familiar Ko cycles and Shen cycles, to form theoretical personality archetypes and then to demonstrate archetype usefulness in a sample clinical case. The patient was being treated with Japanese acupuncture. The main outcome sought was to determine the personality types according to the 5-Phase theory with chakra energy centers included and to demonstrate the application of this system in the clinical case. Results: Fourteen personality archetypes-seven composed of positive emotions and seven composed of negative emotions-were identified. Easy-to-remember names and familiar patterns of emotion that are mapped to the nodes of a pentagon (adapted to chakra acupuncture) were produced. The clinical case showed that the patient's work life conflicts resulted in negative archetype emotional patterns (anger, scarcity, lack of self-esteem) consistent with the presentation of irritable bowel syndrome, insomnia, liver illness, and osteoarthritis. Conclusions: Personality archetypes have clinical value for understanding the emotions associated with illness. PMID: 30147818 [PubMed] View the full article
Pubmed-Corrigendum: Chronic Diffuse Pain and Functional Gastrointestinal Disorders After Traumatic Stress: Pathophysiology Through a Polyvagal Perspective.
Corrigendum: Chronic Diffuse Pain and Functional Gastrointestinal Disorders After Traumatic Stress: Pathophysiology Through a Polyvagal Perspective. Front Med (Lausanne). 2018;5:229 Authors: Kolacz J, Porges SW Abstract [This corrects the article DOI: 10.3389/fmed.2018.00145.]. PMID: 30148133 [PubMed - in process] View the full article
Pubmed-Relationships of Microbiome Markers With Extraintestinal, Psychological Distress and Gastrointestinal Symptoms, and Quality of Life in Women With Irritable Bowel Syndrome.
Relationships of Microbiome Markers With Extraintestinal, Psychological Distress and Gastrointestinal Symptoms, and Quality of Life in Women With Irritable Bowel Syndrome. J Clin Gastroenterol. 2018 Aug 24;: Authors: Hollister EB, Cain KC, Shulman RJ, Jarrett ME, Burr RL, Ko C, Zia J, Han CJ, Heitkemper MM Abstract INTRODUCTION: Altered microbial diversity has been associated with gastrointestinal (GI) symptoms in persons with irritable bowel syndrome (IBS). Less is known about the relationship of microbiome with extraintestinal pain and psychological distress symptoms and quality of life (QOL) in persons with IBS. We aimed to evaluate the relationship of fecal microbiota to GI symptoms, stool consistency, psychological distress, extraintestinal pain, and QOL in participants meeting Rome III criteria for IBS. METHODS: Seventy-six women completed a 28-day diary that included GI, stool consistency, psychological distress, and extraintestinal pain ratings. Participants completed the IBS-Specific Quality of Life questionnaire. Stool samples were collected and analyzed by 16S rRNA gene sequencing. Principal component analysis was performed and the first 2 components (PC1, PC2) were used to test relationships among bacterial families and clinical measures. RESULTS: Participants were categorized as IBS constipation (n=22), IBS diarrhea (n=39), IBS mixed (n=13), and IBS unsubtyped (n=2). There was a significant group effect for the Firmicutes to Bacteroidetes ratio and PC1. Lower microbial diversity and richness were associated with increased urgency and extraintestinal pain, worse QOL, and looser stools. Lower extraintestinal pain was associated with increased Rikenellaceae, Christensenellaceae, Dehalobabacteriaceae, Oscillospiraceae, Mogibacteriaceae, Ruminococcaceae, Sutterellaceae, Desulfovibrionaceae, and Erysipelotrichaceae abundances. QOL was positively associated with many of these same bacterial families. Higher Firmicutes to Bacteroidetes ratio was positively associated with loose stools. There were no statistically significant relationships between daily psychological distress or abdominal pain and bacterial families. CONCLUSIONS: Stool microbial diversity and composition are linked to daily extraintestinal symptoms, stool consistency, and QOL in women with IBS. PMID: 30148765 [PubMed - as supplied by publisher] View the full article
