Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Irritable Bowel Syndrome: HELP
Articles from Newcastle, AU
Based on 31 articles published since 2008
||||

These are the 31 published articles about Irritable Bowel Syndrome that originated from Newcastle, AU during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Editorial Irritable bowel syndrome, dyspepsia and other chronic disorders of gastrointestinal function. 2016

Talley, Nicholas J / Holtmann, Gerald. ·Global Research, University of Newcastle, Newcastle, NSW Nicholas.Talley@newcastle.edu.au. · University of Queensland, Brisbane, QLD. ·Med J Aust · Pubmed #27681970.

ABSTRACT: -- No abstract --

2 Editorial Editorial: differentiating chronic idiopathic constipation from constipation-predominant irritable bowel syndrome--possible and important?--Authors' reply. 2015

Talley, N J / Koloski, N A / Jones, M P. ·Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia. nicholas.talley@newcastle.edu.au. · Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia. · Department of Psychology, Macquarie University, North Ryde, NSW, Australia. ·Aliment Pharmacol Ther · Pubmed #25968151.

ABSTRACT: -- No abstract --

3 Review What's in a name? 'Non-coeliac gluten or wheat sensitivity': controversies and mechanisms related to wheat and gluten causing gastrointestinal symptoms or disease. 2018

Potter, Michael D E / Walker, Marjorie M / Keely, Simon / Talley, Nicholas J. ·Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, New Lambton Heights, New South Wales, Australia. · Department of Gastroenterology, John Hunter Hospital, Newcastle, New South Wales, Australia. ·Gut · Pubmed #30061187.

ABSTRACT: -- No abstract --

4 Review Irritable bowel syndrome and functional dyspepsia: what can epidemiology tell us about etiology? 2018

Talley, Nicholas J / Holtmann, Gerald. ·a University of Newcastle, Faculty of Health and Medicine , Newcastle , Australia. · b Australian GI Research Alliance (AGIRA) , Newcastle , Australia. · c Department of Gastroenterology , University of Queensland , Brisbane , Australia. ·Expert Rev Gastroenterol Hepatol · Pubmed #29774764.

ABSTRACT: -- No abstract --

5 Review Irritable Bowel Syndrome. 2017

Ford, Alexander C / Lacy, Brian E / Talley, Nicholas J. ·From the Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, and the Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom (A.C.F.) · the Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH (B.E.L.) · the Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia (N.J.T.) · the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN (N.J.T.) · and Karolinska Institute, Stockholm (N.J.T.). ·N Engl J Med · Pubmed #28657875.

ABSTRACT: -- No abstract --

6 Review Pathophysiology of irritable bowel syndrome. 2016

Holtmann, Gerald J / Ford, Alexander C / Talley, Nicholas J. ·Department of Gastroenterology and Hepatology, Princess Alexandra Hospital Brisbane, and Translational Research Institute, University of Queensland, Brisbane, QLD, Australia. · Leeds Gastroenterology Institute, St James's University Hospital, Leeds, UK; Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK. · Faculty of Health and Medicine, University of Newcastle, NSW, Australia; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. Electronic address: nicholas.talley@newcastle.edu.au. ·Lancet Gastroenterol Hepatol · Pubmed #28404070.

ABSTRACT: Traditionally, irritable bowel syndrome has been considered to be a disorder with no known underlying structural or biochemical explanation, but this concept is likely to be outdated. In this Review we challenge the widely accepted view that irritable bowel syndrome is an unexplained brain-gut disorder. There is epidemiological evidence that, in a major subset of patients, gastrointestinal symptoms arise first and only later do incident mood disorders occur. Additionally, possible mechanisms for gut-brain dysfunction have been identified, suggesting primary gut disturbances might be the underlying cause in a subgroup. Underlying mechanisms that could lead to irritable bowel syndrome include genetic factors (most notably an identified mutation of SCN5A); post-infectious changes, chronic infections and disturbances in the intestinal microbiota; low-grade mucosal inflammation, immune activation, and altered intestinal permeability; disordered bile salt metabolism (in 10-20% of cases with diarrhoea); abnormalities in serotonin metabolism; and alterations in brain function, which could be primary or secondary factors. Identical irritable bowel syndrome symptoms are probably due to different disease processes; grouping patients with this disorder into either diarrhoea-predominant or constipation-predominant subtypes promotes heterogeneity. An approach based on the underlying pathophysiology could help to develop therapies that target causes and ultimately provide a cure for patients with irritable bowel syndrome.

7 Review Immune dysregulation in the functional gastrointestinal disorders. 2015

Keely, Simon / Walker, Marjorie M / Marks, Ellen / Talley, Nicholas J. ·School of Biomedical Sciences & Pharmacy, University of Newcastle & Vaccine and Asthma (VIVA) Program, Hunter Medical Research Institute, Callaghan, NSW, Australia. · School of Medicine & Public Health, University of Newcastle, Callaghan, NSW, Australia. ·Eur J Clin Invest · Pubmed #26444549.

ABSTRACT: Gastrointestinal conditions may be broadly classified into two: organic and functional disease, with functional disorders accounting for the majority of patients with chronic gastrointestinal symptoms. Functional gastrointestinal disorders (FGIDs) present with no obvious pathology or well-accepted biochemical mechanism and, as such, treatment strategies are limited and focus on symptoms rather than cure. Irritable bowel syndrome and functional dyspepsia are the most widely recognised FGIDs, and there is a growing body of evidence to suggest an underlying inflammatory phenotype in subsets with these conditions. Here, we discuss the current knowledge of immune involvement in FGIDs and the commonalities between the different manifestations of FGIDs and propose a new hypothesis, potentially defining an underlying immunopathological basis of these conditions.

