Irritable Bowel Syndrome Cases Research Articles

Healthy Habits, Physical Activity, Stress, and Food Consumption Trends in Chilean Adults with Irritable Bowel Syndrome during the COVID-19 Pandemic.

The COVID-19 pandemic has increased stress levels in the population due to radical lifestyle changes caused by containment measures. Studies suggest that high levels of stress may be related to the development of irritable bowel syndrome (IBS). This study aims to explain how quarantine habits and lifestyles acted as risk factors for the frequency of this syndrome during the COVID-19 pandemic. An observational study was conducted with 34 Chilean participants (average age 24.5 ± 3.85 years), of whom 21 (62%) were female. Surveys on consumption trends and lifestyles created by the authors were administered. Additionally, we used the global physical activity questionnaire (GPAQ) and the depression anxiety stress scales (DASS-21) to assess psychological stress and the Rome IV criteria to assess IBS. Significant differences were found between individuals with better healthy habits compared to those with poor healthy habits. The former showed lower sedentary activity (32%, p = 0.005), only 27% were fast eaters (vs. 44%, p = 0.001), had shorter nap intervals (14% vs. 28%, p = 0.03), and higher vegetable consumption (p = 0.02). There were 20 cases (59%) of IBS, with a strong association with the female sex (p = 0.004), where females were 15 times more likely to develop it compared to males (p = 0.008). Additionally, when alcohol consumption was added to females, there was a higher likelihood of developing this syndrome (p = 0.009), as individuals who consumed alcohol were 12 times more likely to develop it compared to those who did not (p = 0.02). Among other factors, it was observed that 57% of those with the syndrome consumed drinks more often (p = 0.02) but consumed fewer nuts (p = 0.009). In conclusion, IBS has a multifactorial etiology, and correcting individual habits such as alcohol consumption could potentially prevent or delay its development. Therefore, it is important to maintain healthy lifestyles, regardless of non-modifiable factors such as gender, in order to better cope with this syndrome.

Rome III Criteria Capture Higher Irritable Bowel Syndrome SNP-Heritability and Highlight a Novel Genetic Link with Cardiovascular Traits

Irritable bowel syndrome (IBS) shows genetic predisposition, and large-scale genome-wide association studies (GWAS) are emerging, based on heterogeneous disease definitions. We aimed at investigating the genetic architecture of IBS defined according to gold-standard Rome Criteria. We conducted GWAS meta-analyses of Rome III IBS and its subtypes in 24,735 IBS cases and 77,149 asymptomatic controls from two independent European cohorts (UK Biobank and Lifelines). SNP-based heritability (h2SNP) and genetic correlations (rg) with other traits were calculated. IBS risk loci were functionally annotated to identify candidate genes. Sensitivity and conditional analyses were conducted to assess impact of confounders. Polygenic risk scores (PRS) were computed and tested in independent datasets. Rome III IBS showed significant SNP-heritability (up to 13%) and similar genetic architecture across subtypes, including those with manifestations at the opposite ends of the symptom spectrum (rg=0.48 between IBS-D and IBS-C). Genetic correlations with other traits highlighted commonalities with family history of heart disease and hypertension, coronary artery disease, and angina pectoris (rg=0.20-0.45), among others. Four independent GWAS signals (p<5×10-8) were detected, including two novel loci for IBS (rs2035380) and IBS-Mixed (rs2048419) that had been previously associated with hypertension and coronary artery disease. Functional annotation of GWAS risk loci revealed genes implicated in circadian rhythm (BMAL1), intestinal barrier (CLDN23), immunomodulation (MFHAS1), and the cAMP pathway (ADCY2). PRS allowed the identification of individuals at increased risk of IBS (OR=1.34, p=1.1×10-3). Rome III Criteria capture higher SNP-heritability than previously estimated for IBS. The identified link between IBS and cardiovascular traits may contribute to the delineation of alternative therapeutic strategies, warranting further investigation.