Twitter-Last week to register for my Cleveland 6 CPE FODMAP workshop, taking place on September 7, 2018! https://t.co/2Cvge0zSTo https://t.co/VrUe2TCLxX
Last week to register for my Cleveland 6 CPE FODMAP workshop, taking place on September 7, 2018! https://www.ibsfree.net/fodmap-events/2018/9/7/fodmaps-and-ibs-beyond-the-basics-workshop-for-rdns-cleveland-oh (RSS generated with FetchRss) View the full article
Q&A: Believing IBS is a disease of 'nervous, anxious women' is 'antiquated' and 'wrong' Healio Full coverage View the full article
Combating pregnancy constipation The New Times Full coverage View the full article
Twitter-Wanting to understand #IBS better? This blog will help by explaining the mechanisms underlying IBS and the role of #FODMAPs in triggering symptoms. https://t.co/NId85wzDvY https://t.co/zljM68JZDM
Wanting to understand #IBS better? This blog will help by explaining the mechanisms underlying IBS and the role of #FODMAPs in triggering symptoms. http://bit.ly/2AASQgn (RSS generated with FetchRss) View the full article
Pubmed-Systematic Review with Meta-analysis: The Association between Post-traumatic Stress Disorder (PTSD) and Irritable Bowel Syndrome (IBS).
Systematic Review with Meta-analysis: The Association between Post-traumatic Stress Disorder (PTSD) and Irritable Bowel Syndrome (IBS). J Gastroenterol Hepatol. 2018 Aug 25;: Authors: Ng QX, Soh AYS, Loke W, Venkatanarayanan N, Lim DY, Yeo WS Abstract BACKGROUND AND AIM: Post-traumatic stress disorder (PTSD) is a psychiatric condition characterized by symptoms of hyperarousal and hypervigilance. Increasing research on the "gut-brain" axis (bidirectional signalling between the gut and the brain) has drawn links between PTSD and irritable bowel syndrome (IBS), an exceedingly common yet incompletely understood gastrointestinal condition. This meta-analysis thus aimed to examine the body of evidence and extent of association of PTSD with IBS. METHODS: Using the keywords [early abuse OR childhood abuse OR violence OR trauma OR PTSD] AND [irritable bowel syndrome or IBS], a preliminary search on the PubMed, Medline, Embase, ScienceDirect, PsychINFO, Web of Science and Google Scholar databases yielded 11,257 papers published in English between 1-Jan-1988 and 1-May-2018. Of these, only 8 studies were included in the final meta-analysis. RESULTS: The 8 studies (4 cross-sectional and 4 cohort) contained a total of 648,375 subjects. Most studies were from the United States and conducted on army veterans. The funnel plot revealed a roughly symmetrical distribution of studies and Egger test was not significant for publication bias (P=0.583). Random-effects meta-analysis found PTSD to be a significant risk factor for IBS (pooled OR 2.80, 95% CI: 2.06 to 3.54, p<0.001). CONCLUSIONS: Overall, PTSD is associated with an increased likelihood of IBS. This is the first meta-analysis to specifically examine the association between PTSD and IBS and it provides insights into the probable (patho) physiology and management of IBS, supporting a holistic consideration of the psychosocial aspects of IBS and further research into effective multi-modal therapeutics. PMID: 30144372 [PubMed - as supplied by publisher] View the full article
Pubmed-Efficacy of Secretagogues in Patients With Irritable Bowel Syndrome With Constipation: Systematic Review and Network Meta-analysis.
