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3. Italian guidelines for the management of irritable bowel syndrome in children and adolescents: Joint Consensus from the Italian Societies of: Gastroenterology, Hepatology and Pediatric Nutrition (SIGENP), Pediatrics (SIP), Gastroenterology and Endoscopy (SIGE) and Neurogastroenterology and Motility (SINGEM)

Author

Di Nardo, Giovanni, Barbara, Giovanni, Borrelli, Osvaldo, Cremon, Cesare, Giorgio, Valentina, Greco, Luigi, La Pietra, Michele, Marasco, Giovanni, Pensabene, Licia, Piccirillo, Marisa, Romano, Claudio, Salvatore, Silvia, Saviano, Michele, Stanghellini, Vincenzo, Strisciuglio, Caterina, Tambucci, Renato, Turco, Rossella, Zenzeri, Letizia, and Staiano, Annamaria

Published
2024
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4. Molecular Mechanisms Underlying Loss of Vascular and Epithelial Integrity in Irritable Bowel Syndrome

Author

Barbaro, Maria Raffaella, Cremon, Cesare, Marasco, Giovanni, Savarino, Edoardo, Guglielmetti, Simone, Bonomini, Francesca, Palombo, Marta, Fuschi, Daniele, Rotondo, Luca, Mantegazza, Giacomo, Duncan, Robin, di Sabatino, Antonio, Valente, Sabrina, Pasquinelli, Gianandrea, Vergnolle, Nathalie, Stanghellini, Vincenzo, Collins, Stephen M., and Barbara, Giovanni

Published
2024
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8. The 1st EoETALY Consensus on the Diagnosis and Management of Eosinophilic Esophagitis–Current Treatment and Monitoring

Author

de Bortoli, Nicola, Visaggi, Pierfrancesco, Penagini, Roberto, Annibale, Bruno, Baiano Svizzero, Federica, Barbara, Giovanni, Bartolo, Ottavia, Battaglia, Edda, Di Sabatino, Antonio, De Angelis, Paola, Docimo, Ludovico, Frazzoni, Marzio, Furnari, Manuele, Iori, Andrea, Iovino, Paola, Lenti, Marco Vincenzo, Marabotto, Elisa, Marasco, Giovanni, Mauro, Aurelio, Oliva, Salvatore, Pellegatta, Gaia, Pesce, Marcella, Privitera, Antonino Carlo, Puxeddu, Ilaria, Racca, Francesca, Ribolsi, Mentore, Ridolo, Erminia, Russo, Salvatore, Sarnelli, Giovanni, Tolone, Salvatore, Zentilin, Patrizia, Zingone, Fabiana, Barberio, Brigida, Ghisa, Matteo, and Savarino, Edoardo Vincenzo

Published
2024
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9. The 1st EoETALY Consensus on the Diagnosis and Management of Eosinophilic Esophagitis – Definition, Clinical Presentation and Diagnosis

Author

de Bortoli, Nicola, Visaggi, Pierfrancesco, Penagini, Roberto, Annibale, Bruno, Baiano Svizzero, Federica, Barbara, Giovanni, Bartolo, Ottavia, Battaglia, Edda, Di Sabatino, Antonio, De Angelis, Paola, Docimo, Ludovico, Frazzoni, Marzio, Furnari, Manuele, Iori, Andrea, Iovino, Paola, Lenti, Marco Vincenzo, Marabotto, Elisa, Marasco, Giovanni, Mauro, Aurelio, Oliva, Salvatore, Pellegatta, Gaia, Pesce, Marcella, Privitera, Antonino Carlo, Puxeddu, Ilaria, Racca, Francesca, Ribolsi, Mentore, Ridolo, Erminia, Russo, Salvatore, Sarnelli, Giovanni, Tolone, Salvatore, Zentilin, Patrizia, Zingone, Fabiana, Barberio, Brigida, Ghisa, Matteo, and Savarino, Edoardo Vincenzo

Published
2024
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17. TOP-143-YI Porto-sinusoidal vascular disease among patients undergoing surgery for liver metastases: prevalence, non-invasive diagnosis, and burden on surgical outcomes

Author

Dajti, Elton, primary, Serenari, Matteo, additional, Malvi, Deborah, additional, Dajti, Gerti, additional, Ravaioli, Federico, additional, Colecchia, Luigi, additional, Marasco, Giovanni, additional, Odaldi, Federica, additional, Renzulli, Matteo, additional, Vestito, Amanda, additional, Azzaroli, Francesco, additional, Barbara, Giovanni, additional, Ravaioli, Matteo, additional, Festi, Davide, additional, D'Errico, Maria Antonietta, additional, Cescon, Matteo, additional, and Colecchia, Antonio, additional

Published
2024
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19. µ-opioid receptor, β-endorphin, and cannabinoid receptor-2 are increased in the colonic mucosa of irritable bowel syndrome patients.