Major depressive disorder and irritable bowel syndrome risk: A Mendelian randomization study.

Previous studies have revealed a connection between major depressive disorder (MDD) and irritable bowel syndrome (IBS), but it remains obscure if the two diseases are related causally. Mendelian randomization was utilized in this investigation to ascertain whether MDD contributed to the emergence of IBS. To examine possible connections between MDD and IBS, we used two-sample Mendelian randomization (MR) utilizing summary data from genome-wide association studies (GWAS). The Psychiatric Genomics Consortium (PGC) provided information on genetic associations with MDD (cases: 135,458; controls: 344,901). The Medical Research Council Integrative Epidemiology Unit (MRC-IEU) provided information on genetic associations with IBS (cases:10,939; controls:451,994). Inverse Variance Weighted (main analyses), MR-Egger regression, Weighted mode, and Weighted Median were the four MR methods used in this investigation. In addition, we also performed multiplicity and heterogeneity analyses to eliminate possible biases. In the standard Inverse Variance Weighting (IVW) method, an increased risk of IBS was linked to a genetic susceptibility to MDD (OR: 1.01; 95% CI: 1.006 to 1.014, p = 1.02E-07). In addition, neither significant heterogeneity (IVW Q = 24.80, p = 0.73) nor horizontal pleiotropy (MR Egger p = 0.17; MRPRESSO p = 0.54) were detected in this MR analysis. The bidirectional analysis, however, did not show a genetic link between IBD and MDD (p steiger <0.01). A direct causal relationship between MDD and IBS was revealed by Mendelian randomization study, which contributes to the effective clinical management of both diseases.

Prevalence of Isolated Irritable Bowel Syndrome Among Adults in the Kingdom of Bahrain.

Irritable bowel syndrome (IBS) is a very common gastrointestinal disorder encountered in clinical practice. In this study, we estimated the prevalence of isolated IBS and its associated demographic factors among the adult population in the Kingdom of Bahrain. A cross-sectional study was conducted targeting adults in Bahrain aged 18 years and above. Individuals with a prior diagnosis of any bowel ailment were excluded. Data was acquired via a self-administered questionnaire.IBS-specific questions were derived from the validated Rome IV diagnostic questionnaire for adults. The scoring methodology inherent to this questionnaire was used for the diagnosis of IBS. The data collection process remained anonymous. Data was compiled using Excel spreadsheets, and the Statistical Package for Social Sciences (SPSS) was employed for analytical purposes. Associations between IBS and demographical or behavioral characteristics were explored using the Chi-square test. The prevalence of isolated IBS, adopting the Rome IV criteria, was 156 (18.3%) and IBS-M (mixed) type was 40 (38.1%) of these. IBS was predominantly higher among females compared to males (340 vs 235; 22.6% vs 11.9%). The majority of IBS cases (121, 21%) were in the 41-50 age group. A statistically significant association has been demonstrated between IBS and GERDusing Pearson's chi-squared test (p-value = 0.000). Similarly, it was linked to indigestion (p-value = 0.00). Although the percentage appeared to be significantly higher than the global prevalence of 4% (using Rome IV criteria), our findings were equivalent to the reports conducted in the Middle East region. Integrating holistic patient assessments, including quality of life metrics, along with anxiety, depression, and vitamin D deficiency, will further enhance the understanding of IBS in Bahrain and its impact on the patients and the health services utilization.

