Abnormal accumulation of intestinal fluid following ingestion of an unabsorbable carbohydrate in patients with irritable bowel syndrome: an <scp>MRI</scp> study

Undseth, Ragnhild; Berstad, Arnold; Kløw, Nils Einar; Arnljot, K.; Moi, K. S.; Valeur, Jørgen

doi:10.1111/nmo.12449

Cited by 33 publications

(31 citation statements)

References 24 publications

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“…A lactulose challenge test to induce symptoms in patients with IBS has been developed by our laboratory (5) and was used as a tool in our previous study (6); other studies have used a modified test (7,8). Ingestion of a small dose of lactulose may elicit abdominal and systemic symptoms, including chills and fatigue.…”

Section: Introductionmentioning

confidence: 99%

Systemic symptoms in irritable bowel syndrome: An investigative study on the role of enterocyte disintegrity, endotoxemia and inflammation

Undseth

Berstad

Valeur

2016

Molecular Medicine Reports

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Irritable bowel syndrome (IBS) is often accompanied by extra-intestinal symptoms, including fatigue and musculoskeletal pain. The present study aimed to investigate whether these symptoms were associated with markers of enterocyte disintegrity, endotoxemia and inflammation. Patients with IBS were recruited consecutively from our outpatient clinic (n=94) and compared with a group of healthy controls (n=20). Habitual symptoms were assessed using the IBS Severity Scoring System, the Fatigue Impact Scale and Visual Analogue Scales for measuring musculoskeletal pain. A lactulose challenge test was performed to induce post-prandial symptoms, and blood samples were obtained prior to and 90 min following lactulose ingestion to determine levels of intestinal fatty acid binding protein (iFABP), lipopolysaccharide (LPS), the LPS co-receptor soluble cluster of differentiation (sCD) 14, monocyte chemoattractant protein-1 (MCP-1) and calprotectin. Habitual symptom scores were high among the included patients, and lactulose ingestion induced significantly more symptoms in the patient group compared with the healthy control group (P=0.0001). Serum levels of iFABP were reduced in IBS patients compared with healthy controls, prior to and following lactulose ingestion (P=0.0002 and P=0.0001, respectively). Following lactulose ingestion, iFABP levels decreased in IBS patients (P=0.0001) and in healthy controls (P=0.02). Fasting levels of LPS, sCD14, MCP-1 and calprotectin were not significantly different between IBS patients and healthy controls. However, following lactulose ingestion, LPS levels increased in healthy controls (P=0.03), whereas MCP-1 levels decreased in IBS patients (P=0.008). Intestinal and extra-intestinal symptom severities were not correlated with levels of circulating biomarkers. No assessed biomarker in the present study appeared to be associated with symptom development in IBS patients. However, the implications of the low levels of iFABP observed require further investigation.

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Section: Introductionmentioning

confidence: 99%

Systemic symptoms in irritable bowel syndrome: An investigative study on the role of enterocyte disintegrity, endotoxemia and inflammation

Undseth

Berstad

Valeur

2016

Molecular Medicine Reports

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“…12 Studies using magnetic resonance imaging have shown that osmotically active carbohydrates caused a marked increase in small-bowel water content and subsequent luminal distension in healthy and IBS subjects. [13][14][15] In 1 study, ingestion of 10 g lactulose was shown to provoke more symptoms, higher small-bowel water content, and larger ileal distension in IBS patients as compared with healthy volunteers. 13 In theory, impaired handling of gut contents in combination with increased perception of visceral signals (visceral hypersensitivity) may result in symptoms such as bloating and abdominal distension, 16,17 but the mechanisms involved in the generation of postprandial symptoms are complex and remain to be deciphered.…”

mentioning

confidence: 99%

Lactulose Challenge Determines Visceral Sensitivity and Severity of Symptoms in Patients With Irritable Bowel Syndrome

Nevé

Brazeilles

Derrien

et al. 2016

Clinical Gastroenterology and Hepatology

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“…showed that small bowel water content was increased after ingestion of unabsorbed lactulose, more in the IBS than the control group. In addition, more symptoms were significantly provoked by lactulose in IBS than in healthy controls . A study by Ong et al .…”

Section: Methodsmentioning

confidence: 95%

Low fermentable oligosaccharides, disaccharides, monosaccharides, and polypols diet and irritable bowel syndrome in Asia

et al. 2018

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Functional bowel disorders, including irritable bowel syndrome (IBS), are a chronic condition that can significantly reduce patients’ quality of life. Therefore, this paper will review the roles of a low fermentable oligosaccharides, disaccharides, monosaccharides, and polypols (FODMAP) diet in treating IBS, particularly in an Asian setting. About 20% of the general population is diagnosed with IBS. However, there are limited effective medical therapies available for treating IBS. Therefore, IBS presents a major challenge to the health‐care providers. Recently, there is an increasing interest in the use of a diet low in FODMAP for the treatment of IBS. A low FODMAP diet can decrease the delivery of readily fermentable substrates to the small intestine and colon, thereby improving functional gastrointestinal symptoms.

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Abnormal accumulation of intestinal fluid following ingestion of an unabsorbable carbohydrate in patients with irritable bowel syndrome: an MRI study

Cited by 33 publications

References 24 publications

Systemic symptoms in irritable bowel syndrome: An investigative study on the role of enterocyte disintegrity, endotoxemia and inflammation

Systemic symptoms in irritable bowel syndrome: An investigative study on the role of enterocyte disintegrity, endotoxemia and inflammation

Lactulose Challenge Determines Visceral Sensitivity and Severity of Symptoms in Patients With Irritable Bowel Syndrome

Low fermentable oligosaccharides, disaccharides, monosaccharides, and polypols diet and irritable bowel syndrome in Asia

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