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Pubmed-A randomized controlled and long-term linaclotide study of irritable bowel syndrome with constipation patients in Japan.
Related Articles A randomized controlled and long-term linaclotide study of irritable bowel syndrome with constipation patients in Japan. Neurogastroenterol Motil. 2018 Aug 22;:e13444 Authors: Fukudo S, Miwa H, Nakajima A, Haruma K, Kosako M, Nakagawa A, Akiho H, Yamaguchi Y, Johnston JM, Currie M, Kinoshita Y Abstract BACKGROUND: Clinical testing was required to verify the effect of linaclotide 0.5 mg/d in patients with irritable bowel syndrome with constipation (IBS-C) in Japan. METHODS: This was a randomized, double-blind, placebo-controlled (Part 1) and long-term, open-label extension (Part 2) study of linaclotide at 60 hospitals and clinics in Japan. Patients with IBS-C diagnosed using Rome III criteria (n = 500) were randomly assigned to linaclotide 0.5 mg (n = 249) or placebo (n = 251) for a 12-week treatment period followed by open-label treatment with linaclotide (n = 324) for an additional 40 weeks. The primary endpoints were the responder rate of global improvement of IBS symptoms and complete spontaneous bowel movement (CSBM) during 12 weeks. The secondary endpoints included responder rates of SBM and abdominal pain/discomfort relief. KEY RESULTS: Part 1: The responder rates for global improvement and for CSBM frequency were significantly higher for linaclotide compared to placebo (P < 0.001). Secondary endpoints including responder rates for SBM and abdominal pain/discomfort relief in the linaclotide group were also significantly greater than those in the placebo group. Part 2: Patients switched from placebo to linaclotide showed similar responder rates for global improvement and CSBM frequency to those in patients who continued to receive linaclotide, supporting sustained efficacy. Diarrhea was seen in 14.5% of patients; all cases were mild or moderate. CONCLUSIONS AND INFERENCES: This study suggests that a linaclotide dose of 0.5 mg is effective and safe for IBS-C patients in Japan. PMID: 30136447 [PubMed - as supplied by publisher] View the full article
Pubmed-Practical Evaluation and Management of Irritable Bowel Syndrome with Diarrhea: A Case Study Approach.
Practical Evaluation and Management of Irritable Bowel Syndrome with Diarrhea: A Case Study Approach. J Fam Pract. 2018 Aug;67(8 suppl):S31-S36 Authors: Lacy BE PMID: 30137051 [PubMed - in process] View the full article
Duodenal and Rectal Mucosa Inflammation in Patients With Non-celiac Wheat Sensitivity. Clin Gastroenterol Hepatol. 2018 Aug 20;: Authors: Carroccio A, Giannone G, Mansueto P, Soresi M, La Blasca F, Fayer F, Iacobucci R, Porcasi R, Catalano T, Geraci G, Arini A, D'Alcamo A, Villanacci V, Florena AM Abstract BACKGROUND & AIMS: Studies of non-celiac gluten or wheat sensitivity (NCGWS) have increased but there are no biomarkers of this disorder. We aimed to evaluate histologic features of colon and rectal tissues from patients with NCGWS. METHODS: We performed a prospective study of 78 patients (66 female; mean age, 36.4 years) diagnosed with NCGWS by double-blind wheat challenge at 2 tertiary care centers in Italy, from January 2015 through September 2016. Data were also collected from 55 patients wither either celiac disease or self-reported NCGWS but negative results from the wheat-challenge test (non-NCGWS controls). Duodenal and rectal biopsies were collected and analyzed by immunohistochemistry to quantify intra-epithelial CD3+ T cells, lamina propria CD45+ cells, CD4+ and CD8+ T cells, mast cells, and eosinophils and to determine the presence and size of lymphoid nodules in patients with NCGWS vs patients with celiac disease or non-NCGWS controls. RESULTS: Duodenal tissues from patients with NCGWS had significantly higher numbers of intra-epithelial CD3+ T cells, lamina propria CD45+ cells, and eosinophils than duodenal tissues from non-NCGWS controls. Duodenal tissues from patients with NCGWS and dyspepsia had a higher number of lamina propria eosinophils than patients with NCGWS without upper digestive tract symptoms. Rectal mucosa from patients with NCGWS had a larger number of enlarged lymphoid follicles, intra-epithelial CD3+ T cells, lamina propria CD45+ cells, and eosinophils than rectal mucosa from non-NCGWS controls. Duodenal and rectal mucosal tissues from patients with celiac disease had more immunocytes (CD45+ cells, CD3+ cells, and eosinophils) than tissues from patients with NCGWS or non-NCGWS controls. CONCLUSION: We identified markers of inflammation, including increased numbers of eosinophils, in duodenal and rectal mucosa from patients with NCGWS. NCGWS might therefore involve inflammation of the entire intestinal tract. Eosinophils could serve as a biomarker for NCGWS and be involved in its pathogenesis. Clinicaltrials.gov no: NCT01762579. PMID: 30138736 [PubMed - as supplied by publisher] View the full article