8 Review Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology. 2015

Talley, Nicholas J / Holtmann, Gerald / Walker, Marjorie M. ·Global Research, University of Newcastle, HMRI Building, Room 3419, Kookaburra Circuit, New Lambton, NSW, 2305, Australia, nicholas.talley@newcastle.edu.au. ·J Gastroenterol · Pubmed #25917563.

ABSTRACT: Functional gastrointestinal disorders (FGIDs) are common and distressing. They are so named because a defined pathophysiology in terms of structural or biochemical pathways is lacking. Traditionally FGIDs have been conceptualized as brain-gut disorders, with subgroups of patients demonstrating visceral hypersensitivity and motility abnormalities as well as psychological distress. However, it is becoming apparent that there are certain structural or biochemical gut alterations among subsets with the common FGIDs, most notably functional dyspepsia (FD) and irritable bowel syndrome (IBS). For example, a sodium channel mutation has been identified in IBS that may account for 2 % of cases, and subtle intestinal inflammation has been observed in both IBS and FD. Other research has implicated early life events and stress, autoimmune disorders and atopy and infections, the gut microbiome and disordered mucosal immune activation in patients with IBS or FD. Understanding the origin of symptoms in FGIDs will allow therapy to be targeted at the pathophysiological changes, not at merely alleviating symptoms, and holds hope for eventual cure in some cases. For example, there are promising developments in manipulating the microbiome through diet, prebiotics and antibiotics in IBS, and testing and treating patients for Helicobacter pylori infection remains a mainstay of therapy in patients with dyspepsia and this infection. Locally acting drugs such as linaclotide have been an advance in treating the symptoms of constipation-predominant IBS, but do not alter the natural history of the disease. A role for a holistic approach to patients with FGIDs is warranted, as brain-to-gut and gut-to-brain pathways appear to be activated.

9 Review Current and emerging pharmacotherapeutic options for irritable bowel syndrome. 2014

Barboza, Jose L / Talley, Nicholas J / Moshiree, Baharak. ·University of South Florida College of Pharmacy, 12901 Bruce B. Downs Blvd. MDC30, Tampa, FL, 33612, USA. jbarboza@health.usf.edu. · University of Newcastle, Callaghan, NSW, 2308, Australia. · Mayo Clinic, Jacksonville, FL, USA. · Division of Gastroenterology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL, 33136, USA. ·Drugs · Pubmed #25260888.

ABSTRACT: Treatment of irritable bowel syndrome (IBS) is challenging for both primary care physicians and gastroenterologists because of the heterogeneity of the patient population and the multifactorial pathophysiologies responsible for the symptoms in IBS. This review focuses on the current and emerging pharmacological treatments for IBS. Many of the current medications used to treat this disorder have distinct properties such as efficacy for different symptoms, safety profiles, contraindications, costs, dosing regimens, treatment duration and long-term data. All of these factors, in addition to patient preference and cognitive, food and environmental triggers, must be considered prior to any medication selection. This review will focus on randomized controlled trials with a general uniformity in study design, a rigorous patient selection and appropriate treatment durations. We will also discuss other exciting emerging treatments for IBS such as the µ-opioid receptor (agonists and antagonists), selective κ-opioid receptor agonists, anti-inflammatory drugs, serotonergic agents, bile acid modulators and intestinal bile acid transporters, which may prove promising in treating our patients.

10 Article Gastrointestinal recall questionnaires compare poorly with prospective patient diaries for gastrointestinal symptoms: data from population and primary health centre samples. 2019

Jones, Michael P / Walter, Susanna / Faresjö, Åshild / Grodzinsky, Ewa / Kjellström, Lars / Viktorsson, Lisa / Talley, Nicholas J / Agreus, Lars / Andreasson, Anna. ·Department of Psychology, Macquarie University, North Ryde. · Institution of Clinical and Experimental Medicine (IKE). · Department of Medicine and Health Sciences. · Division of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine and Institute of Medicine and Health Science. · Department of Clinical Neuroscience. · Research and Development Unit of Medical and Health Services, Linköping University, Linköping. · Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. · Division for Family Medicine and Primary Care, Karolinska Institutet. · Stress Research Institute, Stockholm University, Stockholm, Sweden. ·Eur J Gastroenterol Hepatol · Pubmed #30394943.

ABSTRACT: BACKGROUND: Clinical understanding of gastrointestinal symptoms is commonly based on patient reports of symptom experience. For diagnosis and treatment choices to be appropriate, symptom reports need to be accurate. We examined the agreement between questionnaire recall and prospective diary enumeration of symptoms relevant to the irritable bowel syndrome. PATIENTS AND METHODS: Data are reported from a randomly selected general population sample (n=238) and also a primary healthcare centre (PHC) sample (n=503, 10 PHCs). All the patients completed the questionnaires, which included Rome III-qualifying irritable bowel syndrome items and a stool and symptom diary over either 7 or 14 days. Agreement between retrospective questionnaire reports and prospective diaries was evaluated. RESULTS: Concordance between questionnaires and diaries was highest for the simple construct of the occurrence of abdominal pain, although after adjusting for possible chance, agreement was only moderate in the general population sample. More complex constructs, such as pain relieved by defecation, yielded poorer concordance. In general, concordance was stronger among PHC respondents than in the general population sample. CONCLUSION: Concordance between questionnaires and diaries was generally poor and related to the complexity of the symptom construct and the type of respondent. The information used to classify individuals based on patient self-report may be unreliable, and therefore, more effort is needed to develop data collection instruments.