Ultra-Processed Food Consumption and Long-Term Risk of Irritable Bowel Syndrome: A Large-Scale Prospective Cohort Study

The considerable disease burden of irritable bowel syndrome (IBS) has coincided with the increase of ultraprocessed food (UPF) consumption over the past few decades. However, epidemiologic evidence is lacking. We aimed to examine the long-term risk of IBS associated with UPF consumption in a large-scale prospective cohort. Participants who completed 24-hour dietary recalls during 2009 to 2012 from the UK Biobank, and free of IBS, celiac disease, inflammatory bowel disease, and any cancer at baseline, were included (N= 178,711; 53.1% female). UPF consumption was defined according to the NOVA food classification system, expressed as a percentage of UPF content in the total diet intake (as grams per day). The primary outcome was incident IBS. A Cox proportional hazard model was performed to estimate associated risk. The mean UPF consumption was 21.0% (SD, 11.0%) of the total diet. During a median of 11.3 years of follow-up evaluation, 2690 incident IBS cases were identified. An 8% higher risk of IBS (hazard ratio, 1.08; 95% CI, 1.04-1.12) was associated with each 10% increment of UPF consumption. Compared with the lowest quartile of UPF consumption, the highest quartile wasassociated with a significantly increased risk of incident IBS (hazard ratio, 1.19; 95% CI, 1.07-1.33; Ptrend < .001). Subgroup analyses by age, sex, body mass index, smoking, and alcohol drinking status also showed similar results, except for the never/previous drinking subgroup. Further sensitivity analyses confirmed the positive association with a higher UPF consumption. Our findings provide evidence that a higher UPF consumption is associated with an increased risk of incident IBS, with a significant dose-response relationship.

Association of healthy lifestyle behaviours with incident irritable bowel syndrome: a large population-based prospective cohort study

ObjectivesTo evaluate the association between healthy lifestyle behaviours and the incidence of irritable bowel syndrome (IBS).DesignPopulation-based prospective cohort study.SettingThe UK Biobank.Participants64 268 adults aged 37 to 73 years who had...

The Use of Psychotherapy for Refractory Irritable Bowel Syndrome: A Systematic Review.

Irritable bowel syndrome (IBS) is a common yet debilitating and chronic condition that consists of disturbances in bowel habits and abdominal pain that is frequently relieved with defecation. While the first line of treatment for IBS is pharmacological treatment, this has been shown to fail, leading to the patient being classified as having refractory IBS. The quality of life (QOL) of these patients is greatly hindered; in this case, there are rarely moments of relief. Additional modalities of treatment have been employed in classical cases of IBS, such as psychotherapy, and research has started to evaluate its effectiveness with refractory IBS. Both cognitive behavioral therapy (CBT) and gut-directed hypnotherapy (GDH) are effective in treating classical IBS as they restructure and bring a state of meditation to the patient, allowing them to work through the symptoms. The question is whether it remains successful in refractory cases. This systematic review was conducted with strict adherence to PRISMA guidelines with an initial inquiry resulting in 28,978 publications through PubMed, ScienceDirect, and ProQuest databases. Through automatic and manual screening processes, articles that were peer-reviewed experimental or observation publications done between 2003 and 2023 were included in this study, resulting in 21 publications. Across all studies evaluating CBT, it was consistently found to be successful in improving symptom severity and frequency, QOL, and extracolonic symptoms such as anxiety and depression. When broken down into delivery methods, minimal contact CBT was found to be just as, if not superior, to standard contact. Within this, telephone-delivered CBT was superior to web-delivered CBT. GDH and biofeedback therapy were found to also significantly improve all domains of IBS with no difference between them. Acceptance and commitment therapy were found only to improve associated symptoms. However, there was no significant improvement in their QOL, whereas integrative group therapy found no significant improvement in any domain. Because IBS is so common and crippling to those affected, its crucial to continuously improve QOL through advancement in treatment modalities. Further research should focus more on other modes of therapy as success has been shown in standard therapeutic techniques.

Cholecystectomy is associated with a higher risk of irritable bowel syndrome in the UK Biobank: a prospective cohort study.

