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Irritable Bowel Syndrome: HELP
Articles from United Kingdom
Based on 397 articles published since 2008
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These are the 397 published articles about Irritable Bowel Syndrome that originated from United Kingdom during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16
1 Guideline Rome Foundation Working Team Report on Post-Infection Irritable Bowel Syndrome. 2019

Barbara, Giovanni / Grover, Madhusudan / Bercik, Premysl / Corsetti, Maura / Ghoshal, Uday C / Ohman, Lena / Rajilić-Stojanović, Mirjana. ·Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. Electronic address: giovanni.barbara@unibo.it. · Enteric NeuroScience Program, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota. · Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada. · Nottingham Digestive Diseases Biomedical Research Centre, National Institute for Health Research, Nottingham University Hospitals NHS Trust, University of Nottingham, UK. · Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India. · Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Department of Biochemical Engineering and Biotechnology, Faculty of Technology and Metallurgy, University of Belgrade, Belgrade, Serbia. ·Gastroenterology · Pubmed #30009817.

ABSTRACT: BACKGROUND & AIMS: The existence of postinfection irritable bowel syndrome (PI-IBS) has been substantiated by epidemiology studies conducted in diverse geographic and clinical settings. However, the available evidence has not been well summarized, and there is little guidance for diagnosis and treatment of PI-IBS. The ROME Foundation has produced a working team report to summarize the available evidence on the pathophysiology of PI-IBS and provide guidance for diagnosis and treatment, based on findings reported in the literature and clinical experience. METHODS: The working team conducted an evidence-based review of publication databases for articles describing the clinical features (diagnosis), pathophysiology (intestinal sensorimotor function, microbiota, immune dysregulation, barrier dysfunction, enteroendocrine pathways, and genetics), and animal models of PI-IBS. We used a Delphi-based consensus system to create guidelines for management of PI-IBS and a developed treatment algorithm based on published findings and experiences of team members. RESULTS: PI-IBS develops in about 10% of patients with infectious enteritis. Risk factors include female sex, younger age, psychological distress during or before acute gastroenteritis, and severity of the acute episode. The pathogenesis of PI-PBS appears to involve changes in the intestinal microbiome as well as epithelial, serotonergic, and immune system factors. However, these mechanisms are incompletely understood. There are no evidence-based, effective pharmacologic strategies for treatment of PI-IBS. We provide a consensus-based treatment algorithm, based on clinical presentation and potential disease mechanisms. CONCLUSIONS: Based on a systematic review of the literature and team experience, we summarize the clinical features, pathophysiology (from animal models and human studies), and progression of PI-IBS. Based on these findings, we present an algorithm for diagnosis and treatment of PI-IBS based on team consensus. We also propose areas for future investigation.

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 Editorial Editorial: subgroups in irritable bowel syndrome-more than just diarrhoea and constipation? 2017

Black, C J / Ford, A C. ·Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK. · Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK. ·Aliment Pharmacol Ther · Pubmed #28880445.

ABSTRACT: -- No abstract --

5 Editorial Editorial: depression in the setting of inflammatory bowel disease means we have failed to provide early, effective, psychosocial care-authors' reply. 2017

Alexakis, C / Kumar, S / Saxena, S / Hotopf, M / Pollok, R. ·Department of Gastroenterology, St George's University NHS Hospitals Trust, London, UK. · Department of Primary Care and Public Health, Imperial College London, London, UK. · Department of Psychological Medicine, King's College Hospital, London, UK. ·Aliment Pharmacol Ther · Pubmed #28776734.

ABSTRACT: -- No abstract --

6 Editorial Editorial: latent class analysis to improve confidence in the diagnosis of IBS - authors' reply. 2017

Sood, R / Gracie, D J / Gold, M J / To, N / Pinto-Sanchez, M I / Bercik, P / Moayyedi, P / Ford, A C / Law, G R. ·Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK. · Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK. · School of Medicine, University of Leeds, Leeds, UK. · Gastroenterology Division, Health Sciences Center, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada. · Division of Epidemiology & Biostatistics, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK. ·Aliment Pharmacol Ther · Pubmed #28370047.