Oral Glutamine May Ease Post-Infection IBS-D MedPage Today Full coverage View the full article
Related Articles Recent advances in pharmacological research on the management of irritable bowel syndrome. Arch Pharm Res. 2018 Aug 21;: Authors: Nam Y, Min YS, Sohn UD Abstract Irritable bowel syndrome (IBS), a common gastrointestinal (GI) disorder, is associated with various factors, including lifestyle, infection, stress, intestinal flora, and related diseases. The pharmacotherapeutic stimulation of receptors and downstream signaling pathways is effective in reducing IBS symptoms; however, it is still associated with adverse effects. Various receptors related to GI motility and visceral hypersensitivity should be considered to enhance the benefit/risk ratio of IBS treatments. This review discusses recent pharmacological advances in IBS management. Several receptors related to GI motility and abdominal pain are investigated in various angles. 5-Hydroxytryptamine (5-HT) is an important neurotransmitter that activates the colonic mucosal 5-HT4 receptor without causing severe cardiovascular adverse effects. The clinical potential of ramosetron for diarrhea-predominant IBS has been suggested because of a lower risk of ischemic colitis than conventional 5-HT3 receptor antagonists. Toll-like receptors (TLRs), especially TLR2 and TLR4, show a significant effect on the post-infection symptoms and lipopolysaccharide-mediated regulation of GI motility. Histamine is a well-known nitrogenous compound that regulates inflammatory responses and visceral hypersensitivity. Histamine 1 receptor-mediated sensitization of the transient receptor potential vanilloid 1 is associated with IBS. Pharmacological approaches based on these signaling pathways could be useful in the development of novel IBS treatments. PMID: 30132170 [PubMed - as supplied by publisher] View the full article
Twitter-Did you know that some languages don't have a word for "bloating"? Using an analogy of a balloon can be helpful. Do you feel like you have a balloon in your abdomen (bloating), the visible increase in your girth (distension), or both? Learn more a
Did you know that some languages don't have a word for "bloating"? Using an analogy of a balloon can be helpful. Do you feel like you have a balloon in your abdomen (bloating), the visible increase in your girth (distension), or both? Learn more at https://www.iffgd.org/symptoms-causes/bloating-and-distension.html #ibs (RSS generated with FetchRss) View the full article
Ironwood's Linzess Gets Approval in Japan for New Indication Zacks.com Full coverage View the full article
Related Articles Clinical utility of plecanatide in the treatment of chronic idiopathic constipation. Int J Gen Med. 2018;11:323-330 Authors: Islam BN, Sharman SK, Browning DD Abstract Constipation is an important health burden that reduces the quality of life for countless millions of people. Symptom-centric therapeutics are often used to treat constipation due to unknown etiology, but in many cases, these drugs are either inadequate or have significant side effects. More recently, synthetic peptide agonists for epithelial guanylyl cyclase C (GC-C) have been developed which are effective at treating constipation in a sub-population of adult constipation patients. The first to market was linaclotide that is structurally related to the diarrheagenic enterotoxin, but this was followed by plecanatide, which more closely resembles endogenous uroguanylin. Both the drugs exhibit almost identical clinical efficacy in about 20% of patients, with diarrhea being a common side effect. Despite the potential for reduced side effects with plecanatide, detailed analysis suggests that clinically, they are very similar. Ongoing clinical and preclinical studies with these drugs suggest that treating constipation might be the tip of the iceberg in terms of clinical utility. The expression of cGMP signaling components could be diagnostic for functional bowel disorders, and increasing cGMP using GC-C agonists or phosphodiesterase inhibitors has huge potential for treating enteric pain, ulcerative colitis, and for the chemoprevention of colorectal cancer. PMID: 30127634 [PubMed] View the full article