11 Article Overlap of Irritable Bowel Syndrome and Functional Dyspepsia in the Clinical Setting: Prevalence and Risk Factors. 2019

von Wulffen, Moritz / Talley, Nicholas J / Hammer, Johann / McMaster, Jessica / Rich, Graeme / Shah, Ayesha / Koloski, Natasha / Kendall, Bradley J / Jones, Mike / Holtmann, Gerald. ·Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, 199 Ipswich Rd, Woolloongabba, Brisbane, QLD, 4102, Australia. · Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia. · Translational Research Institute, Brisbane, QLD, Australia. · Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia. · Medical University of Vienna, Vienna, Austria. · Department of Psychology, Macquarie University, Sydney, NSW, Australia. · Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, 199 Ipswich Rd, Woolloongabba, Brisbane, QLD, 4102, Australia. g.holtmann@uq.edu.au. · Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia. g.holtmann@uq.edu.au. · Translational Research Institute, Brisbane, QLD, Australia. g.holtmann@uq.edu.au. · Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia. g.holtmann@uq.edu.au. ·Dig Dis Sci · Pubmed #30368683.

ABSTRACT: BACKGROUND: According to Rome IV criteria, functional dyspepsia (FD) and irritable bowel syndrome (IBS) are distinct functional gastrointestinal disorders (FGID); however, overlap of these conditions is common in population-based studies, but clinical data are lacking. AIMS: To determine the overlap of FD and IBS in the clinical setting and define risk factors for the overlap of FD/IBS. METHODS: A total of 1127 consecutive gastroenterology outpatients of a tertiary center were recruited and symptoms assessed with a standardized validated questionnaire. Patients without evidence for structural or biochemical abnormalities as a cause of symptoms were then categorized based upon the symptom pattern as having FD, IBS or FD/IBS overlap. Additionally, this categorization was compared with the clinical diagnosis documented in the integrated electronic medical records system. RESULTS: A total of 120 patients had a clinical diagnosis of a FGID. Based upon standardized assessment with a questionnaire, 64% of patients had FD/IBS overlap as compared to 23% based upon the routine clinical documentation. In patients with severe IBS or FD symptoms (defined as symptoms affecting quality of life), the likelihood of FD/IBS overlap was substantially increased (OR = 3.1; 95%CI 1.9-5.0) and (OR = 9.0; 95%CI 3.5-22.7), respectively. Thus, symptom severity for IBS- or FD symptoms were significantly higher for patients with FD/IBS overlap as compared to patients with FD or IBS alone (p all < 0.01). Age, gender and IBS-subtype were not associated with overlap. CONCLUSION: In the clinical setting, overlap of FD and IBS is the norm rather than the exception. FD/IBS overlap is associated with a more severe manifestation of a FGID.

12 Article Celiac disease is uncommon in irritable bowel syndrome in the USA. 2018

Almazar, Ann E / Talley, Nicholas J / Larson, Joseph J / Atkinson, Elizabeth J / Murray, Joseph A / Saito, Yuri A. ·Department of Medicine, Division of Gastroenterology and Hepatology. · Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. · Department of Health, Division of Biomedical Statistics and Informatics. · Department of Immunology, Mayo Clinic, Rochester, Minnesota, USA. ·Eur J Gastroenterol Hepatol · Pubmed #29240001.

ABSTRACT: BACKGROUND AND AIMS: Routine serologic testing for celiac disease (CD) may be useful in irritable bowel syndrome (IBS) patients, but this is controversial. We aimed to compare the prevalence of unrecognized CD in a large cohort of patients with and without IBS. PARTICIPANTS AND METHODS: This is a family case-control IBS study conducted at a single US academic medical center. Stored serum and DNA were available. Tissue transglutaminase (TTg) immunoglobulin A was performed, followed by indirect immunofluorescence testing for endomysial antibodies with positive or weakly positive TTg results. Individuals were considered to have CD if both results were positive. χ and Fisher's exact tests were used to compare prevalence between the two groups. RESULTS: Serum samples were studied from 533 cases and 531 controls. In all, 80% of participants were female, with a median age of 50 years; 65% of cases and 0% controls met the Rome criteria for IBS. Previous serological testing for CD had occurred in 142 (27%) cases and 13 (2%) controls, but none had CD on subsequent testing. Six (1.1%) cases versus five (0.9%) controls had positive or weakly positive TTg test. Six cases (1.1%) versus three (0.6%) controls were confirmed to have CD by endomysial antibody (P=0.51). CONCLUSION: No difference in the prevalence of CD between patients with IBS and patients without IBS at a tertiary medical center was observed. Our findings do not support routine celiac serologic or genetic testing in patients with IBS in all US populations.

13 Article Undiagnosed pancreatic exocrine insufficiency and chronic pancreatitis in functional GI disorder patients with diarrhea or abdominal pain. 2017

Talley, Nicholas J / Holtmann, Gerald / Nguyen, Quoc Nam / Gibson, Peter / Bampton, Peter / Veysey, Martin / Wong, James / Philcox, Stephen / Koloski, Natasha / Bunby, Lisa / Jones, Michael. ·Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. · Department of Gastroenterology, John Hunter Hospital, New Lambton, New South Wales, Australia. · Department of Gastroenterology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia. · Department of Gastroenterology, Royal Adelaide Hospital, Adelaide, South Australia, Australia. · Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia. · Department of Gastroenterology, Monash University and Alfred Hospital, Melbourne, Victoria, Australia. · Department of Gastroenterology, Flinders Medical Centre, Bedford Park, South Australia, Australia. · Teaching & Research Unit, Gosford & Wyong Hospital, Gosford, New South Wales, Australia. · Mylan EPD, Macquarie, New South Wales, Australia. · Department of Psychology, Macquarie University, Ryde, New South Wales, Australia. ·J Gastroenterol Hepatol · Pubmed #28332731.