ABSTRACT: -- No abstract --

7 Editorial Editorial: ONO-2952 in irritable bowel syndrome with diarrhoea - authors' reply. 2017

Whitehead, W E / Duffy, K / Sharpe, J / Nabata, T / Bruce, M. ·Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. · Ono Pharma UK Ltd, London, UK. ·Aliment Pharmacol Ther · Pubmed #28256085.

ABSTRACT: -- No abstract --

8 Editorial Editorial: metabolic adaptation of colonic microbiota to galactooligosaccharides - good news for prebiotics in irritable bowel syndrome? 2017

Staudacher, H M / Cox, S R. ·Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia. · King's College London, Faculty of Life Sciences and Medicine, London, UK. ·Aliment Pharmacol Ther · Pubmed #28256083.

ABSTRACT: -- No abstract --

9 Editorial Editorial: volatile organic compounds in irritable bowel syndrome - technology for an accurate and reliable point-of-care test? 2017

Sood, R / Ford, A C. ·Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK. · Leeds institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK. ·Aliment Pharmacol Ther · Pubmed #28074509.

ABSTRACT: -- No abstract --

10 Editorial Editorial: fibre and FODMAPs in constipation and irritable bowel syndrome. 2015

Whelan, K. ·King's College London, Faculty of Life Sciences and Medicine, London, UK. kevin.whelan@kcl.ac.uk. ·Aliment Pharmacol Ther · Pubmed #26147109.

ABSTRACT: -- No abstract --

11 Editorial Editorial: colesevelam effects on faecal bile acids in IBS with diarrhoea. 2015

Walters, J R F / Appleby, R N. ·Imperial College London & Imperial College Healthcare NHS Trust, London, UK. julian.walters@imperial.ac.uk. ·Aliment Pharmacol Ther · Pubmed #25736144.

ABSTRACT: -- No abstract --

12 Editorial Editorial: new thoughts on the association between diverticulosis and irritable bowel syndrome. 2014

Spiller, Robin. ·Biomedical Research Unit, Nottingham Digestive Diseases Centre, University of Nottingham, Queens Medical Centre, Nottingham, UK. ·Am J Gastroenterol · Pubmed #25470583.

ABSTRACT: As our population ages it is increasingly common to encounter patients with irritable bowel syndrome (IBS)-like symptoms and diverticulosis, but the nature of the association is obscure. This Editorial discusses the paper from Japan showing an association between IBS-like symptoms and left-sided but not right-sided diverticulosis. The left colon with its higher motor activity is more likely to be associated with complications of diverticulosis, including perforation and abscess formation. The underlying pathophysiology of the syndrome of post-diverticulitis IBS is discussed and clinical markers of centrally driven symptoms suggested as a means to avoid ineffective colonic resections in those with IBS-like diverticular disease.

13 Editorial Editorial: The importance of systematic reviews and meta-analyses of probiotics and prebiotics. 2014

Whelan, Kevin. ·King's College London, Diabetes and Nutritional Sciences Division, School of Medicine, London, UK. ·Am J Gastroenterol · Pubmed #25287086.

ABSTRACT: Irritable bowel syndrome (IBS) and chronic idiopathic constipation are prevalent and burdensome gastrointestinal disorders. A systematic review and meta-analysis of the evidence for probiotics, prebiotics, and synbiotics in IBS and chronic idiopathic constipation has recently been performed. By far, the most convincing evidence was for the use of probiotics in IBS, which reported that overall probiotics reduced the risk of symptom persistence by 21%. However, only a minority of the trials were at a low risk of bias, and some used small sample sizes. Meta-analysis is a powerful tool to combine individual small trials to improve the power to detect the direction, size, and consistency of an effect, but it can do little to overcome the poor design of individual trials. Many debate the use of meta-analysis to combine data from different probiotic species, strains, or combinations. It is recommended that all future meta-analyses of probiotics, in any clinical setting, perform subgroup analysis on specific species/strains and specific combinations. It is hoped that the current meta-analysis will empower clinicians in making evidence-based decisions regarding whether probiotics should be recommended for IBS, which species/strain(s) to use, and for which symptoms.

14 Editorial Editorial: abnormal permeability and altered mucosal serotonin metabolism in the irritable bowel syndrome - is there a link? 2014

Spiller, R. ·Nottingham Digestive Diseases Biomedical Research Unit, Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK. robin.spiller@nottingham.ac.uk. ·Aliment Pharmacol Ther · Pubmed #25280258.

