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Irritable Bowel Syndrome: HELP
Articles by Lukas Van Oudenhove
Based on 36 articles published since 2010
(Why 36 articles?)
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Between 2010 and 2020, L. Van Oudenhove wrote the following 36 articles about Irritable Bowel Syndrome.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Editorial Editorial: subgroups in irritable bowel syndrome-more than just diarrhoea and constipation? Authors' reply. 2017

Polster, A / Van Oudenhove, L / Jones, M / Öhman, L / Törnblom, H / Simrén, M. ·Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, Gothenburg, Sweden. · Translational Research Center for Gastrointestinal Disorders (TARGID), Leuven, Belgium. · Psychology Department, Macquarie University, North Ryde, NSW, Australia. · Department of Microbiology and Immunology, Sahlgrenska Academy, Gothenburg, Sweden. · Center for Functional Gastrointestinal and Motility Disorders, Chapel Hill, NC, USA. ·Aliment Pharmacol Ther · Pubmed #28880440.

ABSTRACT: -- No abstract --

2 Review Role of brain imaging in disorders of brain-gut interaction: a Rome Working Team Report. 2019

Mayer, Emeran A / Labus, Jennifer / Aziz, Qasim / Tracey, Irene / Kilpatrick, Lisa / Elsenbruch, Sigrid / Schweinhardt, Petra / Van Oudenhove, Lukas / Borsook, David. ·G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases David Geffen School of Medicine at UCLA, Los Angeles, California, USA. · Neurogastroenterology Group, Queen Mary University of London, London, UK. · Departments of Anaesthetics and Clinical Neurology, Pembroke College, Oxford, UK. · Institute of Medical Psychology & Behavioral Immunobiology, University Hospital Essen, University of Duisburg, Duisburg, Germany. · Division of Biomedical Sciences, McGill University, Canada. · Translational Research in GastroIntestinal Disorders, KU Leuven Department of Clinical and Experimental Medicine, University of Leuven, Leuven, Belgium. · Center for Pain and the Brain, Boston Children's, Massachusetts General and McLean Hospitals, Harvard Medical School, Boston, Massachusetts, USA. ·Gut · Pubmed #31175206.

ABSTRACT: Imaging of the living human brain is a powerful tool to probe the interactions between brain, gut and microbiome in health and in disorders of brain-gut interactions, in particular IBS. While altered signals from the viscera contribute to clinical symptoms, the brain integrates these interoceptive signals with emotional, cognitive and memory related inputs in a non-linear fashion to produce symptoms. Tremendous progress has occurred in the development of new imaging techniques that look at structural, functional and metabolic properties of brain regions and networks. Standardisation in image acquisition and advances in computational approaches has made it possible to study large data sets of imaging studies, identify network properties and integrate them with non-imaging data. These approaches are beginning to generate brain signatures in IBS that share some features with those obtained in other often overlapping chronic pain disorders such as urological pelvic pain syndromes and vulvodynia, suggesting shared mechanisms. Despite this progress, the identification of preclinical vulnerability factors and outcome predictors has been slow. To overcome current obstacles, the creation of consortia and the generation of standardised multisite repositories for brain imaging and metadata from multisite studies are required.

3 Review The gut-brain axis in health neuroscience: implications for functional gastrointestinal disorders and appetite regulation. 2018

Weltens, Nathalie / Iven, Julie / Van Oudenhove, Lukas / Kano, Michiko. ·Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases, Metabolism, and Ageing (CHROMETA), University of Leuven, Leuven, Belgium. · Leuven Brain Institute, University of Leuven, Leuven, Belgium. · Consultation-Liaison Psychiatry, University Psychiatric Centre KU Leuven, Campus Gasthuisberg, University of Leuven, Leuven, Belgium. · Frontiers Research Institute for Interdisciplinary Sciences (FRIS), Tohoku University, Sendai, Japan. · Department of Behavioral Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan. ·Ann N Y Acad Sci · Pubmed #30255954.

ABSTRACT: Over the past few years, scientific interest in the gut-brain axis (i.e., the bidirectional communication system between the gastrointestinal tract and the brain) has exploded, mostly due to the identification of the gut microbiota as a novel key player in this communication. However, important progress has also been made in other aspects of gut-brain axis research, which has been relatively underemphasized in the review literature. Therefore, in this review, we provide a comprehensive, although not exhaustive, overview of recent research on the functional neuroanatomy of the gut-brain axis and its relevance toward the multidisciplinary field of health neuroscience, excluding studies on the role of the gut microbiota. More specifically, we first focus on irritable bowel syndrome, after which we outline recent findings on the role of the gut-brain axis in appetite and feeding regulation, primarily focusing on the impact of subliminal nutrient-related gut-brain signals. We conclude by providing future perspectives to facilitate translation of the findings from gut-brain axis neuroscientific research to clinical applications in these domains.

4 Review Phenotyping of subjects for large scale studies on patients with IBS. 2016

Boeckxstaens, G E / Drug, V / Dumitrascu, D / Farmer, A D / Hammer, J / Hausken, T / Niesler, B / Pohl, D / Pojskic, L / Polster, A / Simren, M / Goebel-Stengel, M / Van Oudenhove, L / Vassallo, M / Wensaas, K-A / Aziz, Q / Houghton, L A / Anonymous15950871. ·Translational Research Center for Gastrointestinal Disorders, KULeuven & Department of Gastroenterology and Hepatology, University Hospital Leuven, Leuven, Belgium. · Gastroenterology Department, University Hospital "St Spiridon", Gr. T.Popa University of Medicine and Pharmacy, Iasi, Romania. · 2nd Medical Dept., Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. · Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, London, UK. · Department of Gastroenterology, University Hospitals of North Midlands, Stoke on Trent, UK. · Medizinische Universität Wien, Universitätsklinik für Innere Medizin 3, Vienna, Austria. · Department of Medicine, Unit of Gastroenterology, Haukeland University Hospital, Bergen, Norway. · Department of Human Molecular Genetics, University of Heidelberg, Heidelberg, Germany. · Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland. · Institute for Genetic Engineering and Biotechnology, University of Sarajevo, Sarajevo, Bosnia and Herzegovina. · Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. · Department of Internal Medicine, Martin-Luther-Krankenhaus, Berlin, Germany. · Department of Medicine, Mater Dei Hospital, Tal-Qroqq, Malta. · Uni Research Health, Research Unit for General Practice, Bergen, Norway. · Leeds Institute of Biomedical and Clinical Sciences, University of Leeds and Leeds Gastroenterology Institute, Leeds Teaching Hospitals Trust, Leeds, UK. · Centre for Gastrointestinal Sciences, University of Manchester, Manchester, UK. · Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA. ·Neurogastroenterol Motil · Pubmed #27319981.

