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Irritable Bowel Syndrome: HELP
Articles from United Kingdom
Based on 408 articles published since 2009
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These are the 408 published articles about Irritable Bowel Syndrome that originated from United Kingdom during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17
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 American College of Gastroenterology Monograph on Management of Irritable Bowel Syndrome. 2018

Ford, Alexander C / Moayyedi, Paul / Chey, William D / Harris, Lucinda A / Lacy, Brian E / Saito, Yuri A / Quigley, Eamonn M M / Anonymous1331369. ·Leeds Institute of Biomedical and Clinical Sciences, University of Leeds and Leeds Gastroenterology Institute, Leeds Teaching Hospitals Trust, Leeds, UK. · Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada. · Division of Gastroenterology, Department of Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA. · Mayo Clinic, Scottsdale, AZ, USA. · Mayo Clinic, Jacksonville, FL, USA. · Mayo Clinic, Rochester, MN, USA. · Division of Gastroenterology and Hepatology, Houston Methodist Hospital and Weill Cornell Medical College, Houston, TX, USA. equigley@houstonmethodist.org. ·Am J Gastroenterol · Pubmed #29950604.

ABSTRACT: -- No abstract --

3 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.

4 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.

5 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.

6 Editorial Editorial: preventing unnecessary investigation and surgery in the irritable bowel syndrome-the critical role of the general practitioner. 2018

Whorwell, P J. ·Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK. ·Aliment Pharmacol Ther · Pubmed #29878437.

ABSTRACT: -- No abstract --

7 Editorial The importance of cluster analysis for enhancing clinical practice: an example from irritable bowel syndrome. 2018

Windgassen, Sula / Moss-Morris, Rona / Goldsmith, Kimberley / Chalder, Trudie. ·a Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience , King's College London , London , United Kingdom of Great Britain and Northern Ireland. · b Division of Health Psychology, Institute of Psychiatry, Psychology & Neuroscience , King's College London , London , United Kingdom of Great Britain and Northern Ireland. · c Department of Biostatistics, Institute of Psychiatry, Psychology & Neuroscience , King's College London , London , United Kingdom of Great Britain and Northern Ireland , and. · d Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience , King's College London, Weston Education Centre , London , United Kingdom of Great Britain and Northern Ireland. ·J Ment Health · Pubmed #29447026.

ABSTRACT: -- No abstract --

8 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 --

9 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 --

10 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 --

11 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 --

12 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 --

13 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 --

14 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 --

15 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 --

16 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.

17 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.

18 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 --

19 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 --

20 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 --

21 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.

22 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.

23 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.

24 Review Clinical application of dietary therapies in irritable bowel syndrome. 2018

Rej, Anupam / Avery, Amanda / Ford, Alexander Charles / Holdoway, Anne / Kurien, Matthew / McKenzie, Yvonne / Thompson, Julie / Trott, Nick / Whelan, Kevin / Williams, Marianne / Sanders, David Surendran. ·Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, United Kingdom.anupam.rej@sth.nhs.uk. · Division of Nutritional Sciences, School of Biosciences, University of Nottingham, Nottingham, United Kingdom. · Leeds Institute of Biomedical and Clinical Sciences, Leeds University, Leeds, United Kingdom. · Registered dietitian, Bath, Somerset, United Kingdom. · Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust;Academic Unit of Gastroenterology, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom. · Nuffield Health, The Manor Hospital, Oxford, United Kingdom. · Calm Gut Clinic, Todmorden, United Kingdom. · Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, United Kingdom. · Department of Nutritional Sciences, King's College London, London, United Kingdom. · Specialist Gastroenterology Community Dietetic Service, Somerset Partnership NHS Foundation Trust, Bridgwater, United Kingdom. ·J Gastrointestin Liver Dis · Pubmed #30240475.

ABSTRACT: BACKGROUND AND AIMS: Diet appears to play a pivotal role in symptom generation in Irritable Bowel Syndrome (IBS). First line dietary therapy for IBS has focused on advice concerning healthy eating and lifestyle management. Research recently has focused on the role of a diet low in fermentable oligo-, di-, and mono-saccharides and polyols (FODMAPs), gluten free (GFD) and wheat free (WFD) diets for the relief of symptoms in IBS. METHODS: A round table discussion with gastroenterologists and dietitians with a specialist interest in dietary therapies in IBS was held in Sheffield, United Kingdom in May 2017. Existing literature was reviewed. PubMed and EMBASE were searched with the MeSH terms irritable bowel syndrome/diet/diet therapy/gluten/low FODMAP in different combinations to identify relevant articles. A consensus on the application of these dietary therapies into day-to-day practice was developed. RESULTS: Fourteen randomized trials in IBS evaluating the low FODMAP diet (n studies = 9), GFD (n = 4) and WFD (n = 1) were included in this review. The total number of patients recruited from randomized trials reviewed was: n=580 low FODMAP diet (female, n=430), n=203 GFD (female, n=139), n=276 WFD (female, n=215). There was no significant difference in the gender of patients recruited for both the low FODMAP and GFD randomized studies (p=0.12). The response rate in the literature to a low FODMAP diet ranged between 50-76%, and to GFD ranged between 34-71%. Percentage of IBS patients identified as wheat sensitive was reported as 30% in the literature. CONCLUSION: There are no head-to-head trials to date utilizing the low FODMAP diet, GFD and WFD for dietary treatment of IBS and still a number of concerns for diets, including nutritional inadequacy and alteration of the gut microbiota. The consensus suggests that there is evidence for the use of the low FODMAP diet, GFD and WFD as dietary therapies for IBS; the decision-making process for using each individual therapy should be directed by a detailed history by the dietitian, involving the patient in the process.

25 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.

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