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Successful Helicobacter pylori eradication therapy improves symptoms of chronic constipation MD Linx Full coverage View the full article
Can Zelnorm Make a Comeback? Will Resolor Finally Reach the US? MedPage Today Full coverage View the full article
Ad Com October 18 for Shire's constipation med prucalopride Seeking Alpha Full coverage View the full article
Pubmed-Comparing the Efficacy of Mindfulness-Based Stress Reduction Therapy with Emotion Regulation Treatment on Quality of Life and Symptoms of Irritable Bowel Syndrome.
Related Articles Comparing the Efficacy of Mindfulness-Based Stress Reduction Therapy with Emotion Regulation Treatment on Quality of Life and Symptoms of Irritable Bowel Syndrome. Iran J Psychiatry. 2018 Jul;13(3):175-183 Authors: Ghandi F, Sadeghi A, Bakhtyari M, Imani S, Abdi S, Banihashem SS Abstract Objective: Irritable bowel syndrome is a common gastrointestinal disorder. The perception of stress and GI-speciﬁc anxiety play a key role in irritable bowel syndrome (IBS). The present study aims at comparing the efficacy of mindfulness-based stress reduction therapy with emotion regulation on the quality of life and severity in patients IBS. Method : This randomized clinical trial was conducted in 3 phases: pretest, posttest, and follow-up. Follow-up was performed 2 months after the last intervention. The study population consisted of 24 IBS patients who were randomly selected according to Rome-IV Criteria and were then divided into 3 eight-member groups: (1) mindfulness-based stress reduction, (2) emotion regulation, and (3) control group. IBS-QOL34 and IBS-SSS were administered as assessment tools to all the 3 groups. The experimental groups were subjected to MBSR and ER psychotherapy, while the control group received no psychological intervention. After the 2-month follow-up, the 3 groups were evaluated again. RESULTS: The results revealed that MBSR improved the quality of life of IBS patients and dicreased severity of their condition. The findings of between and within subjects design revealed that the difference between MBSR and control groups was significant in IBS at follow-up (p = 0.01). Conclusion: MBSR could be considered as a new, effective, and stable method in psychotherapy, in irritable bowel syndrome. PMID: 30319700 [PubMed] View the full article
Pubmed-Comparison and assessment of flixweed and fig effects on irritable bowel syndrome with predominant constipation: A single-blind randomized clinical trial.
Related Articles Comparison and assessment of flixweed and fig effects on irritable bowel syndrome with predominant constipation: A single-blind randomized clinical trial. Explore (NY). 2018 Sep 11;: Authors: Pourmasoumi M, Ghiasvand R, Darvishi L, Hadi A, Bahreini N, Keshavarzpour Z Abstract BACKGROUND: Irritable bowel syndrome with predominant constipation (IBS-C) is a common digestive disorder. The current therapy is inadequate and evidence regarding the effect of herbal therapies on the relief of affected individuals is insufficient. The aim of this study was to investigate the beneficial effects of flixweed and fig consumption on IBS-C symptoms. METHODS: 150 patients with IBS-C were enrolled in this randomized, controlled trial. All patients were randomly assigned to three groups and received an intervention for four months. The IBS severity score system and quality-of-life questionnaires were used for evaluating IBS-C symptoms. C-reactive protein levels, frequency of defecation and hard stool were also assessed. RESULTS: Consumption of flixweed or fig, compared to a control group, caused a significant improvement in IBS symptoms including frequency of pain, distention, frequency of defecation and hard stool. Also, the findings showed a significant increase in quality of life, as well as satisfaction with overall bowel habits. However, flixweed and fig intake had no significant effects on abdominal pain severity and C-reactive protein levels. CONCLUSIONS: In conclusion, consumption of flixweed or fig for four months would be a useful therapy for alleviating IBS-C symptoms and can be a beneficial option for first-line treatment. PMID: 30318190 [PubMed - as supplied by publisher] View the full article
Pubmed-Characterization of Diarrheagenic Enteroaggregative Escherichia coli in Danish Adults-Antibiotic Treatment Does Not Reduce Duration of Diarrhea.