ABSTRACT: -- No abstract --

15 Editorial Editorial: Noncoeliac gluten sensitivity--a disease of the mind or gut? 2014

Aziz, I / Hadjivassiliou, M / Sanders, D S. ·Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield, UK. imran.aziz@sth.nhs.uk. ·Aliment Pharmacol Ther · Pubmed #24903428.

ABSTRACT: -- No abstract --

16 Editorial Linaclotide for treatment of irritable bowel syndrome--the view of European regulators. 2013

Berntgen, Michael / Enzmann, Harald / Schabel, Elmer / Prieto Yerro, Concepcion / Gómez-Outes, Antonio / Salmonson, Tomas / Musaus, Joachim. ·European Medicines Agency, London, United Kingdom. Electronic address: michael.berntgen@ema.europa.eu. ·Dig Liver Dis · Pubmed #23701993.

ABSTRACT: -- No abstract --

17 Review Montezuma's revenge - the sequel: The one-hundred year anniversary of the first description of "post-infectious" irritable bowel syndrome. 2018

Riddle, Mark S / Connor, Patrick / Porter, Chad K. ·Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, MD 20814, United States. Mark.riddle@usuhs.edu. · Military Enteric Disease Group, Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham Research Park, Birmingham B15 2SQ, United Kingdom. · Department of Enteric Diseases, Naval Medical Research Center, Silver Spring, MD 20910, United States. ·World J Gastroenterol · Pubmed #30568385.

ABSTRACT: One-hundred years have passed since the original description of the commonly described phenomenon of persistent abdominal symptoms being triggered by an acute enteric infection. This first account was generated out of astute observations by Sir Arthur Hurst in World War I. Additional descriptions followed from military and non-military practitioners adding the evidence which has transitioned this recognized condition from association to causation. While mechanistic understanding is an area of active pursuit, this historical accounting of a centuries progress highlights important advances and contributions of military medicine and scientists to advances benefiting global populations.

18 Review Gluten-Free Diet and Its 'Cousins' in Irritable Bowel Syndrome. 2018

Rej, Anupam / Sanders, David Surendran. ·Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield S10 2JF, UK. anupam.rej@sth.nhs.uk. · Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield S10 2JF, UK. david.sanders@sth.nhs.uk. · Academic Unit of Gastroenterology, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK. david.sanders@sth.nhs.uk. ·Nutrients · Pubmed #30423854.

ABSTRACT: Functional disorders are common, with irritable bowel syndrome (IBS) being the commonest and most extensively evaluated functional bowel disorder. It is therefore paramount that effective therapies are available to treat this common condition. Diet appears to play a pivotal role in symptom generation in IBS, with a recent interest in the role of dietary therapies in IBS. Over the last decade, there has been a substantial increase in awareness of the gluten-free diet (GFD), with a recent focus of the role of a GFD in IBS. There appears to be emerging evidence for the use of a GFD in IBS, with studies demonstrating the induction of symptoms following gluten in patients with IBS. However, there are questions with regards to which components of wheat lead to symptom generation, as well as the effect of a GFD on nutritional status, gut microbiota and long-term outcomes. Further studies are required, although the design of dietary studies remain challenging. The implementation of a GFD should be performed by a dietitian with a specialist interest in IBS, which could be achieved via the delivery of group sessions.

19 Review The evolution of magnetic resonance enterography in the assessment of motility disorders in children. 2018

Menys, A / Saliakellis, E / Borrelli, O / Thapar, N / Taylor, S A / Watson, T. ·Centre for Medical Imaging, UCL, London, UK. Electronic address: alex.menys.09@ucl.ac.uk. · Great Ormond Street Hospital, London, UK. · Centre for Medical Imaging, UCL, London, UK. ·Eur J Radiol · Pubmed #30292253.