ABSTRACT: BACKGROUND: Irritable bowel syndrome (IBS) is a complex condition with multiple factors contributing to its aetiology and pathophysiology. Aetiologically these include genetics, life-time events and environment, and physiologically, changes in motility, central processing, visceral sensitivity, immunity, epithelial permeability and gastrointestinal microflora. Such complexity means there is currently no specific reliable biomarker for IBS, and thus IBS continues to be diagnosed and classified according to symptom based criteria, the Rome Criteria. Carefully phenotyping and characterisation of a 'large' pool of IBS patients across Europe and even the world however, might help identify sub-populations with accuracy and consistency. This will not only aid future research but improve tailoring of treatment and health care of IBS patients. PURPOSE: The aim of this position paper is to discuss the requirements necessary to standardize the process of selecting and phenotyping IBS patients and how to organise the collection and storage of patient information/samples in such a large multi-centre pan European/global study. We include information on general demographics, gastrointestinal symptom assessment, psychological factors, quality of life, physiological evaluation, genetic/epigenetic and microbiota analysis, biopsy/blood sampling, together with discussion on the organisational, ethical and language issues associated with implementing such a study. The proposed approach and documents selected to be used in such a study was the result of a thoughtful and thorough four-year dialogue amongst experts associated with the European COST action BM1106 GENIEUR (www.GENIEUR.eu).

5 Review The quest for biomarkers in IBS-where should it lead us? 2014

Corsetti, M / Van Oudenhove, L / Tack, J. ·Translational Research Center for Gastrointestinal disorders (TARGID), Department of Clinical and Experimental Medicine, University of Leuven, Leuven, Belgium. ·Neurogastroenterol Motil · Pubmed #25424580.

ABSTRACT: Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder which represents a major cost to health-care services. The diagnosis of IBS is currently performed by means of symptom-based diagnostic criteria, but there has been an ongoing interest in developing biomarkers which could simplify the diagnosis and/or evaluating the effect of treatments. This article reviews the current literature concerning the proposed biomarkers including those of altered gut motility, of visceral hypersensitivity, of abnormal brain mechanisms, of serum, fecal and mucosal inflammation and of increased intestinal permeability.

6 Clinical Trial Psychological comorbidity increases the risk for postinfectious IBS partly by enhanced susceptibility to develop infectious gastroenteritis. 2016

Wouters, Mira M / Van Wanrooy, Sander / Nguyen, Anh / Dooley, James / Aguilera-Lizarraga, Javier / Van Brabant, Winde / Garcia-Perez, Josselyn E / Van Oudenhove, Lukas / Van Ranst, Marc / Verhaegen, Jan / Liston, Adrian / Boeckxstaens, Guy. ·Department of Clinical and Experimental Medicine, Translational Research Center for Gastrointestinal Disorders, University Hospital Leuven, KU Leuven, Leuven, Belgium. · Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium Autoimmune Genetics Laboratory, VIB, Leuven, Belgium. · Laboratory of Clinical Virology, Rega Institute for Medical Research, University Hospital Leuven, Leuven, Belgium. · Department of Microbiology, University Hospital Leuven, KU Leuven, Leuven, Belgium. ·Gut · Pubmed #26071133.

ABSTRACT: OBJECTIVE: Psychological factors increase the risk to develop postinfectious IBS (PI-IBS), but the mechanisms involved are unclear. As stress affects the immune system, we investigated the potential interaction between psychological factors, the immune response against infectious gastroenteritis (IGE) and the development of IGE and PI-IBS in a large cohort exposed to contaminated drinking water. DESIGN: 18 620 people exposed to contaminated drinking water (norovirus, Giardia lamblia, Campylobacter jejuni) were invited to participate in a prospective controlled cohort study. They were asked to complete questionnaires assessing demographic, psychological and clinical data during the outbreak and 1 year later. At both time points, in-depth immune function (peripheral blood and rectal biopsies) was studied in a subgroup of subjects. RESULTS: 1379 subjects completed the questionnaires during the outbreak, of which 271 developed IGE. Risk factors for IGE included younger age, pre-existing dyspepsia-like symptoms, anxiety and drinking contaminated tap water. Anxiety scores before the outbreak inversely correlated with interleukin-2-expressing CD4+ T cells (r=0.6, p=0.01, n=23). At follow-up, 34 of 172 (20%) IGE subjects developed IBS compared with 24/366 exposed participants (7%, p<0.0001, χ(2) test). A Th2 cytokine phenotype at time of infection was associated with increased risk for PI-IBS 1 year later. Except for increased B cell numbers, no evidence for systemic or rectal mucosal immune activation in PI-IBS was demonstrated at follow-up. CONCLUSIONS: Our study shows that the increased risk of patients with psychological comorbidity to develop PI-IBS may partly result from an increased susceptibility to develop IGE, possibly resulting from a Th2-immune bias. TRIAL REGISTRATION NUMBER: (ClinicalTrials.gov NCT01497847).

7 Clinical Trial Interaction between preprandial and postprandial rectal sensory and motor abnormalities in IBS. 2014

Törnblom, Hans / Van Oudenhove, Lukas / Tack, Jan / Simrén, Magnus. ·Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden University of Gothenburg Centre for Person-Centered Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium. ·Gut · Pubmed #24142965.

ABSTRACT: BACKGROUND AND AIMS: Rectal sensory and motor interactions in patients with IBS have not been studied in detail. The aim of this study was to evaluate fasting and postprandial rectal sensorimotor characteristics and their interactions in IBS compared with healthy controls. DESIGN: We included 274 patients with IBS and 34 controls. All subjects underwent a rectal barostat study before and 60 min after a standardised liquid meal (800 kcal; 60% fat). Sensory thresholds, intensity of sensations, viscerosomatic referral and compliance were measured. During 15 min before the first distension sequence and until 50 min after meal intake, rectal balloon volumes were registered in 5 min intervals at operating pressure to quantify rectal tone. Mixed models were used to analyse the rectal tone response over time. RESULTS: Rectal sensory thresholds and compliance were decreased and viscerosomatic referral areas increased in patients with IBS compared with controls. Meal intake increased rectal sensitivity, compliance and referral areas in patients and controls and the same proportions of patients were hypersensitive to distension before and after meal intake. There was a higher basal rectal tone in IBS and a significantly different rectal tone response after meal intake in patients with IBS compared with controls and, interestingly, also in IBS with rectal hypersensitivity (defined in the preprandial state), compared with normosensitive patients. CONCLUSIONS: Meal intake affects rectal sensorimotor function in IBS and health. Importantly, the rectal tone responses to a high-caloric meal are different between patients with IBS and controls, as well as between hypersensitive and normosensitive patients with IBS.

