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Irritable Bowel Syndrome: HELP
Articles from Denmark
Based on 62 articles published since 2009

These are the 62 published articles about Irritable Bowel Syndrome that originated from Denmark during 2009-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Guideline Danish national guideline: Diagnosis and treatment of Irritable Bowel Syndrome. 2017

Krarup, Anne Lund / Engsbro, Anne Line Østergaard / Fassov, Janne / Fynne, Lotte / Christensen, Anders Bak / Bytzer, Peter. ·pmby@regionsjaelland.dk. ·Dan Med J · Pubmed #28566121.

ABSTRACT: National Danish guidelines for the diagnosis and treatment of irritable bowel syndrome (IBS) in adult patients in secondary and tertiary care have been approved by the Danish Society for Gastroenterology and Hepatology. IBS can be a positive diagnosis in patients fulfilling the Rome III criteria for IBS with no alarm signals, a normal physical examination and a normal CRP and hemoglobin. In patients < 40 years with IBS and diarrhea, a normal fecal calprotectin excludes inflammatory bowel disease with a high probability. Patients with IBS and diarrhea should be tested for celiac disease. Endoscopy is not routinely recommended. The therapeutic gain of various treatment modalities is small and most likely overestimated in older studies. However, side effects are usually mild which may justify empirical treatment. The choice of therapy based on IBS subtyping is pragmatic and there are only few trials as guidance. The significance of previous failure with another treatment modality is unclear. There is a lack of long-term treatment trials. The generalizability of the trials is poor, mainly due to selection bias.

2 Editorial [Diet and other treatment in irritable bowel syndrome]. 2015

de Muckadell, Ove B Schaffalitzky. ·Afdeling for Medicinske Mavetarmsygdomme S, Odense Universitetshospital, Søndre Boulevard 29, 5000 Odense C. sdm@rsyd.dk. ·Ugeskr Laeger · Pubmed #26321581.

ABSTRACT: -- No abstract --

3 Review [Faecal microbiota transplantation for the treatment of bowel disease]. 2017

Rode, Anne A / Chehri, Mahtab / Petersen, Andreas Munk / Bytzer, Peter. ·aala@regionsjaelland.dk. ·Ugeskr Laeger · Pubmed #28869008.

ABSTRACT: Faecal microbiota transplantation (FMT) is the transferral of faeces from a healthy donor to a patient with a disease linked to disturbances in the gut microbiota. The treatment has been implemented at several hospitals in Denmark, and banks with frozen donor stool material have been established. The effect of FMT for recurrent Clostridium difficile infection is well-documented. FMT cannot be recommended for routine clinical use for inflammatory bowel disease and irritable bowel syndrome because of lack of data from clinical trials.

4 Review Can fecal microbiota transplantation cure irritable bowel syndrome? 2017

Halkjær, Sofie Ingdam / Boolsen, Anders Watt / Günther, Stig / Christensen, Alice Højer / Petersen, Andreas Munk. ·Sofie Ingdam Halkjær, Andreas Munk Petersen, Department of Gastroenterology, Copenhagen University Hospital Hvidovre, 2650 Copenhagen, Denmark. ·World J Gastroenterol · Pubmed #28652664.

ABSTRACT: AIM: To verify the utility of treatment with fecal microbiota transplantation (FMT) in patients with irritable bowel syndrome (IBS). METHODS: We searched EMBASE, Cochrane Library and PubMed in March, 2017. The reviewed literature was based on two systematic searches in each of the databases. The MeSH terms used were IBS and fecal microbiota transplantation and the abbreviations IBS and FMT. Reference lists from the articles were reviewed to identify additional pertinent articles. RESULTS: A total of six conference abstracts, one case report, one letter to the editor, and one clinical review were included. In the final analysis, treatment of 48 patients was evaluated. Treatment revealed an improvement in 58% of cases. The varying structure of the nine included studies must be taken into consideration. CONCLUSION: Data on FMT and IBS are too limited to draw sufficient conclusions. Standardized double blinded randomized clinical trials need to be carried out to evaluate the effect of FMT on IBS.

5 Review [Gluten-free diet is for some a necessity, for others a lifestyle]. 2017

Jønsson, Iben Møller / Møller, Gitte Leth / Pærregaard, Anders. ·iben.jonsson@clin.au.dk. ·Ugeskr Laeger · Pubmed #28553923.

ABSTRACT: This review provides a brief overview of the gluten-related conditions coeliac disease (CD), wheat allergy (WA), and non-coeliac gluten sensitivity (NCGS). NCGS is a new entity which includes individuals who report symptoms when exposed to gluten and benefit from gluten-free diet, but do not have CD or WA. The concept NCGS is still controversial and a subject of considerable overdiagnosis, and consensus regarding diagnostic criteria is lacking. Furthermore, the overlap with irritable bowel syndrome is unsettled.

