Functional bowel disorders

Drossman, Douglas A.; Li, Zhiming; Toner, Brenda B.; Diamant, Nicholas E.; Creed, Francis; Thompson, David G.; Read, N W; Babbs, Chris; Barreiro, Marcelo A.; Bank, Leslie; Whitehead, William E.; Schuster, Marvin M.; Guthrie, Elspeth

doi:10.1007/bf02064187

Cited by 140 publications

(17 citation statements)

References 18 publications

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“…As mentioned above, the majority of IBS patients in our study suffered from a mild disease severity, which represent the general IBS population 18 . Moreover, the higher percentage of women 1, 31 , and the age range (18-81 years) with most subjects younger than 45 years, are typical of IBS populations as previously reported 32 .…”

Section: Discussionmentioning

confidence: 74%

“…IBS diagnosis and its clinically relevant subtype were determined using the ROME III criteria for IBS 17 . IBS severity was assessed using the Functional Bowel Disorders Symptom Severity Index (FBDSI) 18 . Somatic and psychological comorbidities were assessed using the Patient Health Questionnaire comprised of 15 somatic symptoms (PHQ-15) 19 and Hospital Anxiety and depression scale (HADS) 20 .…”

Section: Methodsmentioning

confidence: 99%

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High-sensitive C-Reactive Protein as a Marker for Inflammation in Irritable Bowel Syndrome

Hod

Ringel–Kulka

Martin

et al. 2016

Journal of Clinical Gastroenterology

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Background Recent studies demonstrated low-grade inflammation in patients with Irritable Bowel Syndrome (IBS). However, these studies have been relatively small and do not enable examination of this factor in different subtypes of IBS and the possibility of confounding effects of co-morbidities that may be associated with inflammatory responses. Goals To investigate the association between high sensitive C - reactive protein (hs-CRP) and the diagnosis of IBS, IBS-subtypes, symptoms' severity and IBS-associated co-morbidities. Study This cross-sectional study uses data from a large matched case control study of IBS subjects and healthy controls (HC). hs-CRP levels were measured in all subjects. IBS diagnosis was determined by Rome III criteria, negative screening blood tests and normal colonoscopy. Subjects were evaluated for IBS severity and associated pain and psychological co-morbidities Results A total of 242 IBS patients and 244 HC were studied. Median hs-CRP levels in the IBS group were significantly higher than in HC (1.80, IQR 0.7-4.04 mg/l vs 1.20, IQR 0.5-2.97mg/l respectively, p<0.006,). Levels were highest in IBS-D patients with greater disease severity. Hs-CRP levels mildly correlated with symptoms severity (r=0.169, p=0.009); this correlation was stronger for the IBS-D patients (r=0.27, p=0.006). IBS was a significant independent predictor (p=0.025) for higher hs-CRP levels, whereas other pain and psychological co-morbidities were not. Conclusions Given these observations of cross-sectional differences in hs-CRP between IBS subtypes and severity, independent of pain and co-morbidities, more research is needed to explore a possible role of low-grade inflammation in the pathogenesis and/or clinical presentation of IBS.

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Section: Discussionmentioning

confidence: 74%

Section: Methodsmentioning

confidence: 99%

High-sensitive C-Reactive Protein as a Marker for Inflammation in Irritable Bowel Syndrome

Hod

Ringel–Kulka

Martin

et al. 2016

Journal of Clinical Gastroenterology

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“…Other disease-related GI symptom scales that have been validated are the IBS Severity Scoring System for scoring lower GI tract symptoms and the Leeds Dyspepsia Questionnaire or the Gastrointestinal Symptom profile for scoring upper GI tract symptoms [77-79]. Moreover, scores have been developed and tested which assess particular symptoms, such as pain, using the Functional Bowel Disorder Severity Index or the Numeric Rating Scale [80,81], as well as scores that assess anxiety using the Visceral Sensitivity Index [82]. In clinical trials, overall improvement of symptoms has been assessed by using singular global questions such as the IBS Global Assessment of Improvement or the Subject's Global Assessment of Relief, which have yielded reliable results [83,84].…”

Section: Discussionmentioning

confidence: 99%

'Gut health': a new objective in medicine?

Bischoff

2011

BMC Med

263

169

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'Gut health' is a term increasingly used in the medical literature and by the food industry. It covers multiple positive aspects of the gastrointestinal (GI) tract, such as the effective digestion and absorption of food, the absence of GI illness, normal and stable intestinal microbiota, effective immune status and a state of well-being. From a scientific point of view, however, it is still extremely unclear exactly what gut health is, how it can be defined and how it can be measured. The GI barrier adjacent to the GI microbiota appears to be the key to understanding the complex mechanisms that maintain gut health. Any impairment of the GI barrier can increase the risk of developing infectious, inflammatory and functional GI diseases, as well as extraintestinal diseases such as immune-mediated and metabolic disorders. Less clear, however, is whether GI discomfort in general can also be related to GI barrier functions. In any case, methods of assessing, improving and maintaining gut health-related GI functions are of major interest in preventive medicine.

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“…Severity was rated as mild (1–36 points), moderate (37–110 points) and severe (≥111 points). Details of the index calculation are presented in the original article [17]. …”

Section: Methodsmentioning

confidence: 99%

A randomised clinical trial (RCT) of a symbiotic mixture in patients with irritable bowel syndrome (IBS): effects on symptoms, colonic transit and quality of life

Cappello

Tremolaterra

Pascariello

et al. 2012

Int J Colorectal Dis

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PurposeThe aim of this study is to test in a double-blinded, randomised placebo-controlled study the effects of a commercially available multi-strain symbiotic mixture on symptoms, colonic transit and quality of life in irritable bowel syndrome (IBS) patients who meet Rome III criteria.BackgroundThere is only one other double-blinded RCT on a single-strain symbiotic mixture in IBS.MethodsThis is a double-blinded, randomised placebo-controlled study of a symbiotic mixture (Probinul, 5 g bid) over 4 weeks after 2 weeks of run-in. The primary endpoints were global satisfactory relief of abdominal flatulence and bloating. Responders were patients who reported at least 50 % of the weeks of treatment with global satisfactory relief. The secondary endpoints were change in abdominal bloating, flatulence, pain and urgency by a 100-mm visual analog scale, stool frequency and bowel functions on validated adjectival scales (Bristol Scale and sense of incomplete evacuation). Pre- and post-treatment colonic transit time (Metcalf) and quality of life (SF-36) were assessed.ResultsSixty-four IBS patients (symbiotic n = 32, 64 % females, mean age 38.7 ± 12.6 years) were studied. This symbiotic mixture reduced flatulence over a 4-week period of treatment (repeated-measures analysis of covariance, p < 0.05). Proportions of responders were not significantly different between groups. At the end of the treatment, a longer rectosigmoid transit time and a significant improvement in most SF-36 scores were observed in the symbiotic group.ConclusionsThis symbiotic mixture has shown a beneficial effect in decreasing the severity of flatulence in IBS patients, a lack of adverse events and a good side-effect profile; however, it failed to achieve an improvement in global satisfactory relief of abdominal flatulence and bloating. Further studies are warranted.

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Functional bowel disorders

Cited by 140 publications

References 18 publications

High-sensitive C-Reactive Protein as a Marker for Inflammation in Irritable Bowel Syndrome

High-sensitive C-Reactive Protein as a Marker for Inflammation in Irritable Bowel Syndrome

'Gut health': a new objective in medicine?

A randomised clinical trial (RCT) of a symbiotic mixture in patients with irritable bowel syndrome (IBS): effects on symptoms, colonic transit and quality of life

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