8 Clinical Trial In functional dyspepsia, hypersensitivity to postprandial distention correlates with meal-related symptom severity. 2013

Farré, Ricard / Vanheel, Hanne / Vanuytsel, Tim / Masaoka, Tatsuhiro / Törnblom, Hans / Simrén, Magnus / Van Oudenhove, Lukas / Tack, Jan F. ·Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium. ·Gastroenterology · Pubmed #23702005.

ABSTRACT: BACKGROUND & AIMS: Hypersensitivity to gastric distention, an important feature of functional dyspepsia, is assessed by stepwise balloon distention of the proximal stomach in fasting patients. However, symptoms of functional dyspepsia are often worse after a meal, so studies of postprandial balloon distentions might be more relevant. We compared the effects of fasting and postprandial stomach distention in patients with functional dyspepsia. METHODS: Twenty healthy controls and 62 patients with functional dyspepsia participated in a gastric barostat study at Leuven University Hospital with graded isobaric distentions before and after a liquid meal. On a separate day, all patients underwent a gastric emptying breath test with assessment of postprandial severity of 6 different dyspeptic symptoms scored at 15-minute intervals for 4 hours. For each symptom, a meal-related severity score was obtained by adding all scores; the cumulative symptom score (CSS) was obtained by adding individual symptom severity scores. RESULTS: In patients, but not in controls, postprandial sensitivity to balloon distention was significantly greater than fasting sensitivity. The CSS and individual symptom scores did not differ between patients with normal or hypersensitivity to fasting distention, but patients who were hypersensitive to postprandial distention had a significantly higher CSS, along with scores for postprandial fullness, bloating, and nausea (all P < .05). On multivariate analysis, hypersensitivity to postprandial distention was associated with hypersensitivity to fasting distention and with impaired accommodation to a meal. CONCLUSIONS: Postprandial, but not fasting, distention thresholds are related to the severity of meal-related symptoms in patients with functional dyspepsia.

9 Article Adherence to diet low in fermentable carbohydrates and traditional diet for irritable bowel syndrome. 2020

Clevers, Egbert / Tran, Milly / Van Oudenhove, Lukas / Störsrud, Stine / Böhn, Lena / Törnblom, Hans / Simrén, Magnus. ·Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Belgium. · Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Belgium. · Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. Electronic address: magnus.simren@medicine.gu.se. ·Nutrition · Pubmed #32086111.

ABSTRACT: OBJECTIVES: Dietary interventions in irritable bowel syndrome (IBS) include a traditional IBS diet following the guidelines from the National Institute for Health and Clinical Excellence and a diet low in fermentable oligo-, di-, monosaccharides and polyols (FODMAPs). The aim of this study was to evaluate the adherence to these diets, food groups difficult to replace, and dietary determinants of symptom improvement. METHODS: Sixty-six patients with IBS were randomized to a 4-wk low FODMAP or traditional IBS diet. Participants completed 4-d diet diaries before and during the intervention and reported symptoms on the IBS severity scoring system. We described adherence to the diets on the food group and product level and investigated the association between adherence and symptom improvement. RESULTS: Adherence to the low FODMAP diet was good and consistent: All participants had a comparable shift in the diet's principal components compatible with the guidelines. Most high FODMAP products were well replaced with low FODMAP equivalents. However, total energy intake fell by 25%, mainly owing to a 69% decreased intake of snacks (P < 0.001). The traditional IBS diet did not shift the diet's principal components, and despite the guidelines, consumption of coffee and alcoholic beverages remained rather high (>50% of baseline). Total energy intake fell by 11% (P = 0.15). For both diets, there was a trend toward an association between adherence and symptom improvement (P < 0.10). CONCLUSION: In both the low FODMAP and traditional IBS diet, certain food groups were difficult to replace. Because adherence may predict symptom improvement, close dietary guidance might enhance the efficacy of both diets.

10 Article Relations between food intake, psychological distress, and gastrointestinal symptoms: A diary study. 2019

Clevers, Egbert / Törnblom, Hans / Simrén, Magnus / Tack, Jan / Van Oudenhove, Lukas. ·Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Translational Research Centre for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium. ·United European Gastroenterol J · Pubmed #31428421.

ABSTRACT: Background: Gastrointestinal symptoms can be triggered by food intake and psychological distress, but individual-level research on food-symptom and stress-symptom associations is scarce. Objective: We aimed to identify associations between food intake, psychological distress and gastrointestinal symptoms, and their implications for personalised clinical management. Methods: Through the mobile phone application Results: Various gastrointestinal symptoms had demonstrable food-symptom associations (heartburn: 73%, discomfort: 67%, diarrhoea: 57%, bloating: 53%, and gas: 48%). Food-symptom associations for pain in the abdomen (33%) were concentrated in the latent class of individuals with pain in the morning (68%), rather than those with pain in the evening and night (27% and 10%, respectively, Conclusion: Personal food-symptom and stress-symptom relations can be detected, and may translate into specific daily symptom patterns. A next step will be to let personal food-symptom and stress-symptom relations serve as the basis for personalised clinical management.

11 Article Cumulative Effects of Psychologic Distress, Visceral Hypersensitivity, and Abnormal Transit on Patient-reported Outcomes in Irritable Bowel Syndrome. 2019

Simrén, Magnus / Törnblom, Hans / Palsson, Olafur S / Van Oudenhove, Lukas / Whitehead, William E / Tack, Jan. ·University of Gothenburg, Gothenburg, Sweden; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: magnus.simren@medicine.gu.se. · University of Gothenburg, Gothenburg, Sweden. · University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. · Katholieke Universiteit Leuven, Leuven, Belgium. ·Gastroenterology · Pubmed #31022401.