ABSTRACT: BACKGROUND AND AIM: A previous UK study showed that 6.1% of patients with diarrhea-predominant irritable bowel syndrome (IBS-D) had evidence of severe pancreatic exocrine insufficiency (PEI), but these findings need replication. We aimed to identify the prevalence of PEI based on fecal elastase stool testing in consecutive outpatients presenting with chronic unexplained abdominal pain and/or diarrhea and/or IBS-D. METHODS: Patients aged over 40 years presenting to hospital outpatient clinics from six sites within Australia with unexplained abdominal pain and/or diarrhea for at least 3 months and/or IBS-D were studied. Patients completed validated questionnaires and donated a stool sample in which elastase concentration was measured by ELISA. A concentration of < 100 mcg/g stool represented severe and < 200 mcg/g mild to moderate PEI. Patients whose fecal elastase was < 200 mcg/g underwent testing for pancreatic pathology with an endoscopic ultrasound or abdominal CT. RESULTS: Two hundred eighteen patients (mean age of 60 years, 29.4% male) were studied. PEI was found in 4.6% (95% CI 2.2-8.3%) (n = 10), with five patients (2.3% (95% CI 0.8-5.3%) having severe PEI. Only male sex and heavy alcohol use were significantly associated with abnormal versus normal pancreatic functioning. Of seven patients who underwent endoscopic ultrasound or CT, two had features indicative of chronic pancreatitis. CONCLUSION: One in 50 patients with IBS-D or otherwise unexplained abdominal pain or diarrhea have an abnormal fecal elastase, but unexpected pancreatic insufficiency was detected in only a minority of these. This study failed to confirm the high prevalence of PEI among patients with unexplained GI symptoms previously reported.

14 Article Board Review Vignette: Irritable Bowel Syndrome. 2016

Talley, Nicholas J. ·University of Newcastle, New South Wales, Australia. · Gastroenterology and Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA. ·Am J Gastroenterol · Pubmed #27527743.

ABSTRACT: -- No abstract --

15 Article Evidence that independent gut-to-brain and brain-to-gut pathways operate in the irritable bowel syndrome and functional dyspepsia: a 1-year population-based prospective study. 2016

Koloski, N A / Jones, M / Talley, N J. ·Faculty of Health & Medicine, University of Newcastle, Newcastle, NSW, Australia. · Department of Psychology, Macquarie University, North Ryde, NSW, Australia. ·Aliment Pharmacol Ther · Pubmed #27444264.

ABSTRACT: BACKGROUND: Traditionally, functional gastrointestinal disorders (FGIDs) are conceptualised as originating in the brain via stress pathways (brain-to-gut). It is uncertain how many with irritable bowel syndrome (IBS) and functional dyspepsia (FD) have a gut origin of symptoms (gut-to-brain pathway). AIMS: To determine if there is a distinct brain-to-gut FGID (where psychological symptoms begin first) and separately a distinct gut-to-brain FGID (where gut symptoms start first). METHODS: A prospective random population sample from Newcastle, Australia who responded to a validated survey in 2012 and completed a 1-year follow-up survey (n = 1900). The surveys contained questions on Rome III IBS and FD and the Hospital Anxiety and Depression Scale. RESULTS: We found that higher levels of anxiety and depression at baseline were significant predictors of developing IBS (OR = 1.31; 95% CI 1.06-1.61, P = 0.01; OR = 1.54; 95% CI 1.29-1.83, P < 0.001) and FD (OR = 1.28; 95% CI 1.05-1.55, P = 0.01; OR = 1.55, 95% CI 1.32-1.83, P < 0.001), respectively, at the 1-year follow-up. Among those people who did not have elevated levels of anxiety and depression at baseline, subjects at baseline with documented IBS (mean difference 0.34; 95% CI 0.13-0.55, P = 0.002; 0.81; 95% CI 0.47-1.15, P < 0.001) and FD (0.38; 95% CI 0.14-0.63, P = 0.002; 0.92; 95% CI 0.57-1.27, P < 0.001), reported significantly higher levels of anxiety and depression at the 1-year follow-up. We calculated in one-third of individuals a mood disorder precedes FGID but in two-thirds an FGID precedes the mood disorder. CONCLUSION: While brain-gut pathways are bidirectional, a major subset begin with gut symptoms first and only then psychological distress develops, implicating primary gut mechanisms as drivers of the gut and extra-intestinal features in many cases.

16 Article Irritable bowel syndrome and the perinatal period: lower birth weight increases the risk. 2016

Raslau, D / Herrick, L M / Locke, G R / Schleck, C D / Zinsmeister, A R / Almazar, A / Talley, N J / Saito, Y A. ·Department of Medicine, Mayo Clinic, Rochester, MN, USA. · Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. · College of Nursing, South Dakota State University, Brookings, SD, USA. · Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA. · University of Newcastle, Callaghan, NSW, Australia. · Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. saito.yuri@mayo.edu. ·Neurogastroenterol Motil · Pubmed #27193962.

ABSTRACT: BACKGROUND: Early life events have been found to be associated with irritable bowel syndrome (IBS) suggesting a role in development of functional disorders. The study aim was to identify potential perinatal risk factors for adult IBS. METHODS: Utilizing a population-based nested case-control design, cases who met modified Rome III criteria for IBS and age- and-gender matched controls were identified using responses from prior mailed surveys to a random sample of Olmsted County residents. Medical records of eligible respondents were reviewed for perinatal events of interest. The association of early life events with subsequent case status was assessed using conditional logistic regression. KEY RESULTS: Of 3 417 respondents, 513 were born in Olmsted County and 108 met criteria for IBS. Due to missing records, 89 pairs were included in the final analyses. Logistic regression revealed only birth weight as a predictor of IBS. Lower birth weight increased the odds for IBS (OR = 1.54 [95% CI = (1.12, 2.08), p = 0.008]). Median birth weight was 3.35 kg (range: 1.96-5.24) and 3.57 kg (range: 2.18-4.59) for cases and controls, respectively. Maternal age, delivery method, and antibiotic exposure were not associated with IBS status but this study was only powered to detect large odds ratios. CONCLUSIONS AND INFERENCES: Lower birth weight was observed as a risk factor for IBS. It is not clear if in utero developmental delays directly lead to IBS or if low birth weight is a prospective marker for subsequent early life problems leading to IBS.