Association between Allergic Diseases and Irritable Bowel Syndrome: A Retrospective Study. Int Arch Allergy Immunol. 2018 Aug 21;:1-7 Authors: Fang ZY, Zhang HT, Lu C, Lu QM, Yu CH, Wang HY Abstract BACKGROUND: The relationship between allergic disease and irritable bowel syndrome (IBS) is poorly understood. We aimed to investigate the potential association as well as the underlying immunological mechanisms. METHODS: A retrospective case-control study of 108 atopic patients from among outpatients in an allergy clinic (allergic rhinitis [AR], n = 49; chronic urticaria [CU], n = 59) and 74 controls from among ward companions was conducted from November 2016 to March 2017. The detection rates and related gastrointestinal (GI) symptoms of IBS, as well as immunological indices, were calculated. RESULTS: CU patients had a trend of increase in the detection of IBS compared to controls (OR = 4.846; 95% CI 0.967-24.279, p = 0.077). Loose stools (OR = 2.406; 95% CI 1.075-5.386, p < 0.05) and viscous stools (OR = 2.665; 95% CI 1.250-5.682, p < 0.05) were more common in CU patients. Atopic patients positive for serum total immunoglobulin E (IgE) (OR = 3.379; 95% CI 1.088-10.498, p < 0.05) or house dust mite (HDM)-specific IgE (OR = 3.640; 95% CI 1.228-10.790, p < 0.05) were more likely to have abdominal bloating. Besides, a positive association between levels of total IgE and severity of abdominal bloating was observed (p < 0.05). An HDM-specific IgE-positive reaction was independently associated with abdominal bloating in atopic patients (p < 0.05). CONCLUSIONS: Allergic disease has a clear clinical association with IBS with more frequent and severe symptoms of IBS. CU patients have a tendency to suffer from IBS, usually with diarrhea. Serum total IgE and HDM-specific IgE are positively correlated with GI symptoms in atopic patients. PMID: 30130792 [PubMed - as supplied by publisher] View the full article
Fecal transplantation may not improve IBS symptoms MD Linx (press release) Full coverage View the full article
Glutamine supplements improve symptoms of postinfectious IBS-D Healio Full coverage View the full article
Pubmed-The novel peripherally active cannabinoid type 1 and serotonin type 3 receptor agonist AM9405 inhibits gastrointestinal motility and reduces abdominal pain in mouse models mimicking irritable bowel syndrome.
The novel peripherally active cannabinoid type 1 and serotonin type 3 receptor agonist AM9405 inhibits gastrointestinal motility and reduces abdominal pain in mouse models mimicking irritable bowel syndrome. Eur J Pharmacol. 2018 Aug 16;: Authors: Salaga M, Binienda A, Tichkule RB, Thakur GA, Makriyannis A, Storr M, Fichna J Abstract The endocannabinoid system (ECS) plays a crucial role in numerous physiological processes in the central and peripheral nervous systems. In the gastrointestinal (GI) tract, selective cannabinoid (CB) receptor agonists exert potent inhibitory actions on motility and pain signalling. In the present study, we used mouse models of diarrhea, hypermotility, and abdominal pain to examine whether a novel synthetic CB1 receptor agonist AM9405 [(2-(2,6-dihydroxy-4-(2-methyloctan-2-yl)phenyl)-1,3-dimethyl-1H-benzo[d]imidazol-3-ium bromide); also known as GAT379] exhibits effects of potential therapeutic relevance. AM9405 significantly slowed mouse intestinal motility in physiological conditions. Moreover, AM9405 reversed hypermotility and reduced pain in mouse models mimicking symptoms of functional GI disorders, such as stress-induced diarrhoea and writhing test. Interestingly, some of the effects of AM9405 were blocked by a 5-HT3 antagonist suggesting interaction with 5-HT3 receptors. In our study we show that combining CB1 agonism with 5-HT3 agonism may alter physiological functions and experimental pathophysiologies in a manner that make such compounds promising drugs for the future treatment of functional GI disorders. PMID: 30121173 [PubMed - as supplied by publisher] View the full article
Pubmed-Association between SERT insertion/deletion polymorphism and the risk of irritable bowel syndrome: A meta-analysis based on 7039 subjects.