Characterization of Diarrheagenic Enteroaggregative Escherichia coli in Danish Adults-Antibiotic Treatment Does Not Reduce Duration of Diarrhea. Front Cell Infect Microbiol. 2018;8:306 Authors: Hebbelstrup Jensen B, Adler Sørensen C, Hebbelstrup Rye Rasmussen S, Rejkjær Holm D, Friis-Møller A, Engberg J, Mirsepasi-Lauridsen HC, Struve C, Hammerum AM, Porsbo LJ, Petersen RF, Petersen AM, Krogfelt KA Abstract Enteroaggregative Escherichia coli (EAEC) is frequently isolated from sporadic cases of diarrhea and in outbreaks of gastroenteritis in several regions of the world. The pathophysiology of EAEC continues to be enigmatic, and the efficacy of antibiotic treatment in EAEC-associated diarrhea has been discussed. Since the level of antibiotic resistance is increasing, it is essential to restrict the use of antibiotics to prevent further resistance development. We aimed to investigate EAEC strains in adult Danish patients suffering from diarrhea and from healthy controls. We examined the antibiotic resistance in EAEC strains, the clinical response to antibiotic treatment in EAEC diarrheal cases, and the distribution of virulence genes in diarrheal cases. The EAEC strains were collected from patients suffering from diarrhea in a Danish multicenter study. A medical doctor interviewed the patients by using a questionnaire regarding gastrointestinal symptoms, exposures, and use of antibiotic and over-the-counter antidiarrheal drugs. Follow-up was performed after 3-5 months to inquire about differential diagnosis to gastrointestinal disease. A multiplex polymerase chain reaction characterized virulence genes in diarrheal cases. Finally, the level of antibiotic resistance was examined by using the disc diffusion method. Asymptomatic carriage of EAEC in the adult Danish population was rare, in contrast to findings in healthy Danish children. The duration of diarrhea was not shortened by antibiotic treatment, specifically ciprofloxacin treatment, or by over-the-counter antidiarrheal drugs. Follow-up revealed no pathology in diarrheal patients apart from irritable bowel syndrome in two patients. A high number of patients suffered from long-term diarrhea, which was associated with the enterotoxin EAST-1 and a high virulence factor score. A high level of antibiotic resistance was observed and 58% of the EAEC strains were multidrug resistant. Multidrug resistance was most pronounced in cases of travelers' diarrhea, and it was seen that antibiotic treatment did not reduce the duration of diarrhea. PMID: 30319991 [PubMed - in process] View the full article
Cost-effectiveness of interventions for medically unexplained symptoms: A systematic review. PLoS One. 2018;13(10):e0205278 Authors: Wortman MSH, Lokkerbol J, van der Wouden JC, Visser B, van der Horst HE, Olde Hartman TC Abstract BACKGROUND: In primary and secondary care medically unexplained symptoms (MUS) or functional somatic syndromes (FSS) constitute a major burden for patients and society with high healthcare costs and societal costs. Objectives were to provide an overview of the evidence regarding the cost-effectiveness of interventions for MUS or FSS, and to assess the quality of these studies. METHODS: We searched the databases PubMed, PsycINFO, the National Health Service Economic Evaluation Database (NHS-EED) and the CEA registry to conduct a systematic review. Articles with full economic evaluations on interventions focusing on adult patients with undifferentiated MUS or fibromyalgia (FM), irritable bowel syndrome (IBS) and chronic fatigue syndrome (CFS), with no restrictions on comparators, published until 15 June 2018, were included. We excluded preventive interventions. Two reviewers independently extracted study characteristics and cost-effectiveness data and used the Consensus on Health Economic Criteria Checklist to appraise the methodological quality. RESULTS: A total of 39 studies out of 1,613 articles met the inclusion criteria. Twenty-two studies