17 Article Identification of early environmental risk factors for irritable bowel syndrome and dyspepsia. 2015

Koloski, N A / Jones, M / Weltman, M / Kalantar, J / Bone, C / Gowryshankar, A / Walker, M M / Talley, N J. ·Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia. · Department of Psychology, Macquarie University, North Ryde, NSW, Australia. · Department of Gastroenterology & Hepatology, Nepean Hospital, Penrith, NSW, Australia. ·Neurogastroenterol Motil · Pubmed #26202154.

ABSTRACT: BACKGROUND: The role of childhood environment including exposure to infection via siblings and pets in irritable bowel syndrome (IBS) and dyspepsia is relatively unknown. We assessed proxy measures of microbial exposure in early childhood to assess if these are associated with IBS and functional dyspepsia in later life. METHODS: Participants (n = 767, response rate = 53%) were a random population sample from Sydney, Australia who previously responded to a validated survey. IBS and functional dyspepsia were defined using Rome III criteria. Early environmental risk factors assessed included type of birth delivery, premature birth, breastfeeding, bedroom sharing, and pet exposure (the latter two then combined as early hygiene factors) up to 5 years of age. Post infectious IBS (PI-IBS) was assessed by development of IBS following gastroenteritis. KEY RESULTS: In this sample, in adult life 17% developed IBS (of which 20% had PI-IBS) and 12% functional dyspepsia. Development of IBS was associated with childhood factors-a shorter duration of breastfeeding (odds ratios [OR] = 0.87, 95% CI: 0.78-0.97, p = 0.01), sharing a bedroom (OR = 1.89, 95% CI: 1.73-3.08, p = 0.01), exposure to a herbivore pet (OR = 1.65 (1.10, 2.48), p = 0.02), and hygiene factors (OR = 4.39; 95% CI: 1.89-10.21, p = 0.001). The sole factor associated with functional dyspepsia was exposure to a herbivore pet (1.79; 95% CI: 1.19-2.87, p = 0.02). CONCLUSIONS & INFERENCES: Childhood environment factors, particularly bedroom sharing and pet exposure, combined with subsequent risk of microbial exposure are a risk factor for IBS in later life. These associations however need confirmation to rule out any risk of a type I error.

18 Article How individuals with the irritable bowel syndrome describe their own symptoms before formal diagnosis. 2015

Molinder, Herdis / Agréus, Lars / Kjellström, Lars / Walter, Susanna / Talley, Nicholas J / Andreasson, Anna / Nyhlin, Henry. ·a Division of Family Medicine , Karolinska Institutet , Huddinge , Sweden ; · b Centre for Gastrointestinal Disease , Sabbatsberg Hospital , Stockholm , Sweden ; · c Institution of Clinical and Experimental Medicine, Division of Gastroenterology , Linköping University , Linköping , Sweden ; · d Faculty of Health and Medicine , University of Newcastle , Newcastle , Australia ; · e Stress Research Institute , Stockholm University , Stockholm , Sweden ; · f Department of Medicine Huddinge , Karolinska Institutet , Huddinge , Sweden. ·Ups J Med Sci · Pubmed #25947550.

ABSTRACT: AIM: To investigate how individuals fulfilling the Rome II criteria for irritable bowel syndrome (IBS) spontaneously described their symptoms. METHOD: From a general population, 1,244 randomly sampled adults were asked to describe their gastrointestinal symptoms (if any) verbally, in their own words, at a semi-structured interview. Their own descriptions were sorted into five symptom clusters. The participants independently completed a written questionnaire (the Rome II Modular Questionnaire (RMIIMQ)). RESULTS: A total of 601 participants reported at least one gastrointestinal symptom, and 128 had IBS according to the RMIIMQ. After exclusion of organic causes, previously diagnosed IBS, or additional gastrointestinal diagnosis, 81 participants with IBS according to RMIIMQ remained. Five participants (6%) described symptoms included in the full definition of IBS, but none fulfilled the Rome II criteria completely. Abdominal pain or other IBS-related symptoms were reported by 64 (79%), and 12 (15%) did not report any IBS-like symptom. CONCLUSION: Previously undiagnosed individuals, who fulfil criteria for Rome II-IBS, often express their complaints in words that do not fit into the current diagnostic criteria.

19 Article Differentiation of functional constipation and constipation predominant irritable bowel syndrome based on Rome III criteria: a population-based study. 2015

Koloski, N A / Jones, M / Young, M / Talley, N J. ·Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia. ·Aliment Pharmacol Ther · Pubmed #25736433.

