Search

Background: Irritable bowel syndrome (IBS) is a prevalent yet intricate gastrointestinal condition that poses substantial challenges in both diagnosis and treatment. The lack of definitive diagnostic markers and the focus on symptom-based therapies often result in inadequate relief for patients, leading to frustration and psychological distress. In areas where access to healthcare is limited, the uncertainty surrounding IBS frequently drives patients to explore alternative treatments, including traditional medicine, which can potentially worsen the condition or introduce new health risks. Aim: This case report study aimed to examine the underappreciated role of exercise as a viable treatment for IBS, shedding light on the shortcomings of current diagnostic and therapeutic practices. It provides an important perspective on the diagnostic and treatment challenges of IBS and presents exercise as a highly effective non-pharmacological intervention that is often underutilized in clinical practice in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: Linaclotide, a guanylate cyclase-C agonist, is indicated for irritable bowel syndrome with constipation (IBS-C). However, real-world data on the safety and patient-reported outcomes (PROs) of linaclotide are scarce in Chinese patients with IBS-C. Objectives: To assess the real-world safety and PROs of linaclotide in the Chinese IBS-C population. Design: Multicenter, prospective observational study. Methods: Adults with IBS-C who had taken or planned to take at least one dose of linaclotide 290 μg were enrolled and followed up for 3 months. Face-to-face visits were conducted at baseline (V1), Week 4 ± 7 days (V2), and Week 12 ± 7 days (V3). Primary endpoints included the incidences of adverse events (AEs), AEs by severity, adverse drug reactions (ADRs), serious AEs (SAEs), and AEs leading to treatment interruption, discontinuation, and death. Secondary endpoints included mean treatment satisfaction at V2 and V3, and mean overall Irritable Bowel Syndrome-Quality of Life (IBS-QoL) at V2. Results: Out of 3000 enrolled patients, 2963 took at least one dose of linaclotide and were analyzed. Overall, 712 patients (24.0%) reported 1095 AEs, which were mostly mild (89.9%). Diarrhea, reported in 297 out of the 2963 patients analyzed (10.0%), was the most common AE. No severe diarrhea was reported. Totally, 319 patients (10.8%) reported ADRs. Forty-six patients (1.6%) reported 50 SAEs and two cases were considered related to linaclotide treatment. Fifty-one (1.7%) and 70 patients (2.4%) interrupted and discontinued treatment due to AEs, respectively. One patient died of hepatic cancer, which was considered unrelated to linaclotide treatment. During the follow-up, the mean (±SD) treatment satisfaction increased numerically and continuously (V1, 2.8 ± 1.3 (n = 1721); V2, 3.5 ± 1.1 (n = 1705); V3, 3.9 ± 1.0 (n = 833)). The mean (±SD) overall IBS-QoL increased numerically from 73.2 ± 16.6 (n = 1924) at V1 to 80.2 ± 15.5 (n = 1738) at V2. Conclusion: In the Chinese real-world setting, linaclotide was safe and well tolerated in patients with IBS-C. Numerically, there are trends toward improvement in PROs with linaclotide treatment. [ABSTRACT FROM AUTHOR]

Background: Digital health interventions (DHIs) could be a valuable self-management tool for patients with irritable bowel syndrome (IBS), but little research exists on IBS-focused DHIs and their effectiveness. This review aimed to identify DHIs for IBS and evaluate their characteristics, effectiveness, and feasibility. Methods: Our study team, including patient partners, conducted a systematic review using Medline, PsycINFO, Embase, Web of Science, and CINAHL from database inception to May 2024. Experimental and observational studies evaluating DHIs designed for use by IBS patients were included. Data extraction and assessment included study and DHI characteristics, effectiveness outcomes (symptom severity, quality of life, psychological indices, patient empowerment), and feasibility measures (adherence, usability, user satisfaction). Study quality and bias were assessed using a modified checklist of Downs and Black. Results: Of the 929 identified, 13 studies of DHIs were included and deemed good quality on average (21,510 total participants) with six primary areas of focus: education, diet, brain–gut behavior skills, physiological support, health monitoring, and community engagement. Most DHIs were self-directed and reported statistically significant improvements in most effectiveness outcomes. Evidence suggests that DHIs focusing on brain–gut behavior skills or health monitoring may be most effective compared to other types of DHIs. However, their feasibility remains unclear, and the generalization of their impacts is limited. Conclusion: This review underscores the potential of DHIs in supporting IBS patients and improving their outcomes. However, additional research is warranted for continued intervention use in this population, including assessments on feasibility, safety, cost-effectiveness, and patient empowerment and experiences. [ABSTRACT FROM AUTHOR]

