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https://www.readbyqxmd.com/read/28185025/constipation-pathophysiology-and-current-therapeutic-approaches
#1
Amol Sharma, Satish Rao
Chronic constipation is a common, persistent condition affecting many patients worldwide, presenting significant economic burden and resulting in substantial healthcare utilization. In addition to infrequent bowel movements, the definition of constipation includes excessive straining, a sense of incomplete evacuation, failed or lengthy attempts to defecate, use of digital manoeuvres for evacuation of stool, abdominal bloating, and hard consistency of stools. After excluding secondary causes of constipation, chronic idiopathic or primary constipation can be classified as functional defecation disorder, slow-transit constipation (STC), and constipation-predominant irritable bowel syndrome (IBS-C)...
February 10, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28132549/improving-clinical-care-for-patients-with-irritable-bowel-syndrome
#2
Julie Thompson
Progress has been made in the past year in the guidance available for health professionals caring for patients with irritable bowel syndrome (IBS). In April 2016, the first National Institute for Health and Care Excellence (NICE) quality standard on IBS in adults was published and new dietary guidelines were developed. Nurses are at the forefront of caring for people with IBS across all healthcare sectors and may have more time to understand the patient's perspective and advise on lifestyle changes than a general practitioner in the average 10-minute consultation...
January 26, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28110677/predictors-of-medical-and-mental-health-care-use-in-patients-with-irritable-bowel-syndrome-in-the-united-states
#3
Gregory D Gudleski, Nikhil Satchidanand, Laura J Dunlap, Varnita Tahiliani, Xiaohua Li, Laurie Keefer, Jeffrey M Lackner
Because health care demand among IBS patients imposes a heavy economic burden, identifying high utilizers has potential for improving quality and efficiency of care. Previous research has not identified reliable predictors of utilization of IBS patients. We sought to identify factors predictive of health care utilization among severe IBS patients. 291 IBS patients completed testing whose content mapped onto the Andersen model of health care utilization. 2-stage hurdle models were used to determine predictors of health care use (probability and frequency)...
January 2017: Behaviour Research and Therapy
https://www.readbyqxmd.com/read/28110300/irritable-bowel-syndrome-and-diet
#4
REVIEW
Piero Portincasa, Leonilde Bonfrate, Ornella de Bari, Anthony Lembo, Sarah Ballou
Irritable bowel syndrome (IBS) is a chronic functional disorder of the gastrointestinal tract and is one of the most commonly diagnosed gastrointestinal diseases. The impact of IBS on the general population is large due to its high prevalence, suboptimal medical treatments and significant economic burden. The pathophysiology of IBS is complex and treatments are often symptom-specific. The most common therapeutic approaches for IBS include education and reassurance, lifestyles (especially nutrition-based interventions), peripherally acting medications (which typically target motility), centrally acting medications (which target visceral hypersensitivity and pain) and psychological interventions (which aim to reduce the effects of stress or symptom-specific anxiety)...
January 20, 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28070176/advances-in-ibs-2016-a-review-of-current-and-emerging-data
#5
Philip S Schoenfeld
Irritable bowel syndrome (IBS) is characterized by chronic intermittent abdominal pain and associated diarrhea (IBS-D), constipation (IBS-C), or both. IBS can significantly impact patient function and quality of life. The diagnosis of IBS is based on the presence of characteristic symptoms, the exclusion of concerning features, and selected tests to exclude organic diseases that can mimic IBS. The pathophysiology of IBS remains incompletely understood, and new contributing factors have been identified over the past decade...
August 2016: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28049864/irritable-bowel-syndrome-and-nickel-allergy-what-is-the-role-of-the-low-nickel-diet
#6
Angela Rizzi, Eleonora Nucera, Lucrezia Laterza, Eleonora Gaetani, Venanzio Valenza, Giuseppe M Corbo, Riccardo Inchingolo, Alessandro Buonomo, Domenico Schiavino, Antonio Gasbarrini
Background/Aims: Irritable bowel syndrome (IBS) is characterized by chronic abdominal pain or discomfort accompanied by abnormal bowel movements. In sensitized subjects, ingested nickel (Ni) may induce gastrointestinal symptoms similar to IBS, in addition to typical systemic cutaneous lesions (systemic nickel allergy syndrome [SNAS]). A low nickel diet could improve the systemic manifestations. We evaluated prevalence of nickel allergy in IBS and effects of low Ni diet on (1) gastrointestinal symptoms control, (2) intestinal barrier function, (3) quality of life, and (4) psychological status of patients with IBS and Ni-sensitized patients...
