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Irritable Bowel Syndrome: HELP
Articles from Unspecified
Based on 157 articles published since 2008

These are the 157 published articles about Irritable Bowel Syndrome that originated from Unspecified during 2008-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7
1 Guideline Consensus Statement of Definitions for Anorectal Physiology Testing and Pelvic Floor Terminology (Revised). 2018

Bordeianou, Liliana G / Carmichael, Joseph C / Paquette, Ian M / Wexner, Steven / Hull, Tracy L / Bernstein, Mitchell / Keller, Deborah S / Zutshi, Massarat / Varma, Madhulika G / Gurland, Brooke H / Steele, Scott R. ·Prepared on behalf of the Pelvic Floor Disorders Committee and the Clinical Practice Guidelines Committee of The American Society of Colon and Rectal Surgeons. ·Dis Colon Rectum · Pubmed #29521821.

ABSTRACT: -- No abstract --

2 Guideline British Dietetic Association systematic review and evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update). 2016

McKenzie, Y A / Bowyer, R K / Leach, H / Gulia, P / Horobin, J / O'Sullivan, N A / Pettitt, C / Reeves, L B / Seamark, L / Williams, M / Thompson, J / Lomer, M C E / Anonymous5290870. ·Nuffield Health The Manor Hospital, Oxford, UK. yvonne@digestiblenutrition.co.uk. · Department of Nutrition and Dietetics, Great Western Hospitals NHS Foundation Trust, Swindon, UK. · Department of Nutrition and Dietetics, Southampton NHS Foundation Trust, Southampton, UK. · Dr Ashok Ayurveda Clinic, Birmingham, UK. · Department of Nutrition and Dietetics, North Middlesex University Hospital NHS Trust, London, UK. · Faculty of Life Sciences and Medicine, Diabetes and Nutritional Sciences Division, King's College London, London, UK. · Faculty of Medicine, Imperial College London, London, UK. · Allergy Services, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. · Specialist Gastroenterology Community Dietetic Service, Somerset Partnership NHS Foundation Trust, Bridgwater, UK. · Calm Gut Clinic, Todmorden, UK. · Department of Nutrition and Dietetics, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK. ·J Hum Nutr Diet · Pubmed #27272325.

ABSTRACT: BACKGROUND: The first British Dietetic Association (BDA) guidelines for the dietary management of irritable bowel syndrome (IBS) in adults were published in 2012. Subsequently, there has been a wealth of new research. The aim of this work was to systematically review the evidence for the role of diet in the management of IBS and to update the guidelines. METHODS: Twelve questions relating to diet and IBS were defined based on review of the previous guideline questions, current evidence and clinical practice. Chosen topics were on healthy eating and lifestyle (alcohol, caffeine, spicy food, elimination diets, fat and fluid intakes and dietary habits), milk and dairy, dietary fibre, fermentable carbohydrates, gluten, probiotics and elimination diets/food hypersensitivity. Data sources were CINAHL, Cochrane Register of Controlled Trials, Embase, Medline, Scopus and Web of Science up to October 2015. Studies were assessed independently in duplicate using risk of bias tools specific to each included study based on inclusion and exclusion criteria for each question. National Health and Medical Research Council grading evidence levels were used to develop evidence statements and recommendations, in accordance with Practice-based Evidence in Nutrition Global protocol used by the BDA. RESULTS: Eighty-six studies were critically appraised to generate 46 evidence statements, 15 clinical recommendations and four research recommendations. The IBS dietary algorithm was simplified to first-line (healthy eating, provided by any healthcare professional) and second-line [low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) to be provided by dietitian] dietary advice. CONCLUSIONS: These guidelines provide updated comprehensive evidence-based details to achieve the successful dietary management of IBS in adults.

3 Guideline British Dietetic Association systematic review of systematic reviews and evidence-based practice guidelines for the use of probiotics in the management of irritable bowel syndrome in adults (2016 update). 2016

McKenzie, Y A / Thompson, J / Gulia, P / Lomer, M C E / Anonymous3700870. ·Nuffield Health, The Manor Hospital, Oxford, UK. yvonne@digestiblenutrition.co.uk. · Calm Gut Clinic, Todmorden, Lancashire, UK. · Dr Ashok Ayurveda Clinic, Birmingham, UK. · Diabetes and Nutritional Sciences Division, King's College London, London, UK. · Department of Nutrition and Dietetics, Guy's and St Thomas' NHS Foundation Trust, London, UK. ·J Hum Nutr Diet · Pubmed #27265510.

ABSTRACT: BACKGROUND: Probiotics are often taken by individuals with irritable bowel syndrome (IBS). Which products are effective is unclear, despite an increasing research base. This project will systematically review which strain- and dose- specific probiotics can be recommended to adults with IBS to improve symptoms and quality of life (QoL). It is part of a broader systematic review to update British Dietetic Association guidelines for the dietary management of IBS in adults. METHODS: CINAHL, Cochrane, Embase, Medline, Scopus and Web of Science were searched for systematic reviews (SRs) of randomised controlled trial (RCT)s recruiting adults with IBS comparing probiotic intervention with placebo. AMSTAR, risk of bias and diet bias tools were used to appraise methodological quality. Symptom and QoL data were appraised to develop probiotic-specific evidence statements on clinically meaningful and marginal outcomes in various settings, graded clinical practice recommendations and practical considerations. RESULTS: Nine systematic reviews and 35 RCTs were included (3406 participants) using 29 dose-specific probiotic formulations. None of the RCTs were at low risk of bias. Twelve out of 29 probiotics (41%) showed no symptom or QoL benefits. Evidence indicated that no strain or dose specific probiotic was consistently effective to improve any IBS symptoms or QoL. Two general clinical practice recommendations were made. CONCLUSIONS: Symptom outcomes for dose-specific probiotics were heterogeneous. Specific probiotic recommendations for IBS management in adults were not possible at this time. More data from high-quality RCTs treating specific symptom profiles are needed to support probiotic therapy in the management of IBS.