ABSTRACT: BACKGROUND & AIMS: Little is known about the link between pathophysiologic factors and symptoms of irritable bowel syndrome (IBS), or whether these factors have cumulative effects on patient-reported outcomes (PROs). We investigated whether pathophysiologic alterations associated with IBS have cumulative or independent effects on PROs. METHODS: We performed a retrospective analysis of data from 3 cohorts of patients with IBS (n = 407; 74% female; mean age, 36 ± 12 years), based on Rome II or Rome III criteria, seen at a specialized unit for functional gastrointestinal disorders in Sweden from 2002 through 2014. All patients underwent assessments of colonic transit time (radiopaque markers); compliance, allodynia, and hyperalgesia (rectal barostat); anxiety and depression (Hospital Anxiety and Depression scale), as pathophysiologic factors. Dysfunction was defined by available normal values. PROs included IBS symptom severity, somatic symptom severity, and disease-specific quality of life. RESULTS: Allodynia was observed in 36% of patients, hyperalgesia in 22%, accelerated colonic transit in 18%, delayed transit in 7%, anxiety in 52%, and depression in 24%: each of these factors was associated with severity of at least 1 symptom of IBS. Rectal compliance was not associated with more severe symptoms of IBS. At least 3 pathophysiologic factors were present in 20% of patients, 2 in 30%, 1 in 31%, and none in 18%. With increasing number of pathophysiologic abnormalities, there was a gradual increase in IBS symptom severity (P < .0001) and somatic symptom severity (P < .0001), and a gradual reduction in quality of life (P < .0001). CONCLUSION: Visceral hypersensitivity, including allodynia and hyperalgesia, abnormal colonic transit, and psychologic factors are all associated with IBS symptoms. These factors have a cumulative effect on gastrointestinal and nongastrointestinal symptoms, as well as on quality of life, in patients with IBS and are therefore relevant treatment targets.

12 Article Expression of immune-related genes in rectum and colon descendens of Irritable Bowel Syndrome patients is unrelated to clinical symptoms. 2019

Aguilera-Lizarraga, Javier / Florens, Morgane V / Van Brussel, Thomas / Clevers, Egbert / Van Oudenhove, Lukas / Lambrechts, Diether / Wouters, Mira M / Boeckxstaens, Guy E. ·Laboratory of Intestinal Neuroimmune Interactions, Department of Chronic Diseases, Metabolism and Ageing, Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium. · Laboratory of Translational Genetics, Department of Oncology, KU Leuven, Leuven, Belgium. · Laboratory of Translational Genetics, Vesalius Research Center, VIB, Leuven, Belgium. · Laboratory of Brain-Gut Axis Studies, Department of Chronic Diseases, Metabolism and Ageing, Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium. · Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. ·Neurogastroenterol Motil · Pubmed #30854791.

ABSTRACT: BACKGROUND: Mucosal immune activation has been postulated to play an important role in the pathogenesis of irritable bowel syndrome (IBS). However, data are conflicting and often based on small patient cohorts. Here, we aimed to evaluate the gene expression of a large set of immune-related genes in mucosal biopsies from IBS patients and healthy volunteers (HV). METHODS: A total of 171 IBS patients and 127 HV were included in the study. Rectum biopsies were collected from a cohort of 70 HV and 77 IBS patients (Rome III) and colon descendens biopsies from another cohort of 57 HV and 94 IBS patients (Rome II). Gene expression was assessed using OpenArray technology, and validated questionnaires were used to evaluate clinical characteristics (GI symptoms, somatization, anxiety, and depression). KEY RESULTS: A subset of IBS patients (33%) with increased immune activation in the colon descendens was identified using multivariate analysis and displayed increased gene expression of IL1B (3-fold change), prostaglandin synthase PTGS2 (2.1-fold change), and the G-protein-coupled receptor MRGPRX2 (10.7-fold change). Clinical characteristics in this subgroup were however similar to the rest of the patient cohort. Analysis of rectal biopsies failed to identify such subgroup of "immuno-active" IBS patients in the other patient cohort. CONCLUSION: A subset of IBS patients reveals evidence of immune activation in the colon descendens, but not in the rectum; however, gene expression is unrelated to clinical symptoms. To what extent this subgroup might however respond to anti-inflammatory therapy remains to be investigated.

13 Article Prospective study evaluating immune-mediated mechanisms and predisposing factors underlying persistent postinfectious abdominal complaints. 2019

Florens, Morgane V / Van Wanrooy, Sander / Dooley, James / Aguilera-Lizarraga, Javier / Vanbrabant, Winde / Wouters, Mira M / Van Oudenhove, Lukas / Peetermans, Willy E / Liston, Adrian / Boeckxstaens, Guy E. ·Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium. · Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium. · Autoimmune Genetics Laboratory, VIB, Leuven, Belgium. · Laboratory for Clinical Infectious and Inflammatory Disorders, KU Leuven, Leuven, Belgium. ·Neurogastroenterol Motil · Pubmed #30657233.

ABSTRACT: BACKGROUND: The role of persistent immune activation in postinfectious irritable bowel syndrome (PI-IBS) remains controversial. Here, we prospectively studied healthy subjects traveling to destinations with a high-risk to develop infectious gastroenteritis (IGE) in order to identify immune-mediated mechanisms and risk factors of PI-IBS. METHODS: One hundred and one travelers were asked to complete questionnaires on psychological profile and gastrointestinal (GI) symptoms before travel, 2 weeks, 6 months and 1 year after travel. At each visit, blood was collected for PBMC isolation and rectal biopsies were taken. PI-IBS was diagnosed using the Rome III criteria and subjects with persistent postinfectious abdominal complaints (PI-AC) were identified using 3 GSRS symptoms (ie, loose stools, urgency and abdominal pain). RESULTS: Forty-seven of the 101 subjects reported IGE during travel. After 1 year, two subjects were diagnosed with PI-IBS and eight subjects were presented with PI-AC versus two subjects with IBS and two with abdominal complaints in the non-infected group. PBMC analysis showed no differences in T and B cell populations in subjects with PI-AC vs healthy. Additionally, no differences in gene expression were observed in the early postinfectious phase or after 1 year. Regression analysis identified looser stools, higher anxiety and somatization before infection and several postinfectious GI symptoms as risk factors for PI-AC. CONCLUSIONS: The incidence of PI-IBS is low following travelers' diarrhea and there is need for larger studies investigating the role of immune activation in PI-IBS. Psychological factors before infection and the severity of symptoms shortly after infection are risk factors for the persistence of PI-AC.