ABSTRACT: Gastrointestinal symptoms including constipation, diarrhoea, pain and bloating represent some of the most common clinical problems for patients. These symptoms can often be managed with cheap, widely available medication or will spontaneously resolve. However, for many patients, chronic GI symptoms persist and frequently come to dominate their lives. At one end of the spectrum there is Inflammatory Bowel Disease (IBD) with a clearly defined but expensive treatment pathway. Contrasting with this is Irritable Bowel Syndrome (IBS), likely a collection of pathologies, has a poorly standardised pathway with unsatisfactory clinical outcomes. Managing GI symptoms in adult populations is a challenge. The clinical burden of gastrointestinal disease is also prevalent in paediatric populations and perhaps even harder to treat. In this review we explore some of the recent advances in magnetic resonance imaging (MRI) to study the gastrointestinal tract. Complex in both its anatomical structure and its physiology we are likely missing key physiological markers of disease through relying on symptomatic descriptors of gut function. Using MRI we might be able to characterise previously opaque processes, such as non-propulsive contractility, that could lead to changes in how we understand even common symptoms like constipation. This review explores recent advances in the field in adult populations and examines how this safe, objective and increasingly available modality might be applied to paediatric populations.

20 Review Pharmacokinetic drug evaluation of rifaximin for treatment of diarrhea-predominant irritable bowel syndrome. 2018

Bruzzese, Eugenia / Pesce, Marcella / Sarnelli, Giovanni / Guarino, Alfredo. ·a Department of Translational Medical Science , 'Federico II' University of Naples 80131 , Naples , Italy. · b Department of Clinical Medicine and Surgery , 'Federico II' University of Naples 80131 , Naples , Italy. · c Division of Neurogastroenterology & Motility, Department of Pediatric Gastroenterology , Great Ormond Street , Hospital, London , UK. ·Expert Opin Drug Metab Toxicol · Pubmed #29897844.

ABSTRACT: INTRODUCTION: Rifaximin is a poorly absorbable antibiotic with a broad-spectrum activity against both Gram-negative and -positive bacteria. It is active in the small intestine due to its high bile solubility, whereas in the aqueous environment of the colon, it shows limited efficacy against highly susceptible bacteria. These unique pharmacokinetic properties limit its systemic effects and can correct gut microflora imbalances. Thus, rifaximin has become a major therapeutic agent in several gastrointestinal diseases in which an imbalance in gut microflora may play a role, including diarrhea predominant irritable bowel syndrome (IBS-D). Area covered: This is an up-to-date review focusing on the efficacy of rifaximin in the treatment of IBS-D in both adult and pediatric populations. We will review the pharmacokinetic properties of rifaximin, including its absorption in health and disease, mechanisms of action, and interactions with other drugs. Expert opinion: Given its safety profile and its negligible absorption, rifaximin is a suitable treatment for IBS-D, in both adults and children. The possibility of modulating gut microbiota composition without side effects has made this drug an appealing therapeutic agent in highly prevalent gastrointestinal diseases. However, to date, monitoring for the development of resistant bacterial strains during long-term rifaximin use is still lacking.

21 Review New therapies in Irritable Bowel Syndrome: what works and when. 2018

Craig, Orla. ·Leeds Teaching Hospitals Trust, St James University Hospital, Leeds, West Yorkshire, England. ·Curr Opin Gastroenterol · Pubmed #29095765.

ABSTRACT: PURPOSE OF REVIEW: The purpose of this review is to examine the evidence supporting the use of recently developed pharmacological treatments for IBS together with new evidence supporting more traditional therapies in order to understand where the new agents are best used in the treatment pathway. RECENT FINDINGS: There is evidence to support the use of traditional treatments such as antispasmodics, antidepressants and dietary alteration in IBS. New therapeutic agents such as Linaclotide, Lubiprostone, Plecanatide, Rifaxamin and Eluxadoline are all more effective than placebo in treating symptoms of IBS with Tenapanor being a promising new agent. The majority of patients, however, treated with these medications remain symptomatic and they are not suitable for use in all patients. SUMMARY: Traditional treatments such as antispasmodics, antidepressants, dietary and lifestyle modifications retain their importance in the treatment of IBS with the newer agents to be considered wherever these treatments are ineffective or poorly tolerated.