4 Guideline British Dietetic Association evidence-based guidelines for the dietary management of irritable bowel syndrome in adults. 2012

McKenzie, Y A / Alder, A / Anderson, W / Wills, A / Goddard, L / Gulia, P / Jankovich, E / Mutch, P / Reeves, L B / Singer, A / Lomer, M C E / Anonymous920723. ·Nuffield Health The Manor Hospital, Oxford, UK Department of Nutrition and Dietetics, Royal Sussex County Hospital, Brighton, UK. ·J Hum Nutr Diet · Pubmed #22489905.

ABSTRACT: BACKGROUND:  Irritable bowel syndrome (IBS) is a chronic debilitating functional gastrointestinal disorder. Diet and lifestyle changes are important management strategies. The aim of these guidelines is to systematically review key aspects of the dietary management of IBS, with the aim of providing evidence-based guidelines for use by registered dietitians. METHODS: Questions relating to diet and IBS symptom management were developed by a guideline development group. These included the role of milk and lactose, nonstarch polysaccharides (NSP), fermentable carbohydrates in abdominal bloating, probiotics and empirical or elimination diets. A comprehensive literature search was conducted and relevant studies from January 1985 to November 2009 were identified using the electronic database search engines: Cinahl, Cochrane Library, Embase, Medline, Scopus and Web of Science. Evidence statements, recommendations, good practice points and research recommendations were developed. RESULTS: Thirty studies were critically appraised. A dietetic care pathway was produced following a logical sequence of treatment and formed the basis of these guidelines. Three lines of dietary management were identified. first line: Clinical and dietary assessment, healthy eating and lifestyle management with some general advice on lactose and NSP. Second line: Advanced dietary interventions to improve symptoms based on NSP, fermentable carbohydrates and probiotics. Third line: Elimination and empirical diets. Research recommendations were also identified relating to the need for adequately powered and well designed randomised controlled trials. CONCLUSIONS: These guidelines provide evidence-based details of how to achieve the successful dietary management of IBS.

5 Guideline [IBD ahead 2010--Answering important questions in Crohn's disease treatment]. 2011

Schmidt, C / Dignass, A / Hartmann, F / Hüppe, D / Kruis, W / Layer, P / Lüers, A / Stallmach, A / Teich, N / Sturm, A / Anonymous6160703. ·Universitätklinikum Jena, Klinik für Innere Medizin II, Abteilung für Gastroenterologie, Hepatologie und Infektiologie. ·Z Gastroenterol · Pubmed #21866492.

ABSTRACT: The treatment of patients with inflammatory bowel disease has become more complex in recent years through the introduction of various immunosuppressive agents as well as the approval of monoclonal antibodies against TNF-α and patients receiving such treatment must be carefully monitored. National and international guidelines define a diagnostic and therapeutic context for the practitioner, but can only partially respond to specific questions on the procedure for individual patients. Within the framework of a project initiated by Abbott entitled "IBD ahead" 38 German IBD experts have elaborated concrete proposals for dealing with corticosteroids, immunosuppressants and TNF-α antibodies on the basis of the published literature and their own personal experience in order to close the gap between these guidelines and daily clinical practice. Statements were developed on the choice of correct timing of initiation, dose and duration of the individual substances and on how to proceed with patients exhibiting treatment failure. Moreover, recommendations are also made on drug combination strategies, safety monitoring and the risks regarding the development of infectious complications and malignancies. These recommendations are illustrated by case studies from everyday practice in participating centres.

6 Review Effectiveness of vitamin D for irritable bowel syndrome: A protocol for a systematic review of randomized controlled trial. 2019

Shi, Sheng-Mei / Wen, Yan-Li / Hou, Hai-Bin / Liu, Hai-Xia. ·Department of Gastroenterology. · Department of Orthopedics, Yanan University Affiliated Hospital, Yan'an. · Department of Gastroenterology, Baoji Central Hospital, Baoji, China. ·Medicine (Baltimore) · Pubmed #30817618.

