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Twitter-By enrolling in a #clinicaltrial you can learn more about your condition while contributing to the advancement of the science. But, don't take our word for it! Read stories from others who have participated to discover if they're right for you at
By enrolling in a #clinicaltrial you can learn more about your condition while contributing to the advancement of the science. But, don't take our word for it! Read stories from others who have participated to discover if they're right for you at https://www.nih.gov/health-information/nih-clinical-research-trials-you/personal-stories @NIH (RSS generated with FetchRss) View the full article
Twitter-RT @RomeGastroPsych: The effect of anxiety on pain in kids with #IBS is mediated by catastrophizing and somatization, according to this new…
RT @RomeGastroPsych: The effect of anxiety on pain in kids with #IBS is mediated by catastrophizing and somatization, according to this new… (RSS generated with FetchRss) View the full article
Twitter-Are you ready to chat about #constipation? Join us and @uvahealthnews gastroenterologist Jeanetta Frye, MD, for a #Twitterchat tomorrow at 12 PM EST with hashtag #IFFGDChat to get all of your constipation questions answered! #ConstipationAwareness
Are you ready to chat about #constipation? Join us and @uvahealthnews gastroenterologist Jeanetta Frye, MD, for a #Twitterchat tomorrow at 12 PM EST with hashtag #IFFGDChat to get all of your constipation questions answered! #ConstipationAwarenessMonth (RSS generated with FetchRss) View the full article
FDA approves Motegrity for chronic idiopathic constipation HealioThe FDA has approved Motegrity for the treatment of adults with chronic idiopathic constipation, according to a company press release.Motegrity (prucalopride ... View the full article
Google-Cipher Pharmaceuticals Announces PLECANATIDE Accepted for Review by Health Canada - Canada NewsWire
Cipher Pharmaceuticals Announces PLECANATIDE Accepted for Review by Health Canada Canada NewsWireMISSISSAUGA, ON, Dec. 17, 2018 /CNW/ - Cipher Pharmaceuticals Inc. (TSX:CPH) today announced that its New Drug Submission ("NDS") for plecanatide for ... View the full article
Pubmed-Irritable Bowel Syndrome-Like Symptoms in Ulcerative Colitis Patients in Clinical Remission: Association with Residual Colonic Inflammation.
Irritable Bowel Syndrome-Like Symptoms in Ulcerative Colitis Patients in Clinical Remission: Association with Residual Colonic Inflammation. Digestion. 2018 Dec 14;99(1):46-51 Authors: Ishihara S, Kawashima K, Fukuba N, Tada Y, Kotani S, Mishima Y, Oshima N, Kinoshita Y Abstract Ulcerative colitis (UC) patients in clinical remission often experience irritable bowel syndrome (IBS)-like symptoms. The prevalence rate of UC patients meeting the definition of IBS, such as shown by the Rome criteria, is significantly higher in those without ongoing clinical activity as compared to healthy controls. Several studies have investigated residual low-grade inflammation found in colonic mucosa of quiescent UC patients and its association with development of IBS-like symptoms. In these patients, residual colonic inflammation was evaluated using endoscopy and histology findings, as well as fecal calprotectin level and shown to not be simply associated with the presence of IBS-like symptoms in UC patients in clinical remission. However, these results are limited by the low number of related investigations conducted. Additional appropriately designed studies are necessary to confirm the relationship of low-grade colonic inflammation with IBS-like symptoms associated with UC. PMID: 30554229 [PubMed - as supplied by publisher] View the full article
Could cancer anti-sickness drug end the misery for IBS patients? Medical XpressCould a commonly-prescribed anti-sickness drug be the answer for the 1.3 million people in the UK who suffer the pain and misery of irritable bowel syndrome ... View the full article
Ask the Expert: When should someone see a doctor about a stomachache? The Daily ProgressPain in the right lower side of the abdomen (that sometimes starts around the belly button) can indicate appendicitis and warrants immediate evaluation, since it ... View the full article
When it comes to mental health, you need to trust your gut The NationalNew research points to a two-way relationship between our digestive systems and our psychological wellbeing. View the full article
DR MICHAEL MOSLEY has devised a new test for IBS... listen to your tummy Daily MailAccording to studies, about 15 million Britons suffer digestive symptoms regularly, with one in five diagnosed with the most common gut disorder: irritable bowel ... View the full article
Pubmed-Comparison of non-invasive biomarkers faecal BAFF, calprotectin and FOBT in discriminating IBS from IBD and evaluation of intestinal inflammation.