22 Review The Overlapping Area of Non-Celiac Gluten Sensitivity (NCGS) and Wheat-Sensitive Irritable Bowel Syndrome (IBS): An Update. 2017

Catassi, Carlo / Alaedini, Armin / Bojarski, Christian / Bonaz, Bruno / Bouma, Gerd / Carroccio, Antonio / Castillejo, Gemma / De Magistris, Laura / Dieterich, Walburga / Di Liberto, Diana / Elli, Luca / Fasano, Alessio / Hadjivassiliou, Marios / Kurien, Matthew / Lionetti, Elena / Mulder, Chris J / Rostami, Kamran / Sapone, Anna / Scherf, Katharina / Schuppan, Detlef / Trott, Nick / Volta, Umberto / Zevallos, Victor / Zopf, Yurdagül / Sanders, David S. ·Department of Pediatrics, Marche Polytechnic University, 60121 Ancona, Italy. c.catassi@univpm.it. · Department of Medicine, Columbia University Medical Center, New York, NY 10027, USA. aa819@cumc.columbia.edu. · Medical Department, Division of Gastroenterology, Infectiology and Rheumatology, Charité, Campus Benjamin Franklin, 12203 Berlin, Germany. christian.bojarski@charite.de. · Department of Gastroenterology and Liver Diseases, CHU, 38043 Grenoble, France. bbonaz@chu-grenoble.fr. · Celiac Center Amsterdam, Department of Gastroenterology, VU University Medical Center, 1117 Amsterdam, The Netherlands. g.bouma@vumc.nl. · Department of Internal Medicine, "Giovanni Paolo II" Hospital, Sciacca (AG) and University of Palermo, 92019 Sciacca, Italy. acarroccio@hotmail.com. · Paediatric Gastroenterology Unit, Sant Joan de Reus University Hospital. IISPV, 43003 Tarragona, Spain. gcv@tinet.cat. · Department of Internal and Experimental Medicine Magrassi-Lanzara, University of Campania Luigi Vanvitelli, 80131 Naples, Italy. laura.demagistris@unicampania.it. · Medical Clinic 1, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, Germany. walburga.dieterich@uk-erlangen.de. · Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, 90133 Palermo, Italy. diana.diliberto@unipa.it. · Center for the Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy. lucelli@yahoo.com. · Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA 02114, USA. AFASANO@mgh.harvard.edu. · Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK. Marios.Hadjivassiliou@sth.nhs.uk. · Academic Unit of Gastroenterology, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield S10 2TN, UK. matthew.kurien@sth.nhs.uk. · Department of Pediatrics, Marche Polytechnic University, 60121 Ancona, Italy. mariaelenalionetti@gmail.com. · Celiac Center Amsterdam, Department of Gastroenterology, VU University Medical Center, 1117 Amsterdam, The Netherlands. cjmulder@vumc.nl. · Gastroenterology Unit, Milton Keynes University Hospital, Milton Keynes MK6 5LD, UK. krostami@hotmail.com. · Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA 02114, USA. annasapone@yahoo.it. · German Research Centre for Food Chemistry, Leibniz Institute, Lise-Meitner-Straße 34, D-85354 Freising, Germany. Katharina.Scherf@lrz.tu-muenchen.de. · Institute of Translational Immunology, University Medical Center, Johannes Gutenberg University, 55131 Mainz, Germany. detlef.schuppan@unimedizin-mainz.de. · Academic Unit of Gastroenterology, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield S10 2TN, UK. nick.trott@sth.nhs.uk. · Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy. umberto.volta@aosp.bo.it. · Institute of Translational Immunology, University Medical Center, Johannes Gutenberg University, 55131 Mainz, Germany. zevallos@uni-mainz.de. · Medical Clinic 1, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, Germany. Yurdaguel.Zopf@uk-erlangen.de. · Academic Unit of Gastroenterology, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield S10 2TN, UK. david.sanders@sth.nhs.uk. ·Nutrients · Pubmed #29160841.

ABSTRACT: Gluten-related disorders have recently been reclassified with an emerging scientific literature supporting the concept of non-celiac gluten sensitivity (NCGS). New research has specifically addressed prevalence, immune mechanisms, the recognition of non-immunoglobulin E (non-IgE) wheat allergy and overlap of NCGS with irritable bowel syndrome (IBS)-type symptoms. This review article will provide clinicians with an update that directly impacts on the management of a subgroup of their IBS patients whose symptoms are triggered by wheat ingestion.

