Gut Microbiota-Derived Metabolites in Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is the most common functional bowel disorder worldwide and is associated with visceral hypersensitivity, gut motility, immunomodulation, gut microbiota alterations, and dysfunction of the brain-gut axis; however, its pathophysiology remains poorly understood. Gut microbiota and its metabolites are proposed as possible etiological factors of IBS. The aim of our study was to investigate specific types of microbiota-derived metabolites, especially bile acids, short-chain fatty acids, vitamins, amino acids, serotonin and hypoxanthine, which are all implicated in the pathogenesis of IBS. Metabolites-focused research has identified multiple microbial targets relevant to IBS patients, important roles of microbiota-derived metabolites in the development of IBS symptoms have been established. Thus, we provide an overview of gut microbiota and their metabolites on the different subtypes of IBS (constipation-predominant IBS-C, diarrhea-predominant IBS-D) and present controversial views regarding the role of microbiota in IBS.

Positive Effect of Electroacupuncture Treatment on Gut Motility in Constipated Mice Is Related to Rebalancing the Gut Microbiota

Functional constipation (FC) is a common and often recurrent functional bowel disorder that seriously affects the quality of life of affected individuals and incurs a significant economic burden on both the individual and society. There is accumulating evidence that intestinal dysbiosis contributes to constipation and that rebalancing the gut microbiota may be a novel therapeutic modality for FC. Electroacupuncture (EA) has been shown to restore the gut microbiota to normal levels in a variety of diseases. Additionally, several high-quality clinical studies have confirmed that EA is an effective, sustained, and safe treatment for FC. However, whether the effects of EA are secondary to changes in the gut microbiota and how EA modulates intestinal dysbiosis induced by constipation are unknown. Therefore, here, we focused on the potential regulatory mechanisms of EA on diphenoxylate-induced constipation in mice by analyzing structural changes in the gut microbiota. Our results showed that EA treatment effectively rebalanced the gut microbiota of constipated mice, mainly by decreasing the Firmicutes/Bacteroidetes ratio, which may represent one way in which EA promotes gastrointestinal motility and alleviates constipation. Our findings lay the foundation for further mechanistic and clinical research into the application of EA in patients with FC.

Fifteen-minute consultation: Childhood rumination syndrome

Rumination syndrome is a functional bowel disorder where stomach contents effortlessly regurgitate into the mouth. It is an entirely separate entity to gastro-oesophageal reflux disease and requires behavioural rather than pharmaceutical management. Symptoms usually respond well to treatment, though in extreme cases, patients may experience significant weight loss and require inpatient admission.

A modern view of medical accompaniment of the colic in neonate (literature review)

Many infants who represent one of the nosological units that refined functional digestive disorders remain an urgent problem of high frequency of parents' referrals to neonatologists, pediatricians, and general practice — family doctors. Existing studies of a number of hypotheses regarding the etiology, mechanisms of origin, and different approaches to the treatment of colic in infants indicate the relevance of this problem. The article presents current literature data, highlighting the main complaints of parents with suspected colic in a child, presents an analysis of the main causes of this functional bowel disorder, some knowledge about the etiopathogenetic mechanisms of colic, modern components of medical care in infants. Emphasis is placed on the existing ambiguous hypotheses that explain the pathogenetic processes in the body of infants with colic. The focus is on the fact that colic remains a diagnosis of exclusion from other functional bowel diseases. It is noted that the basis of medical support of colic are personalized measures aimed at reducing the severity of pain and choosing the optimal tactics for managing the baby in the period between attacks (background correction), taking into account the existing causes and mechanisms of colic. No conflict of interest was declared by the authors. Key words: functional disorders of digestion refinement, infants, colic in neonate, diagnosis, management.

Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a functional bowel disorder that commonly presents in primary care and has an array of symptoms including abdominal discomfort and altered bowel habit. There may be an overlap of symptoms with other gastrointestinal disorders, leading to difficulty or delay in diagnosis. The condition can produce a variety of troublesome physical and psychological sequelae causing significant impact on an individual’s quality of life. The aim of this article is to highlight the ways in which IBS can present to the General Practitioner and guide the approach to investigation, diagnosis and management in primary care.

Gluten-Free Diet and Its ‘Cousins’ in Irritable Bowel Syndrome

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.

Functional gastrointestinal diseases

Irritable bowel syndrome is a functional bowel disorder characterized by chronic abdominal pain associated with a change in bowel habit or stool consistency in the absence of any definite organic abnormality. It is the commonest functional gastrointestinal syndrome. Many others have been defined clinically, including functional dyspepsia, functional biliary pain, functional abdominal pain, and so on.