reported costs per quality-adjusted life year (QALY) gained and cost-utility analyses (CUAs). In 13 CUAs the intervention conditions dominated the control conditions or had an incremental cost-effectiveness ratio below the willingness-to-pay threshold of € 50,000 per QALY, meaning that the interventions were (on average) cost-effective in comparison with the control condition. Group interventions focusing on MUS (n = 3) or FM (n = 4) might be more cost-effective than individual interventions. The included studies were heterogeneous with regard to the included patients, interventions, study design, and outcomes. CONCLUSION: This review provides an overview of 39 included studies of interventions for patients with MUS and FSS and the methodological quality of these studies. Considering the limited comparability due to the heterogeneity of the studies, group interventions might be more cost-effective than individual interventions. REGISTRATION: Study methods were documented in an international prospective register of systematic reviews (PROSPERO) protocol, registration number: CRD42017060424. PMID: 30321193 [PubMed - in process] View the full article
Twitter-RT @FodyFoods: Not too late to register for @KateScarlata_RD & @Toni_Fiori_RD's Low FODMAP workshop!! https://t.co/LI246cY7hK
RT @FodyFoods: Not too late to register for @KateScarlata_RD & @Toni_Fiori_RD's Low FODMAP workshop!! https://twitter.com/KateScarlata_RD/status/1050542539827240960 (RSS generated with FetchRss) View the full article
Is Anxiety the Real Cause of Your Poor Digestion? The Epoch Times Full coverage View the full article
Pubmed-Characteristics of endometriosis: A case-cohort study showing elevated IgG titers against the TSH receptor (TRAb) and mental comorbidity.
Characteristics of endometriosis: A case-cohort study showing elevated IgG titers against the TSH receptor (TRAb) and mental comorbidity. Eur J Obstet Gynecol Reprod Biol. 2018 Oct 06;231:8-14 Authors: Ek M, Roth B, Nilsson PM, Ohlsson B Abstract OBJECTIVES: Endometriosis has been associated with a wide range of factors. The disease share immunological features with autoimmune diseases, and the prevalence of both hypo- and hyperthyroidism has been reported to be increased. However, the associations have to be confirmed and the mechanisms explored. The aim of this observational study was to investigate socioeconomic factors, lifestyle habits, and somatic and mental comorbidities in endometriosis compared to the general population. STUDY DESIGN: In all, 172 women with endometriosis completed a study questionnaire and were interviewed regarding socioeconomic factors, lifestyle habits, psychological well-being, and medical history. Bowel symptoms were measured by the Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS). Serum was analyzed for IgG levels of TSH receptor antibodies (TRAb) and anti-thyroid peroxidase (TPO) antibodies. Women from the general population served as controls. Differences were calculated by logistic regression, adjusted for confounders. RESULTS: Alcohol intake, leisure time physical activity, body mass index and asthma were inversely, whereas IBS was positively associated with endometriosis. Hypothyroidism and anti-TPO antibodies did not associate, but elevated TRAb antibody titers were associated with endometriosis (odds ratio (OR): 539.26; 95% confidence interval (CI): 114.29-2544.32 for highest versus lowest tertile; p for trend < 0.001). Impaired psychological well-being (p for trend = 0.003) and current intake of antidepressant medication (OR: 3.54; 95% CI: 1.22-10.28; p = 0.020) associated with endometriosis, and impaired psychological well-being correlated with all gastrointestinal symptoms measured (all p < 0.001). CONCLUSIONS: Lifestyle habits and asthma are inversely associated, and IBS and impaired psychological well-being are positively associated with endometriosis. TRAb titers are associated with endometriosis, supporting a link between endometriosis, autoimmunity and thyroid pathophysiology, although overt thyroid diseases do not associate. PMID: 30317144 [PubMed - as supplied by publisher] View the full article