The endocannabinoid system (ECS), composed of receptors, endocannabinoids, and enzymes that regulate biosynthesis and degradation, plays a fundamental role in the physiology and pathology of the gastrointestinal tract, particularly in the small and large intestine and liver. Specifically, cannabinoid receptor type 1 (CB1R) and cannabinoid receptor type 2 (CB2R), located principally in the nervous system and immune cells, orchestrate processes such as intestinal motility, intestinal and hepatic inflammation, and energy metabolism, respectively. The main endocannabinoids, anandamide (AEA) and 2-arachidonoylglycerol (2-AG), influence appetite, body weight regulation, and inflammatory states and thus have implications in obesity, non-alcoholic fatty liver disease (NAFLD) and irritable bowel syndrome (IBS). Recent studies have highlighted the therapeutic potential of targeting the ECS to modulate gastrointestinal and metabolic diseases. In particular, peripheral CB1R antagonists and CB2R agonists have shown efficacy in treating intestinal inflammation, reducing hepatic steatosis, and controlling IBS symptoms. Moreover, the ECS is emerging as a potential target for the treatment of colorectal cancer, acting on cell proliferation and apoptosis. This review highlights the opportunity to exploit the endocannabinoid system in the search for innovative therapeutic strategies, emphasizing the importance of a targeted approach to optimize treatment efficacy and minimize side effects. [ABSTRACT FROM AUTHOR]

Irritable bowel syndrome (IBS) is a common disease, whose etiopathogenesis is poorly understood. Human endogenous retroviruses (HERVs) originate from ancient infections of germinal cells and represent 8% of our DNA. Most HERVs have become defective due to the accumulated mutations; some can, however, still be activated, and their altered expressions have been associated with a number of chronic inflammatory and immune-mediated disorders, including gastrointestinal diseases. Retroviral transcription is modulated by TRIM28 and SETDB1, which also participate in the regulation of epigenetic mechanisms and in shaping the immune system. Expressions of HERVs and TRIM28/SETDB1 have not been investigated in patients affected by IBS. Using a PCR real-time Taqman amplification assay, we explored the RNA levels of HERV-H-pol, HERV-K-pol, and HERV-W-pol; syncytin 1 (SYN1), SYN2, and HERV-W-env; and TRIM28 and SETDB1 in the peripheral blood of 37 IBS patients and healthy controls (HCs) of similar age. The transcript levels were higher in IBS patients than in HCs for all HERVs except for HERV-W-pol, with significant p-values for HERV-H-pol, HERV-K-pol, and SYN1 and borderline p-values for SYN2 and HERV-W-env. The RNA levels of SETDB1 were significantly enhanced in IBS patients, while those of TRIM28 were in the normal range. Patients with severe disease had significant upregulation of SETDB1 compared to those with mild or moderate symptoms. These findings suggest that overexpression of HERVs and SETDB1 may contribute to the development of IBS and open the way to innovative therapeutic strategies. [ABSTRACT FROM AUTHOR]