6 Review Systematic review: quality of trials on the symptomatic effects of the low FODMAP diet for irritable bowel syndrome. 2017

Krogsgaard, L R / Lyngesen, M / Bytzer, P. ·Department of Gastroenterology, Zealand University Hospital, Køge, Denmark. · Department of Clinical Medicine, Copenhagen University, Denmark. ·Aliment Pharmacol Ther · Pubmed #28440580.

ABSTRACT: BACKGROUND: The low Fermentable Oligo-, Di- Monosaccharides, and Polyoles (FODMAP) diet is a new treatment option for irritable bowel syndrome (IBS). Experts refer to the diet as supported by high level of evidence, but an evaluation of the quality of trials is lacking. AIM: To provide a systematic review of the quality of trials on the symptomatic effects of the low FODMAP diet for IBS. METHODS: Pubmed and EMBASE were searched for randomised controlled trials (RCTs) reporting effect of the low FODMAP diet on IBS symptoms. The quality of trials was evaluated by estimating risk of bias and assessing trial methodology. RESULTS: Nine RCTs were eligible, including 542 patients. The intervention period was from 2 days to 6 weeks and one trial included a 6-month follow-up. Three trials intervened by providing meals, controlling with a diet high in FODMAP content. In six trials, the intervention was instruction by a dietician and a variety of control interventions were used, all with limited established efficacy. Domains with a high risk of bias were identified for all the trials. High risk of bias dominated domains regarding blinding, with only one trial double-blinded. CONCLUSIONS: The RCTs on the low FODMAP diet are characterized by high risk of bias. The diet has not been studied in a randomised, controlled setting for more than 6 weeks and trials examining the effect of the important reintroduction period are lacking. There is a risk that the symptomatic effects reported in the trials are driven primarily by a placebo response.

7 Review Using eHealth strategies in delivering dietary and other therapies in patients with irritable bowel syndrome and inflammatory bowel disease. 2017

Ankersen, Dorit Vedel / Carlsen, Katrine / Marker, Dorte / Munkholm, Pia / Burisch, Johan. ·Gastroenterology Department, North Zealand University Hospital, Frederikssund, Denmark. · Pediatric Department, Hvidovre University Hospital, Hvidovre, Denmark. ·J Gastroenterol Hepatol · Pubmed #28244677.

ABSTRACT: Health-care systems around the world are facing increasing costs. Non-adherent, chronically ill patients are one such expense incurred by health-care providers. Web-based home-monitoring of patients-or eHealth-has been shown to increase adherence to medical therapy, facilitate contact between patients and health-care professionals, and reduce time to remission for patients with inflammatory bowel disease (IBD). Web-based treatment is a supportive tool for the health-care provider in an out-patient clinic. eHealth web-programs, such as the Constant Care application, visualize disease activity in a traffic light system and empower patients to screen for disease activity, enabling them to respond appropriately to their symptoms. The eHealth screening procedure for monitoring both pediatric and adult IBD patients is based on a self-obtained symptom score, together with a fecal biomarker for inflammation (fecal calprotectin) that the patients can measure independently using their smart phone, providing both patient and physician with an immediate disease status that they can react to instantaneously. Likewise, web applications for IBD patients, web applications for irritable bowel syndrome (IBS) patients and also IBD patients with co-existing IBS, have proven valuable for monitoring and treating IBS symptoms with a diet low in fermentable oligo-, di-, monosaccharides and polyols (low-FODMAP diet). With careful disease monitoring via the web application and increased patient adherence, eHealth might be capable of improving the natural disease course of IBD and IBS.

8 Review [Irritable bowel treatment]. 2016

Fassov, Janne / Fynne, Lotte / Krarup, Anne Lund. ·janfas@rm.dk. ·Ugeskr Laeger · Pubmed #27592867.

ABSTRACT: More than every tenth Dane have irritable bowel syndrome. The condition is diagnosed by a positive strategy including fulfilment of the Rome III criteria, absence of alarm symptoms, and if needed a few paraclinical tests. Currently, there is no cure of the disorder. Treatment is recommended on a symptom-based approach targeting the dominating symptom/symptoms. If symptoms are reduced, the quality of life is considerably improved.

9 Review Irritable bowel syndrome, the microbiota and the gut-brain axis. 2016

Raskov, Hans / Burcharth, Jakob / Pommergaard, Hans-Christian / Rosenberg, Jacob. ·a Speciallægecentret ved Diakonissestiftelsen , Frederiksberg , Denmark. · b Department of Surgery , Zealand University Hospital, University of Copenhagen, Copenhagen , Denmark. · c Centre for Perioperative Optimization, Herlev Hospital, University of Copenhagen , Copenhagen , Denmark. · d Department of Surgery , Hvidovre Hospital, University of Copenhagen , Copenhagen , Denmark. ·Gut Microbes · Pubmed #27472486.