Background: Recent studies have shown that bile acids are essential in irritable bowel syndrome (IBS) pathology, and cholecystectomy has direct effects on bile acid metabolism. However, whether cholecystectomy increases the risk of IBS remains unclear. We aimed to investigate the association between cholecystectomy and IBS risk in the UK Biobank (UKB). Methods: This study is a prospective analysis of 413,472 participants who were free of IBS, inflammatory bowel disease, cancer, or common benign digestive tract diseases. We identified incidents of IBS through self-reporting or links to primary healthcare and hospitalization data. We evaluated hazard ratios (HRs) adjusted for sociodemographic characteristics, health behaviours, comorbidities, and medications. Results: During a median follow-up period of 12.7years, we observed 15,503 new cases of IBS. Participants with a history of cholecystectomy had a 46% higher risk of IBS than those without (HR = 1.46, 95% CI: 1.32-1.60), and further subtype analysis showed that the risk of IBS with diarrhoea was significantly higher than the risk of IBS without diarrhoea (HR = 1.71, 95% CI: 1.30-2.25 vs. HR = 1.42, 95% CI: 1.28-1.58). The overall covariate-adjusted HRs for IBS were similar between the group with both cholecystectomy and gallstones (HR = 1.45, 95% CI: 1.32-1.58) and the group with cholecystectomy without gallstones (HR = 1.50, 95% CI: 1.36-1.67) when the group without both cholecystectomy and gallstones was used as a reference. The overall covariate-adjusted HR was not significantly different in the group without cholecystectomy with gallstones (HR = 1.18, 95% CI: 0.95-1.47). The positive association of cholecystectomy with IBS risk did not change when stratifying the data based on age, sex, BMI, smoking, alcohol consumption, healthy diet, quality sleep, physical activity, type 2 diabetes, hypertension, hyperlipidaemia, mental illness, NSAID intake, or acid inhibitor intake. Sensitivity analyses, including propensity score matching analysis and lagging the exposure for two or fouryears, indicated that the effects were robust. Conclusion: Cholecystectomy was associated with a higher risk of IBS, especially IBS with diarrhoea. Additional prospective randomized controlled and experimental studies are warranted to further validate the association and to explore the relevant biological mechanisms.

Knowledge, Attitude, and Practices Regarding the Rome IV Criteria for the Diagnosis of Irritable Bowel Syndrome Among Primary Healthcare Physicians in Saudi Arabia.

Irritable bowel syndrome (IBS) presents a significant challenge in the medical field due to its complex nature as a functional gastrointestinal illness (FGID) without clear biological markers. Diagnosis often involves ruling out other potential causes, leading to frustration for patients and difficulty in effective treatment. Given its high prevalence among FGIDs, primary healthcare (PHC) physicians play a crucial role in its initial assessment and management. This cross-sectional study surveyed 623 PHC physicians using a structured, closed-ended questionnaire. Employing a multistage sampling approach, physicians were selected from various provinces and cities in Saudi Arabia. Clusters within these cities were also sampled. The research revealed that a majority of physicians (n = 411, 66%) exhibited a strong awareness of the Rome IV criteria, essential for diagnosing IBS. This awareness correlated significantly with variables, such as age, nationality, marital status, specialty, classifications, and years of experience. PHC physicians in the study demonstrated a commendable level of familiarity with the Rome IV criteria for diagnosing IBS. Their knowledge was particularly robust concerning symptoms outlined in these criteria. However, there is room for improvement in their understanding, attitude, and application of the Rome IV guidelines in practice. Addressing these gaps could enhance the overall management of IBS cases by these physicians.

Evolutionary medicine approaches to chronic disease: The case of irritable bowel syndrome.

Irritable bowel syndrome (IBS), a gastrointestinal disease, is a global phenomenon correlated with industrialization. We propose that an evolutionary medicine approach is useful to understand this disease from an ultimate perspective and conducted a scoping literature review to synthesize the IBS literature within this framework. Our review suggests five potential evolutionary hypotheses for the cause of IBS, including (a) a dietary mismatch accompanying a nutritional transition, (b) an early hygienic life environment leading to the immune system and microbiotic changes, (c) an outcome of decreased physical activity, (d) a response to changes in environmental light-dark cycles, and (e) an artifact of an evolved fight or flight response. We find key limitations in the available data needed to understand early life, nutritional, and socioeconomic experiences that would allow us to understand evolutionarily relevant risk factors and identify a need for further empirical research to distinguish potential causes and test evolutionary hypotheses.