Background: A review of previous studies has shown that psychological factors such as disease acceptance and emotional self-regulation have a significant effect on the exacerbation of irritable bowel syndrome and its therapeutic consequences. Among the effective methods for increasing disease acceptance and improving emotional self-regulation, we can mention relaxation training and awareness and emotional expression training. Aims: The present study was conducted with the aim of comparing the efficacy of relaxation training and awareness and emotional expression training on disease acceptance and emotional self-regulation in patients with irritable bowel syndrome. Methods: The current research design was a semi-experimental pre-test-post-test type with a control group and a two-month follow-up. The statistical population of the study included all patients with irritable bowel syndrome who referred to the gastroenterology Subspecialty offices in northwest Tehran from 2021 to July 2022, who had received the diagnostic criteria of irritable bowel syndrome. Using the purposeful sampling, 60 patients with irritable bowel syndrome were selected, And then they were randomly divided into three groups of 20 people (two experimental groups and one control group). The tools used in this research was the Chronic Illness Acceptance Questionnair (Beacham et al., 2015) and Emotional self-regulation (affective style) questionnaire (Hofmann & Kashdan, 2010). Also, for the first experimental group, relaxation training, For the second experimental group, awareness and emotional expression training in 8 sessions of 90 minutes it was held virtually. In order to analyze the research data, the Analysis of variance with repeated measures and SPSS-26 software was used. Results: The findings showed that compared to relaxation training, awareness and emotional expression training increase disease acceptance in people with irritable bowel syndrome. The difference in the efficacy of relaxation and awareness and emotional expression on the components of commitment to engaging in activities (P= 0.004) and Willingness to endure (P= 0.034) and consequently on the total score of disease acceptance (P= 0.001) was significant. Also, the results showed that relaxation training is not an effective method for improving emotional self-regulation in patients with irritable bowel syndrome, however, the difference between the effect of relaxation training and awareness and emotional expression training on the factors of adjusting (P= 0.011), concealing (P= 0.001) and tolerating (P= 0.008) is significant. Conclusion: Based on the findings of the present study, it seems awareness and emotional expression training is a more effective method to increase disease acceptance and improve emotional selfregulation in irritable bowel syndrome patients compared to relaxation training. [ABSTRACT FROM AUTHOR]

Irritable bowel syndrome (IBS) is a chronic digestive illness characterized by symptoms such as bloating, stomach discomfort, diarrhea, irregular bowel motions, and constipation. IBS is caused by genetic predisposition and the gut-brain axis, which affects the brain and psychological health. The gut microbiome may mediate dysbiosis in IBS patients, stress, and psychological comorbidity. Medications for IBS include probiotics, antispasmodics, antibiotics, and several agents acting on central nervous system. However, the disappointing results of conventional treatments are leading many patients to consider complementary and alternative medicines. The current study examines different herbal remedies, their phytoconstituents, the ways in which herbs work, and novel approaches based on nanotechnology to treat IBS. Moreover, with the help of the phytoconstituents discussed in this review, a ligand-based pharmacophore was generated in order to obtain structural knowledge for potential future developments of leads for the treatment of IBS. Potent activity against IBS may be enhanced by structural alterations of these phytoconstituents on hydrophobic, donor, and acceptor regions. In summary, this research could pave the way for the management of IBS through the use of herbal medicinal plants and encourage scientists to explore for novel natural remedies. [ABSTRACT FROM AUTHOR]

Irritable bowel syndrome (IBS) is one of the disorders most frequently diagnosed by gastroenterologists. Probiotics are promising tools for the management of IBS. The objective of the present study was to evaluate the effectiveness and tolerability of a probiotic (Bifidobacterium longum 35624®) in adults (aged 18 or over) with IBS (as defined by the Rome IV criteria). In an open-label, observational, post-market study conducted in Germany, adults with IBS and a prior recommendation for the intake of B. longum 35624® were recruited by family physicians. During the 8-week course of treatment, the study participants filled out a weekly questionnaire that enabled calculation of a total IBS symptom score (TISS, the sum of abdominal pain, bloating, passage of gas, constipation, and diarrhea individual symptom scores) and the well-known IBS severity scoring system (IBS-SSS) score. Thirty-seven patients were included. The course of B. longum 35624® was associated with a significant reduction (43.4%) in the TISS vs. baseline. The mean individual symptom grades for passage of gas and bloating fell significantly from "moderate" at baseline to "very mild to mild" after 8 weeks of treatment, whereas those for abdominal pain and diarrhea fell significantly from "mild to moderate" to "very mild to mild." Over 60% of the participants achieved clinically meaningful reductions in the TISS (> 30%) and the IBS-SSS score (> 50 points). The effectiveness of B. longum 35624® was rated as "good to satisfactory" by study participants and the investigating physicians. One mild adverse event (nausea) was potentially linked to the study treatment. We conclude that an 8-week course of B. longum 35624® was associated with significant, clinically meaningful symptom relief in a typical population of adult patients with IBS. [ABSTRACT FROM AUTHOR]