ABSTRACT: BACKGROUND: Irritable bowel syndrome (IBS) is a prevalent and debilitating condition for patients who experience this disorder. Clinical researches indicate that vitamin D (VD) can help relief the symptoms of IBS. However, no systematic review has addressed this issue yet. Thus, this systematic review aims to investigate the effectiveness and safety of VD for patients with IBS. METHODS: We will retrieve the following databases for randomized controlled trials to assess the effectiveness and safety of VD for patients with IBS: Cochrane Library, EMBASE, MEDICINE, Web of Science, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. Each database will be retrieved from its inception to January 31, 2019. Two researchers will independently selection studies, extract data and assess methodological quality. RevMan 5.3 software will be used to pool the data, and carry out the meta-analysis if it is possible. RESULTS: This systematic review will evaluate the effectiveness and safety of VD for patients with IBS. The primary outcomes include stool frequency and abdominal pain. The secondary outcomes consist of stool status, quality of life, and adverse effects. CONCLUSIONS: The findings of this systematic review may provide the existing evidence on the effectiveness and safety of VD for patients with IBS. ETHICS AND DISSEMINATION: This systematic review will not require ethical approval, because all data will be extracted from the published literature. The findings of this study will be disseminated at peer-reviewed journals.PROSPERO registration number: PROSPERO CRD42019122641.

7 Review Fibromyalgia and Irritable Bowel Syndrome in Female Pelvic Pain. 2018

Johnson, Christina M / Makai, Gretchen E H. ·Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Christiana Care Health System, Newark, Delaware. ·Semin Reprod Med · Pubmed #30566979.

ABSTRACT: Fibromyalgia and irritable bowel syndrome are common disorders which often coexist in women with chronic pelvic pain. Like pelvic pain, these disorders describe symptoms without pathologic findings. Women with chronic pelvic pain have a higher prevalence of fibromyalgia (4-31%) and irritable bowel syndrome (8-41%) than the general population. Aberrant pain processing and psychosocial stressors are implicated in the co-occurrence of these pain syndromes (chronic overlapping pain conditions), but active epidemiologic, psychosocial, and neurobiologic research is ongoing. Given the higher prevalence of fibromyalgia and irritable bowel syndrome in women with chronic pelvic pain, gynecologists should have more education in diagnosis and treatment of these and other chronic overlapping pain conditions to improve care for women.

8 Review [Irritable bowel syndrome: comorbid psychiatric disorders and psychological treatment options]. 2018

Gajdos, Panna / Rigó, Adrien. ·Pszichológiai Intézet, Eötvös Loránd Tudományegyetem Budapest, Izabella u. 46., 1064. · Pszichológiai Doktori Iskola, Eötvös Loránd Tudományegyetem Budapest. ·Orv Hetil · Pubmed #30545263.

ABSTRACT: Irritable bowel syndrome is a chronic functional gastrointestinal disorder with a prevalence of 7-21%. It has a negative impact on health-related quality of life and work productivity and it is associated with increased psychological distress and mental comorbidity, like major depression disorder and generalised anxiety disorder. Due to biopsychosocial factors and the brain-gut axis playing a key role in the aetiology of the disease, the use of psychological treatments has great importance in the therapy of irritable bowel syndrome. These interventions focus on central mechanisms, like visceral sensitivity, pain amplification, hypervigilance and gastrointestinal symptom-specific anxiety. They significantly reduce damaging illness-related cognitions, the use of maladaptive coping strategies, catastrophic appraisals of bodily sensations and chronic muscle tension. The utilization of these treatments is associated with clinically significant symptom improvement and positive mental health outcomes. This review study focuses on the psychiatric comorbidity of irritable bowel syndrome and the use of evidence-based psychological therapies in the treatment of the disease. Using ScienceDirect and PubMed databases, almost 60 studies have been selected. A high number of studies investigate the efficacy of cognitive behaviour therapy and hypnotherapy with meta-analyses included. There is also growing evidence on the beneficial impacts of mindfulness-based stress reduction. Future research will need to concentrate on studying the utility of mind-body therapies such as relaxation techniques in the treatment of irritable bowel syndrome with meta-analyses on the effects of mindfulness-based interventions. Orv Hetil. 2018; 159(50): 2115-21121.

9 Review Overlap between functional abdominal pain disorders and organic diseases in children. 2018

Langshaw, A H / Rosen, J M / Pensabene, L / Borrelli, O / Salvatore, S / Thapar, N / Concolino, D / Saps, M. ·Departamento de Pediatría, División de Gastroenterología Pediátrica, University of Miami Jackson Memorial Hospital, Miami, Estados Unidos. · División de Gastroenterología Pediátrica, The Children's Mercy Hospital, Kansas City, MO, Estados Unidos. Electronic address: jmrosen@cmh.edu. · Unidad Pediátrica, Departamento de Ciencias Médicas y Quirúrgicas, University Magna Graecia of Catanzaro, Catanzaro, Italia. · Unidad de Neurogastroenterología y Motilidad, Departamento de Gastroenterología, Great Ormond Street Hospital for Children, Londres, Reino Unido. · Departamento de Medicina Clínica y Experimental, Pediatría, University of Insubria, Varese, Italia. · División de Gastroenterología, Hepatología y Nutrición, Nationwide Children's Hospital, Columbus, OH, Estados Unidos. ·Rev Gastroenterol Mex · Pubmed #29622363.