January 30, 2017: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/27980496/reversal-of-irritable-bowel-syndrome-sleep-disturbance-and-fatigue-with-an-elimination-diet-lifestyle-modification-and-dietary-supplements-a-case-report
#7
Stephanie Davis
BACKGROUND: A 53-y-old Caucasian patient presented in August 2015 with chief complaints of irritable bowel syndrome (IBS; gas/bloating, gastroesophageal reflux), fatigue, and sleep disturbances. He also noted a history of chronic sinusitis, seasonal allergies, multiple chemical sensitivities, and right knee pain (3 surgeries). His primary care physician, in 2014, diagnosed prediabetes based on an elevated hemoglobin A1c and high-sensitivity C-reactive protein, which was treated with diet and lifestyle modification...
October 2016: Integrative Medicine
https://www.readbyqxmd.com/read/27884012/gut-microbiota-bacterial-translocation-and-interactions-with-diet-pathophysiological-links-between-major-depressive-disorder-and-non-communicable-medical-comorbidities
#8
Anastasiya Slyepchenko, Michael Maes, Felice N Jacka, Cristiano A Köhler, Tatiana Barichello, Roger S McIntyre, Michael Berk, Iria Grande, Jane A Foster, Eduard Vieta, André F Carvalho
BACKGROUND: Persistent low-grade immune-inflammatory processes, oxidative and nitrosative stress (O&NS), and hypothalamic-pituitary-adrenal axis activation are integral to the pathophysiology of major depressive disorder (MDD). The microbiome, intestinal compositional changes, and resultant bacterial translocation add a new element to the bidirectional interactions of the gut-brain axis; new evidence implicates these pathways in the patho-aetiology of MDD. In addition, abnormalities in the gut-brain axis are associated with several chronic non-communicable disorders, which frequently co-occur in individuals with MDD, including but not limited to irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS), obesity, and type 2 diabetes mellitus (T2DM)...
2017: Psychotherapy and Psychosomatics
https://www.readbyqxmd.com/read/27881403/irritable-bowel-syndrome-a-gut-microbiota-related-disorder
#9
REVIEW
Yogesh Bhattarai, David A Muniz Pedrogo, Purna C Kashyap
Irritable bowel syndrome (IBS) is one of the most common gastrointestinal (GI) disorders. Despite its prevalence, the pathophysiology of IBS is not well understood although multiple peripheral and central factors are implicated. Recent studies suggest a role for alterations in gut microbiota in IBS. Significant advances in next-generation sequencing technology and bioinformatics and the declining cost have now allowed us to better investigate the role of gut microbiota in IBS. In the following review, we propose gut microbiota as a unifying factor in the pathophysiology of IBS...
January 1, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/27869798/gluten-induced-symptoms-in-diarrhea-predominant-irritable-bowel-syndrome-are-associated-with-increased-myosin-light-chain-kinase-activity-and-claudin-15-expression
#10
Richard L Wu, Maria I Vazquez-Roque, Paula Carlson, Duane Burton, Madhusudan Grover, Michael Camilleri, Jerrold R Turner
The mechanisms underlying diarrhea-predominant irritable bowel syndrome (IBS-D) are poorly understood, but increased intestinal permeability is thought to contribute to symptoms. A recent clinical trial of gluten-free diet (GFD) demonstrated symptomatic improvement, relative to gluten-containing diet (GCD), which was associated with reduced intestinal permeability in non-celiac disease IBS-D patients. The aim of this study was to characterize intestinal epithelial tight junction composition in IBS-D before and after dietary gluten challenge...