Related Articles Comparison of non-invasive biomarkers faecal BAFF, calprotectin and FOBT in discriminating IBS from IBD and evaluation of intestinal inflammation. Sci Rep. 2017 06 01;7(1):2669 Authors: Fu Y, Wang L, Xie C, Zou K, Tu L, Yan W, Hou X Abstract Faecal calprotectin and faecal occult blood test (FOBT) were widely used in the diagnosis and assessment of intestinal inflammation in inflammatory bowel disease (IBD). Recently we identified an excellent new biomarker B cell-activating factor (BAFF) for IBD. Here in this study we compared the efficacy of faecal BAFF, calprotectin and FOBT to find the "best non-invasive marker". Results showed that for discriminating IBD from IBS, BAFF ≥227.3 pg/ml yield 84% sensitivity, 100% specificity, 100% positive predictive value (PPV) and 64% negative predictive value (NPV) while calprotectin ≥50 µg/g yield 76% sensitivity, 93% specificity, 97% PPV and 53% NPV. FOBT yield 65% sensitivity, 93% specificity, 97% PPV and 43% NPV. Combining BAFF with calprotectin tests yield 94% sensitivity, 93% specificity, 98% PPV, 81% NPV. Faecal BAFF level showed the stronger correlation with endoscopic inflammatory score as compared to calprotectin not only in UC (correlation coefficient [r] = 0.69, p < 0.0001 vs. r = 0.58, p < 0.0001), but also in CD (r = 0.58, p < 0.0001 vs. r = 0.52, p = 0.0003). Our results indicating that faecal BAFF is a promising non-invasive biomarker in IBD differential diagnosis and monitoring of intestinal inflammation. PMID: 28572616 [PubMed - indexed for MEDLINE] View the full article
Pubmed-Multiple psychological factors predict abdominal pain severity in children with irritable bowel syndrome.
Multiple psychological factors predict abdominal pain severity in children with irritable bowel syndrome. Neurogastroenterol Motil. 2018 Dec 13;:e13509 Authors: Hollier JM, van Tilburg MAL, Liu Y, Czyzewski DI, Self MM, Weidler EM, Heitkemper M, Shulman RJ Abstract BACKGROUND: Anxiety and depression are implicated as contributors to abdominal pain in pediatric irritable bowel syndrome (IBS) but is unclear if this pain is associated with other psychological factors. The study objective was to test if the impact of anxiety or depression on IBS symptom severity is mediated by somatization and/or pain catastrophizing. METHODS: We utilized baseline data from local pediatric IBS clinical studies. Through mediation analysis, we assessed whether somatization or pain catastrophizing mediated (either independently or combined) the separate relationships of anxiety or depression with IBS abdominal pain severity. KEY RESULTS: We analyzed 261 participants. All psychological factors were positively correlated with one another and IBS abdominal pain severity. The association of anxiety with IBS abdominal pain was mediated by both somatization and pain catastrophizing in individual analyses (each mediated standardized coefficient [β] 0.11, CI 0.05-0.18) and in multiple analysis (mediated standardized β 0.18, CI 0.09-0.27). The association of depression with IBS abdominal pain was also mediated by somatization (mediated standardized β 0.08, CI0.02-0.14) and pain catastrophizing (mediated standardized β 0.06, CI 0.01-0.11) in individual analyses and in multiple analysis (mediated standardized β 0.19, CI 0.04-0.19). CONCLUSIONS AND INFERENCES: Somatization and pain catastrophizing mediate the relationships between anxiety/depression and IBS abdominal pain severity. These findings suggest that somatization and pain catastrophizing may be better treatment targets than anxiety and depression. Clinicians should assess these psychological factors in pediatric IBS patients and refer for intervention to improve outcomes. PMID: 30549152 [PubMed - as supplied by publisher] View the full article
Pubmed-Enkephalinase inhibitors, potential therapeutics for the future treatment of diarrhea predominant functional gastrointestinal disorders.