ABSTRACT: Functional abdominal pain disorders are highly prevalent in children. These disorders can be present in isolation or combined with organic diseases, such as celiac disease and inflammatory bowel diseases. Intestinal inflammation (infectious and non-infectious) predisposes children to the development of visceral hypersensitivity that can manifest as functional abdominal pain disorders, including irritable bowel syndrome. The new onset of irritable bowel syndrome symptoms in a patient with an underlying organic disease, such as inflammatory bowel disease, is clinically challenging, given that the same symptomatology may represent a flare-up of the inflammatory bowel disease or an overlapping functional abdominal pain disorder. Similarly, irritable bowel syndrome symptoms in a child previously diagnosed with celiac disease may occur due to poorly controlled celiac disease or the overlap with a functional abdominal pain disorder. There is little research on the overlap of functional abdominal disorders with organic diseases in children. Studies suggest that the overlap between functional abdominal pain disorders and inflammatory bowel disease is more common in adults than in children. The causes for these differences in prevalence are unknown. Only a handful of studies have been published on the overlap between celiac disease and functional abdominal pain disorders in children. The present article provides a review of the literature on the overlap between celiac disease, inflammatory bowel disease, and functional abdominal pain disorders in children and establish comparisons with studies conducted on adults.

10 Review Painful neurotrophins and their role in visceral pain. 2018

López-Pérez, Ana E / Nurgali, Kulmira / Abalo, Raquel. ·Pain Unit, Anaesthesia Service, Gregorio Marañon University Hospital. · Group of Excellent Research URJC-Bank of Santander-Multidisciplinary Group in Pain Research and Treatment (i+DOL). · College of Health & Biomedicine, Victoria University. · Department of Medicine, Western Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Regenerative Medicine and Stem Cells Program, Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, Victoria, Australia. · Associated Unit I+D+i to the Institute of Medicinal Chemistry (IQM). · Associated Unit I+D+i to the Institute of Research in Food Sicence (CIAL), Spanish National Research Council (CSIC), Madrid. · Area of Pharmacology and Nutrition, Department of Basic Health Sciences, University Rey Juan Carlos (URJC), Alcorcón, Spain. ·Behav Pharmacol · Pubmed #29543647.

ABSTRACT: Beyond their well-known role in embryonic development of the central and peripheral nervous system, neurotrophins, particularly nerve growth factor and brain-derived neurotrophic factor, exert an essential role in pain production and sensitization. This has mainly been studied within the framework of somatic pain, and even antibodies (tanezumab and fasinumab) have recently been developed for their use in chronic somatic painful conditions, such as osteoarthritis or low back pain. However, data suggest that neurotrophins also exert an important role in the occurrence of visceral pain and visceral sensitization. Visceral pain is a distressing symptom that prompts many consultations and is typically encountered in both 'organic' (generally inflammatory) and 'functional' (displaying no obvious structural changes in routine clinical evaluations) disorders of the gut, such as inflammatory bowel disease and irritable bowel syndrome, respectively. The present review provides a summary of neurotrophins as a molecular family and their role in pain in general and addresses recent investigations of the involvement of nerve growth factor and brain-derived neurotrophic factor in visceral pain, particularly that associated with inflammatory bowel disease and irritable bowel syndrome.

11 Review Diagnosis and management of irritable bowel syndrome: a guide for the generalist. 2017

Linedale, Ecushla C / Andrews, Jane M. ·University of Adelaide, Adelaide, SA Jane.Andrews@sa.gov.au. · Royal Adelaide Hospital, Adelaide, SA. ·Med J Aust · Pubmed #28954618.

ABSTRACT: Irritable bowel syndrome (IBS) and other functional gastrointestinal disorders (FGIDs) are so prevalent they cannot reasonably have their diagnoses and management based within specialty care. However, delayed diagnosis, lengthy wait times for specialist review, overinvestigation and lack of clear diagnostic communication are common. The intrusive symptoms of IBS and other FGIDs impair patient functioning and reduce quality of life, and come with significant costs to individual patients and the health care system, which could be reduced with timely diagnosis and effective management. IBS, in particular, is no longer a diagnosis of exclusion, and there are now effective dietary and psychological therapies that may be accessed without specialist referral. The faecal calprotectin test is widely available, yet not on the Medical Benefits Schedule, and a normal test result reliably discriminates between people with IBS and patients who warrant specialist referral.

12 Review The role of bile acids in the pathogenesis of bowel diseases. 2017

Panek-Jeziorna, Magdalena / Mulak, Agata. ·Katedra i Klinika Gastroenterologii i Hepatologii, Uniwersytet Medyczny we Wrocławiu. ·Postepy Hig Med Dosw (Online) · Pubmed #28894048.

ABSTRACT: Bile acids not only play a cardinal role in the digestion and absorption of fat and fat-soluble vitamins, but also significantly affect gastrointestinal motor, sensory and secretory functions, intestinal barrier permeability and the regulation of the inflammatory response. The results of recent studies have revealed complex interactions between bile acids and the gut microbiota. In addition, bile acids also play a role of signaling molecules regulating the activity of lipid and glucose metabolic pathways, as well as a role of ligands for transcription factors. Genetic factors associated with the regulation of bile acid synthesis, transport and action may significantly influence gastrointestinal function and predispose to diarrhea resulting from bile acid malabsorption. Methods used in the diagnosis of bile acid malabsorption include 75selenium-homotaurocholic acid test, serum C4 and fibroblast growth factor 19 (FGF19), as well as fecal bile acid levels. The paper presents the latest data on the role of bile acid in the pathogenesis of irritable bowel syndrome, inflammatory bowel diseases and colorectal cancer. Advances in the treatment of disturbances in bile acids absorption and synthesis are also presented. A better understanding of molecular mechanisms regulating bile acid action may have implication for colorectal cancer prevention.