ABSTRACT: Irritable bowel syndrome is a common functional gastrointestinal disorder and it is now evident that irritable bowel syndrome is a multi-factorial complex of changes in microbiota and immunology. The bidirectional neurohumoral integrated communication between the microbiota and the autonomous nervous system is called the gut-brain-axis, which integrates brain and GI functions, such as gut motility, appetite and weight. The gut-brain-axis has a central function in the perpetuation of irritable bowel syndrome and the microbiota plays a critical role. The purpose of this article is to review recent research concerning the epidemiology of irritable bowel syndrome, influence of microbiota, probiota, gut-brain-axis, and possible treatment modalities on irritable bowel syndrome.

10 Review [Insufficient evidence of the effect of the low FODMAP diet on irritable bowel syndrome]. 2015

Krogsgaard, Laura Rindom / Lyngesen, Malene / Bytzer, Peter. ·Medicinsk Afdeling, Køge Sygehus, Lykkebækvej 1, 4600 Køge. lkrr@regionsjaelland.dk. ·Ugeskr Laeger · Pubmed #25922242.

ABSTRACT: The low FODMAP (Fermentable Oligo-, Di- and Monosaccharides and Polyoles) diet (LFD) allegedly reduces symptoms of irritable bowel syndrome (IBS). Eleven studies have examined the effects of LFD on IBS. Most studies reported a symptomatic effect, but methodological weaknesses such as lack of relevant control group and of proper blinding means that a placebo response cannot be excluded. No studies have examined the effect of the important reintroduction phase nor the effects of LFD on IBS patients in primary care. Evidence suggests that intake of high dose FODMAP can induce gastrointestinal symptoms, but the clinical relevance of this is doubtful.

11 Review [Posttraumatic stress disorder is correlated to irritable bowel syndrome]. 2014

Wernersson, Rebecca / Carlsson, Jessica. ·Det Sundhedsvidenskablige Fakultet, Københavns Universitet. rebecca.wernersson@hotmail.com. ·Ugeskr Laeger · Pubmed #25534220.

ABSTRACT: Stress influences the whole body, including the gut. Irritable bowel syndrome (IBS) is a syndrome characterized by gastrointestinal symptoms, with the absence of clinical signs. IBS is seen in several psychiatric co-morbidities. Only few studies have examined the association between IBS and posttraumatic stress disorder (PTSD). There are several hypotheses of how this association can be explained, e.g. oxytocin dysregulation, hypothalamic-pituitary-adrenal axis dysfunction, the vulnerability of the patient group, post-infectious irritable bowel and side effects of the medical treatment of PTSD.

12 Review [Diagnostic strategy in patients suspected of irritable bowel syndrome]. 2014

Engsbro, Anne Line Østergaard / Bytzer, Peter. ·Klinisk Mikrobiologisk Afdeling, Hvidovre Hospital, Kettegård Alle 30, 2650 Hvidovre. anne.line.oestergaard.engsbro@regionh.dk. ·Ugeskr Laeger · Pubmed #25347436.

ABSTRACT: Irritable bowel syndrome, a very common condition with a high use of health-care costs especially related to diagnostic testing, is traditionally approached by a diagnostic strategy of exclusion. However, data from clinical studies support a positive diagnostic strategy based on symptom-based criteria, absence of alarm signals and, if needed, a few simple blood tests in young patients presenting in primary care. For older patients, and for patients not fulfilling symptom-based criteria or presenting with alarm signals, more thorough investigations are needed, directed by the symptomatology.

13 Review [Faecal calprotectin is a useful biomarker for intestinal inflammation]. 2014

Theede, Klaus / Kiszka-Kanowitz, Marianne / Nordgaard-Lassen, Inge / Nielsen, Anette Mertz. ·Gastroenheden, Medicinsk Sektion, Hvidovre Hospital, Kettegård Allé 30, 2650 Hvidovre. E-mail: klaus.theede@regionh.dk. ·Ugeskr Laeger · Pubmed #25294035.

ABSTRACT: Faecal calprotectin is a biomarker for inflammation in the intestinal mucosa. Faecal calprotectin has the ability to detect inflammatory causes of gastrointestinal symptoms and to distinguish these from irritable bowel syndrome. The test is very sensitive but not specific to any particular gastrointestinal disease. In inflammatory bowel disease, faecal calprotectin correlates with symptoms, biochemical markers and the endoscopic findings. It can be used to monitor disease activity, treatment response and mucosal healing as well as predict relapse. We propose an algorithm for the use of faecal calprotectin in patients with unspecific abdominal complaints.

14 Review Analgesic effects of melatonin: a review of current evidence from experimental and clinical studies. 2011

Wilhelmsen, Michael / Amirian, Ilda / Reiter, Russel J / Rosenberg, Jacob / Gögenur, Ismail. ·Department of Surgical Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev, Denmark. ·J Pineal Res · Pubmed #21615490.