The effect of epicardial adipose tissue thickness with irritable bowel syndrome. J Pak Med Assoc. 2018 Oct;68(10):1456-1460 Authors: Cicek Y, Durakoglugil ME, Rakici H, Balcioglu AS, Duman H, Erdogan T Abstract OBJECTIVE: To investigate the association of epicardial adipose tissue thickness with irritable bowel syndrome. METHODS: This case-control and observational study was conducted in Recep Tayyip Erdogan University between January and December 2014, and comprised patients of irritable bowel syndrome and healthy controls who underwent a complete transthoracic echocardiographic examination as well as measurements of epicardial adipose tissue. They were screened for psychiatric or organic bowel diseases for the sake of precise diagnosis. Epicardial fat thickness was measured perpendicularly in front of the right ventricular free wall at end-diastole.SPSS 15 was used to analyse the data. RESULTS: Of the 75 subjects, 44(59%) were patients and 31(41%) were controls. There was no statistically significant difference between the groups except epicardial adipose tissue thickness, which was significantly elevated in patients (p<0.001). C-reactive protein was significantly higher in patients (p=0.002). Epicardial adipose tissue (p<0.001) and haematocrit (p<0.05) were independent predictors of irritable bowel syndrome. CONCLUSIONS: Increased epicardial adipose tissue thickness, and accompanying low-grade inflammation appeared to be involved in irritable bowel syndrome pathogenesis. PMID: 30317341 [PubMed - in process] View the full article
Twitter-RT @JohannahRuddy: The @RomeFoundation #CME in #SantaFe is wrapping up our first full day at the beautiful @BuffaloThunderResort. @DrPalsso…
RT @JohannahRuddy: The @RomeFoundation #CME in #SantaFe is wrapping up our first full day at the beautiful @BuffaloThunderResort. @DrPalsso… (RSS generated with FetchRss) View the full article
Twitter-RT @sweetdietitian: Excited to be at #theromefoundation conference. Thanks @umfoodoc for your diet and lifestyle change presentation! https…
RT @sweetdietitian: Excited to be at #theromefoundation conference. Thanks @umfoodoc for your diet and lifestyle change presentation! https… (RSS generated with FetchRss) View the full article
Related Articles Influence of Dietary Restriction on Irritable Bowel Syndrome. Am J Gastroenterol. 2018 Oct 12;: Authors: Kamal A, Pimentel M Abstract Up to two-thirds of patients with IBS attribute their gastrointestinal symptoms to food. The therapeutic focus of IBS has been to alleviate gastrointestinal symptoms, approached by pharmaceutical and non-pharmaceutical treatments. Although the most traditional approach has involved the use of medications such as bulking agents, anticholinergics, antispasmodics, and antidiarrheals, unfortunately these are only modestly effective and patients are left with a small menu of successful pharmacologic agents. These treatments, however, are not always enough to alleviate symptoms. Alternative approaches have therefore been tried, including dietary manipulation. This article aims to review dietary restrictions as a non-pharmaceutical management approach for IBS, covering literature on various dietary triggers and the impact of dietary manipulation on gastrointestinal symptoms. PMID: 30315281 [PubMed - as supplied by publisher] View the full article
Google-DR MICHAEL MOSLEY: The diet that can banish the agony of IBS - including cutting down on potatoes and calming the ...
DR MICHAEL MOSLEY: The diet that can banish the agony of IBS - including cutting down on potatoes and calming the ... Daily Mail Full coverage View the full article
Pubmed-Alleviation of Irritable Bowel Syndrome-Like Symptoms and Control of Gut and Brain Responses with Oral Administration of Dolichos lablab L. in a Mouse Model.
