- The effect of prunes on stool output, gut transit time and gastrointestinal microbiota: A randomised controlled trial. [Journal Article]
- CNClin Nutr 2018 Feb 02
- CONCLUSIONS: In healthy individuals with infrequent stool habits and low fibre intake, prunes significantly increased stool weight and frequency and were well tolerated. Prunes may have health benefits in populations with low stool weight.
- Fructans Exacerbate Symptoms in a Subset of Children With Irritable Bowel Syndrome. [Journal Article]
- CGClin Gastroenterol Hepatol 2018; 16(2):219-225.e1
- CONCLUSIONS: In a randomized controlled trial of children with IBS, we found fructans to exacerbate several symptoms. However, fructan sensitivity cannot be identified based on baseline gastrointestinal symptoms, dietary intake, psychosocial factors, or gas production. Clinicaltrials.gov no: NCT02842281.
- Efficacy of antibiotherapy for treating flatus incontinence associated with small intestinal bacterial overgrowth: A pilot randomized trial. [Randomized Controlled Trial]
- PlosPLoS One 2017; 12(8):e0180835
- CONCLUSIONS: Our results show a promising trend indicating that metronidazole might significantly improve flatus incontinence associated with SIBO and might be more successful in treating flatus incontinence than gas absorbents.
- Dietary fiber in irritable bowel syndrome (Review). [Journal Article]
- IJInt J Mol Med 2017; 40(3):607-613
- Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder. It is widely believed that IBS is caused by a deficient intake of dietary fiber, and most physicians recommend that patie...
Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder. It is widely believed that IBS is caused by a deficient intake of dietary fiber, and most physicians recommend that patients with IBS increase their intake of dietary fiber in order to relieve their symptoms. However, different types of dietary fiber exhibit marked differences in physical and chemical properties, and the associated health benefits are specific for each fiber type. Short-chain soluble and highly fermentable dietary fiber, such as oligosaccharides results in rapid gas production that can cause abdominal pain/discomfort, abdominal bloating/distension and flatulence in patients with IBS. By contrast, long-chain, intermediate viscous, soluble and moderately fermentable dietary fiber, such as psyllium results in a low gas production and the absence of the symptoms related to excessive gas production. The effects of type of fiber have been documented in the management of IBS, and it is known to improve the overall symptoms in patients with IBS. Dietary fiber acts on the gastrointestinal tract through several mechanisms, including increased fecal mass with mechanical stimulation/irritation of the colonic mucosa with increasing secretion and peristalsis, and the actions of fermentation byproducts, particularly short-chain fatty acids, on the intestinal microbiota, immune system and the neuroendocrine system of the gastrointestinal tract. Fiber supplementation, particularly psyllium, is both safe and effective in improving IBS symptoms globally. Dietary fiber also has other health benefits, such as lowering blood cholesterol levels, improving glycemic control and body weight management.
- The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS. [Review]
- GutGut 2017; 66(8):1517-1527
- There is an intensifying interest in the interaction between diet and the functional GI symptoms experienced in IBS. Recent studies have used MRI to demonstrate that short-chain fermentable carbohydr...
There is an intensifying interest in the interaction between diet and the functional GI symptoms experienced in IBS. Recent studies have used MRI to demonstrate that short-chain fermentable carbohydrates increase small intestinal water volume and colonic gas production that, in those with visceral hypersensitivity, induces functional GI symptoms. Dietary restriction of short-chain fermentable carbohydrates (the low fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet) is now increasingly used in the clinical setting. Initial research evaluating the efficacy of the low FODMAP diet was limited by retrospective study design and lack of comparator groups, but more recently well-designed clinical trials have been published. There are currently at least 10 randomised controlled trials or randomised comparative trials showing the low FODMAP diet leads to clinical response in 50%-80% of patients with IBS, in particular with improvements in bloating, flatulence, diarrhoea and global symptoms. However, in conjunction with the beneficial clinical impact, recent studies have also demonstrated that the low FODMAP diet leads to profound changes in the microbiota and metabolome, the duration and clinical relevance of which are as yet unknown. This review aims to present recent advances in the understanding of the mechanisms by which the low FODMAP diet impacts on symptoms in IBS, recent evidence for its efficacy, current findings regarding the consequences of the diet on the microbiome and recommendations for areas for future research.