Author

Dothel, Giovanni, Chang, Lin, Shih, Wendy, Barbaro, Maria, Cremon, Cesare, Stanghellini, Vincenzo, De Ponti, Fabrizio, Mayer, Emeran, Barbara, Giovanni, and Sternini, Catia

Subjects
cannabinoid, immune system, irritable bowel syndrome, neuro-immune cross talk, opioid, Female, Humans, Intestinal Mucosa, Irritable Bowel Syndrome, Male, Receptor, Cannabinoid, CB2, Receptors, Opioid, mu, Sex Characteristics, beta-Endorphin
Abstract

BACKGROUND AND AIMS: The gut immune, cannabinoid, and opioid systems constitute an integrated network contributing to visceral sensation and pain modulation. We aimed to assess the expression of the µ-opioid receptor (MOR), its ligand β-endorphin (β-END), and cannabinoid receptor-2 (CB2 ) in patients with irritable bowel syndrome (IBS) and asymptomatic controls (AC) and their correlation with sex and symptom perception. METHODS: Mucosal biopsies were obtained from the left colon of 31 IBS patients (45% women) with predominant constipation (IBS-C, 9) or diarrhea (IBS-D, 10) or with mixed bowel habits (IBS-M, 12) and 32 AC (44% women) and processed for qRT-PCR, Western blotting, and immunohistochemistry. KEY RESULTS: µ-opioid receptor and CB2 mRNA and protein expression and β-END protein levels were increased in patients with IBS compared to AC (all Ps=0.021). A significant sex by IBS interaction was found in relation to CB2 mRNA expression (P = .003) with women showing a markedly higher expression to men (P = .035). In contrast, in AC, men had higher expression than women (P = .033). β-END, MOR, and CB2 immunoreactivities (IR) were localized to CD4+T cells including EMR-1+ eosinophils and CD31+ T cells but not to mast cells. CONCLUSIONS: The increased expression of MOR, β-END, and CB2 in the mucosa of IBS patients, where they are localized to immune cells, suggests that opioid and cannabinoid systems play an immune-related compensatory role in visceral pain in IBS patients. Further work is necessary to support this hypothesis.

Published
2019

20. Increased Prevalence of Rare Sucrase-isomaltase Pathogenic Variants in Irritable Bowel Syndrome Patients

Author

Garcia-Etxebarria, Koldo, Zheng, Tenghao, Bonfiglio, Ferdinando, Bujanda, Luis, Dlugosz, Aldona, Lindberg, Greger, Schmidt, Peter T, Karling, Pontus, Ohlsson, Bodil, Simren, Magnus, Walter, Susanna, Nardone, Gerardo, Cuomo, Rosario, Usai-Satta, Paolo, Galeazzi, Francesca, Neri, Matteo, Portincasa, Piero, Bellini, Massimo, Barbara, Giovanni, Jonkers, Daisy, Eswaran, Shanti, Chey, William D, Kashyap, Purna, Chang, Lin, Mayer, Emeran A, Wouters, Mira M, Boeckxstaens, Guy, Camilleri, Michael, Franke, Andre, and D’Amato, Mauro

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Chronic Pain, Digestive Diseases, Genetics, Pain Research, Aetiology, 2.1 Biological and endogenous factors, Oral and gastrointestinal, Gene Frequency, Genotype, Humans, Irritable Bowel Syndrome, Prevalence, Sucrase-Isomaltase Complex, Gastroenterology & Hepatology, Clinical sciences
Abstract