14 Article Functional Dyspepsia and Severity of Psychologic Symptoms Associate With Postprandial Symptoms in Patients With Irritable Bowel Syndrome. 2018

Pohl, Daniel / Van Oudenhove, Lukas / Törnblom, Hans / Le Nevé, Boris / Tack, Jan / Simrén, Magnus. ·Functional Diagnostics Laboratory, Division of Gastroenterology, University Hospital Zurich, Zurich, Switzerland. Electronic address: daniel.pohl@usz.ch. · Translational Research Center for Gastrointestinal Disorders, University of Leuven, Belgium. · Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Sweden. · Danone Nutricia Research, Palaiseau, France. · Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Sweden; Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina, Chapel Hill, North Carolina. ·Clin Gastroenterol Hepatol · Pubmed #29702295.

ABSTRACT: BACKGROUND & AIMS: Patients with irritable bowel syndrome (IBS) have an increased response of postprandial symptoms to a combined lactulose nutrient challenge test, compared with healthy volunteers. We investigated the associations among comorbid functional dyspepsia (FD), severity of psychologic symptoms, and breath test results in response to this test. METHODS: We performed a prospective study of 205 patients with IBS (Rome III criteria), 94 of whom also had FD (IBS-FD), and 83 healthy volunteers in Sweden from 2008 through 2015. All participants completed a breath hydrogen test after a 400-mL liquid meal with 25 g lactulose. Gastrointestinal (GI) symptom severity was assessed using a graded scale and digestive comfort was recorded before the meal and every 15 minutes until 240 minutes after the meal. GI symptom scores over time were compared between groups using linear mixed models with anxiety, depression, and somatization as covariates. RESULTS: Average levels of all GI symptoms varied over time among all groups (P < .0001). Patients with IBS-FD had higher levels of bloating (P = .004), abdominal pain (P = .005), and lower levels of digestive comfort (P < .01) than patients with only IBS. We observed a difference in increase in abdominal pain from baseline between IBS-FD and IBS groups (P = .013). Anxiety levels were associated with levels of all symptoms (all P < .025) except abdominal pain, which was associated with somatization severity (P < .0001). Furthermore, anxiety levels associated with level of exhaled hydrogen (P = .0042). CONCLUSIONS: In a prospective study of patients with IBS, we found those with FD to have increased GI symptoms before and after a liquid meal with lactulose. Anxiety and somatization have an independent additional effect. The presence of comorbid FD and levels of psychologic symptoms affect reports of food-related symptoms in patients with IBS. ClinicalTrial.gov no: NCT01252550.

15 Article Health problems associated with irritable bowel syndrome: analysis of a primary care registry. 2018

Clevers, E / Vaes, B / Henrard, S / Goderis, G / Tack, J / Törnblom, H / Simrén, M / Van Oudenhove, L. ·Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium. · Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Department of Public Health and Primary Care, Universiteit Leuven (KU Leuven), Leuven, Belgium. · Institute of Health and Society, Université catholique de Louvain (UCL), Brussels, Belgium. · Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. ·Aliment Pharmacol Ther · Pubmed #29572885.

ABSTRACT: BACKGROUND: Associations between irritable bowel syndrome and other health problems have been described, but comprehensive reports are missing, especially in primary care. AIMS: To investigate which health problems are associated with irritable bowel syndrome, how they cluster together and when they are typically diagnosed relative to irritable bowel syndrome. METHODS: We used Intego, a general practice registry in Flanders, Belgium. Patients with an irritable bowel syndrome diagnosis (n = 13 701) were matched with controls without gastrointestinal diagnosis and controls with organic gastrointestinal disease. Long-term prevalences of 680 symptoms and diagnoses were compared between patients and controls. Results were summarised using functional enrichment analysis and visualised in a network and we calculated incidence rate ratios in the 10 years before and after the irritable bowel syndrome diagnosis for the network's key components. RESULTS: Various symptoms and infections, but not neoplasms, were enriched in irritable bowel syndrome patients compared to both control groups. We characterised the comorbidities of irritable bowel syndrome as psychosocial health problems, urogenital symptoms and infections, musculoskeletal symptoms and other somatic symptoms. These had a uniform incidence in the years around the irritable bowel syndrome diagnosis, and did not structurally precede or follow irritable bowel syndrome. CONCLUSIONS: Irritable bowel syndrome shares long-term associations with psychosocial health problems, urogenital symptoms and infections, musculoskeletal symptoms and other somatic symptoms in primary care. Clinicians are encouraged to take comorbidities into account when diagnosing and managing irritable bowel syndrome, as this may have important treatment implications.

16 Article Relationships between psychological state, abuse, somatization and visceral pain sensitivity in irritable bowel syndrome. 2018

Grinsvall, Cecilia / Törnblom, Hans / Tack, Jan / Van Oudenhove, Lukas / Simrén, Magnus. ·Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium. · Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. ·United European Gastroenterol J · Pubmed #29511560.

ABSTRACT: Background and objective: Psychological states may interfere with visceral sensitivity. Here we investigate associations between psychosocial factors and visceral sensitivity in irritable bowel syndrome (IBS). Methods: Two IBS patient cohorts (Cohort 1: Results: Cohort 1. Pain threshold was positively associated with age and female gender, and negatively with adult sexual abuse and somatization. Pain referral area was negatively associated with age and positively with somatization and GI-specific anxiety, the latter effect mediated by somatization. Cohort 2. Pain threshold was positively associated with age and male gender, and negatively with adult sexual abuse. Pain intensity ratings were positively associated with somatization, female gender and depression, the latter effect mediated by somatization. Conclusion: Somatization is associated with most visceral sensitivity parameters, and mediates the effect of some psychological factors on visceral sensitivity. It may reflect a psychobiological sensitization process driving symptom generation in IBS. In addition, abuse history was found to independently affect some visceral sensitivity parameters.

17 Article Development of Irritable Bowel Syndrome Features Over a 5-year Period. 2018

Clevers, Egbert / Tack, Jan / Törnblom, Hans / Ringström, Gisela / Luyckx, Koen / Simrén, Magnus / Van Oudenhove, Lukas. ·Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium; Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: egbert.clevers@kuleuven.be. · Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium. · Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Faculty of Psychology and Educational Sciences, School Psychology and Child and Adolescent Development, KU Leuven, Leuven, Belgium. · Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. ·Clin Gastroenterol Hepatol · Pubmed #29510214.