Antibiotic use as a risk factor for irritable bowel syndrome: Results from a nationwide, case-control study.

The microbiome plays an important role in the pathophysiology of irritable bowel syndrome (IBS). Antibiotic use can fundamentally alter gut microbial ecology. We examined the association of antibiotic use with IBS in a large population-based investigation. A case-control study with prospectively collected data on 29,111 adult patients diagnosed with IBS in Sweden between 2007 and 2016 matched with 135,172 controls. Using a comprehensive histopathology cohort, the Swedish Patient Register, and the Prescribed Drug Register, we identified all consecutive cases of IBS in addition to cumulative antibiotic dispensations accrued until 1 year prior to IBS (exclusionary period) for cases and time of matching for up to five general population controls matched on the basis of age, sex, country and calendar year. Conditional logistic regression estimated multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of IBS. Patients with IBS (n = 29,111) were more likely than controls (n = 135,172) to have used antibiotics up to 1 year prior to diagnosis (74.9% vs. 57.8%). After multivariable adjustment, this translated to a more than twofold increased odds of IBS (OR 2.21, 95% CI 2.14-2.28) that did not differ according to age, sex, year of IBS diagnosis or IBS subtype. Compared to none, 1-2 (OR 1.67, 95% CI 1.61-1.73) and ≥3 antibiotics dispensations (OR 3.36, 95% CI 3.24-3.49) were associated with increased odds of IBS (p for trend <0.001) regardless of the antibiotic class. Prior antibiotics use was associated with an increased odds of IBS with the highest risk among people with multiple antibiotics dispensations.

Evaluation of the Impact of Some Single-Nucleotide Gene Polymorphisms on the Development of Adenomatous Polyps of the Colon in Patients with Irritable Bowel Syndrome.

The number of cases of irritable bowel syndrome is growing worldwide, in which adenomatous polyps can develop as a result of microinflammation of the colonic epithelium. Our study was aimed at the identification of the possible effect of single-nucleotide polymorphisms on the risk of the development of irritable bowel syndrome-related colonic adenomatous polyps. The study involved 187 irritable bowel syndrome patients. The single-nucleotide polymorphisms were investigated by the polymerase chain reaction method and DNA was extracted with the phenol-chloroform: interleukin-1β gene-31C/T (rs1143627), -511C/T (rs16944); interleukin-6 gene-174G/C (rs1800795); interleukin-10 gene-592C/A (rs1800872), -819T/C (rs1800871), -1082A/G (rs1800896); Toll-like receptor-2 gene Arg753Gln (rs5743708); Toll-like receptor-4 gene Thr399ile (rs4986791), Asp299Gly (rs4986790); and metalloproteinase-9 gene-8202A/G (rs11697325). The study of polymorphic loci was checked for compliance with the Hardy- Weinberg equilibrium using Fisher's exact test along with the analyses of the frequency of alleles and the genotypes. The association of diseases with G allele Toll-like receptor-2 gene Arg753Gln (rs5743708) was revealed in irritable bowel syndrome patients with adenomatous polyps of the colon (P < .0006) and AG single-nucleotide polymorphisms s of Toll-like receptor-2 gene (χ2 = 12.78, P < .002); A allele had a protective effect. The AG genotype metalloproteinase-9 gene-8202A/G (rs11697325) polymorphism in irritable bowel syndrome patients with adenomatous polyps of the colon had a protective effect (P < .05). AA genotype interleukin-10 gene-1082A/G (rs1800896) polymorphism in the irritable bowel syndrome patient (χ2 = 33.97, 4.0E-8) can be considered as the risk for adenomatous polyps of the colon in irritable bowel syndrome. G allele Toll-like receptor-2 gene Arg753Gln (rs5743708) and AA genotype interleukin-10 gene-1082A/G (rs1800896) polymorphisms can be the marker of the emergence of adenomatous polyps of the colon concomitant with irritable bowel syndrome.