Association between SERT insertion/deletion polymorphism and the risk of irritable bowel syndrome: A meta-analysis based on 7039 subjects. Gene. 2018 Aug 16;: Authors: Zhu Y, Zheng G, Hu Z Abstract PURPOSE: We performed this study to better assess the relationship between serotonin transporter (SERT) insertion/deletion polymorphism and the risk of irritable bowel syndrome (IBS). METHODS: Eligible studies were searched in PubMed, Medline, Embase and CNKI. A total of 27 studies with 7039 participants were analyzed. RESULTS: Significant association with the risk of IBS was detected for the SERT insertion/deletion polymorphism in additive comparison (p < 0.0001). Further subgroup analyses according to ethnicity of participants revealed that the SERT insertion/deletion polymorphism was significantly associated with the risk of IBS in Asians (dominant model: p = 0.001; recessive model: p = 0.0003; allele model: p = 0.001) and Caucasians (dominant model: p = 0.04; additive model: p < 0.0001). When we stratified available data according to type of disease, we found that the SERT insertion/deletion polymorphism was significantly correlated with the risk of constipation predominant IBS (IBS-C) in recessive comparison (p = 0.04). However, no positive results were detected in the diarrhea predominant IBS (IBS-D) and mixture of diarrhea and constipation IBS (IBS-M) subgroups. CONCLUSIONS: Our findings indicated that the SERT insertion/deletion polymorphism may serve as a genetic biomarker of IBS in Asians and Caucasians. PMID: 30121382 [PubMed - as supplied by publisher] View the full article
Pubmed-Effect of probiotic Bifidobacterium bifidum G9-1 on the relationship between gut microbiota profile and stress sensitivity in maternally separated rats.
Related Articles Effect of probiotic Bifidobacterium bifidum G9-1 on the relationship between gut microbiota profile and stress sensitivity in maternally separated rats. Sci Rep. 2018 Aug 17;8(1):12384 Authors: Fukui H, Oshima T, Tanaka Y, Oikawa Y, Makizaki Y, Ohno H, Tomita T, Watari J, Miwa H Abstract Although gut microbiota and early life events are likely involved in the development of irritable bowel syndrome (IBS), it remains unclear how these factors interact in the pathophysiology of IBS. In the present study, using rats subjected to maternal separation (MS) as a model of IBS, we investigated interrelationships among gut microbiota, stress susceptibility and intestinal permeability, and examined the effect of the probiotic Bifidobacterium bifidum G9-1 (BBG9-1) on those interrelationships. When compared with the controls at postnatal day 20, MS rats showed hypercorticosteronemia, enhanced intestinal permeability and changes in gut microbiota structure. All of these changes in MS rats were prevented by treatment with BBG9-1. Although the gut microbiota profile and basal serum corticosterone level did not differ between MS and control rats at postnatal day 56, MS rats showed hypersensitivity to restraint stress in terms of serum corticosterone level and fecal frequency. However, such hypersensitivity was not observed in MS rats treated with BBG9-1. These findings suggest that MS initiates the link between gut microbiota alteration and hypersensitivity to stress and that the triggering of this process can be prevented by the treatment with the probiotic BBG9-1. PMID: 30120330 [PubMed - in process] View the full article
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Related Articles The Effect of Trimebutine on the Overlap Syndrome Model of Guinea Pigs. J Neurogastroenterol Motil. 2018 Aug 16;: Authors: Hussain Z, Jung DH, Lee YJ, Park H Abstract Background/Aims: Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are common gastrointestinal (GI) disorders and these patients frequently overlap. Trimebutine has been known to be effective in controlling FD co-existing diarrhea-dominant IBS, however its effect on overlap syndrome (OS) patients has not been reported. Therefore, we investigated the effect of trimebutine on the model of OS in guinea pigs. Methods: Male guinea pigs were used to evaluate the effects of trimebutine in corticotropin-releasing factor (CRF) induced OS model. Different doses (3, 10, and 30 mg/kg) of trimebutine were administered orally and incubated for 1 hour and the next treatment of 10 &mμg/kg of CRF was intraperitoneally injected and stabilized for 30 minutes. Subsequently, intragastric 3 mL charcoal mix was administered, incubated for 10 minutes and the upper GI transit analyzed.Colonic transits were assessed after the same order and concentrations of trimebutine and CRF treatment by fecal pellet output assay. Results: CRF 10 &mμg/kg was the most effective dose in the experimental OS model of guinea pigs.Trimebutine (3, 10, and 30 mg/kg) treatment significantly reversed the upper and lower GItransit of CRF induced OS model. Trimebutine significantly increased upper GI transit whileit reduced fecal pellet output in the CRF induced OS model. Conclusions: Trimebutine has been demonstrated to be effective on both upper and lower GI motorfunction in peripheral CRF induced OS model. Therefore, trimebutine might be an effectivedrug for the treatment of OS between FD and IBS patients. PMID: 30114898 [PubMed - as supplied by publisher] View the full article
Pubmed-The potential of computerised analysis of bowel sounds for diagnosis of gastrointestinal conditions: a systematic review.