ABSTRACT: BACKGROUND & AIMS: There are few data from longitudinal studies of the gastrointestinal and psychologic features of irritable bowel syndrome (IBS). We studied within-person correlations among features of IBS, along with progression of gastrointestinal (GI) symptoms and quality of life, and factors associated with changes over time. METHODS: We performed a longitudinal study of 276 patients with IBS in Sweden (70% female; ages, 19-76 years) who completed questionnaires, each year for 5 years, about their GI symptom severity, quality of life, GI-specific anxiety, general anxiety, depression, and coping resources. We performed within-person correlation analyses, latent class growth analysis, and random-intercept cross-lagged panel analysis. RESULTS: Within-person correlations with GI symptom severity were strongest for quality of life (r = -0.56) and GI-specific anxiety (r = 0.47). Progression of GI symptom severity was defined based on 3 classes; the class with the highest mean levels of GI, depression, and (GI-specific) anxiety symptoms at baseline did not improve over the 5-year period, contrary to the other classes. GI-specific anxiety was associated with an increase in GI symptom severity and decrease in quality of life 1 year later (P < .05) but other features of IBS were not. CONCLUSIONS: In a 5-year study of patients with IBS in Sweden, we found 3 classes of GI symptom development. We found levels of GI-specific anxiety to associate with GI symptom severity and quality of life 1 year later. Clinicians should be aware of GI-specific anxiety in patients with IBS, to identify patients at risk for lack of long-term symptom improvement with standard medical treatment.

18 Article Plausibility criteria for putative pathophysiological mechanisms in functional gastrointestinal disorders: a consensus of experts. 2018

Tack, Jan / Corsetti, Maura / Camilleri, Michael / Quigley, Eamonn Mm / Simren, Magnus / Suzuki, Hidekazu / Talley, Nicholas J / Tornblom, Hans / Van Oudenhove, Lukas. ·Translational Research Center for Gastrointestinal Disorders, KULeuven, Leuven, Belgium. · Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK. · CENTER Program, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA. · Division of Gastroenterology and Hepatology, Lynda K and David M Underwood Center for Digestive Disorders, Houston Methodist Hospital, Weill Cornell Medical College, Houston, Texas, USA. · Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Gastroenterology, Keio University, Tokyo, Japan. · Faculty of Health, University of Newcastle, Callaghan, New South Wales, Australia. ·Gut · Pubmed #28814481.

ABSTRACT: BACKGROUND AND AIMS: The functional gastrointestinal disorders (FGIDs) are extremely common conditions associated with a considerable personal, social and health economic burden. Managing FGIDs in clinical practice is challenging because of the uncertainty of symptom-based diagnosis, the high frequency of overlap between these conditions and the limited efficacy of available therapies. It has often been argued that successful drug development and management of FGIDs requires knowledge of the underlying pathophysiology. Numerous and highly variable candidate pathophysiological mechanisms have been implicated in the generation of FGID symptoms, but there is no current consensus on how to best define the relevance of these disturbances. METHODS: A group of international experts on FGIDs developed plausibility criteria that should be fulfilled by relevant pathophysiological mechanisms in FGIDs. RESULTS: Five criteria are proposed: (1) the presence of the abnormality in a subset of patients, (2) temporal association between proposed mechanism and symptom(s), (3) correlation between the level of impairment of the mechanism and symptom(s), (4) induction of the symptom(s) by provoking the pathophysiological abnormality in healthy subjects and (5) treatment response by a therapy specifically correcting the underlying disorder or congruent natural history of symptoms and dysfunction in the absence of specific therapy. Based on strength of evidence for these five criteria according to the Grading of Recommendations Assessment, Development and Evaluation system, a plausibility score can be calculated for each mechanism. CONCLUSION: Evaluation of the strength of evidence for candidate pathophysiological abnormalities fulfilling these five plausibility criteria will help to identify the most relevant mechanisms to target for novel diagnostic approaches and for the development of new therapies.

19 Article Effect of intragastric FODMAP infusion on upper gastrointestinal motility, gastrointestinal, and psychological symptoms in irritable bowel syndrome vs healthy controls. 2018

Masuy, I / Van Oudenhove, L / Tack, J / Biesiekierski, J R. ·Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium. ·Neurogastroenterol Motil · Pubmed #28762592.

ABSTRACT: BACKGROUND: The low fermentable oligo-, di-, mono-saccharides and polyol (FODMAP) diet is a treatment strategy to reduce symptoms of irritable bowel syndrome (IBS). Acute effects of FODMAPs on upper gastrointestinal motility are incompletely understood. Our objectives were to assess the acute effects of intragastric FODMAP infusions on upper gastrointestinal motility and gastrointestinal and psychological symptoms in healthy controls (HC) and IBS patients. METHODS: A high-resolution solid-state manometry probe and an infusion tube were positioned into the stomach. Fructans, fructose, FODMAP mix, or glucose was intragastrically administered to HC, and fructans or glucose was administered to IBS patients until full satiation (score 0-5), in a randomized crossover fashion. Manometric measurements continued for 3 hours. Gastrointestinal and psychological symptoms were assessed by questionnaires at predefined time points. The study was registered on www.clinicaltrials.gov (NCT02980406). KEY RESULTS: Twenty HC and 20 IBS patients were included. Fructans induced higher postprandial gastric pressures compared with glucose over both groups (P<.001). Bloating, belching, and pain increased more in IBS over both carbohydrates (P<.041). In addition, IBS patients reported more flatulence and cramps compared with HC following fructans (P<.001). Glucose induced more fatigue and dominance compared with fructans (P=.028, P=.001). Irritable bowel syndrome patients reported a higher increase in anger (P=.030) and a stronger decrease in positive affect (P=.021). CONCLUSIONS & INFERENCES: The upper gastrointestinal motility response varies between carbohydrates. Irritable bowel syndrome patients are more sensitive to fructan infusion, reflected in their higher gastrointestinal symptom scores. Acute carbohydrate infusion can have differential psychological effects in IBS and HC.

20 Article Visceral hypersensitivity is associated with GI symptom severity in functional GI disorders: consistent findings from five different patient cohorts. 2018

Simrén, Magnus / Törnblom, Hans / Palsson, Olafur S / van Tilburg, Miranda A L / Van Oudenhove, Lukas / Tack, Jan / Whitehead, William E. ·Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. · Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium. ·Gut · Pubmed #28104632.