Assessment of Sleep Quality Among Adolescents and Adults With Self-Diagnosed Irritable Bowel Syndrome, in Jeddah, Saudi Arabia.

Background The frequency of irritable bowel syndrome (IBS) has increased significantly in the last ten years. Few studies were done in Saudi Arabia to assess the relationship between sleep quality and IBS. This study aims to assess the prevalence of IBS and its association with sleep quality among adolescents and adults in Saudi Arabia. Methods A cross-sectional study was done on 651 participants aged 15-65 years. An online questionnaire was used to collect data, including demographics; the Rome IV criteria (R4DQ) was used in the diagnosis of IBS, the IBS symptoms severity scale (IBS-SSS) assessed IBS symptoms and severity, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Results Based on the Rome IV criteria, 25.7% of the participants had IBS. Among them, 23.3%, 17.9%, 47.3%, and 11.5% had IBS types constipation (C), diarrhea (D), mixed bowel habits (M), and undefined subtype (U), respectively. Mild, moderate, and severe IBS were found among 43.1%, 39.5%, and 17.4% of IBS cases, respectively. About 46% had poor sleep quality, which was significantly higher among those with younger mean age, females, and students. Patients with IBS exhibited a considerably greater prevalence of poor sleep quality, and IBS-C had the highest prevalence. Conclusion A correlation was found between poor sleep quality and the positive status of IBS diagnosis among adolescents and adults. An evaluation of specific sleep disorders among IBS patients is needed.

Changes in structural units in dough and bread from wheat flour with the addition of pumpkin cellulose in combination with phospholipids

Unfavorable ecological and food security situation in the world causes frequent spread of diseases of the gastrointestinal tract. In particular, the number of cases of irritable bowel syndrome is increasing, especially among the young working population. Diet therapy, which includes increasing the amount of dietary fiber in combination with phospholipids, is effective for the prevention of these diseases. A perspective raw material with a high content of dietary fibers is pumpkin cellulose, which can be added to the recipe of bakery products instead of part of wheat flour. The aim of the work was to find the effect of pumpkin cellulose in combination with sunflower lecithin on the conformational changes of the structure of dough and bread from wheat flour and the completeness of assimilation of products with this raw material by the organism. It was established that the infrared spectra of wheat flour, pumpkin cellulose and sunflower lecithin differ in reflection intensity and character. In the process of dough fermentation, the conformational transformations deepened with an increase in the amount of replacement of wheat flour with pumpkin cellulose, and the reflection coefficient increased. For bread samples, the reflectance coefficient was lower compared to dough, but there were almost no differences in the location of the spectra. In general, the biological value of samples of bread with additives was lower than the control sample, however, the high content of dietary fibers in pumpkin cellulose makes it a promising raw material for enriching bakery products with a valuable nutrient and giving bread health properties. The rational amount of replacing wheat flour with pumpkin cellulose is no more than 7 %, taking into account the decrease in the biological value of bread with this raw material