Enkephalinase inhibitors, potential therapeutics for the future treatment of diarrhea predominant functional gastrointestinal disorders. Neurogastroenterol Motil. 2018 Dec 14;:e13526 Authors: Szymaszkiewicz A, Storr M, Fichna J, Zielinska M Abstract The endogenous opioid system (EOS) is considered being a crucial element involved in the pathophysiology of irritable bowel syndrome (IBS) as it regulates gastrointestinal (GI) homeostasis through modulation of motility and water and ion secretion/absorption. Along with opioid receptors (ORs), the following components of EOS can be distinguished: 1. endogenous opioid peptides (EOPs), namely enkephalins, endorphins, endomorphins and dynorphins, and 2. peptidases, which regulate the metabolism (synthesis and degradation) of EOPs. Enkephalins, which are δ-opioid receptors agonists, induce significant effects in the GI tract as they act as potent pro-absorptive neurotransmitters. The action of enkephalins and other EOPs is limited, since EOPs are easily and rapidly inactivated by a natural metalloendopeptidase (enkephalinase/neprilysin) and aminopeptidase N. Studies show that the activity of EOPs can be enhanced by inhibition of these enzymes. In this review, we discuss the antidiarrheal and antinociceptive potential of enkephalinase inhibitors. Furthermore, our review is to answer the question whether enkephalinase inhibitors may be helpful in the future treatment of diarrhea predominant functional GI disorders. PMID: 30549162 [PubMed - as supplied by publisher] View the full article
Plecanatide for Treatment of Chronic Constipation and Irritable Bowel Syndrome. Am J Med. 2018 Dec 11;: Authors: Love BL Abstract Chronic idiopathic constipation and irritable bowel syndrome with constipation are commonly encountered in ambulatory patients, but limited options exist for patients with persistent or severe symptoms following treatment with non-prescription products. Plecanatide (Trulance, Synergy Pharmaceuticals) is a 16-amino acid peptide analogue of uroguanylin that stimulates guanylate cyclase-C receptors to increase chloride and bicarbonate secretion into the intestine and prevents the absorption of sodium ions, thereby increasing the secretion of water into the lumen. The influx of additional fluid accelerates intestinal transit, softens the stool and facilitates easier defecation. Plecanatide is the second guanylate cyclase-C receptor agonist to be approved by the US Food and Drug Administration for chronic idiopathic constipation and irritable bowel syndrome, but plecanatide is unique since its effects are limited to the proximal small bowel. PMID: 30550753 [PubMed - as supplied by publisher] View the full article
Twitter-RT @GMFHx: There is still uncertainty regarding the mechanisms of action of probiotics on gut motility and constipation. This Review from @…
RT @GMFHx: There is still uncertainty regarding the mechanisms of action of probiotics on gut motility and constipation. This Review from @… (RSS generated with FetchRss) View the full article
Related Articles Management Options for Irritable Bowel Syndrome. Mayo Clin Proc. 2018 Dec;93(12):1858-1872 Authors: Camilleri M Abstract Irritable bowel syndrome (IBS) is associated with diverse pathophysiologic mechanisms. These mechanisms include increased abnormal colonic motility or transit, intestinal or colorectal sensation, increased colonic bile acid concentration, and superficial colonic mucosal inflammation, as well as epithelial barrier dysfunction, neurohormonal up-regulation, and activation of secretory processes in the epithelial layer. Novel approaches to treatment include lifestyle modification, changes in diet, probiotics, and pharmacotherapy directed to the motility, sensation, and intraluminal milieu of patients with IBS. Despite recent advances, there is a need for development of new treatments to relieve pain in IBS without deleterious central or other adverse effects. PMID: 30522596 [PubMed - in process] View the full article
Pubmed-Key mechanisms of cognitive behavioural therapy in irritable bowel syndrome: The importance of gastrointestinal related cognitions, behaviours and general anxiety.
Related Articles Key mechanisms of cognitive behavioural therapy in irritable bowel syndrome: The importance of gastrointestinal related cognitions, behaviours and general anxiety. J Psychosom Res. 2018 Nov 22;: Authors: Windgassen S, Moss-Morris R, Goldsmith K, Chalder T Abstract BACKGROUND: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterised by abdominal pain and altered bowel movements. Cognitive behavioural therapy (CBT) has been shown to be effective in reducing symptom severity in IBS and enhancing quality of life/functioning. The present study sought to identify how CBT achieves change in these outcomes. METHOD: Secondary analysis was conducted on 149 patients with irritable bowel syndrome who had been randomised to cognitive behavioural therapy plus an antispasmodic medication or antispasmodic alone. Single and sequential mediation was modelled using structural equation modelling. Gastrointestinal (GI) related avoidance behaviour, safety behaviour, cognitions and general anxiety were included as mediators. RESULTS: GI safety behaviours, cognitions and general anxiety mediated treatment effect on the outcomes of symptom severity and work and social adjustment. Avoidance behaviour was not a significant mediator for either outcome. Sequential mediation models indicated that unhelpful GI related cognitions reduced before anxiety did, and this sequential path (R➔GI related cognitions➔anxiety➔outcome) was significant for both symptom severity (b = -0.22, CI [-0.40 to -0.90], p = .005) and work and social adjustment (b = -0.26, CI [-0.44 to -0.11], p = .003) where 'R' is randomisation. Reduction in GI safety behaviours also preceded reduction in anxiety. This sequence (R ➔GI safety behaviours➔anxiety➔outcome) was significant for both symptom severity (b = -0.11, CI [-0.24 to -0.01], p = .049) and work and social adjustment (b = -0.12, CI [-0.23 to -0.03], p = .03). CONCLUSION: Results suggest that it is important for psychological treatments to target IBS specific factors for change. PMID: 30522750 [PubMed - as supplied by publisher] View the full article
Pubmed-Pioglitazone improves visceral sensation and colonic permeability in a rat model of irritable bowel syndrome.
