Background and aim: Irritable bowel syndrome (IBS) is referred to as a functional bowel disorder which is diagnosed by a number of characteristic symptoms (Rome II criteria) in the absence of detectable structural abnormalities. Low-grade inflammation of the intestine may be one of the reasons for development of diarrhoea-predominant IBS (IBS-D). We undertook this study to estimate the serum levels of pro-inflammatory (IL-6, TNF-α) and anti-inflammatory (IL-10) cytokines in IBS-D patients. Methods: A total of 108 diarrhoea patients were screened. Out of these only 63 adult IBS-D patients were enrolled. Age and sex matched 62 apparently healthy controls with no GI symptoms were also recruited. Out of 63 IBS-D patients, 37 were males while there were 32 males among the controls. The patients with IBS-D were diagnosed according to the Rome II criteria. Levels of serum IL-6, TNF-α and IL-10 were measured in all subjects using ELISA. Results: Mean (+SD) age of IBS-D patients (42.6+19.5 years) was comparable (p=0.64) to that of controls (43.5+18.7 years). The mean (+SD) levels of IL-6 in IBS-D patients (32.2+12.01pg/ ml) was significantly higher (p<0.001) than in controls (7.48+2.55pg/ml). The levels of TNF-α in IBS-D patients (16.3+5.2 pg/ml) were also significantly higher (p<0.05) than in controls (7.94+2.19 pg/ml). There was no significant difference in the serum levels of IL-10 (p=0.23) between IBS-D patients (5.75+2.1 pg/ml) and controls (5.84+1.9 pg/ml). Conclusion: Our results indicate that mild inflammation is involved in IBS-D patients as proinflammatory cytokines were increased although no difference in anti-inflammatory cytokine was observed.

Background: Type 2 diabetes mellitus (T2DM) is most demanding public health problem of 21st century. Uncontrolled diabetes may cause complications affecting any part of gut from mouth to rectum presenting as vomiting, nausea, bloating, abdominal pain, constipation and diarrhoea. The aim of this study was to compare levels of oxidative stress and inflammatory markers in small intestinal bacterial overgrowth (SIBO)-positive and negative diabetic patients. Subjects and methods: An observational analytical study was conducted on 300 T2DM (>5 years' duration) attending Diabetic Clinic. A total of 200 age-and sexmatched healthy individuals were enrolled as controls. Noninvasive glucose hydrogen breath test was used to diagnose SIBO. A total of 5 mL blood was taken. Plasma was used for measurement of inflammatory cytokines (TNF-α, IL-6 and IL-10) by ELISA. Hemolysate was used for measurement of lipid peroxidation, reduced GSH, superoxide dismutase and catalase. Results: It was observed that constipation was present in 59.6% T2DM patients.SIBO was observed significantly higher (P < .0001) in T2DM patients than controls.Inflammatory and oxidative stress markers were significantly (P < .001) higher in diabetic and SIBO-positive patients than controls and SIBO negative. Reduced GSH was significantly (P < .05) lower whereas superoxide dismutase (SOD) and catalase antioxidant enzymes were significantly (<.05) higher in diabetic and SIBO-positive patients than controls and SIBO-negative patients. Conclusion: From this study, it could be concluded that SIBO in T2DM patients can cause oxidative stress and inflammation. Therefore, SIBO should be taken care to prevent further damage to intestine. K E Y W O R D Sinflammatory markers, orocecal transit time, oxidative stress, small intestinal bacterial over growth, type 2 diabetes mellitus 2 of 6 | MALIK et AL.

This study indicates that there is association between hyperglycaemia, oxidative stress (LPO), anti-oxidants (GSH, SOD and catalase), inflammatory cytokines, gut motility (OCTT), and small intestinal overgrowth in type 1 diabetes mellitus patients. This association is intensified as duration of disease increases.

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