Related Articles Alleviation of Irritable Bowel Syndrome-Like Symptoms and Control of Gut and Brain Responses with Oral Administration of Dolichos lablab L. in a Mouse Model. Nutrients. 2018 Oct 10;10(10): Authors: Chun E, Yoon S, Parveen A, Jin M Abstract Irritable bowel syndrome (IBS) is a common gastrointestinal disorder manifesting as unexplained abdominal pain and bowel habit changes. The pathogenesis of post-infectious IBS is associated with gut⁻brain axis dysfunction, including low-grade colonic inflammation and anxiety-related long-term brain changes. This study analyzed the efficacy of a standardized extract of Dolichos lablab L. extract (DL), a bean species, in an IBS mouse model resembling post-infectious, diarrhea-dominant IBS. Using a zymosan-induced animal IBS model, we found that oral administration of DL significantly attenuated zymosan-induced increases in colonic macroscopic scores and minimized weight loss without affecting food intake. In the DL-treated mice, the mast cell count and tumor necrosis factor-α level in the colon markedly decreased, similar to results in sulfasalazine-treated mice and in mice with lipopolysaccharide-stimulated bone marrow-derived mast cells. The number of visceral pain-related behaviors was much lower in the DL-treated mice. Anxiety-like behaviors significantly improved, comparable to that after treatment with amitriptyline. The c-Fos expression level in the prefrontal cortex was significantly reduced. Our data suggest that DL could be beneficial for treating IBS by acting on the gut and brain. PMID: 30309025 [PubMed - in process] View the full article
Pubmed-Association of Fatigue With TPH2 Genetic Polymorphisms in Women With Irritable Bowel Syndrome.
Related Articles Association of Fatigue With TPH2 Genetic Polymorphisms in Women With Irritable Bowel Syndrome. Biol Res Nurs. 2018 Oct 11;:1099800418806055 Authors: Han CJ, Jarrett ME, Cain KC, Jun S, Heitkemper MM Abstract Fatigue is the most common extraintestinal symptom in women with irritable bowel syndrome (IBS). Genetic polymorphisms of monoamines are associated with fatigue in many chronic diseases. In this pilot exploratory study, the primary aim was to determine whether genetic polymorphisms of tryptophan hydroxylase ( TPH1/TPH2), serotonin reuptake transporter ( SERT), or catechol-O-methyltransferase ( COMT) are associated with fatigue in women with IBS. Additionally, analysis explored whether these genetic associations with fatigue would be present when controlling for abdominal pain, psychological distress, feeling stressed, and sleepiness during the day. Secondary analysis of two randomized controlled trial baseline data sets in Caucasian women with IBS ( N = 185) was conducted. Participants kept a daily diary with one dimension (i.e., severity) for each of the 26 symptoms, including fatigue, for 28 days prior to randomization. DNA samples were tested for single-nucleotide polymorphisms (SNPs) of TPH1 (four SNPs) /TPH2 (one SNP), SERT (one SNP), and COMT (one SNP). Analysis of covariance was used to examine associations of percentage of diary days with moderate to very severe symptoms with genetic polymorphisms. Only one SNP, TPH2 rs4570625, was significantly associated with fatigue ( p = .005). T-allele (low functional) carriers of TPH2 (i.e., G/T or T/T genotypes) reported a greater percentage of days with moderate to very severe fatigue than G/G homozygotes ( p = .001). Reduced synthesis of tryptophan in the central nervous system may contribute to reports of fatigue in women with IBS. Understanding genetic risk factors for fatigue may elucidate preemptive strategies to reduce fatigue in individuals with IBS. PMID: 30309244 [PubMed - as supplied by publisher] View the full article
Pubmed-Characteristics and determinants of dietary intake and physical activity in a group of patients with multiple chemical sensitivity.