ABSTRACT: Melatonin is an endogenous indoleamine, produced mainly by the pineal gland. Melatonin has been proven to have chronobiotic, antioxidant, antihypertensive, anxiolytic and sedative properties. There are also experimental and clinical data supporting an analgesic role of melatonin. In experimental studies, melatonin shows potent analgesic effects in a dose-dependent manner. In clinical studies, melatonin has been shown to have analgesic benefits in patients with chronic pain (fibromyalgia, irritable bowel syndrome, migraine). The physiologic mechanism underlying the analgesic actions of melatonin has not been clarified. The effects may be linked to G(i) -coupled melatonin receptors, to G(i) -coupled opioid μ-receptors or GABA-B receptors with unknown downstream changes with a consequential reduction in anxiety and pain. Also, the repeated administration of melatonin improves sleep and thereby may reduce anxiety, which leads to lower levels of pain. In this paper, we review the current evidence regarding the analgesic properties of melatonin in animals and humans with chronic pain.

15 Article A Protocol-Driven Assessment Promotes a More Accurate Diagnosis of Irritable Bowel Syndrome. 2018

Moore, Judith S / Gibson, Peter R / Perry, Richard E / Burgell, Rebecca E. ·Judith S. Moore, MSc, RN, PhD Student, is Functional Gut Nurse Consultant, Department of Gastroenterology, Central Clinical School, Monash University and The Alfred Hospital, Melbourne, Australia. Peter R. Gibson, MBBS (Hons), MD, FRACP, is Director of Gastroenterology, The Alfred Hospital, Melbourne, Australia; and Professor of Gastroenterology, Central Clinical School, Monash University, Melbourne, Australia. Richard E. Perry, MBChB, DipObs, FRACS, is Colorectal Surgeon, Intus Digestive and Colorectal Care, Christchurch, New Zealand. Rebecca E. Burgell, MBBS (Hons), FRACP, is Gastroenterologist, Department of Gastroenterology, Central Clinical School, Monash University and The Alfred Hospital, Melbourne, Australia. ·Gastroenterol Nurs · Pubmed #30418343.

ABSTRACT: A diverse range of conditions share symptoms commonly identified with irritable bowel syndrome. The objective of this study was to examine the diagnostic process in identifying additional diagnoses in women who are attending a clinic for evaluation of symptoms suggestive of irritable bowel syndrome. A retrospective audit was conducted of anonymous data gathered on consecutive female patients presenting to a specialist nurse-led service in Christchurch, New Zealand, with a provisional diagnosis of irritable bowel syndrome. A protocol containing routine pathology investigations and physical examination was used. Alarm features were identified and pertinent investigations were implemented. Rectocele was detected on rectal examination. Final diagnosis was noted and compared with baseline symptom data. Of 231 patients, 187 initially met Rome III criteria for irritable bowel syndrome. Red flags and abnormal investigations led to an alternate diagnosis in a further 27 patients. Of the 160 patients with irritable bowel syndrome, 31% were found to have a rectocele. They were seven times more likely to report a symptom associated with pelvic floor dysfunction (p < .0001) and four times more likely to report constipation (p = .0003). The use of a protocol including routine investigations and physical examination improves diagnostic yield. Pelvic floor dysfunction should be considered in those with unique symptom patterns and rectocele in the setting of irritable bowel syndrome.

16 Article Is endometriosis associated with irritable bowel syndrome? A cross-sectional study. 2018

Schomacker, Mia L / Hansen, Karina E / Ramlau-Hansen, Cecilia H / Forman, Axel. ·Department of Obstetrics and Gynecology, Aarhus University Hospital, Brendstrupgaardsvej 100, Aarhus C, 8210, Denmark. Electronic address: miaschomacker@outlook.com. · Department of Psychology and Behavioral Sciences, Aarhus University, Bartholins Allé 9, Aarhus C, 8000, Denmark. · Department of Public Health, Section for Epidemiology, Aarhus University, Nordre Ringgade 1, Aarhus C, 8000, Denmark. · Department of Obstetrics and Gynecology, Aarhus University Hospital, Brendstrupgaardsvej 100, Aarhus C, 8210, Denmark. ·Eur J Obstet Gynecol Reprod Biol · Pubmed #30326376.

ABSTRACT: OBJECTIVES: Previous studies have found a high prevalence of irritable bowel syndrome (IBS). However, data on this relation in women without bowel endometriosis is limited. The aim of this study was to compare the prevalence of IBS in women with endometriosis to the prevalence in women without endometriosis and to investigate if the prevalence of IBS was associated with bowel involved endometriosis. STUDY DESIGN: Information for this cross-sectional study was collected through an online questionnaire. A total of 373 women completed the questionnaire. After exclusions, 254 with endometriosis and 102 without endometriosis were included (N = 356). Endometriosis was identified by self-reported diagnosis. IBS was identified by; 1. self-reported diagnosis prior to the study and 2. fulfillment of ROME III diagnostic criteria in this study. Odds ratios were calculated to estimate the strength of the association between IBS and endometriosis. A separate analysis, restricted to women without bowel involved endometrioses, was conducted. Adjustment for potential confounders (age, gastroenterological comorbidities and length of education) was performed. RESULTS AND CONCLUSIONS: The prevalence of IBS was higher in women with endometriosis compared to the women without endometriosis (OR = 5.32 (CI: 2.88; 9.81)). In the analysis restricted to women without bowel involved endometriosis, the prevalence was also higher in women with endometriosis compared to women without endometriosis (OR = 6.54 (CI95% 3.22; 13.29)). Thus, this study found a higher prevalence of IBS in women with endometriosis compared to women without endometriosis. This finding seems to be unrelated to bowel involvement. This opens new perspectives in relation to treatment of endometriosis.