Patients with irritable bowel syndrome (IBS) often associate their symptoms to certain foods. In congenital sucrase-isomaltase deficiency (CSID), recessive mutations in the SI gene (coding for the disaccharidase digesting sucrose and 60% of dietary starch)1 cause clinical features of IBS through colonic accumulation of undigested carbohydrates, triggering bowel symptoms.2 Hence, in a previous study,3 we hypothesized that CSID variants reducing SI enzymatic activity may contribute to development of IBS symptoms. We detected association with increased risk of IBS for 4 rare loss-of-function variants typically found in (homozygous) CSID patients, because carriers (heterozygous) of these rare variants were more common in patients than in controls.1,4 Through a 2-step computational and experimental strategy, the present study aimed to determine whether other (dys-)functional SI variants are associated with risk of IBS in addition to known CSID mutations. We first aimed to identify all SI rare pathogenic variants (SI-RPVs) on the basis of integrated Mendelian Clinically Applicable Pathogenicity (M-CAP) and Combined Annotation Dependent Depletion (CADD) predictive (clinically relevant) scores; next, we inspected genotype data currently available for 2207 IBS patients from a large ongoing project to compare SI-RPV case frequencies with ethnically matched population frequencies from the Exome Aggregation Consortium (ExAC).

Published
2018

21. Female-Specific Association Between Variants on Chromosome 9 and Self-Reported Diagnosis of Irritable Bowel Syndrome

Author

Bonfiglio, Ferdinando, Zheng, Tenghao, Garcia-Etxebarria, Koldo, Hadizadeh, Fatemeh, Bujanda, Luis, Bresso, Francesca, Agreus, Lars, Andreasson, Anna, Dlugosz, Aldona, Lindberg, Greger, Schmidt, Peter T, Karling, Pontus, Ohlsson, Bodil, Simren, Magnus, Walter, Susanna, Nardone, Gerardo, Cuomo, Rosario, Usai-Satta, Paolo, Galeazzi, Francesca, Neri, Matteo, Portincasa, Piero, Bellini, Massimo, Barbara, Giovanni, Latiano, Anna, Hübenthal, Matthias, Thijs, Vincent, Netea, Mihai G, Jonkers, Daisy, Chang, Lin, Mayer, Emeran A, Wouters, Mira M, Boeckxstaens, Guy, Camilleri, Michael, Franke, Andre, Zhernakova, Alexandra, and D'Amato, Mauro

Subjects
Genetics, Prevention, Digestive Diseases, Pain Research, Human Genome, 2.1 Biological and endogenous factors, Aetiology, Adult, Aged, Chromosomes, Human, Pair 9, Constipation, Europe, Female, Genetic Predisposition to Disease, Genetic Variation, Genome-Wide Association Study, Genotype, Humans, Irritable Bowel Syndrome, Male, Menarche, Middle Aged, Polymorphism, Single Nucleotide, Self Report, Sex Factors, Sweden, United States, SNP, Biobank Research, Bowel Symptoms, Clinical Sciences, Neurosciences, Paediatrics and Reproductive Medicine, Gastroenterology & Hepatology
Abstract

Background & aimsGenetic factors are believed to affect risk for irritable bowel syndrome (IBS), but there have been no sufficiently powered and adequately sized studies. To identify DNA variants associated with IBS risk, we performed a genome-wide association study (GWAS) of the large UK Biobank population-based cohort, which includes genotype and health data from 500,000 participants.MethodsWe studied 7,287,191 high-quality single nucleotide polymorphisms in individuals who self-reported a doctor's diagnosis of IBS (cases; n = 9576) compared to the remainder of the cohort (controls; n = 336,499) (mean age of study subjects, 40-69 years). Genome-wide significant findings were further investigated in 2045 patients with IBS from tertiary centers and 7955 population controls from Europe and the United States, and a small general population sample from Sweden (n = 249). Functional annotation of GWAS results was carried out by integrating data from multiple biorepositories to obtain biological insights from the observed associations.ResultsWe identified a genome-wide significant association on chromosome 9q31.2 (single nucleotide polymorphism rs10512344; P = 3.57 × 10-8) in a region previously linked to age at menarche, and 13 additional loci of suggestive significance (P < 5.0×10-6). Sex-stratified analyses revealed that the variants at 9q31.2 affect risk of IBS in women only (P = 4.29 × 10-10 in UK Biobank) and also associate with constipation-predominant IBS in women (P = .015 in the tertiary cohort) and harder stools in women (P = .0012 in the population-based sample). Functional annotation of the 9q31.2 locus identified 8 candidate genes, including the elongator complex protein 1 gene (ELP1 or IKBKAP), which is mutated in patients with familial dysautonomia.ConclusionsIn a sufficiently powered GWAS of IBS, we associated variants at the locus 9q31.2 with risk of IBS in women. This observation may provide additional rationale for investigating the role of sex hormones and autonomic dysfunction in IBS.