13 Review Eluxadoline in the treatment of diarrhea-predominant irritable bowel syndrome. The SEPD perspective. 2017

Vera, Isabel / Júdez, F Javier. ·Hospital Universitario Puerta de Hierro Majadahonda. · Gestión del Conocimiento, SEPD, España. ·Rev Esp Enferm Dig · Pubmed #28747053.

ABSTRACT: Functional gut disorders, including diarrhea-predominant irritable bowel syndrome, are highly prevalent conditions worldwide that significantly impact health economy and patient quality of life, yet lacking fully satisfactory therapeutic options. These circumstances fostered research on various molecules with more specific therapeutic targets, including opioid receptors. Eluxadoline (Allergan's Vibercy® in the USA, Truberzi® in Europe) is a locally-acting mixed mu- and kappa-opioid receptor agonist, and delta-opioid receptor antagonist, that was licensed in 2015 by the Food and Drug Administration (FDA) and in 2016 by the European Medicines Agency (EMA) for use in diarrhea-predominant irritable bowel syndrome. Eluxadoline provides, with advantage over the current standard of care, control of both stool consistency and abdominal pain, good tolerability in most cases, and improved quality of life, hence it deserves consideration when approaching a patient with this disorder. As with any recently approved therapy, adequate pharmacovigilance is to be expected, as well as studies to inform on different scenarios such as on-demand therapy, loss of response assessment, use as rescue therapy for other molecules, and cost-effectiveness, to further characterize and more accurately position eluxadoline within the therapeutic spectrum.

14 Review Fecal microbiota transplantation - methods of treatment of recurrent Clostridium difficile infections and other diseases. 2017

Juszczuk, Klaudia / Grudlewska, Katarzyna / Mikucka, Agnieszka / Gospodarek, Eugenia. ·Katedra i Zakład Mikrobiologii Collegium Medicum w Bydgoszczy Uniwersytet Mikołaja Kopernika w Toruniu. ·Postepy Hig Med Dosw (Online) · Pubmed #28345530.

ABSTRACT: Clostridium difficile is a serious epidemiological problem and particularly dangerous microorganism causing hospital infections. Currently, the treatment of C. difficile infections is the use of metronidazole or vancomycin. However, in some patients, recurrent infection difficult to treat occurs. Fecal microbiota transplantation (FMT) is a new method used to treat the recurrent CDI. FMT consists in the infusion of the fecal suspension from a healthy donor into the gastrointestinal tract of a patient with CDI to restore the natural intestinal microflora. FMT is safe and effective treatment of recurrent CDI. FMT is extensively described around the world, but to date only two randomized studies confirming the effectiveness of FMT have been conducted. This method was also applied in the treatment of diseases such as pseudomembranous colitis, ulcerative colitis, Crohn's disease and irritable bowel syndrome. The review describes the procedure for FMT and the current state of knowledge about the effectiveness of FMT in the treatment of recurrent CDI.

15 Review The global prevalence of IBS in adults remains elusive due to the heterogeneity of studies: a Rome Foundation working team literature review. 2017

Sperber, Ami D / Dumitrascu, Dan / Fukudo, Shin / Gerson, Charles / Ghoshal, Uday C / Gwee, Kok Ann / Hungin, A Pali S / Kang, Jin-Yong / Minhu, Chen / Schmulson, Max / Bolotin, Arkady / Friger, Michael / Freud, Tamar / Whitehead, William. ·Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. · 2nd Medical Department of Internal Medicine, University of Medicine and Pharmacy, Cluj-Napoca, Romania. · Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Seiryo Aoba, Japan. · Division of Gastroenterology, Mt. Sinai School of Medicine, Mind-Body Digestive Center, New York, New York, USA. · Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGI), Lucknow, India. · Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. · Durham University School of Medicine, Pharmacy and Health, Wolfson Research Institute, Stockton-on-Tees, UK. · Department of Gastroenterology, St. George's Hospital, London, UK. · Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. · Laboratory of Liver, Pancreas and Motility (HIPAM), Unit of Research in Experimental Medicine, Faculty of Medicine, Universidad Nacional Autonoma de Mexico (UNAM), Hospital General de México, Mexico City, Mexico. · Center for Functional GI & Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. ·Gut · Pubmed #26818616.

ABSTRACT: OBJECTIVES: The global prevalence of IBS is difficult to ascertain, particularly in light of the heterogeneity of published epidemiological studies. The aim was to conduct a literature review, by experts from around the world, of community-based studies on IBS prevalence. DESIGN: Searches were conducted using predetermined search terms and eligibility criteria, including papers in all languages. Pooled prevalence rates were calculated by combining separate population survey prevalence estimates to generate an overall combined meta-prevalence estimate. The heterogeneity of studies was assessed. RESULTS: 1451 papers were returned and 83, including 288 103 participants in 41 countries, met inclusion criteria. The mean prevalence among individual countries ranged from 1.1% in France and Iran to 35.5% in Mexico. There was significant variance in pooled regional prevalence rates ranging from 17.5% (95% CI 16.9% to 18.2%) in Latin America, 9.6% (9.5% to 9.8%) in Asia, 7.1% (8.0% to 8.3%) in North America/Europe/Australia/New Zealand, to 5.8% (5.6% to 6.0%) in the Middle East and Africa. There was a significant degree of heterogeneity with the percentage of residual variation due to heterogeneity at 99.9%. CONCLUSIONS: The main finding is the extent of methodological variance in the studies reviewed and the degree of heterogeneity among them. Based on this, we concluded that publication of a single pooled global prevalence rate, which is easily calculated, would not be appropriate or contributory. Furthermore, we believe that future studies should focus on regional and cross-cultural differences that are more likely to shed light on pathophysiology.