ABSTRACT: BACKGROUND: While the Rome III classification recognises functional constipation (FC) and constipation predominant IBS (IBS-C) as distinct disorders, recent evidence has suggested that these disorders are difficult to separate in clinical practice. AIM: To identify whether clinical and lifestyle factors differentiate Rome III-defined IBS-C from FC based on gastrointestinal symptoms and lifestyle characteristics. METHOD: 3260 people randomly selected from the Australian population returned a postal survey. FC and IBS-C were defined according to Rome III. The first model used logistic regression to differentiate IBS-C from FC based on lifestyle, quality-of-life and psychological characteristics. The second approach was data-driven employing latent class analysis (LCA) to identify naturally occurring clusters in the data considering all symptoms involved in the Rome III criteria for IBS-C and FC. RESULTS: We found n = 206 (6.5%; 95% CI 5.7-7.4%) people met strict Rome III FC whereas n = 109 (3.5%; 95% CI 2.8-4.1%) met strict Rome III IBS-C. The case-control approach indicated that FC patients reported an older age at onset of constipation, were less likely to exercise, had higher mental QoL and less health care seeking than IBS-C. LCA yielded one latent class that was predominantly (75%) FC, while the other class was approximately half IBS-C and half FC. The FC-dominated latent class had clearly lower levels of symptoms used to classify IBS (pain-related symptoms) and was more likely to be male (P = 0.046) but was otherwise similar in distribution of lifestyle factors to the mixed class. CONCLUSION: The latent class analysis approach suggests a differentiation based more on symptom severity rather than the Rome III view.

20 Article Family history of mental illness or alcohol abuse and the irritable bowel syndrome. 2015

Knight, James R / Locke, G Richard / Zinsmeister, Alan R / Schleck, Cathy D / Talley, Nicholas J. ·Division of Hospital Medicine, Department of Internal Medicine and Pediatrics, The Ohio State University Medical Center, Columbus, OH, USA. · Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. · Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA. · Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA; Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia. Electronic address: nicholas.talley@newcastle.edu.au. ·J Psychosom Res · Pubmed #25582802.

ABSTRACT: OBJECTIVE: We have observed that many patients with IBS drink very little alcohol and postulated that this may reflect membership in families affected by alcoholism and mental illness. We aimed to evaluate whether a family history of substance or alcohol abuse, or psychiatric illness, is associated with IBS. METHODS: A valid GI questionnaire was mailed to a randomly selected population-based cohort to identify IBS and healthy controls. The electronic medical record was reviewed to record the subjects' self-reported personal and family health histories. RESULTS: A total of 2300 subjects responded (response rate 55%; IBS 13%, n=287); 230 subjects with IBS and 318 controls were eligible. Family history of alcohol/substance abuse was reported by 33% of cases and 25% of controls (OR=1.4, 95% CI=1.0-2.1, p=0.06). Family history of psychiatric illness was reported by 37% of cases and 22% of controls (OR=2.0, 95% CI=1.3-2.9, p<0.001). In the absence of a personal history of alcohol use, a family history of alcohol/substance abuse was predictive of IBS status (OR adjusted for age and gender=1.5, 95% CI=1.0-2.3, p=0.05). In the absence of a personal history of alcohol use, reporting both a family history of alcohol/substance abuse and anxiety/depression/mental illness was clearly predictive of IBS status (OR=2.5, 95% CI=1.4-4.5; p<0.005). Substance abuse as a child was associated with an increased risk of IBS (OR=2.3, 95% CI=1.1-4.8; p<0.03). CONCLUSION: IBS is independently associated with a family history of psychiatric illness and may be linked to a family history of alcohol/substance abuse.

21 Article Colonic spirochetosis is associated with colonic eosinophilia and irritable bowel syndrome in a general population in Sweden. 2015

Walker, Marjorie M / Talley, Nicholas J / Inganäs, Linn / Engstrand, Lars / Jones, Michael P / Nyhlin, Henry / Agréus, Lars / Kjellstrom, Lars / Öst, Åke / Andreasson, Anna. ·Anatomical Pathology, Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, 2308 NSW, Australia. Electronic address: marjorie.walker@newcastle.edu.au. · Faculty of Health and Medicine, University of Newcastle, Newcastle, 2308 NSW, Australia. · Center of Family Medicine, Karolinska Institutet, SE-141 83 Huddinge Stockholm, Sweden; Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-141 83 Stockholm, Sweden. · Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-141 83 Stockholm, Sweden. · Psychology Department, Macquarie University, North Ryde, 2109 NSW, Australia. · Internal Medicine, Karolinska Hospital, SE-141 83 Huddinge, Sweden. · Center of Family Medicine, Karolinska Institutet, SE-141 83 Huddinge Stockholm, Sweden. · Internal Medicine, Aleris Sabbatsbergs Hospital, SE-113 24 Stockholm, Sweden. · Pathology, Aleris Medilab, SE-183 53 Täby, Sweden. · Center of Family Medicine, Karolinska Institutet, SE-141 83 Huddinge Stockholm, Sweden; Stress Research Institute, Stockholm University, SE-106 91 Stockholm, Sweden. ·Hum Pathol · Pubmed #25540866.

ABSTRACT: Irritable bowel syndrome (IBS) is a functional disorder defined by symptoms in the absence of overt pathology. Colonic spirochetosis (CS), defined by histologic observation of spirochetal strains of Brachyspira in colonic biopsies, is uncommon and considered of doubtful significance. We aimed to determine the prevalence of CS in the general population, identify subtle colon pathologies, and evaluate a link with symptoms of IBS. Colonoscopy was performed in 745 subjects (aged 19-70 years, mean age 51 years, 43% male) with biopsies (ileum and 4 colonic sites) from a random population sample, Stockholm, Sweden, who completed a validated questionnaire of gastrointestinal symptoms; IBS was identified by Rome III criteria. CS was identified by histology and immunohistochemistry. In a general population, 17 individuals (2.28%; 95% confidence interval, 1.2%-3.5%) were diagnosed as having CS by histology; 6 (35%) had IBS. CS was always present in the sigmoid colon, but only 14 rectal biopsies. Eosinophils were increased in colon biopsies in CS cases versus controls, in the transverse (P = .02), sigmoid colon (P = .001), and rectum (P = .0005) with subepithelial eosinophil clusters (P = .053). Lymphoid follicles (at any site) were present in 13 CS (P = .0003). There was a 3-fold increased risk of IBS in CS (odds ratio, 3.59; 95% confidence interval, 1.27-10.11; P = .015). Polyps and diverticular disease were similar in CS cases and controls. The prevalence of CS in a general population is 2% and associated with nonconstipating IBS. Colonic eosinophilia with lymphoid follicles may signify the presence of CS.