ABSTRACT: OBJECTIVE: Our aim was to evaluate the association between visceral hypersensitivity and GI symptom severity in large cohorts of patients with functional GI disorder (FGID) and to adjust for psychological factors and general tendency to report symptoms. DESIGN: We included five cohorts of patients with FGIDs (IBS or functional dyspepsia; n=1144), who had undergone visceral sensitivity testing using balloon distensions (gastric fundus, descending colon or rectum) and completed questionnaires to assess GI symptom severity, non-GI somatic symptoms, anxiety and depression. Subjects were divided into sensitivity tertiles based on pain/discomfort thresholds. GI symptom severity was compared between sensitivity tertiles in each cohort and corrected for somatisation, and anxiety and depression. RESULTS: In all five cohorts, GI symptom severity increased gradually with increasing visceral sensitivity, with significant differences in GI symptom severity between the sensitivity tertiles (p<0.0001), with small to medium effect sizes (partial η CONCLUSIONS: A gradual increase in GI symptom severity with increasing GI sensitivity was demonstrated in IBS and functional dyspepsia, which was consistent across several large patient groups from different countries, different methods to assess sensitivity and assessments in different parts of the GI tract. This association was independent of tendency to report symptoms or anxiety/depression comorbidity. These findings confirm that visceral hypersensitivity is a contributor to GI symptom generation in FGIDs.

21 Article Altered brain and gut responses to corticotropin-releasing hormone (CRH) in patients with irritable bowel syndrome. 2017

Kano, Michiko / Muratsubaki, Tomohiko / Van Oudenhove, Lukas / Morishita, Joe / Yoshizawa, Makoto / Kohno, Keiji / Yagihashi, Mao / Tanaka, Yukari / Mugikura, Shunji / Dupont, Patrick / Ly, Huynh Giao / Takase, Kei / Kanazawa, Motoyori / Fukudo, Shin. ·Frontier Research Institute for Interdisciplinary Sciences (FRIS), Tohoku University, Sendai, Japan. mkano@med.tohoku.ac.jp. · Behavioral Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan. mkano@med.tohoku.ac.jp. · Behavioral Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan. · Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium. · Research Division on Advanced Information Technology, Cyberscience Center, Tohoku University, Sendai, Japan. · Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan. · Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan. · Laboratory for Cognitive Neurology, University of Leuven, Leuven, Belgium. · Behavioral Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan. sfukudo@med.tohoku.ac.jp. ·Sci Rep · Pubmed #28963545.

ABSTRACT: Stress is a known trigger of irritable bowel syndrome (IBS) and exacerbates its gastrointestinal symptoms. However, underlying the physiological mechanism remains unknown. Here, we investigated hypothalamic-pituitary-adrenal (HPA) axis, colonic motility, and autonomic responses to corticotropin-releasing hormone (CRH) administration as well as brain activity alterations in IBS. The study included 28 IBS patients and 34 age and sex-matched healthy control subjects. IBS patients demonstrated greater adrenocorticotropic hormone (ACTH) responses to CRH than control subjects. Male IBS patients had greater increases in colonic motility than male HCs after CRH. Female IBS patients showed altered sympathovagal balance and lower basal parasympathetic tone relative to female control subjects. Brain responses to rectal distention were measured in the same subjects using functional magnetic resonance imaging, and their associations with individual ACTH responses to CRH were tested. A negative association between ACTH response to CRH and activity in the pregenual anterior cingulate cortex (pACC) during rectal distention was identified in controls but not in IBS patients. Impaired top-down inhibitory input from the pregenual ACC to the HPA axis may lead to altered neuroendocrine and gastrointestinal responses to CRH. Centrally acting treatments may dampen the stress induced physical symptoms in IBS.

22 Article Brain responses to vestibular pain and its anticipation in women with Genito-Pelvic Pain/Penetration Disorder. 2017

Pazmany, Els / Ly, Huynh Giao / Aerts, Leen / Kano, Michiko / Bergeron, Sophie / Verhaeghe, Johan / Peeters, Ronald / Tack, Jan / Dupont, Patrick / Enzlin, Paul / Van Oudenhove, Lukas. ·Institute for Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium. · Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium. · Department of Psychology, Université de Montréal, Montreal, Canada. · The Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai, Japan. · Department of Gynaecology, University Hospitals Leuven, Leuven, Belgium. · Medical Diagnostic Sciences, KU Leuven & Radiology University Hospitals Leuven, Leuven, Belgium. · Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven & Medical Imaging Centre, University Hospitals Leuven, Leuven, Belgium. · Centre for Clinical Sexology and Sex Therapy, University Psychiatric Centre, KU Leuven, Leuven, Belgium. ·Neuroimage Clin · Pubmed #28932680.

ABSTRACT: OBJECTIVE: In DSM-5, pain-related fear during anticipation of vaginal penetration is a diagnostic criterion of Genito-Pelvic Pain/Penetration Disorder (GPPPD). We aimed to investigate subjective and brain responses during anticipatory fear and subsequent induction of vestibular pain in women with GPPPD. METHODS: Women with GPPPD (n = 18) and age-matched healthy controls (HC) (n = 15) underwent fMRI scanning during vestibular pain induction at individually titrated pain threshold after a cued anticipation period. (Pain-related) fear and anxiety traits were measured with questionnaires prior to scanning, and anticipatory fear and pain intensity were rated during scanning using visual analog scales. RESULTS: Women with GPPPD reported significantly higher levels of anticipatory fear and pain intensity. During anticipation and pain induction they had stronger and more extensive brain responses in regions involved in cognitive and affective aspects of pain perception, but the group difference did not reach significance for the anticipation condition. Pain-related fear and anxiety traits as well as anticipatory fear ratings were positively associated with pain ratings in GPPPD, but not in HC. Further, in HC, a negative association was found between anticipatory fear ratings and brain responses in regions involved in cognitive and affective aspects of pain perception, but not in women with GPPPD. CONCLUSIONS: Women with GPPPD are characterized by increased subjective and brain responses to vestibular pain and, to a lesser extent, its anticipation, with fear and anxiety associated with responses to pain, supporting the introduction of anticipatory fear as a criterion of GPPPD in DSM-5.

23 Article Mixture model analysis identifies irritable bowel syndrome subgroups characterised by specific profiles of gastrointestinal, extraintestinal somatic and psychological symptoms. 2017

Polster, A / Van Oudenhove, L / Jones, M / Öhman, L / Törnblom, H / Simrén, M. ·Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium. · Psychology Department, Faculty of Human Sciences, Macquarie University, North Ryde, NSW, Australia. · Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. ·Aliment Pharmacol Ther · Pubmed #28671338.