Depression causes various Inflammatory Processes in the Human Body

Background: We tried to understand whether or not there are some relationships between irritable bowel syndrome (IBS), chronic gastritis (CG), depression, and various inflammatory processes in the body. Method: Consecutive patients with IBS and age and sex-matched control cases were included. Results: The study included 936 patients with IBS (592 females) and 346 control cases. Mean age of the patients was 41.0 years, and 63.2% of them were female. Although gastric sample biopsies were taken just in suspected cases, CG was diagnosed nearly in all of the patients with the IBS (80.4% vs 15.0%, p&lt;0.001). Interestingly, prevalence of antidepressants use was also higher in the IBS cases, significantly (46.4% vs 16.1%, p&lt;0.001). Similarly, smoking (35.2% vs 20.8%, p&lt;0.001), hemorrhoids (37.1% vs 7.2%, p&lt;0.001), and urolithiasis (22.0% vs 9.5%, p&lt;0.001) were all higher in the IBS patients, again. Beside that the mean values of fasting plasma glucose (FPG) (111.9 vs 105.4 mg/dL, p= 0.002) and plasma triglycerides (167.0 vs 147.3 mg/dL, p= 0.013) were also higher in the IBS patients, significantly. Conclusion: Because FPG and triglycerides are well-known acute phase reactants in the body, IBS and CG may be some low-grade inflammatory processes initiated with anxiety, depression, infection, inflammation, trauma, and cancer fear-like stresses of the body, and eventually terminate with hemorrhoids and urolithiasis. Due to the highly significant associations between IBS, CG, and depression, IBS and CG may actually be the two sides of the same paper, and just be two examples of depression-induced various inflammatory processes in human body. Key words: Depression, irritable bowel syndrome, chronic gastritis, irritable gastrointestinal syndrome, smoking, fasting plasma glucose, triglycerides

High-Dimensional Clustering of 4000 Irritable Bowel Syndrome Patients Reveals Seven Distinct Disease Subsets

Irritable bowel syndrome (IBS) is a pain disorder classified by bowel habits, disregarding other factors that may influence the clinical course. The aim of this study was to determine if IBS patients can be clustered based on clinical, dietary, lifestyle, and psychosocial factors. Between 2013 and 2020, the Mayo Clinic Biobank surveyed and received 40,291 responses to a questionnaire incorporating Rome III criteria. Factors associated with IBS were determined and latent class analysis, a model-based clustering, was performed on IBS cases. We identified 4021 IBS patients (mean 64 years; 75% women) and 12,063 controls. Using 26 variables separating cases from controls, the optimal clustering revealed 7 latent clusters. These were characterized by perceived health impairment (moderate or severe), psychoneurological factors, and bowel dysfunction (diarrhea or constipation predominance). Health impairment clusters demonstrated more pain, with the severe cluster also having more psychiatric comorbidities. The next 3 clusters had unique enrichment of psychiatric, neurological, or both comorbidities. The bowel dysfunction clusters demonstrated less abdominal pain, with diarrhea cluster most likely to report pain improvement with defecation. The constipation cluster had the highest exercise score and consumption of fruits, vegetables, and alcohol. The distribution of clusters remained similar when Rome IV criteria were applied. Physiologic tests were available on a limited subset (6%), and there were no significant differences between clusters. In this cohort of older IBS patients, 7 distinct clusters were identified demonstrating varying degrees of gastrointestinal symptoms, comorbidities, dietary, and lifestyle factors. Further research is required to assess whether these unique clusters could be used to direct clinical trials and individualize patient management.

AYURVEDIC MANAGEMENT OF IRRITABLE BOWEL SYNDROME INDUCED PARIKARTIKA (FISSURE-IN ANO): A CASE REPORT

Background: Irritable Bowel Syndrome is a gastrointestinal motility disorder characterized by abdominal pain or discomfort associated with altered defecation or a change in bowel habits, constipation, and abdominal bloating. In Irritable Bowel Syndrome, predominantly diarrhoea type due to repeated elimination, the patient may develop Parikartika. Parikartika is one of the common anorectal anomalies observed in clinical practice. As per the description of signs and symptoms, Parikartika can be co-related to fissure-in ano in modern contexts. The treatment in current clinical practice shows significant recurrence and is mainly indicated for surgery. Rationale of the case report: Here is a case report of 72 years; the male patient is a known case of irritable bowel syndrome predominantly diarrhoea type which got lead to the formation of Fissure-in ano, treatment concentrates both on irritable bowel syndrome and Parikartika since both occur due to vitiation of Vata. Intervention: The patient was given internal medication with Triphala churna avagaha and Jatyadi Ghritha pichu over the anus. Result and outcome: The patient got a satisfactory result within 14 days of Ayurveda treatment. After completion of 21 days course of treatment, surgery was prorogued as the patient improved.