22 Article Exploring the genetics of irritable bowel syndrome: a GWA study in the general population and replication in multinational case-control cohorts. 2015

Ek, Weronica E / Reznichenko, Anna / Ripke, Stephan / Niesler, Beate / Zucchelli, Marco / Rivera, Natalia V / Schmidt, Peter T / Pedersen, Nancy L / Magnusson, Patrik / Talley, Nicholas J / Holliday, Elizabeth G / Houghton, Lesley / Gazouli, Maria / Karamanolis, George / Rappold, Gudrun / Burwinkel, Barbara / Surowy, Harald / Rafter, Joseph / Assadi, Ghazaleh / Li, Ling / Papadaki, Evangelia / Gambaccini, Dario / Marchi, Santino / Colucci, Rocchina / Blandizzi, Corrado / Barbaro, Raffaella / Karling, Pontus / Walter, Susanna / Ohlsson, Bodil / Tornblom, Hans / Bresso, Francesca / Andreasson, Anna / Dlugosz, Aldona / Simren, Magnus / Agreus, Lars / Lindberg, Greger / Boeckxstaens, Guy / Bellini, Massimo / Stanghellini, Vincenzo / Barbara, Giovanni / Daly, Mark J / Camilleri, Michael / Wouters, Mira M / D'Amato, Mauro. ·Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden. · Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA. · Department of Human Molecular Genetics, Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany. · Department of Gastroenterology and Hepatology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden. · Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. · Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia. · Faculty of Medical and Human Sciences, Institute of Inflammation and Repair, University of Manchester, Manchester, UK Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA. · Laboratory of Biology, School of Medicine, University of Athens, Athens, Greece. · Academic Department of Gastroenterology, School of Medicine, University of Athens, Athens, Greece. · Molecular Epidemiology Group, German Cancer Research Centre (DKFZ) Heidelberg, Heidelberg, Germany Division of Molecular Biology of Breast Cancer, Department of Gynaecology and Obstetrics, University Women's Clinic, University Heidelberg, Heidelberg, Germany. · Gastroenterology Unit, Department of Gastroenterology, University of Pisa, Pisa, Italy. · Division of Pharmacology and Chemotherapy, Department of Clinical and Experimental Medicine University of Pisa, Pisa, Italy. · Department of Medical and Surgical Sciences, University of Bologna, St. Orsola-Malpighi Hospital, Bologna, Italy. · Department of Medicine, Umeå, University, Umeå, Sweden. · Division of Gastroenterology, Institution of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. · Department of Clinical Sciences, Skånes University Hospital, Malmoe, Sweden. · Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden Department of Gastroenterology and Hepatology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden. · Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Stress Research Institute, Stockholm University, Stockholm, Sweden. · Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. · Translational Research Center for Gastrointestinal Disorders, Leuven University, Leuven, Belgium. · Clinical Enteric Neuroscience Translational and Epidemiological Research, Mayo Clinic, Rochester, Minnesota, USA. ·Gut · Pubmed #25248455.

ABSTRACT: OBJECTIVE: IBS shows genetic predisposition, but adequately powered gene-hunting efforts have been scarce so far. We sought to identify true IBS genetic risk factors by means of genome-wide association (GWA) and independent replication studies. DESIGN: We conducted a GWA study (GWAS) of IBS in a general population sample of 11,326 Swedish twins. IBS cases (N=534) and asymptomatic controls (N=4932) were identified based on questionnaire data. Suggestive association signals were followed-up in 3511 individuals from six case-control cohorts. We sought genotype-gene expression correlations through single nucleotide polymorphism (SNP)-expression quantitative trait loci interactions testing, and performed in silico prediction of gene function. We compared candidate gene expression by real-time qPCR in rectal mucosal biopsies of patients with IBS and controls. RESULTS: One locus at 7p22.1, which includes the genes KDELR2 (KDEL endoplasmic reticulum protein retention receptor 2) and GRID2IP (glutamate receptor, ionotropic, delta 2 (Grid2) interacting protein), showed consistent IBS risk effects in the index GWAS and all replication cohorts and reached p=9.31×10(-6) in a meta-analysis of all datasets. Several SNPs in this region are associated with cis effects on KDELR2 expression, and a trend for increased mucosal KDLER2 mRNA expression was observed in IBS cases compared with controls. CONCLUSIONS: Our results demonstrate that general population-based studies combined with analyses of patient cohorts provide good opportunities for gene discovery in IBS. The 7p22.1 and other risk signals detected in this study constitute a good starting platform for hypothesis testing in future functional investigations.

23 Article Perinatal maternal probiotic intervention impacts immune responses and ileal mucin gene expression in a rat model of irritable bowel syndrome. 2015

Barouei, J / Moussavi, M / Hodgson, D M. ·Laboratory of Microbiology, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia Laboratory of Neuroimmunology, School of Psychology, The University of Newcastle, Callaghan, NSW 2308, Australia. · Laboratory of Neuroimmunology, School of Psychology, The University of Newcastle, Callaghan, NSW 2308, Australia. ·Benef Microbes · Pubmed #25245571.