17 Article Lacto-fermented sauerkraut improves symptoms in IBS patients independent of product pasteurisation - a pilot study. 2018

Nielsen, Elsa Sandberg / Garnås, Eirik / Jensen, Kathrine Juul / Hansen, Lars Hestbjerg / Olsen, Peder Sandvold / Ritz, Christian / Krych, Lukasz / Nielsen, Dennis Sandris. ·Department of Food Science, University of Copenhagen, Denmark. dn@food.ku.dk. ·Food Funct · Pubmed #30256365.

ABSTRACT: Lacto-fermented sauerkraut contains a natural variety of lactic acid bacteria (LAB) and has not previously been studied in the treatment of irritable bowel syndrome (IBS) patients. The present study investigated the effect of a daily lacto-fermented sauerkraut supplement in relation to IBS patients' gastrointestinal symptoms and gut microbiota composition. A randomized double-blinded intervention was conducted with 34 Norwegian IBS patients. The patients were consuming either pasteurized sauerkraut (PS; n = 15) or unpasteurized sauerkraut (UPS; n = 19) as a supplement to their daily diet for 6 weeks. The differences in change of symptoms were assessed using the questionnaire IBS-Symptom Severity Score (IBS-SSS) measured at the baseline, and at weeks 2, 4, 6 and 8 (follow-up). The gut microbiota composition was analysed using 16S rRNA gene amplicon sequencing of faecal samples from the baseline and week 6. The mean change in IBS-SSS was -38.57 ± 17.08 PS vs. -56.99 ± 16.92 UPS and was significantly improved in both groups (P < 0.04), while the improvement in symptoms was not different between the intervention groups. The sauerkraut intervention (pasteurized or not) also led to significant gut microbiota compositional changes as determined by 16S rRNA gene amplicon sequencing (un-weighted UniFrac: P = 0.001, weighted UniFrac: P = 0.001). Sauerkraut related LAB in feces (Lactobacillus plantarum and Lactobacillus brevis) were significantly more often present in the UPS-group. In conclusion lacto-fermented sauerkraut had an effect on IBS patients' symptoms and gut microbiota even though the study was underpowered. Our results indicate that the observed effect to a larger extent can be attributed to the potential prebiotics in lacto-fermented sauerkraut rather than the viable LAB. Future studies with greater statistical power are needed to clarify the possible effects of LAB from lacto-fermented sauerkraut in the treatment of IBS patients.

18 Article Systematic review with meta-analysis: conditioned pain modulation in patients with the irritable bowel syndrome. 2018

Albusoda, Ahmed / Ruffle, James K / Friis, Kathrine A / Gysan, Maximilian R / Drewes, Asbjørn M / Aziz, Qasim / Farmer, Adam D. ·Centre for Neuroscience and Trauma, Blizard Institute, Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK. · Faculty of Health Sciences, Aarhus University, Aarhus, Denmark. · School of Medicine, Heidelberg University, Heidelberg, Germany. · Mech-Sense, Department of Gastroenterology and Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark. · Department of Gastroenterology, University Hospitals Midlands NHS Trust, Stoke on Trent, Staffordshire, UK. · Institute of Applied Clinical Science, University of Keele, Keele, Staffordshire, UK. ·Aliment Pharmacol Ther · Pubmed #30206948.

ABSTRACT: BACKGROUND: Irritable bowel syndrome (IBS) is common and is characterised by recurrent abdominal pain, which is a major contributor to healthcare seeking. The neurobiological basis of this pain is incompletely understood. Conditioned pain modulation is a neuromodulatory mechanism through which the brain inhibits the nociceptive afferent barrage through the descending pathways. Reduced conditioned pain modulation has been implicated in the pathophysiology of IBS, although to date only in studies with relatively small sample sizes. AIM: To clarify the relationship between conditioned pain modulation and IBS by undertaking a systemic review and meta-analysis METHODS: A systematic review of MEDLINE and Web of Science databases was searched (up to 10 May 2018). We included studies examining conditioned pain modulation in adults with IBS and healthy subjects. Data were pooled for meta-analysis to calculate the odds ratio and effect size of abnormal conditioned pain modulation in IBS, with 95% confidence intervals (CI). RESULTS: The search strategy identified 645 studies, of which 13 were relevant and 12 met the inclusion criteria. Conditioned pain modulation in IBS patients vs healthy subjects was significantly reduced, odds ratio 4.84 (95% CI: 2.19-10.71, P < 0.0001), Hedges' g effect size of 0.85 (95% CI: 0.42-1.28, P < 0.001). There was significant heterogeneity in effect sizes (Q-test χ CONCLUSION: Conditioned pain modulation is significantly diminished in patients with IBS vs healthy controls. These data suggest that abnormal descending pathways may play an important pathophysiological role in IBS, which could represent an investigation and a therapeutic target in IBS.