Published
2018

22. Distinguishing features between patients with acute diverticulitis and diverticular bleeding: Results from the REMAD registry

Author

Andrealli, Alida, Andriulli, Angelo, Ardizzone, Sandro, Astegiano, Marco, Bachetti, Francesco, Bartolozzi, Simona, Bargiggia, Stefano, Bassotti, Gabrio, Bianco, Maria Antonia, Binda, Gian Andrea, Biscaglia, Giuseppe, Bosani, Matteo, Bottiglieri, Maria Erminia, Cargiolli, Martina, Ciacci, Carolina, Colecchia, Antonio, Dell'Era, Alessandra, De Matthaeis, Marina, Di Ciaula, Agostino, Di Ruscio, Mirko, Dinelli, Marco, Festa, Virginia, Festi, Davide, Galliani, Ermenegildo, Germanà, Bastianello, Grassini, Mario, Guido, Ennio, Iafrate, Franco, Iovino, Paola, Iuliano, Donato, Laghi, Andrea, Latella, Giovanni, Manes, Giampiero, Marabotto, Elisa, Marchi, Santino, Mauro, Biagio, Maurano, Attilio, Moscatelli, Alessandro, Nascimbeni, Riccardo, Neri, Matteo, Occhipinti, Pietro, Parravicini, Marco, Pennazio, Marco, Peralta, Sergio, Portincasa, Piero, Radaelli, Franco, Reati, Raffaella, Redaelli, Alessandro, Rossi, Marco, Salerno, Raffale, Savarino, Vincenzo, Segato, Sergio, Severi, Carola, Scaccianoce, Giuseppe, Usai, Paolo, Valle, Valentina, Virgilio, Clara, Carabotti, Marilia, Morselli Labate, Antonio M, Cremon, Cesare, Cuomo, Rosario, Pace, Fabio, Andreozzi, Paolo, Falangone, Francesca, Barbara, Giovanni, and Annibale, Bruno

Published
2021
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24. The Brain-Gut Axis and the Gender

Author

Barbara, Giovanni, Regazzi, Maria Giulia, Barbaro, Maria Raffaella, Dothel, Giovanni, Tarricone, Ilaria, Tarricone, Ilaria, editor, and Riecher-Rössler, Anita, editor

Published
2019
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25. The Role of the FODMAP Diet in IBS

Author

Bertin, Luisa, primary, Zanconato, Miriana, additional, Crepaldi, Martina, additional, Marasco, Giovanni, additional, Cremon, Cesare, additional, Barbara, Giovanni, additional, Barberio, Brigida, additional, Zingone, Fabiana, additional, and Savarino, Edoardo Vincenzo, additional

Published
2024
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27. Collinsella aerofaciens as a predictive marker of response to probiotic treatment in non-constipated irritable bowel syndrome

Author

Gargari, Giorgio, primary, Mantegazza, Giacomo, additional, Cremon, Cesare, additional, Taverniti, Valentina, additional, Valenza, Alice, additional, Barbaro, Maria Raffaella, additional, Marasco, Giovanni, additional, Duncan, Robin, additional, Fiore, Walter, additional, Ferrari, Roberto, additional, De Vitis, Valerio, additional, Barbara, Giovanni, additional, and Guglielmetti, Simone, additional

Published
2024
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29. Eosinophilic esophagitis in adults and adolescents: epidemiology, diagnostic challenges, and management strategies for a type 2 inflammatory disease

Author

Savarino, Edoardo Vincenzo, primary, Barbara, Giovanni, additional, Bilò, Maria Beatrice, additional, De Bortoli, Nicola, additional, Di Sabatino, Antonio, additional, Oliva, Salvatore, additional, Penagini, Roberto, additional, Racca, Francesca, additional, Tortora, Annalisa, additional, Rumi, Filippo, additional, and Cicchetti, Americo, additional

Published
2024
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33. Fecal short-chain fatty acids in non-constipated irritable bowel syndrome: a potential clinically relevant stratification factor based on catabotyping analysis