Efficacy of Secretagogues in Patients With Irritable Bowel Syndrome With Constipation: Systematic Review and Network Meta-analysis. Gastroenterology. 2018 Aug 22;: Authors: Black CJ, Burr NE, Quigley EMM, Moayyedi P, Houghton LA, Ford AC Abstract BACKGROUND & AIMS: Several secretagogues have been approved treatment of irritable bowel syndrome with constipation (IBS-C). However, their relative efficacy is unclear because there have been no head-to-head randomized controlled trials. We conducted a network meta-analysis to compare their efficacies in patients with IBS-C. METHODS: We searched MEDLINE, EMBASE, EMBASE Classic, and the Cochrane central register of controlled trials through June 2018 to identify randomized controlled trials assessing the efficacy of secretagogues in adults with IBS-C. Trials included in the analysis reported a dichotomous assessment of overall response to therapy, and data were pooled using a random effects model. Efficacy and safety of secretagogues were reported as a pooled relative risk with 95% CIs to summarize the effect of each comparison tested, and treatments were ranked according to their P-score. RESULTS: We identified 15 eligible randomized controlled trials of secretagogues, containing 8462 patients. Linaclotide, lubiprostone, plecanatide, and tenapanor were all superior to placebo for the treatment of IBS-C. Linaclotide (290 mcg, once daily) was ranked first in efficacy, based on the Food and Drug Administration-recommended endpoint for trials in IBS-C, the primary endpoint used in each trial, abdominal pain, and complete spontaneous bowel movements. Tenapanor (50 mg twice daily) was ranked first for reducing bloating. Total numbers of adverse events were significantly greater with linaclotide (290 mcg, once daily and 500 mcg, once daily) and plecanatide (3 mg, once daily) compared with placebo. However, 6 mg, once-daily plecanatide ranked first for safety. Diarrhea was significantly more common with all drugs, except lubiprostone (8 mcg, twice daily). Nausea was significantly more common among patients who received lubiprostone. CONCLUSIONS: In a network analysis of randomized controlled trials of secretagogues for IBS-C, we found all drugs to be superior to placebo. Efficacy was similar among individual drugs and dosages for most endpoints. However, data were extracted at the 12-week time point, so the long term relative efficacy of these drugs is unknown. PMID: 30144426 [PubMed - as supplied by publisher] View the full article
Twitter-RT @MvenuGI: Great point @LindaNguyenMD - vagus nerve is the “power cord” for the GI tract. Surgical interventions can disrupt this vital c…
RT @MvenuGI: Great point @LindaNguyenMD - vagus nerve is the “power cord” for the GI tract. Surgical interventions can disrupt this vital c… (RSS generated with FetchRss) View the full article
Twitter-Interesting trial showing that #yoga and a #LowFODMAP diet can reduce symptoms in #IBS patients https://t.co/YKHV0rDjce Is this something you'd consider incorporating into your routine? Let us know your experiences! https://t.co/pFqUCdiQnE
Interesting trial showing that #yoga and a #LowFODMAP diet can reduce symptoms in #IBS patients http://bit.ly/2iLaKWa Is this something you'd consider incorporating into your routine? Let us know your experiences! (RSS generated with FetchRss) View the full article
Related Articles Altered colonic sensory and barrier functions by CRF: roles of TLR4 and IL-1. J Endocrinol. 2018 Aug 23;: Authors: Nozu T, Miyagishi S, Nozu R, Takakusaki K, Toshikatsu O Abstract Visceral allodynia and increased colonic permeability are considered to be crucial pathophysiology of irritable bowel syndrome (IBS). Corticotropin-releasing factor (CRF) and immune-mediated mechanisms have been proposed to contribute to these changes in IBS, but the precise roles have not been determined. We explored these issues in rats in vivo. The threshold of visceromotor response, i.e., abdominal muscle contractions induced by colonic balloon distention was electrophysiologically measured. Colonic permeability was estimated by quantifying the absorbed Evans blue in colonic tissue. Intraperitoneal injection of CRF increased the permeability, which was blocked by astressin, a non-selective CRF receptor antagonist, but astressin2-B, a selective CRF receptor subtype 2 (CRF2) antagonist did not modify it. Urocortin 2, a selective CRF2 agonist inhibited the increased permeability by CRF. Eritoran, a toll-like receptor 4 (TLR4) antagonist or anakinra, an interleukin-1 receptor antagonist blocked the visceral allodynia and the increased gut permeability induced by CRF. Subcutaneous injection of lipopolysaccharide (immune stress) or repeated water avoidance stress (WAS, psychological stress), 1 h daily for 3 days induced visceral allodynia and increased gut permeability (animal IBS models), which were also blocked by astressin, eritoran or anakinra. In conclusion, stress-induced visceral allodynia and increased colonic permeability were mediated via peripheral CRF receptors. CRF induced these visceral changes via TLR4 and cytokine system, which were CRF1 dependent, and activation of CRF2 inhibited these CRF1-triggered responses. CRF may modulate immune system to alter visceral changes, which are considered to be pivotal pathophysiology of IBS. PMID: 30139928 [PubMed - as supplied by publisher] View the full article
Twitter-Have you seen my #Ibelieveinyourstory video? I created this video to advocate for people awith #IBS & raise research funding + awareness. Watch here: https://t.co/2Dxy7BaJHT via @youtube
Have you seen my #Ibelieveinyourstory video? I created this video to advocate for people awith #IBS & raise research funding + awareness. Watch here: https://www.youtube.com/watch?v=7HQAlraW50s&sns=tw via @youtube (RSS generated with FetchRss) View the full article
Does Club Soda Help Stop Stomach Pain and Constipation? Care2.com Full coverage View the full article
Association between allergic diseases and irritable bowel syndrome: A retrospective study MD Linx (press release) Full coverage View the full article
Keto Diarrhea Is A Real Problem Women's Health All the Negative Side Effects of the Keto Diet The Cheat Sheet Full coverage View the full article
Keto Diarrhea Is A Real Problem Women's Health Full coverage View the full article
Pubmed-The effect of a multispecies probiotic on microbiota composition in a clinical trial of patients with diarrhea-predominant irritable bowel syndrome.
Related Articles The effect of a multispecies probiotic on microbiota composition in a clinical trial of patients with diarrhea-predominant irritable bowel syndrome. Neurogastroenterol Motil. 2018 Aug 23;:e13456 Authors: Hod K, Dekel R, Aviv Cohen N, Sperber A, Ron Y, Boaz M, Berliner S, Maharshak N Abstract BACKGROUND: Although probiotics are increasingly used in irritable bowel syndrome (IBS), their mechanism of action has not been elucidated sufficiently. We aimed to evaluate the impact of a multispecies probiotic on enteric microbiota composition in women with diarrhea-predominant-IBS (IBS-D) and to determine whether these effects are associated with changes in IBS symptoms or inflammatory markers. METHODS: In a double-blind, placebo-controlled study, Rome III IBS-D women completed a two-week run-in period and eligible women were assigned at random to a probiotic capsule (BIO-25) or an indistinguishable placebo, twice daily for 8 weeks. IBS symptoms and stool consistency were rated daily by visual analogue scales and the Bristol stool scale. High sensitivity C-reactive protein, fecal calprotectin and microbial composition were tested at baseline and at 4 and 8 weeks. Microbial sequencing of the 16S rRNA was performed and data were analyzed to compare patients who responded to treatment with those who did not. KEY RESULTS: 172 IBS-D patients were recruited and 107 eligible patients were allocated to the intervention (n = 54) or placebo (n = 53) group. Compared to placebo, BIO-25 did not result in changes in microbial diversity or taxa proportions, except for higher relative proportions of Lactobacillus in the BIO-25 group (P = 0.002). Symptomatic responders to BIO-25 showed a reduction in the proportion of Bilophila(P = 0.003) posttreatment. Patients with beneficial inflammatory-marker changes had higher baseline proportions of Faecalibacterium(P = 0.03), Leuconostoc (P = 0.03), and Odoribacter (P = 0.05) compared to corresponding non-responders. CONCLUSIONS & INFERENCES: Identifying patients with a more amenable microbiome at treatment initiation may result in better treatment response. PMID: 30136337 [PubMed - as supplied by publisher] View the full article