Related Articles Characteristics and determinants of dietary intake and physical activity in a group of patients with multiple chemical sensitivity. Endocrinol Diabetes Nutr. 2018 Oct 08;: Authors: Aguilar-Aguilar E, Marcos-Pasero H, de la Iglesia R, Espinosa-Salinas I, Ramírez de Molina A, Reglero G, Loria-Kohen V Abstract BACKGROUND AND OBJECTIVE: Multiple chemical sensitivity (MCS) is a complex, acquired, chronic syndrome of multifactorial etiology with multiple symptoms. The aim of the study was to assess the nutritional habits, dietary characteristics and physical activity, as well as their determinants, of a population diagnosed with MCS, which may allow for a more precise approach to nutritional improvement. PATIENTS AND METHOD: A descriptive, cross-sectional study in patients diagnosed with MCS. Information was collected using adapted questionnaires. Data included presence of comorbidities, nutritional (use of supplements, types of diet) and food purchasing habits. Dietary intake, food intolerances, and physical activity were also recorded. RESULTS: The study included of 52 patients (48 female) aged 50.9±10.3 years. Diagnosis of MCS was commonly associated to chronic fatigue syndrome (70.1%), fibromyalgia (65.4%), or electrosensitivity (51.9%). The most common comorbidities were irritable bowel, gastroesophageal reflux, and depression/anxiety-depressive disorder. Exclusion diets were followed by 57.7%, 52.1% commonly used supplements (6.4±5.2 per person), and 16.0% took more than 10 daily. A high proportion of volunteers did not take the recommended amounts of dairy products (84.3%), fruit (82.3%), and cereals (64.7%), the foods to which intolerance was greatest. As regards physical activity, active subjects only represented 12.5%. CONCLUSIONS: The data collected support the need to improve food pattern and to perform physical activity according to individual characteristics. Nutritional education and diet personalization could prevent incomplete, monotonous, and unbalanced diets which impair quality of life and physiological status. PMID: 30309810 [PubMed - as supplied by publisher] View the full article
Pubmed-Enteric RET inhibition attenuates gastrointestinal secretion and motility via cholinergic signaling in rat colonic mucosal preparations.
Enteric RET inhibition attenuates gastrointestinal secretion and motility via cholinergic signaling in rat colonic mucosal preparations. Neurogastroenterol Motil. 2018 Oct 12;:e13479 Authors: Russell JP, Mohammadi E, Ligon C, Latorre R, Johnson AC, Hoang B, Krull D, Ho MW, Eidam HS, DeMartino MP, Cheung M, Oliff AI, Kumar S, Greenwood-Van Meerveld B Abstract BACKGROUND: The expression of RET in the developing enteric nervous system (ENS) suggests that RET may contribute to adult intestinal function. ENS cholinergic nerves play a critical role in the control of colonic function through the release of acetylcholine (ACh). In the current study, we hypothesized that a RET-mediated mechanism may regulate colonic ion transport and motility through modulation of cholinergic nerves. METHODS: The effect of RET inhibition on active ion transport was assessed electrophysiologically in rat colonic tissue mounted in Ussing chambers via measurements of short circuit current (Isc) upon electrical field stimulation (EFS) or pharmacologically with cholinergic agonists utilizing a gastrointestinal (GI)-restricted RET inhibitor. We assessed the effect of the RET inhibitor on propulsive motility via quantification of fecal pellet output (FPO) induced by the acetylcholinesterase inhibitor neostigmine. KEY RESULTS: We found that enteric ganglia co-expressed RET and choline acetyltransferase (ChAT) transcripts. In vitro, the RET kinase inhibitor GSK3179106 attenuated the mean increase in Isc induced by either EFS or carbachol but not bethanechol. In vivo, GSK3179106 significantly reduced the prokinetic effect of neostigmine. CONCLUSION AND INFERENCES: Our findings provide evidence that RET-mediated mechanisms regulate colonic function by maintaining cholinergic neuronal function and enabling ACh-evoked chloride secretion and motility. We suggest that modulating the cholinergic control of the colon via a RET inhibitor may represent a novel target for the treatment of intestinal disorders associated with increased secretion and accelerated GI transit such as irritable bowel syndrome with diarrhea (IBS-D). PMID: 30311722 [PubMed - as supplied by publisher] View the full article
Twitter-RT @caterina_oneto: “39% of #IBD patients in remission have #IBS symptoms” says Dr. Hirten. Important to remember that there is often disco…
RT @caterina_oneto: “39% of #IBD patients in remission have #IBS symptoms” says Dr. Hirten. Important to remember that there is often disco… (RSS generated with FetchRss) View the full article