23 Review Irritable bowel syndrome and diet: where are we in 2018? 2017

Dimidi, Eirini / Rossi, Megan / Whelan, Kevin. ·King's College London, Department of Nutritional Sciences, London, United Kingdom. ·Curr Opin Clin Nutr Metab Care · Pubmed #28872467.

ABSTRACT: PURPOSE OF REVIEW: The aim is to review the most recent advances in the evidence supporting the use of various dietary interventions for the management of irritable bowel syndrome (IBS). RECENT FINDINGS: There is insufficient evidence of the effect of fibres other than psyllium in IBS, whereas the recent studies on prebiotics suggest a limited effect in IBS. Recent probiotic trials continue to provide varying results, with some probiotic strains exhibiting beneficial effects, whereas others show no effect. Recent trials have also confirmed the clinical effectiveness of a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (i.e. low FODMAP diet) in IBS. Although gluten sensitivity has also been recently investigated, its presence cannot be confirmed yet because of the presence of other potential contributing compounds in wheat. Studies also suggest a potential beneficial effect of peppermint oil, which warrants further research. SUMMARY: It is clear that a low FODMAP diet has a beneficial effect in a majority of patients with IBS. Probiotics also have great potential in the management of IBS; however, it is still unclear which strains and doses are the most beneficial. Further research is needed on the effect of different fibres, or combinations of fibres, in IBS.

24 Review Antidepressants for chronic non-cancer pain in children and adolescents. 2017

Cooper, Tess E / Heathcote, Lauren C / Clinch, Jacqui / Gold, Jeffrey I / Howard, Richard / Lord, Susan M / Schechter, Neil / Wood, Chantal / Wiffen, Philip J. ·Cochrane Pain, Palliative and Supportive Care Group, Pain Research Unit, Churchill Hospital, Churchill Hospital, Oxford, Oxfordshire, UK, OX3 7LE. ·Cochrane Database Syst Rev · Pubmed #28779487.