16 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 / Anonymous3490872. ·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).

17 Review Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult. 2016

Mearin, Fermín / Ciriza, Constanza / Mínguez, Miguel / Rey, Enrique / Mascort, Juan José / Peña, Enrique / Cañones, Pedro / Júdez, Javier. ·Centro Médico Teknon, España. · Aparato Digestivo, Hospital Universitario Doce de Octubre, España. · Hospital Clínico Universitario de Valencia, España. · Aparato Digestivo, Hospital Clínico San Carlos, España. · Coordinador Digestivo, semFYC. · Coordinador Digestivo, SEMERGEN. · Coordinador de Digestivo, SEMG. · Gestión del Conocimiento, SEPD, España. ·Rev Esp Enferm Dig · Pubmed #27230827.

ABSTRACT: In this Clinical Practice Guideline we discuss the diagnostic and therapeutic approach of adult patients with constipation and abdominal complaints at the confluence of the irritable bowel syndrome spectrum and functional constipation. Both conditions are included among the functional bowel disorders, and have a significant personal, healthcare, and social impact, affecting the quality of life of the patients who suffer from them. The first one is the irritable bowel syndrome subtype, where constipation represents the predominant complaint, in association with recurrent abdominal pain, bloating, and abdominal distension. Constipation is characterized by difficulties with or low frequency of bowel movements, often accompanied by straining during defecation or a feeling of incomplete evacuation. Most cases have no underlying medical cause, and are therefore considered as a functional bowel disorder. There are many clinical and pathophysiological similarities between both disorders, and both respond similarly to commonly used drugs, their primary difference being the presence or absence of pain, albeit not in an "all or nothing" manner. Severity depends not only upon bowel symptom intensity but also upon other biopsychosocial factors (association of gastrointestinal and extraintestinal symptoms, grade of involvement, and perception and behavior variants). Functional bowel disorders are diagnosed using the Rome criteria. This Clinical Practice Guideline has been made consistent with the Rome IV criteria, which were published late in May 2016, and discuss alarm criteria, diagnostic tests, and referral criteria between Primary Care and gastroenterology settings. Furthermore, all the available treatment options (exercise, fluid ingestion, diet with soluble fiber-rich foods, fiber supplementation, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback, antidepressants, psychological therapy, acupuncture, enemas, sacral root neurostimulation, surgery) are discussed, and practical recommendations are made regarding each of them.

18 Review Lubiprostone Is Effective in the Treatment of Chronic Idiopathic Constipation and Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 2016

Li, Fan / Fu, Tao / Tong, Wei-Dong / Liu, Bao-Hua / Li, Chun-Xue / Gao, Yu / Wu, Jin-Song / Wang, Xiang-Feng / Zhang, An-Ping. ·Department of General Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China. · Department of General Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China. Electronic address: anping_zhang@163.com. ·Mayo Clin Proc · Pubmed #27046523.

ABSTRACT: OBJECTIVE: To evaluate the efficacy and safety of lubiprostone in the treatment of chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). PATIENTS AND METHODS: We performed a literature search of the MEDLINE, Cochrane, Google Scholar, and ClinicalTrials.gov databases (from January 1, 2005, through January 31, 2015). Relevant studies meeting the inclusion criteria were manually searched by 2 independent reviewers. Efficacy outcomes evaluated at 1 week, 1 month, and 3 months of intervention were weekly frequency of spontaneous bowel movements, severity of constipation, consistency of stools, degree of abdominal pain/discomfort, degree of straining, and abdominal bloating. RESULTS: Of 246 studies identified, data from 9 trials comprising 1468 patients (63.6%) in the lubiprostone group and 841 (36.4%) in the placebo group were analyzed. We found that lubiprostone treatment significantly improved the severity of constipation, stool consistency, abdominal pain, degree of straining, and abdominal bloating at 1 week (P≤.03) and 1 month (P≤.004), except for abdominal pain at 1 month, which was similar to that when treated with placebo (P=.21). At 3 months, except for abdominal bloating (P=.03), there was no difference between lubiprostone and placebo groups in all other outcomes (P≥.05). Adverse effects such as nausea, vomiting, and diarrhea were common (incidence rate, 2.4%-75%); however, the incidence of serious adverse effects was low (<5%) and was mostly unrelated to lubiprostone treatment. CONCLUSION: Lubiprostone is a safe and efficacious drug for the treatment of chronic idiopathic constipation and irritable bowel syndrome with constipation, with limited adverse effects in 3 months of follow-up.

19 Review Novel pharmacological therapies for irritable bowel syndrome. 2016

Corsetti, Maura / Whorwell, Peter. ·a Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven , Leuven , Belgium. · b Centre for Gastrointestinal Sciences , University Manchester , Manchester , UK. ·Expert Rev Gastroenterol Hepatol · Pubmed #26907518.