ABSTRACT: BACKGROUND: Current subgrouping of Irritable Bowel Syndrome (IBS) is exclusively based on stool consistency without considering other relevant gastrointestinal (GI), extraintestinal somatic or psychological features. AIM: To identify subgroups based on a comprehensive set of IBS-related parameters. METHODS: Mixture model analysis was used, with the following input variables: 13 single-item scores from the IBS-specific Gastrointestinal Symptom Rating Scale, average stool consistency and frequency from a 7-day Bristol Stool Form diary, 12 single-item extraintestinal symptom scores from the Patient Health Questionnaire-12, and anxiety and depression subscale scores from the Hospital Anxiety and Depression scale. The resulting latent subgroups were compared regarding symptom profiles using analysis of variance followed by pair-wise comparisons. RESULTS: One hundred and seventy-two IBS patients (Rome III; 69% female; mean age 33.7 [range 18-60] years) were included. The optimal subgrouping showed six latent groups, characterised by: (I) constipation with low comorbidities, (II) constipation with high comorbidities, (III) diarrhoea with low comorbidities, (IV) diarrhoea and pain with high comorbidities, (V) mixed GI symptoms with high comorbidities, (VI) a mix of symptoms with overall mild severity. The subgroups showed differences in the distribution of Rome III-subtypes, IBS severity, presence of anxiety and depression, and gender, but not regarding age, IBS duration or reported post-infectious onset of IBS. CONCLUSIONS: This model-based subgrouping of IBS partly supports the distinction of subgroups based on bowel habits, but additionally distinguishes subgroups with or without co-morbid extraintestinal somatic and psychological symptoms. The resulting groups show specific profiles of symptom combinations.

24 Article Influence of Uncertain Anticipation on Brain Responses to Aversive Rectal Distension in Patients With Irritable Bowel Syndrome. 2017

Kano, Michiko / Muratsubaki, Tomohiko / Morishita, Joe / Kono, Keiji / Mugikura, Shunji / Takase, Kei / Ly, Huynh Giao / Dupont, Patrick / Van Oudenhove, Lukas / Fukudo, Shin. ·From the Frontier Research Institute for Interdisciplinary Sciences (Kano) and Behavioral Medicine (Kano, Muratsubaki, Morishita, Kono, Fukudo), Graduate School of Medicine, Tohoku University · Diagnostic Radiology (Mugikura, Takase), Tohoku University Hospital, Sendai, Japan · Laboratory for Brain-Gut Axis Studies (Ly, Van Oudenhove), Translational Research Center for Gastrointestinal Disorders, University of Leuven · and Laboratory for Cognitive Neurology (Dupont), KU Leuven, Belgium. ·Psychosom Med · Pubmed #28498276.

ABSTRACT: OBJECTIVE: We investigated whether certainty and uncertainty of impending aversive visceral sensation differently modulate regional brain activity, both during anticipation and visceral sensation in irritable bowel syndrome (IBS) patients compared with healthy controls. METHODS: Twenty-six IBS patients (14 women) and 29 healthy controls (15 women) were enrolled in a functional magnetic resonance imaging study. Participants received rectal distention at an individually titrated severe discomfort level that was preceded by visual cues to induce certain (100% chance of distention), uncertain (50% chance), and safe (0% chance) anticipation. RESULTS: Subjective ratings of anticipatory fear before and discomfort during distention were similar between IBS and control participants under cued certainty and uncertainty (p > .05). Uncertain anticipation compared with certain anticipation induced greater activation of anterior midcingulate cortex, thalamus, and visual processing areas in IBS patients compared with controls. Rectal distention after the uncertain, but not certain, cue induced higher activity in the posterior- and midcingulate cortices and the precuneus in IBS compared with controls. Controls exhibited bilateral insula activation during the nondistention period after the uncertain cue compared with the safe cue. IBS patients failed to produce this response, which was possibly due to elevated bilateral insular responses during nondistention after the safe cue. Brain data were significant at a voxel-level threshold of puncorrected value of less than .005 combined with a cluster-level threshold of pFWE-corrected value of less than .05. CONCLUSIONS: Preceding uncertainty differentially modulates the brain processing of physiologically identical rectal stimulation in IBS patients. Cue-dependent alterations in brain responses may underlie hypervigilance to visceral sensations in IBS patients.

25 Article Coping Skills Are Associated With Gastrointestinal Symptom Severity and Somatization in Patients With Irritable Bowel Syndrome. 2017

Wilpart, Katarina / Törnblom, Hans / Svedlund, Jan / Tack, Jan F / Simrén, Magnus / Van Oudenhove, Lukas. ·Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; University of Gothenburg Centre for Person-Centered Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Department of Psychiatry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Translational Research Center for Gastrointestinal Disorders, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium. · Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; University of Gothenburg Centre for Person-Centered Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Center for Functional GI and Motility Disorders, University of North Carolina, Chapel Hill, North Carolina. Electronic address: magnus.simren@medicine.gu.se. · Translational Research Center for Gastrointestinal Disorders, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium; Liaison Psychiatry, University Psychiatric Centre KU Leuven, Campus Gasthuisberg, Leuven, Belgium. ·Clin Gastroenterol Hepatol · Pubmed #28286196.

ABSTRACT: BACKGROUND & AIMS: Coping resources and processes are altered in patients with irritable bowel syndrome (IBS). We investigated the relationship between coping resources and gastrointestinal (GI) and extraintestinal symptom severity in patients with IBS and potential mediators of this relationship. METHODS: We performed a cross-sectional study of 216 patients with IBS attending a secondary/tertiary care specialized outpatient center in Sweden from 2003 through 2007. We collected data on coping resources, levels of anxiety (general and GI specific), depressive symptoms, levels of GI symptoms, and extraintestinal somatic symptoms (somatization) by administering validated self-report questionnaires. General Linear Models were used to assess associations and mediation. RESULTS: GI symptoms: low levels of physical coping resources (practice of activities that are beneficial for health; P = .0016), high levels of general anxiety symptoms (P = .033), and GI-specific anxiety symptoms (P < .0001), but not depressive symptoms (P = .89), were independently associated with GI symptom levels (R CONCLUSIONS: In a cross-sectional study of patients with IBS in Sweden, we found associations of levels of coping resources with GI and extraintestinal symptom severity; these associations were mediated by levels of anxiety and depressive symptoms. Although confirmation in longitudinal studies is needed, this identifies coping as a potential psychological treatment target in IBS.

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