19 Article Antibiotics: a risk factor for irritable bowel syndrome in a population-based cohort. 2018

Krogsgaard, Laura Rindom / Engsbro, Anne Line / Bytzer, Peter. ·a Department of Medicine , Zealand University Hospital , Køge , Denmark. · b Department of Clinical Microbiology , Hvidovre University Hospital , Hvidovre , Denmark. · c Department of Clinical Medicine , University of Copenhagen , ‎ Copenhagen ‎, Denmark. ·Scand J Gastroenterol · Pubmed #30189148.

ABSTRACT: OBJECTIVES: Use of antibiotics affects the composition of the gut microbiome. The microbiome is thought to play a role in development of irritable bowel syndrome (IBS), but antibiotics as a possible risk factor for IBS has not been clarified. We aimed to explore if antibiotics is a risk factor for IBS by investigating use of antibiotics and development of IBS in a cohort from the Danish background population. MATERIALS AND METHODS: An internet-based web panel representative of the Danish background population was invited to participate in a survey regarding the epidemiology of IBS in 2010, 2011 and 2013. A questionnaire based on the Rome III criteria for IBS were answered at all three occasions. In 2013, a question regarding use of antibiotics in the past year was included. RESULTS: In 2013, use of antibiotics was reported by 22.4% (624/2781) of the population. A higher proportion of individuals with IBS reported use of antibiotics compared with asymptomatic controls [29.0% (155/534) vs. 17.9% (212/1,184), p < .01]. For asymptomatic respondents in 2010 and 2011 (n = 1004), the relative risk of IBS in 2013 related with use of antibiotics was 1.9 [95% confidence interval (CI): 1.1-3.1]. Adjusting for sex by logistic regression, development of IBS was predicted by use of antibiotics with an odds ratio of 1.8 (95% CI: 1.0-3.2). CONCLUSIONS: Antibiotics is a risk factor for IBS in asymptomatic individuals. Possible mechanisms should be investigated in future studies.

20 Article Faecal microbiota transplantation alters gut microbiota in patients with irritable bowel syndrome: results from a randomised, double-blind placebo-controlled study. 2018

Halkjær, Sofie Ingdam / Christensen, Alice Højer / Lo, Bobby Zhao Sheng / Browne, Patrick Denis / Günther, Stig / Hansen, Lars Hestbjerg / Petersen, Andreas Munk. ·Department of Gastroenterology, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark. · Department of Gastroenterology, Aleris-Hamlet Hospitals Copenhagen, Soborg, Denmark. · Department of Environmental Science, Aarhus University, Roskilde, Denmark. ·Gut · Pubmed #29980607.

ABSTRACT: OBJECTIVE: IBS is associated with an intestinal dysbiosis and faecal microbiota transplantation (FMT) has been hypothesised to have a positive effect in patients with IBS. We performed a randomised, double-blind placebo-controlled trial to investigate if FMT resulted in an altered gut microbiota and improvement in clinical outcome in patients with IBS. DESIGN: We performed this study in 52 adult patients with moderate-to-severe IBS. At the screening visit, clinical history and symptoms were assessed and faecal samples were collected. Patients were randomised to FMT or placebo capsules for 12 days and followed for 6 months. Study visits were performed at baseline, 1, 3 and 6 months, where patients were asked to register their symptoms using the IBS-severity scoring system (IBS-SSS) and IBS-specific quality of life (IBS-QoL). Prior to each visit, faecal samples were collected. RESULTS: A significant difference in improvement in IBS-SSS score was observed 3 months after treatment (p=0.012) favouring placebo. This was similar for IBS-QoL data after 3 months (p=0.003) favouring placebo. Patients receiving FMT capsules had an increase in faecal microbial biodiversity while placebos did not. CONCLUSION: In this randomised double-blinded placebo-controlled study, we found that FMT changed gut microbiota in patients with IBS. But patients in the placebo group experienced greater symptom relief compared with the FMT group after 3 months. Altering the gut microbiota is not enough to obtain clinical improvement in IBS. However, different study designs and larger studies are required to examine the role of FMT in IBS. TRIAL REGISTRATION NUMBER: NCT02788071.