ABSTRACT: Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder, which represents a major cost to healthcare services. Current pharmacological treatment includes fibre supplements, antispasmodics, laxatives, loperamide and antidepressants. This article reviews the novel pharmacological treatments already or recently approved for patients with IBS-C (lubiprostone, linaclotide) and IBS-D (alosetron, ramosetron, rifaximin, eluxadoline). Furthermore, results for drugs in development (plecanatide, ibudutant and ebastine) or used in chronic constipation or for other indications, with potential application in IBS (prucalopride, elobixibat, mesalazine, ondansetron and colesevelam) are also reviewed.

20 Review Rifaximin for Irritable Bowel Syndrome: A Meta-Analysis of Randomized Placebo-Controlled Trials. 2016

Li, Jun / Zhu, Wenhua / Liu, Wenhui / Wu, Yingqiao / Wu, Benyan. ·From the Department of Gastroenterology, Chinese PLA General Hospital, Fuxing Road (JL, WL, YW, BW) · and Department of Oncology, Chinese 309th Hospital of PLA, Hei Shan Hu Road, Beijing, China (WZ). ·Medicine (Baltimore) · Pubmed #26825893.

ABSTRACT: The current treatments for irritable bowel syndrome (IBS) are suboptimal. The findings of previous studies of rifaximin treatment for IBS may have differed due to variations in study design. Our study aimed to determine the therapeutic and adverse effects of rifaximin treatment for IBS based on a meta-analysis of published randomized controlled trials (RCTs). We searched the MEDLINE, EMBASE, EBSCO, Springer, Ovid, and Cochrane Library databases for RCTs investigating the effects of rifaximin on IBS. Data from each selected RCT was evaluated individually based on an intention-to-treat analysis, and a meta-analysis was performed in which the odds ratios (ORs) and 95% confidence intervals (CIs) of clinical outcomes and adverse events were calculated using fixed-effects models. Four eligible studies were identified. Overall relief of IBS symptoms in the rifaximin groups was greater than that in the placebo groups at the ends of both the treatment and follow-up periods (OR = 1.19; 95% CI: 1.08-1.32 and OR = 1.36; 95% CI: 1.18-1.58, respectively, P < 0.05 for both). Significant relief of abdominal distention was observed at the follow-up endpoint (OR = 1.69; 95% Cl: 1.27-2.23; P < 0.05), but not at the treatment endpoint (OR = 1.19; 95% CI: 0.96-1.49; P > 0.05). Abdominal pain (OR = 1.01; 95% CI: 0.98-1.03; P > 0.05), nausea (OR = 1.00; 95% CI: 0.98-1.02; P > 0.05), vomiting (OR: 0.99; 95% CI: 0.98-1.01; P > 0.05), and headache (OR = 1.01; 95% CI: 0.98-1.03; P > 0.05) did not differ significantly between the rifaximin and placebo groups. In the RCTs selected, our meta-analysis showed that the efficacy of rifaximin for the resolution of overall IBS symptoms was greater than that of the placebos, and that rifaximin was well-tolerated. The course of relief from abdominal distention in IBS patients treated with rifaximin may be delayed in some patients, compared with that of overall IBS symptom relief.

21 Review [Lactose intolerance: past and present. Part 1]. 2015

Buzás, György Miklós. ·Ferencvárosi Egészségügyi Szolgáltató Kiemelten Közhasznú Nonprofit Kft. Budapest, Mester u. 45., 1095. ·Orv Hetil · Pubmed #26550699.

ABSTRACT: Lactose intolerance is the most prevalent intestinal malabsorption disorder. After presentation of its history, the author describes the emergence of lactose intolerance during the evolution of species, and the biochemistry of lactose as well as features of human and bacterial lactase enzymes are then described. The unequal distribution of lactose intolerance in different continents and population is discussed, followed by presentation of past and present prevalence data in Hungary. Adult-type hypolactasia is caused by a polymorphism of the MCM6 gene located upstream from the lactase gene on the long arm of the chromosome 2. It can be determined with the polymerase chain reaction. The intestinal symptoms of lactose intolerance are well known, but its extra-intestinal manifestations are less recognised. Invasive diagnostic methods (determination of lactase activity from small intestinal biopsies, lactose tolerance test), are accurate, but have been replaced by the non-invasive methods; their gold standard is the H2 breath test. Genetic testing is being used more and more frequently in Hungary too, and, presumably, the methane breath test will be also available in the near future. Lactose intolerance can be accompanied by inflammatory bowel diseases, coeliac disease and irritable bowel syndrome; it could be established whether this association is causal or not in order to start a correct diet and therapy.

22 Review [Stress and the kynurenine pathway]. 2015

Majláth, Zsófia / Vécsei, László. ·Neurológiai Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Centrum Szeged, Semmelweis u. 6., 6725. ·Orv Hetil · Pubmed #26299831.

ABSTRACT: The kynurenine pathway is the main route of tryptophan degradation which gives rise to several neuroactive metabolites. Kynurenic acid is an endogenous antagonist of excitatory receptors, which proved to be neuroprotective in the preclinical settings. Kynurenines have been implicated in the neuroendocrine regulatory processes. Stress induces several alterations in the kynurenine metabolism and this process may contribute to the development of stress-related pathological processes. Irritable bowel disease and gastric ulcer are well-known disorders which are related to psychiatric comorbidity and stress. In experimental conditions kynurenic acid proved to be beneficial by reducing inflammatory processes and normalizing microcirculation in the bowel. Further investigations are needed to better understand the relations of stress and the kynurenines, with the aim of developing novel therapeutic tools for stress-related pathologies.