Related Articles Pioglitazone improves visceral sensation and colonic permeability in a rat model of irritable bowel syndrome. J Pharmacol Sci. 2018 Nov 24;: Authors: Nozu T, Miyagishi S, Nozu R, Takakusaki K, Okumura T Abstract Visceral hypersensitivity and impaired gut barrier with minor inflammation are considered to play an important role in the pathophysiology of irritable bowel syndrome (IBS). Since pioglitazone is known to have anti-inflammatory property, we hypothesized that pioglitazone is beneficial for treating IBS. In this study, the effect was tested in rat IBS models such as lipopolysaccharide or repeated water avoidance stress-induced visceral allodynia and increased colonic permeability. Pioglitazone blocked these visceral changes, and GW9662, a peroxisome proliferator-activated receptor gamma (PPAR-γ) antagonist fully reversed the effect by pioglitazone. These results suggest that PPAR-γ activation by pioglitazone may be useful for IBS treatment. PMID: 30522964 [PubMed - as supplied by publisher] View the full article
Related Articles Separating "good" from "bad" faecal dysbiosis - evidence from two cross-sectional studies. BMC Obes. 2018;5:30 Authors: Farup PG, Aasbrenn M, Valeur J Abstract Background: Faecal dysbiosis associated with the use of metformin has been conceived as a favourable ("good") dysbiosis and that with intake of non-nutritive sweeteners (NNS) as unfavourable ("bad"). The study aimed to construct an alternative dysbiosis index (ADI) for the separation of the dysbioses into "good" and "bad", and to validate the ADI. Methods: Subjects with morbid obesity were included. Use of NNS and drugs were noted, IBS was classified according to the Rome III criteria and the severity measured with the Irritable bowel severity scoring system (IBSSS). Faecal dysbiosis was tested with GA-Map ™ Dysbiosis test (Genetic Analysis AS, Oslo, Norway). The result was given as Dysbiosis Index (DI) scores 1-5, score > 2 indicates dysbiosis. An ADI was constructed and validated in subjects with IBS at another hospital. Results: Seventy-six women and 14 men aged 44.7 years (SD 8.6) with BMI 41.8 kg/m2 (SD 3.6) were included. Dysbiosis was associated with the use of NNS and metformin, but not with IBS or IBSSS. An ADI based on differences in 7 bacteria was positively and negatively associated with the "good" metformin dysbiosis and the "bad" NNS dysbiosis respectively. The ADI was also negatively associated with IBSSS (a "bad" dysbiosis). The negative associations between ADI and IBS and IBSS were confirmed in the validation group. Conclusions: The new ADI, but not the DI, allowed separation of the "good" and "bad" faecal dysbiosis. Rather than merely reporting dysbiosis and degrees of dysbiosis, future diagnostic tests should distinguish between types of dysbiosis. PMID: 30524735 [PubMed] View the full article
Pubmed-Adherence with a low-FODMAP diet in irritable bowel syndrome: are eating disorders the missing link?
Related Articles Adherence with a low-FODMAP diet in irritable bowel syndrome: are eating disorders the missing link? Eur J Gastroenterol Hepatol. 2018 Dec 12;: Authors: Mari A, Hosadurg D, Martin L, Zarate-Lopez N, Passananti V, Emmanuel A Abstract OBJECTIVES: The low-FODMAP diet has emerged as an option for the treatment of irritable bowel syndrome (IBS). This diet is very restrictive, and compliance is usually low. Preliminary findings suggest an association between eating disorders (EDs) and the risk of developing IBS. The aim of this study was to assess the correlation between compliance with a low-FODMAP diet and the risk of ED behaviours among patients with IBS. PATIENTS AND METHODS: A single-centre prospective study was carried out among 233 IBS patients (79.8% females) at University College London Hospital, who commenced a low FODMAPs group programme for IBS (Rome III or IV). Self-reported diet adherence at the end of the 6-week programme was measured. At baseline, and at the 6-week follow-up visit, participants completed the validated IBS-Symptom Severity Score, the SCOFF ED screening questionnaire and the Hospital Anxiety and Depression Scale. RESULTS: Adherence with a low-FODMAP diet was found in 95 (41%) patients. Overall, 54 (23%) patients were classified to be at risk for ED behaviour. Adherence was 57% in the ED group (31/54) versus 35% in the non-ED group (64/179); P<0.05. Adherence with a low-FODMAP diet was highest (51%) in the IBS with diarrhoea subtype and lowest (10%) in IBS with constipation. There was no significant correlation between IBS-Symptom Severity Score and either adherence (P=0.39) or ED behaviour (P=0.28). CONCLUSION: In this IBS cohort, greater adherence to a low-FODMAP diet is associated with ED behaviour. The implications of our study are important in clinical practice for a clinician to have a high index of suspicion of EDs in IBS patients when a high level of low-FODMAP diet achieved. PMID: 30543574 [PubMed - as supplied by publisher] View the full article