21 Article Characteristics of the bacterial microbiome in association with common intestinal parasites in irritable bowel syndrome. 2018

Krogsgaard, Laura Rindom / Andersen, Lee O 'Brien / Johannesen, Thor Bech / Engsbro, Anne Line / Stensvold, Christen Rune / Nielsen, Henrik Vedel / Bytzer, Peter. ·Department of Gastroenterology, Zealand University Hospital, Lykkebækvej 1, DK-4600, Køge, Denmark. Lrk@dadlnet.dk. · Department of Clinical Medicine, University of Copenhagen, København, Denmark. Lrk@dadlnet.dk. · Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark. · Department of Clinical Microbiology, Copenhagen University Hospital, Kettegård Alle 30, DK-2560, Hvidovre, Denmark. · Department of Gastroenterology, Zealand University Hospital, Lykkebækvej 1, DK-4600, Køge, Denmark. · Department of Clinical Medicine, University of Copenhagen, København, Denmark. ·Clin Transl Gastroenterol · Pubmed #29915224.

ABSTRACT: OBJECTIVE: A low prevalence of intestinal parasites has been identified in individuals with irritable bowel syndrome (IBS), but potential associations with alterations in the bacterial microbiome remain largely unexplored. We aimed to investigate the relationship between parasites and bacteria in individuals with IBS in order to identify potential trans-kingdom microbial characteristics. DESIGN: Stool samples were collected from the Danish background population classified into IBS (n = 119), unspecific gastrointestinal (GI) symptoms (n = 114), and asymptomatic controls (n = 186) based on the Rome III criteria for IBS. Bacterial (16S) and eukaryotic (18S) ribosomal DNA was sequenced, and 18S data were merged with data from conventional parasite laboratory tests. The bacterial microbiome was analyzed according to symptom group and parasite colonization status. RESULTS: Bacterial richness and diversity were similar for IBS and controls but higher in those with unspecific GI symptoms. A higher abundance of Bacteroides and a lower abundance of Faecalibacterium were detected in individuals with IBS and unspecific GI symptoms compared with controls. Principal component analyses indicated differences in bacterial composition related to parasite colonization rather than symptom group. Parasites were detected at the lowest frequency in the IBS group (39%) and in samples dominated by Bacteroides. Higher bacterial richness and diversity were found in parasite-positive samples from controls and those with unspecific GI symptoms but not in individuals with IBS. CONCLUSION: Parasite colonization, rather than bacterial composition, differed between individuals with IBS and healthy controls. Parasite colonization was associated to a rich and diverse bacterial microbiome; however, this association was altered in IBS.

22 Article A Pilot Study of the Effect of Green Kiwifruit on Human Intestinal Fermentation Measured by Hydrogen and Methane Breath Testing. 2018

Chen, Amanda G Y / Offereins, Marleen S L / Mulder, Christopher J / Frampton, Christopher M / Gearry, Richard B. ·1 Department of Gastroenterology and Medicine, Christchurch Hospital, University of Otago , Christchurch, Christchurch, New Zealand . · 2 Department of Medicine, VU Medical Centre , Amsterdam, The Netherlands . ·J Med Food · Pubmed #29694795.

ABSTRACT: We investigated the impact of the ingestion of two green kiwifruit (Actinidia deliciosa var. Hayward) and one Royal Gala apple on breath hydrogen and methane production in humans. Consumption of two green kiwifruit led to no evidence of carbohydrate malabsorption (0/20), whereas consumption of one apple was associated with carbohydrate malabsorption in 6/20 participants (P = .008). There were no significant differences in the area under the curve for hydrogen or methane breath concentrations after consumption of the two fruits. Rates of lactose and fructose breath tests in this cohort were within expected parameters. Green kiwifruit are not associated with clinically significant carbohydrate malabsorption compared with apples in this pilot study.

23 Article The Importance of Detecting Irritable Bowel-like Symptoms in Inflammatory Bowel Disease Patients. 2018

Weimers, Petra / Burisch, Johan. ·Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark. ·J Crohns Colitis · Pubmed #29390096.

ABSTRACT: -- No abstract --

24 Article Ulcerative colitis, Crohn's disease, and irritable bowel syndrome have different profiles of extracellular matrix turnover, which also reflects disease activity in Crohn's disease. 2017

Mortensen, Joachim Høg / Manon-Jensen, Tina / Jensen, Michael Dam / Hägglund, Per / Klinge, Lone Gabriels / Kjeldsen, Jens / Krag, Aleksander / Karsdal, Morten Asser / Bay-Jensen, Anne-Christine. ·Nordic Bioscience, Biomarkers and Research, Herlev, Denmark. · Department of Internal Medicine, Lillebaelt Hospital Vejle, Vejle, Denmark. · Department of Biotechnology and Biomedicin, Technical University of Denmark. · Odense University Hospital, Department of Gastroenterology, Odense, Denmark. ·PLoS One · Pubmed #29028807.