23 Review Systematic review with meta-analysis: the prevalence of bile acid malabsorption in the irritable bowel syndrome with diarrhoea. 2015

Slattery, S A / Niaz, O / Aziz, Q / Ford, A C / Farmer, A D. ·Neurogastroenterology Group, Blizard Institute of Cell & Molecular Science, Wingate Institute of Neurogastroenterology, Barts & the London School of Medicine & Dentistry, Queen Mary University of London, London, UK. · Blackpool Victoria Hospital, Blackpool, UK. · Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK. · Leeds Institute of Biomedical and Clinical Sciences, Leeds University, Leeds, UK. · Department of Gastroenterology, University Hospitals of the North Midlands, Stoke on Trent, UK. ·Aliment Pharmacol Ther · Pubmed #25913530.

ABSTRACT: BACKGROUND: Irritable bowel syndrome is a widespread disorder with a marked socioeconomic burden. Previous studies support the proposal that a subset of patients with features compatible with diarrhoea-predominant IBS (IBS-D) have bile acid malabsorption (BAM). AIM: To perform a systematic review and meta-analysis to assess the prevalence of BAM in patients meeting the accepted criteria for IBS-D. METHODS: MEDLINE and EMBASE were searched up to March 2015. Studies recruiting adults with IBS-D, defined by the Manning, Kruis, Rome I, II or III criteria and which used 23-seleno-25-homotaurocholic acid (SeHCAT) testing for the assessment of BAM were included. BAM was defined as 7 day SeHCAT retention of <10%. We calculated the rate of BAM and 95% confidence intervals (CI) using a random effects model. The methodological quality of included studies was evaluated using the Quality Assessment for Diagnostic Accuracy Studies (QUADAS-2). RESULTS: The search strategy identified six relevant studies comprising 908 individuals. The rate of BAM ranged from 16.9% to 35.3%. The pooled rate was 28.1% (95% CI: 22.6-34%). There was significant heterogeneity in effect sizes (Q-test χ(2)  = 17.9, P < 0.004; I(2)  = 72.1%). The type of diagnostic criteria used or study country did not significantly modify the effect. CONCLUSIONS: These data provide evidence that in excess of one quarter of patients meeting accepted criteria for IBS-D have bile acid malabsorption. This distinction has implications for the interpretation of previous studies, as well as contemporaneous clinical practice and future guideline development.

24 Review Irritable bowel syndrome in adults in primary care: summary of updated NICE guidance. 2015

Hookway, Cheryl / Buckner, Sara / Crosland, Paul / Longson, Damien. ·National Institute for Health and Care Excellence, Clinical Guideline Updates Team, Manchester M1 4BT, UK cheryl.hookway@NICE.org.uk. · National Institute for Health and Care Excellence, Clinical Guideline Updates Team, London, UK. · Department of Psychiatry, Manchester Mental Health and Social Care Trust, Manchester, UK. ·BMJ · Pubmed #25716701.

ABSTRACT: -- No abstract --

25 Review Irritable bowel syndrome: an integrated explanatory model for clinical practice. 2015

Hungin, A P S / Becher, A / Cayley, B / Heidelbaugh, J J / Muris, J W M / Rubin, G / Seifert, B / Russell, A / De Wit, N J. ·School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees, UK. · Research and Evaluation Unit, Oxford PharmaGenesis Ltd, Oxford, UK. · Department of Family Medicine, University of Wisconsin, Madison, WI, USA. · Departments of Family Medicine and Urology, Medical School, University of Michigan, Ann Arbor, MI, USA. · Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands. · Institute of General Practice, Charles University, Praha, Czech Republic. · Department of Anthropology, Durham University, Durham, UK. · Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. ·Neurogastroenterol Motil · Pubmed #25703486.

ABSTRACT: BACKGROUND: Although irritable bowel syndrome (IBS) is a symptom-based diagnosis, clinicians' management of and communication about the disorder is often hampered by an unclear conceptual understanding of the nature of the problem. We aimed to elucidate an integrated explanatory model (EM) for IBS from the existing literature for pragmatic use in the clinical setting. METHODS: Systematic and exploratory literature searches were performed in PubMed to identify publications on IBS and EMs. KEY RESULTS: The searches did not identify a single, integrated EM for IBS. However, three main hypotheses were elucidated that could provide components with which to develop an IBS EM: (i) altered peripheral regulation of gut function (including sensory and secretory mechanisms); (ii) altered brain-gut signaling (including visceral hypersensitivity); and (iii) psychological distress. Genetic polymorphisms and epigenetic changes may, to some degree, underlie the etiology and pathophysiology of IBS and could increase the susceptibility to developing the disorder. The three model components also fit into one integrated explanation for abdominal symptoms and changes in stool habit. Additionally, IBS may share a common pathophysiological mechanism with other associated functional syndromes. CONCLUSIONS & INFERENCES: It was possible to elucidate an integrated, three-component EM as a basis for clinicians to conceptualize the nature of IBS, with the potential to contribute to better diagnosis and management, and dialog with sufferers.