Author

Gargari, Giorgio, primary, Mantegazza, Giacomo, additional, Taverniti, Valentina, additional, Gardana, Claudio, additional, Valenza, Alice, additional, Rossignoli, Federico, additional, Barbaro, Maria Raffaella, additional, Marasco, Giovanni, additional, Cremon, Cesare, additional, Barbara, Giovanni, additional, and Guglielmetti, Simone, additional

Published
2023
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34. Current and Novel Therapies for Eosinophilic Gastrointestinal Diseases

Author

Marasco, Giovanni, primary, Visaggi, Pierfrancesco, additional, Vassallo, Mariagiulia, additional, Fiocca, Miriam, additional, Cremon, Cesare, additional, Barbaro, Maria Raffaella, additional, De Bortoli, Nicola, additional, Bellini, Massimo, additional, Stanghellini, Vincenzo, additional, Savarino, Edoardo Vincenzo, additional, and Barbara, Giovanni, additional

Published
2023
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35. Can We Slow Down Biological Age Progression? Study Protocol for the proBNPage Reduction (PBAR) Randomized, Double-Blind, Placebo-Controlled Trial (Effects of 4 “Anti-Aging” Food Supplements in Healthy Older Adults)

Author

Muscari, Antonio, primary, Forti, Paola, additional, Brizi, Mara, additional, Magalotti, Donatella, additional, Capelli, Eleonora, additional, Potì, Simona, additional, Piro, Filomena, additional, Pandolfi, Paolo, additional, Perlangeli, Vincenza, additional, Ramazzotti, Eric, additional, and Barbara, Giovanni, additional

Published
2023
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36. Alternative Defibrillation Strategies for Refractory Ventricular Fibrillation: A Systematic Review and Meta-Analysis

Author

Perna, Benedetta, primary, Guarino, Matteo, additional, De Fazio, Roberto, additional, Esposito, Ludovica, additional, Portoraro, Andrea, additional, Rossin, Federica, additional, Remelli, Francesca, additional, Trevisan, Caterina, additional, Raparelli, Valeria, additional, Marasco, Giovanni, additional, Barbara, Giovanni, additional, Petrini, Stefano, additional, Vason, Milo, additional, Spampinato, Michele Domenico, additional, and De Giorgio, Roberto, additional

Published
2023
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38. Pharmacological and nutritional therapy of children and adults with chronic intestinal pseudo-obstruction

Author

Di Nardo, Giovanni, Zenzeri, Letizia, Guarino, Matteo, Molfino, Alessio, Parisi, Pasquale, Barbara, Giovanni, Stanghellini, Vincenzo, and De Giorgio, Roberto

Subjects
digestive symptoms, Hepatology, abdominal pain, antibiotics, enteral nutrition, parenteral nutrition, prokinetic agents, severe intestinal dysmotility, small intestinal bacterial overgrowth, Gastroenterology
Published
2023

41. Journal of Clinical GastroenterologyLectureship Dubai 2022

Author

Marasco, Giovanni, Cremon, Cesare, Barbaro, Maria Raffaella, Stanghellini, Vincenzo, and Barbara, Giovanni

Abstract

Irritable bowel syndrome (IBS) with diarrhea (IBS-D) affects ~1% of the general population and is characterized by abdominal pain associated with diarrhea. IBS-D symptoms significantly impact the quality of life of patients. Major uncertainties remain regarding the optimal management of these patients. Several therapies have been investigated over the years for the treatment of IBS-D. In the initial management, commonly prescribed approaches with an effect on global IBS symptoms include a low Fermentable Oligo-, Di-, Mono-Saccharides and Polyols diet and probiotics, while antispasmodics are used for targeting abdominal pain and loperamide for diarrhea only. Additional therapeutic options for the relief of global IBS symptoms include rifaximin, 5-HT3antagonists, gut-directed psychological therapies, and eluxadoline, while tricyclic antidepressants can target abdominal pain and bile acid sequestrants diarrhea. Promising evidence exists for the use of mesalazine and fecal microbiota transplantation in IBS-D, although further evidence is needed for definitive conclusions regarding their efficacy.

Published
2024
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43. The role of microbiota and its modulation in colonic diverticular disease.