Non-alcoholic fatty liver is associated with increased risk of irritable bowel syndrome: a prospective cohort study

BackgroundThe relationship between non-alcoholic fatty liver degree as well as non-alcoholic fatty liver disease (NAFLD) and irritable bowel syndrome (IBS) remains poorly understood. We aimed to investigate the prospective association of non-alcoholic fatty liver degree as well as NAFLD with incident IBS in a large-scale population-based cohort.MethodsParticipants free of IBS, coeliac disease, inflammatory bowel disease, alcoholic liver disease, and any cancer at baseline from the UK Biobank were included. Non-alcoholic fatty liver degree was measured by a well-validated fatty liver index (FLI), with FLI ≥ 60 as an indicator of NAFLD. Primary outcome was incident IBS. Cox proportional hazard model was used to investigate the associated risk of incident IBS.ResultsAmong 396,838 participants (mean FLI was 48.29 ± 30.07), 153,203(38.6%) were with NAFLD diagnosis at baseline. During a median of 12.4-year follow-up, 7129 cases of incident IBS were identified. Compared with non-NAFLD, NAFLD patients showed a 13% higher risk of developing IBS (HR = 1.13, 95%CI: 1.05–1.17) after multivariable adjustment. Compared with the lowest, the highest FLI quartile was associated with a significantly increased risk of IBS (HRQ4 VS Q1 = 1.21, 1.13–1.30, Ptrend < 0.001). Specifically, the positive association between non-alcoholic fatty liver degree and IBS was also observed by per SD change of FLI (adjusted HR = 1.08, 1.05–1.10). Further sensitivity analysis and subgroup analysis indicated similar results, with the positive association particularly observed in females, but not in males.ConclusionsHigh degree of non-alcoholic fatty liver as well as non-alcoholic fatty liver disease is associated with increased risk of incident IBS. Further studies are warranted to confirm the findings and elucidate the underlying biological mechanisms.

A Case of Irritable Bowel Syndrome Treated by Nux Vomica: A Case Report

Irritable Bowel Syndrome (IBS) is the most commonest functional disorder of the digestive tract. Most of the person in this world suffers from it. In the Homoeopathy, we have lots of scope for treating this kind of functional disease. In this article, I discussed brief summary of IBS and a case which was treated by homoeopathic medicine ‘Nux Vomica’.

Association of Irritable Bowel Syndrome with Somatization

Objective: To evaluate the association of irritable bowel syndrome with somatization. Study Design: Prospective study Prospective study Place and Duration of Study: Department of Gastroenterology, Chandka Medical College @ Shaheed Mohtarma Benazir Bhutto Medical University, Larkana from 1st May 2021 to 31st October 2021. Methodology: Fifty patients suffering from somatization were registered from the hospital based setting. Symptoms checklist 90 revised as SCL-90 revised psychopathological symptoms measuring tool was applied for measuring somatization. Gastrointestinal Symptoms-Rating Scale (GSRS) was also applied which used seven level Likert scale based on frequency, intensity of GI symptoms within last 7 days. Demographic information, clinical co morbidity associations, family history was also recorded. Results: Irritable bowel syndrome presented in only 14% males while it was seen in 34% females. High scored somatization was more common in females. The statistical analysis showed that there was a significant difference in the severe abdominal pain between low and high somatization cases with IBS. A high scoring of indigestion and diarrhea was also noticed in the high somatization cases of IBS. High level of somatization (58% cases) was observed within the irritable bowel syndrome cases. Conclusion: Somatization exacerbates the symptom profile of irritable bowel syndrome patients that need to be timely and properly assessed. Key words: Somatization; Symptomology; Worsen, Disease management