January 2017: Laboratory Investigation; a Journal of Technical Methods and Pathology
https://www.readbyqxmd.com/read/27867690/good-adherence-to-mediterranean-diet-can-prevent-gastrointestinal-symptoms-a-survey-from-southern-italy
#11
Francesco Paolo Zito, Barbara Polese, Letizia Vozzella, Antonietta Gala, Daniela Genovese, Viviana Verlezza, Fabiana Medugno, Antonello Santini, Luigi Barrea, Martina Cargiolli, Paolo Andreozzi, Giovanni Sarnelli, Rosario Cuomo
AIM: To evaluate how different levels of adherence to a mediterranean diet (MD) correlate with the onset of functional gastrointestinal disorders. METHODS: As many as 1134 subjects (598 M and 536 F; age range 17-83 years) were prospectively investigated in relation to their dietary habits and the presence of functional gastrointestinal symptoms. Patients with relevant chronic organic disease were excluded from the study. The Mediterranean Diet Quality index for children and adolescents (KIDMED) and the Short Mediterranean Diet Questionnaire were administered...
November 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27799885/symptomatic-improvement-with-gluten-restriction-in-irritable-bowel-syndrome-a-prospective-randomized-double-blinded-placebo-controlled-trial
#12
Vinay G Zanwar, Sunil V Pawar, Pravir A Gambhire, Samit S Jain, Ravindra G Surude, Vinaya B Shah, Qais Q Contractor, Pravin M Rathi
BACKGROUND/AIMS: The existence of non-celiac gluten sensitivity has been debated. Indeed, the intestinal and extra-intestinal symptoms of many patients with irritable bowel syndrome (IBS) but without celiac disease or wheat allergy have been shown to improve on a gluten-free diet. Therefore, this study set out to evaluate the effects of gluten on IBS symptoms. METHODS: We performed a double-blind randomized placebo-controlled rechallenge trial in a tertiary care hospital with IBS patients who fulfilled the Rome III criteria...
October 2016: Intestinal Research
https://www.readbyqxmd.com/read/27797273/wheat-challenge-in-self-reported-gluten-sensitivity-a-comparison-of-scoring-methods
#13
Gry I Skodje, Christine Henriksen, Trude Salte, Thea Drivenes, Ieva Toleikyte, Astrid M Lovik, Marit B Veierød, Knut E A Lundin
BACKGROUND: The condition non-coeliac gluten sensitivity (NCGS) is clinically similar to coeliac disease, but lack objective diagnostic criteria. Symptom relief on gluten-free diet followed by gluten containing food challenge may confirm the condition in clinical settings. AIM: To describe the results of an open bread challenge in patients with suspected NCGS, and to compare the results with recently suggested cut-offs for symptom change. MATERIAL AND METHODS: Fifty-six patients (12 males) self-instituted on gluten-free diet with negative coeliac disease diagnostics were examined for NCGS by an open bread challenge...
February 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27750262/the-obestatin-ghrelin-ratio-and-ghrelin-genetics-in-adult-celiac-patients-before-and-after-a-gluten-free-diet-in-irritable-bowel-syndrome-patients-and-healthy-individuals
#14
Francesco Russo, Guglielmina Chimienti, Michele Linsalata, Caterina Clemente, Antonella Orlando, Giuseppe Riezzo
BACKGROUND: Ghrelin levels and obestatin/ghrelin ratio have been proposed as activity markers in ulcerative colitis, but no data are available in celiac disease (CD) and irritable bowel syndrome (IBS). Our aims were as follows: (a) to assess obestatin and ghrelin concentrations in adult active CD patients, diarrhea-predominant IBS (IBS-d), and healthy controls (HC) in relation to intestinal permeability; (b) to evaluate the ghrelin-obestatin profile in CD patients after a 1-year gluten-free diet (GFD); and (c) to establish the impact of ghrelin genetics...
February 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27747984/effects-of-varying-dietary-content-of-fermentable-short-chain-carbohydrates-on-symptoms-fecal-microenvironment-and-cytokine-profiles-in-patients-with-irritable-bowel-syndrome
#15
T N Hustoft, T Hausken, S O Ystad, J Valeur, K Brokstad, J G Hatlebakk, G A Lied
BACKGROUND: A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) is increasingly recommended for patients with irritable bowel syndrome (IBS). We aimed to investigate the effects of a blinded low-FODMAP vs high-fructo-oligosaccharides (FOS) diet on symptoms, immune activation, gut microbiota composition, and short-chain fatty acids (SCFAs). METHODS: Twenty patients with diarrhea-predominant or mixed IBS were instructed to follow a low-FODMAP diet (LFD) throughout a 9-week study period...