Author

Marasco, Giovanni, Buttitta, Francesco, Cremon, Cesare, Barbaro, Maria Raffaella, Stanghellini, Vincenzo, and Barbara, Giovanni

Subjects
DIVERTICULOSIS, GUT microbiome, DISEASE complications, FECAL microbiota transplantation, WESTERN countries
Abstract

Background: Diverticular disease (DD) is a common condition in Western countries. The role of microbiota in the pathogenesis of DD and its related symptoms has been frequently postulated since most complications of this disease are bacteria‐driven and most therapies rely on microbiota modulation. Preliminary data showed fecal microbial imbalance in patients with DD, particularly when symptomatic, with an increase of pro‐inflammatory and potentially pathogenetic bacteria. In addition, bacterial metabolic markers can mirror specific pathways of the disease and may be even used for monitoring treatment effects. All treatments currently suggested for DD can affect microbiota structure and metabolome compositions. Purpose: Sparse evidence is available linking gut microbiota perturbations, diverticular disease pathophysiology, and symptom development. We aimed to summarize the available knowledge on gut microbiota evaluation in diverticular disease, with a focus on symptomatic uncomplicated DD, and the relative treatment strategies. [ABSTRACT FROM AUTHOR]

Published
2023
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44. Patients with Diverticular Disease Have Different Dietary Habits Compared to Control Subjects: Results from an Observational Italian Study

Author

Polese, Barbara, Carabotti, Marilia, Rurgo, Sara, Ritieni, Camilla, Sarnelli, Giovanni, Barbara, Giovanni, Pace, Fabio, Cuomo, Rosario, Annibale, Bruno, Polese, Barbara, Carabotti, Marilia, Rurgo, Sara, Ritieni, Camilla, Sarnelli, Giovanni, Barbara, Giovanni, Pace, Fabio, Cuomo, Rosario, and Annibale, Bruno

Subjects
dietary protein, diet survey, diverticulosi, dietary fat, dietary fibre, colonic, dietary habit, vitamins, diverticuliti
Abstract

he role of dietary habits as risk factor for the development of diverticular complications has strongly emerged in the last years. We aimed to evaluate possible differences in dietary habits between patients with diverticular disease (DD) and matched controls without diverticula. Dietary habits were obtained from standardized food frequency questionnaires collected at entry to the Diverticular Disease Registry (REMAD). We compared controls (C) (n = 119) with asymptomatic diverticulosis (D) (n = 344), symptomatic uncomplicated diverticular disease (SUDD) (n = 154) and previous diverticulitis (PD) (n = 83) patients, in terms of daily calories, macro and micronutrients and dietary vitamins. Daily kcal intake and lipids, both saturated and unsaturated, were significantly lower in patients with DD than C. Total protein consumption was lower in PD than D, with differing consumption of unprocessed red meat, white meat and eggs between groups. Consumption of fibre, both soluble and insoluble, was lower in patients with PD compared to patients with SUDD, D and C, whereas dietary vitamins A, C, D and E and Oxygen Radical Adsorbance Capacity index were lower in all DD groups compared to C. This observational study showed that DD patients have different dietary habits, mainly in terms of caloric, fat, fibre and vitamin intake, compared to control subjects.

Published
2023

45. Italian guidelines for the management of irritable bowel syndrome. Joint Consensus from the Italian Societies of: Gastroenterology and Endoscopy (SIGE), Neurogastroenterology and Motility (SINGEM), Hospital Gastroenterologists and Endoscopists (AIGO), Digestive Endoscopy (SIED), General Medicine (SIMG), Gastroenterology, Hepatology and Pediatric Nutrition (SIGENP) and Pediatrics (SIP)

Author

Barbara, Giovanni, Cremon, Cesare, Bellini, Massimo, Corsetti, Maura, Di Nardo, Giovanni, Falangone, Francesca, Fuccio, Lorenzo, Galeazzi, Francesca, Iovino, Paola, Sarnelli, Giovanni, Savarino, Edoardo Vincenzo, Stanghellini, Vincenzo, Staiano, Annamaria, Stasi, Cristina, Tosetti, Cesare, Turco, Rossella, Ubaldi, Enzo, Zagari, Rocco Maurizio, Zenzeri, Letizia, Marasco, Giovanni, Barbara, Giovanni, Cremon, Cesare, Bellini, Massimo, Corsetti, Maura, Di Nardo, Giovanni, Falangone, Francesca, Fuccio, Lorenzo, Galeazzi, Francesca, Iovino, Paola, Sarnelli, Giovanni, Savarino, Edoardo Vincenzo, Stanghellini, Vincenzo, Staiano, Annamaria, Stasi, Cristina, Tosetti, Cesare, Turco, Rossella, Ubaldi, Enzo, Zagari, Rocco Maurizio, Zenzeri, Letizia, and Marasco, Giovanni