Related Articles The potential of computerised analysis of bowel sounds for diagnosis of gastrointestinal conditions: a systematic review. Syst Rev. 2018 Aug 17;7(1):124 Authors: Inderjeeth AJ, Webberley KM, Muir J, Marshall BJ Abstract BACKGROUND: Gastrointestinal (GI) conditions are highly prevalent, and their standard diagnostic tests are costly and carry risks. There is a need for new, cost-effective, non-invasive tests. Our main objective was to assess the potential for use of bowel sounds computerised analysis in the diagnosis of GI conditions. METHODS: The systematic review followed the PRISMA requirements. Searches were made of four databases (PubMed, MEDLINE, Embase, and IEEE Xplore) and the references of included papers. Studies of all types were included. The titles and abstracts were screened by one author. Full articles were reviewed and data collected by two authors independently. A third reviewer decided on inclusion in the event of disagreement. Bias and applicability were assessed via a QUADAS tool adapted to accommodate studies of multiple types. RESULTS: Two thousand eight hundred eighty-four studies were retrieved; however, only 14 studies were included. Most of these simply assessed associations between a bowel sound feature and a condition. Four studies also included assessments of diagnostic accuracy. We found many significant associations between a bowel sound feature and a GI condition. Receiver operating characteristic curve analyses revealed high sensitivity and specificity for an irritable bowel syndrome test, and a high negative predictive value for a test for post-operative ileus. Assessment of methodological quality identified weaknesses in all studies. We particularly noted a high risk of bias in patient selection. Because of the limited number of trials included and the variety in conditions, technology, and statistics, we were unable to conduct pooled analyses. CONCLUSIONS: Due to concerns over quality and small sample sizes, we cannot yet recommend an existing BSCA diagnostic test without additional studies. However, the preliminary results found in the included studies and the technological advances described in excluded studies indicate excellent future potential. Research combining sophistical clinical and engineering skills is likely to be fruitful. SYSTEMATIC REVIEW REGISTRATION: The review protocol (review ID number 42016054028) was developed by three authors (AI, KMW, and JM) and was published in the PROSPERO International prospective register of systematic reviews. It can be accessed from https://www.crd.york.ac.uk/PROSPERO/ . PMID: 30115115 [PubMed - in process] View the full article
Pubmed-[Irritable bowel syndrome subtypes and characteristics in children from Panama, Ecuador,El Salvador, Nicaragua and Mexico].
[Irritable bowel syndrome subtypes and characteristics in children from Panama, Ecuador,El Salvador, Nicaragua and Mexico]. Rev Gastroenterol Peru. 2018 Apr-Jun;38(2):131-137 Authors: Velasco-Benítez CA, Chanís R, Játiva E, Zablah R, Mejía M, Rodriguez Reynosa L, Leyva Jimenez SA Abstract INTRODUCTION: Few pediatric studies classify the irritable bowel syndrome (IBS) subtypes. OBJECTIVE: To describe the characteristics and subtypes of IBS in children from Panama, Ecuador, El Salvador, Nicaragua and Mexico. MATERIAL AND METHODS: Prevalence study performed in children between 8 and 18 years of age with a diagnosis of IBS. The children answered the Questionnaire for Pediatric Gastrointestinal Symptoms Roma III for Schoolchildren and Adolescents (QPGS-III) to identify functional gastrointestinal disorders. Variables such as age and sex were taken into account. The subtypes of IBS were classified in IBS with constipation (IBS-c), with diarrhea (IBS-d), mixed (IBS-m) and without subtype (IBS-ss). Statistical analysis included measures of central tendency, two-tailed student t-test, chi-square test, and Fisher's exact test, with a significant p<0.05. RESULTS: We included 79 children (54.4% female, 12.1±2.1 years) presenting IBS-ss in 55.7%, IBS-c in 15.2%, IBS-m in 15.2% and SII-d in 13.9%. Severe pain predominated most of the day and with mucous stools; possible associations for IBS-d school and sex. CONCLUSION: After IBS-ss, the IBS-e, IBS-d and IBS-m are similar, being the possible risk factors for IBS-d, the public school and the female gender. PMID: 30118458 [PubMed - in process] View the full article
What Is the BRAT Diet? Prevention.com Full coverage View the full article
Pubmed-Unravelling the mechanisms behind the persistent gastrointestinal symptoms in celiac disease - how can they lead to better treatment outcomes?
Related Articles Unravelling the mechanisms behind the persistent gastrointestinal symptoms in celiac disease - how can they lead to better treatment outcomes? Expert Rev Gastroenterol Hepatol. 2017 07;11(7):605-607 Authors: Laurikka P, Kaukinen K, Kurppa K PMID: 28347161 [PubMed - indexed for MEDLINE] View the full article