October 16, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27725652/a-randomized-controlled-trial-comparing-the-low-fodmap-diet-vs-modified-nice-guidelines-in-us-adults-with-ibs-d
#16
Shanti L Eswaran, William D Chey, Theresa Han-Markey, Sarah Ball, Kenya Jackson
OBJECTIVES: There has been an increasing interest in the role of fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) in irritable bowel syndrome (IBS). We report results from the first randomized controlled trial of the low FODMAP diet in US adults with IBS and diarrhea (IBS-D). The objectives were to compare the efficacy of the low FODMAP diet vs. a diet based upon modified National Institute for Health and Care Excellence guidelines (mNICE) on overall and individual symptoms in IBS-D patients...
December 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27725146/identification-of-an-intestinal-microbiota-signature-associated-with-severity-of-irritable-bowel-syndrome
#17
Julien Tap, Muriel Derrien, Hans Törnblom, Rémi Brazeilles, Stéphanie Cools-Portier, Joël Doré, Stine Störsrud, Boris Le Nevé, Lena Öhman, Magnus Simrén
BACKGROUND & AIMS: We have limited knowledge about the association between the composition of the intestinal microbiota and clinical features of irritable bowel syndrome (IBS). We collected information on the fecal and mucosa-associated microbiota of patients with IBS and evaluated whether these were associated with symptoms. METHODS: We collected fecal and mucosal samples from adult patients who met the Rome III criteria for IBS at a secondary/tertiary care outpatient clinics in Sweden, as well as from healthy subjects...
January 2017: Gastroenterology
https://www.readbyqxmd.com/read/27695975/long-term-response-to-gluten-free-diet-as-evidence-for-non-celiac-wheat-sensitivity-in-one-third-of-patients-with-diarrhea-dominant-and-mixed-type-irritable-bowel-syndrome
#18
Christian Barmeyer, Michael Schumann, Tim Meyer, Christina Zielinski, Torsten Zuberbier, Britta Siegmund, Jörg-Dieter Schulzke, Severin Daum, Reiner Ullrich
PURPOSE: Irritable bowel syndrome (IBS) is common but therapies are unsatisfactory. Food is often suspected as cause by patients, but diagnostic procedures, apart from allergy testing, are limited. Based on the hypothesis of non-celiac wheat sensitivity (WS) in a subgroup of IBS patients, we tested the long-term response to a gluten-free diet (GFD) and investigated HLA-DQ2 or -DQ8 expression as a diagnostic marker for WS in diarrhea-dominant (IBS-D) and mixed-type IBS (IBS-M). METHODS: The response to a GFD served as reference test for WS and HLA-DQ2/8 expression was determined as index test...
January 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27664186/restriction-of-fodmap-in-the-management-of-bloating-in-irritable-bowel-syndrome
#19
Wei Mon Wong
Irritable bowel syndrome (IBS) is a common functional bowel disorder. Up to 96% of IBS patients experience bloating, resulting in poor response to conventional therapies and high consultation rates. Many IBS patients report that food triggers symptoms, particularly diets with poorly absorbed, short-chain carbohydrates, and restrict intake of certain foods to control their symptoms. IBS patients are especially susceptible to an attack due to visceral hypersensitivity. An emerging therapeutic strategy excludes fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) from the diet...
September 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27642742/-chronic-non-infectious-diarrhea-diagnostics-and-therapy
#20
Korinna Ulbricht, Peter Layer, Viola Andresen
Chronic, non-infectious diarrhea can be caused by a variety of gastrointestinal diseases. In anamnesis, it is important to take accompanying warning symptoms and specific triggers into account. The fecal inflammatory marker calprotectin may help differentiating between organic and functional gastrointestinal disorders, but it is not specific. Among other options, gelling fibres, Loperamide and Cholestyramine as well as probiotics are available for the symptomatic treatment of chronic diarrhea. For long-term treatment of chronic diarrhea with the enkephalinase inhibitor racecadotril, which is approved for acute diarrhea, only limited data are available...
September 2016: Deutsche Medizinische Wochenschrift
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