Intestinal microbiota fingerprint in subjects with Irritable Bowel Syndrome responders to a low FODMAP diet

2021 ◽  
Author(s):  
Fernanda Valdez-Palomares ◽  
Rafael Nambo-Venegas ◽  
Jacqueline Uribe-García ◽  
Alfredo Mendoza-Vargas ◽  
Omar Granados-Portillo ◽  
...  

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain and altered bowel habit. IBS patients report that FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet induce...

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1506
Author(s):  
Annamaria Altomare ◽  
Claudia Di Rosa ◽  
Elena Imperia ◽  
Sara Emerenziani ◽  
Michele Cicala ◽  
...  

Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by abdominal pain associated with defecation or a change in bowel habits. Gut microbiota, which acts as a real organ with well-defined functions, is in a mutualistic relationship with the host, harvesting additional energy and nutrients from the diet and protecting the host from pathogens; specific alterations in its composition seem to play a crucial role in IBS pathophysiology. It is well known that diet can significantly modulate the intestinal microbiota profile but it is less known how different nutritional approach effective in IBS patients, such as the low-FODMAP diet, could be responsible of intestinal microbiota changes, thus influencing the presence of gastrointestinal (GI) symptoms. The aim of this review was to explore the effects of different nutritional protocols (e.g., traditional nutritional advice, low-FODMAP diet, gluten-free diet, etc.) on IBS-D symptoms and on intestinal microbiota variations in both IBS-D patients and healthy subjects. To date, an ideal nutritional protocol does not exist for IBS-D patients but it seems crucial to consider the effect of the different nutritional approaches on the intestinal microbiota composition to better define an efficient strategy to manage this functional disorder.


Gut ◽  
2021 ◽  
pp. gutjnl-2021-325214
Author(s):  
Christopher J. Black ◽  
Heidi M. Staudacher ◽  
Alexander C. Ford

ObjectiveA diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) is recommended for irritable bowel syndrome (IBS), if general lifestyle and dietary advice fails. However, although the impact of a low FODMAP diet on individual IBS symptoms has been examined in some randomised controlled trials (RCTs), there has been no recent systematic assessment, and individual trials have studied numerous alternative or control interventions, meaning the best comparator is unclear. We performed a network meta-analysis addressing these uncertainties.DesignWe searched the medical literature through to 2 April 2021 to identify RCTs of a low FODMAP diet in IBS. Efficacy was judged using dichotomous assessment of improvement in global IBS symptoms or improvement in individual IBS symptoms, including abdominal pain, abdominal bloating or distension, and bowel habit. Data were pooled using a random effects model, with efficacy reported as pooled relative risks (RRs) with 95% CIs, and interventions ranked according to their P-score.ResultsWe identified 13 eligible RCTs (944 patients). Based on failure to achieve an improvement in global IBS symptoms, a low FODMAP diet ranked first vs habitual diet (RR of symptoms not improving=0.67; 95% CI 0.48 to 0.91, P-score=0.99), and was superior to all other interventions. Low FODMAP diet ranked first for abdominal pain severity, abdominal bloating or distension severity and bowel habit, although for the latter it was not superior to any other intervention. A low FODMAP diet was superior to British Dietetic Association (BDA)/National Institute for Health and Care Excellence (NICE) dietary advice for abdominal bloating or distension (RR=0.72; 95% CI 0.55 to 0.94). BDA/NICE dietary advice was not superior to any other intervention in any analysis.ConclusionIn a network analysis, low FODMAP diet ranked first for all endpoints studied. However, most trials were based in secondary or tertiary care and did not study effects of FODMAP reintroduction and personalisation on symptoms.


2019 ◽  
pp. 118-124 ◽  
Author(s):  
D. N. Andreev ◽  
D. T. Dicheva

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is characterized by periodic abdominal pain associated with altered bowel habits and/or changes in stool consistency. The chronic course of the disease marked by alternating periods of exacerbation and remission necessitates the long-term use of non-drug and pharmacological methods for the treatment of IBS, which is extremely negative for the patient’s compliance. A strategy for improving compliance of a patient with IBS is the cornerstone that allows a physician to ensure the optimal level of effectiveness of the prescribed therapy and minimize the risk of disease recurrence.


Author(s):  
Farzaneh Assadollah pour ◽  
Assie Jokar ◽  
Mohammad Azadbakht ◽  
Ebrahim Nasiri ◽  
Zohreh Bari ◽  
...  

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder that causes abdominal pain, distension, change of bowel habit, bloating, constipation, diarrhea, and mucus discharge along with stools. Although the disease causes long-term and agonizing pain, no ideal cure has been found for it so far. This study aimed to investigate the efficacy and compliance of Mentha aquatica L. extract for the treatment of bloating caused by IBS. This double-blind, randomized, placebo-controlled trial study was conducted in Tooba gastroenterology clinic in Sari, Iran, during 2019 (from January to May). A total of 104 patients with IBS in the age range of 20-80 years were randomly divided into two parallel groups of herbal medicine (MAC-330) and placebo. Study period consisted of a 4 weeks of administration, and 2 weeks of follow-up. IBS-associated symptoms including severity of bloating (as primary outcome) and frequency of defecation and abdominal pain were evaluated using a questionnaire before treatment, 1, 2 and 4 weeks after beginning treatment and 2 weeks after stopping treatment. There were no significant differences between the two groups in terms of their baseline characteristics (p > 0.05). The severity of bloating was significantly reduced in the both groups at fourth week (p < 0.030) and 2 weeks after stopping intervention (sixth week) (p < 0.026). The frequency of defecation has increased with the onset of the intervention until the fourth week of the treatment which was not significant. The abdominal pain reduced during the 4 weeks’ intervention, but it was not significant. Based on the obtained results, MAC-330 could not be used as an effective treatment for patients with IBS in short time; however, it reduces the abdominal bloating and pain in these patients, especially in the long-term use.