ABSTRACT: BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past pain was largely dismissed and was frequently left untreated, views on children's pain have changed over time and relief of pain is now seen as important.We designed a suite of seven reviews on chronic non-cancer pain and cancer pain (looking at antidepressants, antiepileptic drugs, non-steroidal anti-inflammatory drugs, opioids, and paracetamol) in order to review the evidence for children's pain utilising pharmacological interventions.As the leading cause of morbidity in the world today, chronic disease (and its associated pain) is a major health concern. Chronic pain (that is pain lasting three months or longer) can arise in the paediatric population in a variety of pathophysiological classifications (nociceptive, neuropathic, or idiopathic) from genetic conditions, nerve damage pain, chronic musculoskeletal pain, and chronic abdominal pain, as well as for other unknown reasons.Antidepressants have been used in adults for pain relief and pain management since the 1970s. The clinical impression from extended use over many years is that antidepressants are useful for some neuropathic pain symptoms, and that effects on pain relief are divorced and different from effects on depression; for example, the effects of tricyclic antidepressants on pain may occur at different, and often lower, doses than those on depression. Amitriptyline is one of the most commonly used drugs for treating neuropathic pain in the UK. OBJECTIVES: To assess the analgesic efficacy and adverse events of antidepressants used to treat chronic non-cancer pain in children and adolescents aged between birth and 17 years, in any setting. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of Studies Online, MEDLINE via Ovid, and Embase via Ovid from inception to 6 September 2016. We also searched the reference lists of retrieved studies and reviews, and searched online clinical trial registries. SELECTION CRITERIA: Randomised controlled trials, with or without blinding, of any dose and any route, treating chronic non-cancer pain in children and adolescents, comparing any antidepressant with placebo or an active comparator. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for eligibility. We planned to use dichotomous data to calculate risk ratio and number needed to treat for one additional event, using standard methods. We assessed the evidence using GRADE and created three 'Summary of findings' tables. MAIN RESULTS: We included four studies with a total of 272 participants (6 to 18 years of age) who had either chronic neuropathic pain, complex regional pain syndrome type 1, irritable bowel syndrome, functional abdominal pain, or functional dyspepsia. All of the studies were small. One study investigated amitriptyline versus gabapentin (34 participants), two studies investigated amitriptyline versus placebo (123 participants), and one study investigated citalopram versus placebo (115 participants). Due to a lack of available data we were unable to complete any quantitative analysis.Risk of bias for the four included studies varied, due to issues with randomisation and allocation concealment (low to unclear risk); blinding of participants, personnel, and outcome assessors (low to unclear risk); reporting of results (low to unclear risk); and size of the study populations (high risk). We judged the remaining domains, attrition and other potential sources of bias, as low risk of bias. Primary outcomesNo studies reported our primary outcomes of participant-reported pain relief of 30% or greater or 50% or greater (very low-quality evidence).No studies reported on Patient Global Impression of Change (very low-quality evidence).We rated the overall quality of the evidence (GRADE rating) as very low. We downgraded the quality of the evidence by three levels to very low because there was no evidence to support or refute. Secondary outcomesAll studies measured adverse events, with very few reported (11 out of 272 participants). All but one adverse event occurred in the active treatment groups (amitriptyline, citalopram, and gabapentin). Adverse events in all studies, across active treatment and comparator groups, were considered to be a mild reaction, such as nausea, dizziness, drowsiness, tiredness, and abdominal discomfort (very low-quality evidence).There were also very few withdrawals due to adverse events, again all but one from the active treatment groups (very low-quality evidence).No serious adverse events were reported across any of the studies (very low-quality evidence).There were few or no data for our remaining secondary outcomes (very low-quality evidence).We rated the overall quality of the evidence (GRADE rating) for these secondary outcomes as very low. We downgraded the quality of the evidence by three levels to very low due to too few data and the fact that the number of events was too small to be meaningful. AUTHORS' CONCLUSIONS: We identified only a small number of studies with small numbers of participants and insufficient data for analysis.As we could undertake no meta-analysis, we are unable to comment about efficacy or harm from the use of antidepressants to treat chronic non-cancer pain in children and adolescents. Similarly, we cannot comment on our remaining secondary outcomes: Carer Global Impression of Change; requirement for rescue analgesia; sleep duration and quality; acceptability of treatment; physical functioning; and quality of life.There is evidence from adult randomised controlled trials that some antidepressants, such as amitriptyline, can provide some pain relief in certain chronic non-cancer pain conditions.There is no evidence from randomised controlled trials to support or refute the use of antidepressants to treat chronic non-cancer pain in children or adolescents.

25 Review New psychological therapies for irritable bowel syndrome: mindfulness, acceptance and commitment therapy (ACT). 2017

Sebastián Sánchez, Beatriz / Gil Roales-Nieto, Jesús / Ferreira, Nuno Bravo / Gil Luciano, Bárbara / Sebastián Domingo, Juan José. ·Psicología, Universidad de Almería. · Psychology, University of Edinburgh. · Digestivo, Hospital Royo Villanova, España. ·Rev Esp Enferm Dig · Pubmed #28724306.

ABSTRACT: The current goal of treatment in irritable bowel syndrome (IBS) focuses primarily on symptom management and attempts to improve quality of life. Several treatments are at the disposal of physicians; lifestyle and dietary management, pharmacological treatments and psychological interventions are the most used and recommended. Psychological treatments have been proposed as viable alternatives or compliments to existing care models. Most forms of psychological therapies studied have been shown to be helpful in reducing symptoms and in improving the psychological component of anxiety/depression and health-related quality of life. According to current NICE/NHS guidelines, physicians should consider referral for psychological treatment in patients who do not respond to pharmacotherapy for a period of 12 months and develop a continuing symptom profile (described as refractory irritable bowel syndrome). Cognitive behavioral therapy (CBT) is the best studied treatment and seems to be the most promising therapeutic approach. However, some studies have challenged the effectiveness of this therapy for irritable bowel syndrome. One study concluded that cognitive behavioral therapy is no more effective than placebo attention control condition and another study showed that the beneficial effects wane after six months of follow-up. A review of mind/body approaches to irritable bowel syndrome has therefore suggested that alternate strategies targeting mechanisms other than thought content change might be helpful, specifically mindfulness and acceptance-based approaches. In this article we review these new psychological treatment approaches in an attempt to raise awareness of alternative treatments to gastroenterologists that treat this clinical syndrome.

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