- Rome Foundation-Asian working team report: Asian functional gastrointestinal disorder symptom clusters. [Journal Article]
- GutGut 2017 Jun 07
- CONCLUSIONS: We found that the broad categorisation used both in clinical practice and in the Rome system, that is, broad anatomical divisions, and certain diagnoses with long historical records, that is, IBS with diarrhoea, and chronic constipation, are still valid in our Asian societies. In addition, we found a bowel symptom cluster with meal trigger and a gas cluster that suggests a different emphasis in our populations. Future studies to compare a non-Asian cohort and to match to putative pathophysiology will help to verify our findings.
- Safety and tolerability of Bifidobacterium longum subspecies infantis EVC001 supplementation in healthy term breastfed infants: a phase I clinical trial. [Journal Article]
- BPedBMC Pediatr 2017 May 30; 17(1):133
- CONCLUSIONS: The B. infantis EVC001 supplement was safely consumed and well-tolerated. Stools were fewer and better formed in infants in the BiLS group compared with LS group. Adverse events were those expected in healthy infants and not different between groups.
- Bloating and Abdominal Distension: Old Misconceptions and Current Knowledge. [Review]
- AJAm J Gastroenterol 2017; 112(8):1221-1231
- Bloating, as a symptom and abdominal distension, as a sign, are both common functional-type complaints and challenging to manage effectively. Individual patients may weight differently the impact of ...
Bloating, as a symptom and abdominal distension, as a sign, are both common functional-type complaints and challenging to manage effectively. Individual patients may weight differently the impact of bloating and distension on their well-being. Complaints may range from chronic highly distressing pain to simply annoying and unfashionable protrusion of the abdomen. To avoid mishaps, organic bloating, and distension should always be considered first and appropriated assessed. Functional bloating and distension often present in association with other manifestations of irritable bowel syndrome or functional dyspepsia and in that context patients tend to regard them as most troublesome. A mechanism-based management bloating and distension should be ideal but elucidating key operational mechanisms in individual patients is not always feasible. Some clues may be gathered through a detailed dietary history, by assessing bowel movement frequency and stool consistency and special imaging technique to measure abdominal shape during episodes of distension. In severe, protracted cases it may be appropriate to refer the patient to a specialized center where motility, visceral sensitivity, and abdominal muscle activity in response to intraluminal stimuli may be measured. Therapeutic resources focussed upon presumed or demonstrated pathogenetic mechanism include dietary modification, microbiome modulation, promoting gas evacuation, attenuating visceral perception, and controlling abdominal wall muscle activity via biofeedback.
- Generation of Lactobacillus plantarum strains with improved potential to target gastrointestinal disorders related to sugar malabsorption. [Journal Article]
- FRFood Res Int 2017; 94:45-53
- Malabsorption of dietary sugars is a common cause of gastrointestinal discomfort, affecting up to one in three people with debilitating symptoms, such as abdominal pain, osmotic diarrhoea, bloating a...
Malabsorption of dietary sugars is a common cause of gastrointestinal discomfort, affecting up to one in three people with debilitating symptoms, such as abdominal pain, osmotic diarrhoea, bloating and flatulence. Besides dietary interventions, it has been suggested that ingestion of lactobacilli may alleviate these symptoms. The objectives of this study were to generate strains with improved potential to ameliorate sugar malabsorption related gastrointestinal disorders. Initial selection was made from 183 natural isolates of lactic acid bacteria, on the basis of broad sugar fermentation ability, absence of gas production, gastrointestinal survival and susceptibility to important medical antimicrobials. Two strains of L. plantarum (KR6 and M5) exhibited favourable characteristics for all criteria, and were further optimised through random mutagenesis and selection approaches. Ultraviolet light (UV) exposure resulted in mutants characterized by better survival (for 1.9 log and 1.4 log) in gastrointestinal conditions. Subsequent exposure to ethyl methanesulfonate (EMS) provided mutants with greater tolerance to glucose induced catabolic repression. UV and UV-EMS mutants of L. plantarum M5 showed improved adhesion ability. As a result of this optimisation, L. plantarum MP2026 and L. plantarum MP2420 have been identified as promising candidates for probiotics, intended for alleviation of gastrointestinal discomfort originating from sugar malabsorption.
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- PREVALENCE OF SMALL INTESTINE BACTERIAL OVERGROWTH IN PATIENTS WITH GASTROINTESTINAL SYMPTOMS. [Journal Article]
- AGArq Gastroenterol 2017 Apr-Jun; 54(2):91-95
- CONCLUSIONS: The data found in this study is consistent with the findings of the current literature and underscores the need for using devices capable of capturing the two gases (exhaled H 2 and CH 4 ) to improve the sensitivity and hence the accuracy of small intestine bacterial overgrowth diagnosis in daily medical practice.