Subjects
disorders of gut-brain interaction, irritable bowel syndrome, constipation, diarrhea
Abstract

The irritable bowel syndrome (IBS) is a chronic disorder of gut-brain interaction. IBS is still associated with areas of uncertainties, especially regarding the optimal diagnostic work-up and the more appropriate management. Experts from 7 Italian Societies conducted a Delphi consensus with literature summary and voting process on 27 statements. Recommendations and quality of evidence were evaluated using the grading of recommendations, assessment, development, and evaluation (GRADE) criteria. Consensus was defined as >80% agreement and reached for all statements. In terms of diagnosis, the consensus supports a positive diagnostic strategy with a symptom-based approach, including the psychological comorbidities assessment and the exclusion of alarm symptoms, together with the digital rectal examination, full blood count, C-reactive protein, serology for coeliac disease, and fecal calprotectin assessment. Colonoscopy should be recommended in patients with alarm features. Regarding treatment, the consensus strongly supports a dietary approach for patients with IBS, the use of soluble fiber, secretagogues, tricyclic antidepressants, psychologically directed therapies and, only in specific IBS subtypes, rifaximin. A conditional recommendation was achieved for probiotics, polyethylene glycol, antispasmodics, selective serotonin reuptake inhibitors and, only in specific IBS subtypes, 5-HT3 antagonists, 5-HT4 agonists, bile acid sequestrants.

Published
2023

47. Can We Slow Down Biological Age Progression? Study Protocol for the proBNPage Reduction (PBAR) Randomized, Double-Blind, Placebo-Controlled Trial (Effects of 4 “Anti-Aging” Food Supplements in Healthy Older Adults)

Author

Muscari,Antonio, Forti,Paola, Brizi,Mara, Magalotti,Donatella, Capelli,Eleonora, Potì,Simona, Piro,Filomena, Pandolfi,Paolo, Perlangeli,Vincenza, Ramazzotti,Eric, Barbara,Giovanni, Muscari,Antonio, Forti,Paola, Brizi,Mara, Magalotti,Donatella, Capelli,Eleonora, Potì,Simona, Piro,Filomena, Pandolfi,Paolo, Perlangeli,Vincenza, Ramazzotti,Eric, and Barbara,Giovanni

Abstract

Antonio Muscari,1 Paola Forti,1,2 Mara Brizi,2 Donatella Magalotti,2 Eleonora Capelli,2 Simona Potì,2 Filomena Piro,3 Paolo Pandolfi,4 Vincenza Perlangeli,4 Eric Ramazzotti,5 Giovanni Barbara1,2 On behalf of PBAR Study Group1Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; 2Medical-Surgical Department of Digestive, Hepatic and Endocrine-Metabolic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 3Pharmaceutical Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 4Epidemiological and Health Promotion Unit, Department of Public Health, AUSL Bologna, Bologna, Italy; 5LUM Metropolitan Laboratory, AUSL Bologna, Bologna, ItalyCorrespondence: Antonio Muscari, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, Via Albertoni, 15, Bologna, 40138, Italy, Tel +39-347-1126386, Fax +39-051-6362210, Email antonio.muscari@unibo.itPurpose: The availability of a simple and reliable marker of biological age might allow an acceleration of the research in the field of longevity extension. Previous studies suggest that this marker might be the N-terminal of B-type natriuretic peptide precursor (NT-proBNP), from which proBNPage, a biological age surrogate, can be calculated. Objectives of the study: 1) To fine-tune the method of proBNPage progression assessment and 2) To establish whether 4 “anti-aging” treatments, which provided promising results in previous studies, can modify proBNPage progression.Patients and Methods: This is a double-blind randomized placebo-controlled clinical trial on 120 adults aged 65– 80 years, free of cardiovascular diseases. Participants will be randomized into 3 groups: A) Coenzyme Q10 100 mg bid + Selenium 100 mcg; B) Resveratrol 350 mg bid + TA-65 (Astragalus Membranaceus extract) 100U; C) Placebo-1 bid + Placebo-2. They will be followed for 2 years and checked 8 times, to assess both proBNPage progression and treatment safety. Secondary

Published
2023

48. Fecal short-chain fatty acids in non-constipated irritable bowel syndrome: a potential clinically relevant stratification factor based on catabotyping analysis