Irritable bowel syndrome (IBS) is a multifactorial disorder, with altered intestinal motility, visceral hypersensitivity, and dysfunction of the gut-brain axis. The aim of our study was to analyze the role of nitric oxide (NO) in the inhibitory effects of sodium butyrate on spontaneous contractility of proximal colon in a mouse model of IBS. IBS was induced by intracolonic infusion of acetic acid in the early postnatal period. Spontaneous contractions of proximal colon segments were studied in isometric conditions. The amplitude and frequency of colon contractions were higher in the IBS group. Sodium butyrate exerted inhibitory effects on colon contractions, which were less pronounced in IBS group. NO donors decreased spontaneous colon contractility and prevented the inhibitory effects of sodium butyrate in control and IBS groups. Nitric oxide synthase (NOS) inhibition by L-NAME increased contractile activity more effective in the control group and decreased the inhibitory action of sodium butyrate. In IBS group, preliminary application of L-NAME did not prevent sodium butyrate action. Our data indicate that butyrate exerts its inhibitory effects on colon motility at least partially through activation of NO synthesis. In the IBS model group, the NO-dependent mechanisms were less effective probably due to downregulation of NOS. [ABSTRACT FROM AUTHOR]

Background/Objectives: Irritable Bowel Syndrome (IBS) is a disorder of the gut-brain axis for which the gastroenterologist is most often consulted. Gastrointestinal symptoms and decreased quality of life lead to a considerable burden of disease. The exact causes of IBS are not well understood, and no standard therapy has been established. The primary outcome of the study focused on the improvements of the IBS symptoms assessed through the validated questionnaire IBS-Severity Scoring System (IBS-SSS). Similarly, secondary outcomes geared towards the improvement of the quality of life (IBS-Quality of Life (IBS-QoL) and the Gastrointestinal Quality of Life Index (GIQLI)) and specific IBS symptoms (bloating, abdominal distension, feeling of heaviness, abdominal pain, and flatulence), were assessed through self-administered questionnaires. Intestinal habits (consistency and frequency of depositions) through subject stratification into diarrhoea (IBS-D), constipation (IBS-C), mixed type (IBS-M), as well as the treatment tolerability were also evaluated. Methods: A randomised, placebo-controlled, double-blind, clinical trial was conducted on 156 enrolled IBS patients (79 female and 77 male), aged 18–70 years, randomised (1:1 allocation ratio) to receive either two capsules per day of the food supplement (containing 480 mg of a complex of tannin extracts) or a placebo for 56 days. Linear random intercept mixed models (LMM) were used to analyse all experimental variables Results: Supplementation resulted in a significant improvement (p < 0.05) in the primary outcome IBSS score, with respect to the placebo group, changing the IBS condition going from mild (242.3 ± 89.8) to moderate (148.1 ± 60.6). Similarly, all indicators concerning quality of life, and specific intestinal symptoms resulted in a significant improvement (p < 0.05). Furthermore, the tannin-based treatment showed the ability to modulate the response to different symptomatology such as diarrhoea and constipation, without side effects being reported. Conclusions: The use of a supplement based on chestnut and quebracho tannins presents great application potential in the management of IBS-related disorders, with the peculiarity of resolving opposite symptoms, such as diarrhoea and constipation, indiscriminately. [ABSTRACT FROM AUTHOR]

Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder characterized by chronic abdominal pain, bloating, and altered bowel habits. Low-FODMAP diets, which involve restricting fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, have emerged as an effective dietary intervention for alleviating IBS symptoms. This review paper aims to synthesize current insights into the impact of a low-FODMAP diet on the gut microbiome and its mechanisms of action in managing IBS. We explore the alterations in microbial composition and function associated with a low-FODMAP diet and discuss the implications of these changes for gut health and symptom relief. Additionally, we examine the balance between symptom improvement and potential negative effects on microbial diversity and long-term gut health. Emerging evidence suggests that while a low-FODMAP diet can significantly reduce IBS symptoms, it may also lead to reductions in beneficial microbial populations. Strategies to mitigate these effects, such as the reintroduction phase and the use of probiotics, are evaluated. This review highlights the importance of a personalized approach to dietary management in IBS, considering individual variations in microbiome responses. Understanding the intricate relationship between diet, the gut microbiome, and IBS symptomatology will guide the development of more effective, sustainable dietary strategies for IBS patients. [ABSTRACT FROM AUTHOR]