ABSTRACT: Alterations in immune responses and intestinal secretory state are among features commonly observed in the maternal separation (MS) rat model of Irritable Bowel Syndrome. This study examined whether perinatal maternal introduction of probiotics influences plasma immune markers and ileal mucin-2 (MUC2) gene expression in rat offspring exposed to neonatal maternal separation (MS, 3 h/day, postnatal days (PND) 2-14) and/or subsequently to acute restraint stress in adulthood (AS, 30 min/day, PND 83-85). Data analysis indicated that stress protocols did not affect plasma tumour necrosis factor alpha (TNF-α), interferon gamma (IFN-γ) and interleukin (IL)-6 levels in young offspring (PND 24) born to the vehicle-treated dams. Maternal probiotic intervention was associated with significantly decreased IFN-γ levels in young offspring compared with non-probiotic offspring (P≤0.05). It also induced a significant increase in IL-6 levels in MS pups (P≤0.05). Exposure of both non-MS and MS offspring to AS induced a significant increase in haptoglobin levels compared to controls (P≤0.05), whereas all offspring born to the probiotic-treated dams, irrespective of stress treatment conditions, exhibited significantly decreased haptoglobin levels to well below the control levels (P≤0.05). MS and/or AS did not affect ileal expression of MUC2 in offspring born to the non-probiotic treated dams. While maternal probiotic intake significantly downregulated ileal gene expression of MUC2 in MS male young offspring, it was associated with significantly upregulated MUC2 mRNA expression in MS or AS adult male offspring. These findings suggest that maternal probiotic intervention may exert long-lasting anti-inflammatory effects and impact gut outcomes in offspring at increased risk of dysfunctional gut.

24 Article A randomly selected population sample undergoing colonoscopy: prevalence of the irritable bowel syndrome and the impact of selection factors. 2014

Kjellström, Lars / Molinder, Herdis / Agréus, Lars / Nyhlin, Henry / Talley, Nicholas J / Andreasson, Anna. ·aCentre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge bDepartment of Medicine, Karolinska Institutet, Solna cCentre for Gastrointestinal Disease, Sabbatsberg Hospital dStress Research Institute, Stockholm University, Stockholm, Sweden eFaculty of Health, University of Newcastle, Callaghan, New South Wales, Australia. ·Eur J Gastroenterol Hepatol · Pubmed #24384686.

ABSTRACT: OBJECTIVE: To analyse the epidemiology of irritable bowel syndrome (IBS) symptoms in a random sample of the general population and in a subsample consenting to a colonoscopy, and to what extent this introduces symptom selection bias. MATERIALS AND METHODS: Overall, 3347 randomly selected Swedish adults aged 18-70 years were mailed the validated Abdominal Symptom Questionnaire (ASQ). Responders (n=2293; 68.5%) were contacted by phone, and 745 consented to a colonoscopy. All nonresponders were contacted by phone; 265 were reached and asked seven key ASQ questions. Colonoscopy participants also completed the Rome II Modular Questionnaire. RESULTS: The prevalence of IBS on the basis of the mailed ASQ (troublesome abdominal pain and bowel disturbance in the past 3 months) was 26.2% [95% confidence interval (CI): 24.4-28.0] among the ASQ responders and 36.6% (95% CI: 33.2-40.1) among the colonoscopy participants (P<0.001). Nonresponders had a lower prevalence of IBS (15.8%; 95% CI: 11.4-20.3, P<0.001) than ASQ responders. Colonoscopy participants were slightly older than noncolonoscoped participants completing the ASQ (P<0.001), but men and women were equally represented and no significant socioeconomic differences were identified. The prevalence of IBS was 14.8% (95% CI: 12.2-17.5) on the basis of the Rome II Modular Questionnaire in colonoscopy participants and 14.5% (95% CI: 11.9-17.2) when visible inflammatory disease was excluded. Of the colonoscopy participants, 31.9% (95% CI: 28.5-35.3) were symptom free. CONCLUSION: IBS symptoms are common and rarely explained by visible inflammatory disease or cancer. There was a modest selection bias by IBS in participants accepting a screening colonoscopy, but still, one-third were symptom free. Thus, conclusions for the general population can be made from findings in the study cohort.

25 Article The brain--gut pathway in functional gastrointestinal disorders is bidirectional: a 12-year prospective population-based study. 2012

Koloski, N A / Jones, M / Kalantar, J / Weltman, M / Zaguirre, J / Talley, N J. ·Faculty of Health, University of Newcastle, Callaghan, New South Wales, Australia. nicholas.talley@newcastle.edu.au ·Gut · Pubmed #22234979.

ABSTRACT: OBJECTIVE: Psychological factors are known to be associated with functional gastrointestinal disorders (FGIDs) including irritable bowel syndrome (IBS) and functional dyspepsia (FD). No prospective studies have evaluated whether it is the brain (eg, via anxiety) that drives gut symptoms, or whether gut dysfunction precipitates the central nervous system features such as anxiety. In a 12-year longitudinal, prospective, population-based study, we aimed to determine the directionality of the brain-gut mechanism in FGIDs. DESIGN: Participants (n=1775) were a random population sample from Australia who responded to a survey on FGIDs in 1997 and agreed to be contacted for future research; 1002 completed the 12-year follow-up survey (response rate =60%), with 217, 82 and 45 people meeting Rome II for new onset FGIDs, IBS and FD, respectively. Anxiety and depression were measured using the Delusions Symptom States Inventory at baseline and follow-up. RESULTS: Among people free of a FGID at baseline, higher levels of anxiety (OR 1.11; 95% CI 1.03 to 1.19, p=0.006) but not depression at baseline was a significant independent predictor of developing new onset FGIDs 12 years later. Among people who did not have elevated levels of anxiety and depression at baseline, those with a FGID at baseline had significantly higher levels of anxiety and depression at follow-up (mean difference coefficient 0.76, p<0.001 and 0.30, p=0.01 for anxiety and depression, respectively). In IBS higher levels of anxiety and depression at baseline were predictive of IBS at follow-up, while only depression was predictive of FD at follow-up. CONCLUSIONS: The central nervous system and gut interact bidirectionally in FGIDs.

Next