Author

Gargari, G, Mantegazza, G, Taverniti, V, Gardana, C, Valenza, A, Rossignoli, F, Barbaro, M, Marasco, G, Cremon, C, Barbara, G, Guglielmetti, S, Gargari, Giorgio, Mantegazza, Giacomo, Taverniti, Valentina, Gardana, Claudio, Valenza, Alice, Rossignoli, Federico, Barbaro, Maria Raffaella, Marasco, Giovanni, Cremon, Cesare, Barbara, Giovanni, Guglielmetti, Simone, Gargari, G, Mantegazza, G, Taverniti, V, Gardana, C, Valenza, A, Rossignoli, F, Barbaro, M, Marasco, G, Cremon, C, Barbara, G, Guglielmetti, S, Gargari, Giorgio, Mantegazza, Giacomo, Taverniti, Valentina, Gardana, Claudio, Valenza, Alice, Rossignoli, Federico, Barbaro, Maria Raffaella, Marasco, Giovanni, Cremon, Cesare, Barbara, Giovanni, and Guglielmetti, Simone

Abstract

The gut microbiota is believed to be a critical factor in the pathogenesis of IBS, and its metabolic byproducts, such as short-chain fatty acids (SCFAs), are known to influence gut function and host health. Despite this, the precise role of SCFAs in IBS remains a topic of debate. In this study, we examined the bacterial community structure by 16S rRNA gene profiling and SCFA levels by UPLC-MS/MS in fecal samples from healthy controls (HC; n = 100) and non-constipated patients (IBS-D and IBS-M; NC-IBS; n = 240) enrolled in 19 hospitals in Italy. Our findings suggest a significant difference between the fecal microbiomes of NC-IBS patients and HC subjects, with HC exhibiting higher intra-sample biodiversity. Furthermore, we were able to classify non-constipated patients into two distinct subgroups based on their fecal SCFA levels (fecal catabotype "high" and "low"), each characterized by unique taxonomic bacterial signatures. Our results suggest that the fecal catabotype with higher SCFA levels may represent a distinct clinical phenotype of IBS that could have implications for its diagnosis and treatment. This study provides a new perspective on the intricate relationship between the gut microbiome and bowel symptoms in IBS, underscoring the importance of personalized strategies for its management.

Published
2023

49. Central Sensitization in Vulvodynia and Endometriosis: What Have We Been Overlooking So Far?

Author

Cetera, G. E., Merli, C. E. M., Boero, V., Caia, C., Facchin, Federica, Barbara, Giovanni, Monti, E., Vercellini, P., Facchin F. (ORCID:0000-0001-8944-1440), Barbara G., Cetera, G. E., Merli, C. E. M., Boero, V., Caia, C., Facchin, Federica, Barbara, Giovanni, Monti, E., Vercellini, P., Facchin F. (ORCID:0000-0001-8944-1440), and Barbara G.

Abstract

Importance Women experience more frequent and greater pain than men, although they receive less adequate treatment and are perceived as more anxious than males. Recent clinical research has lead to hypothesize a common etiology for overlapping chronic pain conditions and mood disorders, namely, central sensitization, which originates from an alteration of pain processing pathways in the central nervous system. Objective The aim of this review was to collect all available evidence regarding the potential role of central sensitization in vulvodynia and endometriosis. Evidence Acquisition A systematic literature search was performed between July and August 2022 using the electronic database PubMed. The extracted data were summarized using a narrative approach. Results Ten articles were chosen for the review. Participants' mean age was 39.2 years (SD = 5.1). Among serum markers of central sensitization, nitric oxide levels were greater in women with endometriosis than in controls, whereas brain-derived neurotrophic factor and S100B levels differed among pain conditions with structural anomalies and those without. Functional magnetic resonance imaging showed different resting state networks between patients with endometriosis and controls. In neurophysiology studies, cases had reduced pain thresholds, compared with healthy controls. Lastly, self-reported questionnaires suggested a central component of pain in women with endometriosis-related dyspareunia and associated bladder/pelvic floor tenderness. Conclusions and Relevance The management of vulvodynia and endometriosis may benefit from a new perspective, which considers their possible central etiology. It is compelling that treatment of pain starts to be considered a therapeutic goal in its own right. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After completing this activity, the learner should be better able to describe central sensitization as a common etiology for vulvody

Published
2023

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