2020 ◽  
pp. 2951-2959
Author(s):  
Adam D. Farmer ◽  
Qasim Aziz

Symptoms suggestive of disturbed lower gastrointestinal function without adequate explanation are very common in adults in the Western world, up to 15% of whom experience such symptoms at any one time, although most do not seek medical advice. The currently used terms are best viewed as an attempt to provide some clinically useful, rather than pathophysiologically accurate, categorization of patients and their symptoms based on disordered gut–brain interactions. Irritable bowel syndrome is defined according to the Rome III criteria as recurrent abdominal pain or discomfort associated with a change in bowel habit for at least 6 months, with symptoms experienced on at least 3 days of at least 3 months. Many subtypes are recognized. Routine haematological and biochemical screening is usually performed on the assumption that it will be normal. Features that raise the suspicion of organic disease and indicate a need for further investigation include the onset of symptoms in middle-aged or older individuals, weight loss, or blood in the stool. Management remains empirical: no single pharmacological agent or group of agents has ever been found to be consistently effective. The principal task of the physician is to provide explanation and reassurance (sometimes supplemented by psychological treatments), but particular symptoms are often treated as follows: (1) constipation—defecation may be eased by supplementary dietary fibre and poorly absorbed fermentable carbohydrates which increase faecal bulk and soften the stool; osmotic laxatives and enemas are used for the severely constipated patient, as well as more novel agents; (2) diarrhoea—attention to diet is often helpful, as are simple antidiarrhoeal agents; and (3) abdominal pain—antispasmodics (e.g. hyoscine butyl bromide) are frequently used, as are antidepressants.


Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 928 ◽  
Author(s):  
Antonietta Gerarda Gravina ◽  
Marcello Dallio ◽  
Mario Romeo ◽  
Antonietta Di Somma ◽  
Gaetano Cotticelli ◽  
...  

Introduction: Irritable bowel syndrome represents one of the most difficult gastroenterological diseases to treat, that usually induces the patients to follow different drug therapies, often not useful in symptom control. In this scenario low FODMAP diet could have positive effects in patients with irritable bowel syndrome, even because this type of diet regimen is characterized by a low gluten amount due to the exclusion of cereals. Methods: We enrolled 120 patients with irritable bowel syndrome, according to the Rome IV criteria, who were referred to Hepatogastroenterology Division of the University of Campania L. Vanvitelli from June to December 2018. They underwent a low FODMAP diet for six weeks, followed by a gradual weekly reintroduction of every category of food for three months. The patients had a follow-up evaluation for six months after the end of food reintroduction period. We measured abdominal pain with subjective numerical scale from 0 to 10. We evaluated other gastrointestinal symptoms with a questionnaire about symptoms of lower digestive tract, evaluating their frequency and intensity. We also evaluated the impact of irritable bowel syndrome on daily life with neurological bowel dysfunction score. Results: We obtained a good patient-adherence to diet and a statistically significant decrease of abdominal pain, bloating, flatulence, diarrhea, constipation, and neurological bowel dysfunction score (p < 0.001) at the end of the diet. These results remained constant in the follow-up period. Conclusions: We recommend the use of a low FODMAP diet regimen in patients with irritable bowel syndrome in order to control the symptoms and improve the quality of life.


Medicina ◽  
2020 ◽  
Vol 56 (1) ◽  
pp. 38 ◽  
Author(s):  
Ioana-Miruna Balmus ◽  
Ovidiu-Dumitru Ilie ◽  
Alin Ciobica ◽  
Roxana-Oana Cojocariu ◽  
Carol Stanciu ◽  
...  

Irritable bowel syndrome (IBS) remains to date an intriguing functional gastrointestinal disorder. Recent studies described a multitude of exogenous factors that work together in IBS, gradually impairing intestinal lining cellular metabolism, including oxidative status balance, with or without a genetic background. Although the current biomarkers support the differentiation between IBS subtypes and other functional gastrointestinal disorder, they are mostly non-specific, referring to clinical, biochemical, and inflammatory imbalances. Since IBS could be also the result of deficient signaling pathways involving both gastrointestinal secretion and neuro-vegetative stimulation, IBS makes no exception from the oxidative hypothesis in the pathological mechanisms. Regarding the oxidative stress implication in IBS, the previous research efforts showed controversial results, with some animal models and patient studies reporting clear oxidative imbalance both on systemic and local levels, but still with no concrete evidence to point to a direct correlation between oxidative stress and IBS. Additionally, it seems that a major role could be also attributed to gut microbiota and their ability to shape our bodies and behaviors. Moreover, the genetic features study in IBS patients showed that several genetic similarities point to a possible correlation of IBS with affective spectrum disorders. Thus, we focus here the discussion on the assumption that IBS could in fact be more likely a stress-related disorder rather than a gastrointestinal one.


1986 ◽  
Vol 24 (24) ◽  
pp. 93-95

Irritable bowel syndrome (IBS) is commonly diagnosed when the typical symptoms of irregular bowel habit, abdominal pain and distension, and a feeling of incomplete defaecation are not associated with other gastro-intestinal disease. The management of the patient with IBS has been covered previously1 but if dietary advice, reassurance and simple psychotherapy have proved unhelpful the doctor may be under pressure to prescribe as symptoms are usually recurrent. We now review the evidence to support the use of some antispasmodic drugs.


2009 ◽  
Vol 7 (1) ◽  
pp. 73-79 ◽  
Author(s):  
Brian Bond ◽  
Judith Quinlan ◽  
George E. Dukes ◽  
Fermin Mearin ◽  
Ray E. Clouse ◽  
...  

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