ABSTRACT: BACKGROUND: Increased protease activity is a key pathological feature of inflammatory bowel disease (IBD). However, the differences in extracellular matrix remodelling (ECM) in Crohn's disease (CD) and ulcerative colitis (UC) are not well described. An increased understanding of the inflammatory processes may provide optimized disease monitoring and diagnostics. We investigated the tissue remodelling in IBD and IBS patients by using novel blood-based biomarkers reflecting ECM remodelling. METHODS: Five ECM biomarkers (VICM, BGM, EL-NE, C5M, Pro-C5) were measured by competitive ELISAs in serum from 72 CD patients, 60 UC patients, 22 patients with irritable bowel syndrome (IBS), and 24 healthy donors. One-way analysis of variance, Mann-Whitney U-test, logistic regression models, and receiver operator characteristics (ROC) curve analysis was carried out to evaluate the diagnostic accuracy of the biomarkers. RESULTS: The ECM remodelling was significantly different in UC compared to CD. The best biomarker combination to differentiate UC from CD and colonic CD was BGM and VICM (AUC = 0.98, P<0.001; AUC = 0.97, P<0.001), and the best biomarker combination to differentiate IBD from IBS patients were BGM, EL-NE, and Pro-C5 (AUC = 0.8, P<0.001). When correcting for the use of immunosuppressant and elevated CRP levels (CRP>5mg/mL), correlation of Pro-C5 (r = 0.36) with CDAI was slightly improved compared to CRP (r = 0.27) corrected for the use of immunosuppressant. Furthermore, BGM and EL-NE biomarkers were highly associated with colon inflammation in CD patients. CONCLUSION: ECM fragments of tissue remodelling in IBD affect UC and CD differently, and may aid in differentiating IBD from IBS (EL-NE, BGM, Pro-C5), and UC from CD patients (BGM, VICM). Formation of type V collagen is related to the level of inflammation in CD and may reflect disease activity in CD.

25 Article Constipation in adults with neurofibromatosis type 1. 2017

Ejerskov, Cecilie / Krogh, Klaus / Ostergaard, John R / Fassov, Janne L / Haagerup, Annette. ·Centre for Rare Diseases, Pediatrics and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark. CECILIE@EJERSKOV.DK. · NIDO | Danmark, Research in Education and Health, West Danish Hospital, HEV, Gl. Landevej 61, 7400, Herning, Denmark. CECILIE@EJERSKOV.DK. · Department of Clinical Medicine, Health, Aarhus University, Incuba/Skejby, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark. CECILIE@EJERSKOV.DK. · Department of Hepatology and Gastroenterology, Aarhus University Hospital, Noerrebrogade 44 Bygn. 7, 8000, Aarhus C, Denmark. · Centre for Rare Diseases, Pediatrics and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark. · NIDO | Danmark, Research in Education and Health, West Danish Hospital, HEV, Gl. Landevej 61, 7400, Herning, Denmark. · Department of Clinical Medicine, Health, Aarhus University, Incuba/Skejby, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark. ·Orphanet J Rare Dis · Pubmed #28814319.

ABSTRACT: BACKGROUND: Neurofibromatosis type 1 (NF1) is an autosomal-dominant disease characterised by symptoms of the skin, eyes, nervous system and bones. A previous study indicated that constipation, large rectal diameters and prolonged colorectal transit times are common in children with NF1. The aim of the present study was to investigate and compare the prevalence of gastrointestinal symptoms in adult patients with NF1 to their unaffected relatives serving as the control group. Patients with NF1 were recruited from one of two Danish National Centres of Expertise for NF1 and their unaffected relatives were invited to participate as controls. Gastrointestinal symptoms were assessed with a web-based, self-administered, validated, Rome® III diagnostic questionnaire. Logistic regression was used to estimate the prevalence of functional dyspepsia, IBS and functional constipation in each group and the groups were compared using their odds ratios. RESULTS: The response rates for patients and controls were 66.4% and 82.4%, respectively. We compared 175 patients, median age 34.2 (IQR = 20.1) and 91 of their unaffected relatives, median age 42.0 (IQR = 12). The overall likelihood of fulfilling the diagnostic criteria for functional constipation, irritable bowel syndrome or functional dyspepsia was 33.1% among patients vs. 14.3% among controls, (odds ratio (OR): 2.97; 95% CI: 1.56-5.66) and after adjustment for age and gender (OR: 3.06; 95% CI: 1.62-5.79). The likelihood of functional constipation was higher among patients (OR: 3.80; 95% CI: 1.27-11.31), and this was still true after adjustment (OR: 3.49; 95% CI: 1.14-10.64). The likelihood of irritable bowel syndrome (OR: 2.29; 95% CI: 0.98-5.33) was evident after adjustment (OR: 2.46; 95% CI: 1.10-5.47), whereas there was no difference in the likelihood of functional dyspepsia (OR: 2.35; 95% CI: 0.67-8.32) after adjustment (OR:2.25; 95% CI: 0.70-7.17). CONCLUSIONS: Overall, having symptoms usually attributed to either functional dyspepsia, IBS or functional constipation is more common in adults with NF1 compared to unaffected relatives. Of the three, the likelihood of constipation is markedly higher. The high prevalence of constipation indicates that it is not functional but part of the NF1 disorder.