Cause Of Irritable Bowel Syndrome Research Articles

A Review on Functional Gastrointestinal Disorders: Irritable Bowel Syndrome and its Association with Obesity

Worldwide, Functional Gastrointestinal Disorders (FGIDs) are common, although their prevalence varies among cultures, ethnic groups, and geographic regions. FGIDs, now referred to as Disorders of Gut-Brain Interactions (DGBIs), encompass a variety of chronic or recurrent gastrointestinal symptoms that are not related to structural or morphological abnormalities. Irritable Bowel Syndrome (IBS) and Functional Dyspepsia are two of the most common examples of FGIDs. According to the Rome IV criteria established in 2016, these disorders are classified based on specific diagnostic guidelines. The Rome Foundation is expected to launch the updated Rome V criteria in 2026. IBS is one of the most common types of FGID. The causes of IBS include a range of factors such as dietary habits, psychological influences, and genetic predispositions. The role of neurotransmitters such as serotonin, norepinephrine, histamine, dopamine, and gamma-aminobutyric acid (GABA) has been identified in the development of IBS. Due to gender differences, it is anticipated that the symptoms and treatment approaches for men and women with IBS may vary. Studies have shown that IBS is more frequent in women than in men. Various treatment strategies are used for the management of IBS, including medications (such as laxatives, antidepressants, and analgesics), lifestyle modifications, and herbal approaches. Increasing emphasis is being placed on plant-based products and probiotics. Management often differs from one individual to another; a treatment that works for one person may not be effective for another. Different studies have suggested an association between obesity and FGIDs, particularly IBS. Some research indicates that obesity could exacerbate the inflammatory processes associated with IBS, while other studies suggest a bidirectional link between IBS and obesity. Common pathophysiological features found in both obesity and IBS include alterations in the gut microbiome, changes in intestinal permeability, visceral hypersensitivity, and low-grade inflammation.

Cryptosporidium and irritable bowel syndrome.

Cryptosporidium is an apicomplexan parasite that causes gastrointestinal disease in a wide variety of hosts and is associated with waterborne outbreaks. Nonetheless, the parasite is underdiagnosed. Cryptosporidium has been proposed as an etiological cause of irritable bowel syndrome (IBS) in several studies. However, the exact mechanism of pathogenesis is unknown, and no direct link has been discovered. This review will discuss several parasite-induced modifications, such as immunological, microbiome, and metabolite modifications, as well as their interactions. To summarize, Cryptosporidium causes low inflammation, dysbiosis, and unbalanced metabolism, which leads to a lack of homeostasis in the intestine in a comparable pattern to postinfectious IBS.

Gut microbiota and irritable bowel syndrome: status and prospect.

Irritable bowel syndrome (IBS) is a very common gastrointestinal disease that, although not as aggressive as tumors, affects patients' quality of life in different ways. The cause of IBS is still unclear, but more and more studies have shown that the characteristics of the gut microbiota, such as diversity, abundance, and composition, are altered in patients with IBS, compared to the healthy population, which confirms that the gut microbiota plays a crucial role in the development of IBS. This paper aims to identify the commonalities by reviewing a large body of literature. Changes in the characteristics of gut microbiota in patients with different types of IBS are discussed, relevant mechanisms are described, and the treatment modalities of gut microbiota in IBS are summarized. Although there are more clinical trials that have made good progress, more standardized, more generalized, larger-scale, multi-omics clinical studies are what is missing. Overall, gut microbiota plays a crucial role in the development of IBS, and there is even more potential for treating IBS by modulating gut microbiota.

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.

Pharmacological management of irritable bowel syndrome

Irritable bowel syndrome (IBS) is a common longstanding condition with a variety of symptoms including constipation, diarrhoea and abdominal cramps or bloating. There are no specific causes of IBS; therefore, symptoms and management are individualised to each patient. Management strategies involve lifestyle advice on diet and exercise, medications and psychological therapies. IBS can be extremely debilitating to patients’ quality of life and is usually diagnosed as a process of elimination of other gastrointestinal conditions that can have similar symptoms, such as inflammatory bowel disease. Medications to manage IBS include laxatives, antispasmodics, antimotility agents and neuromodulators, as IBS is believed to be a disorder of the gut–brain axis.

Pharmacological management of irritable bowel syndrome

Irritable bowel syndrome (IBS) is a common longstanding condition with a variety of symptoms including constipation, diarrhoea and abdominal cramps or bloating. There are no specific causes of IBS; therefore, symptoms and management are individualised to each patient. Management strategies involve lifestyle advice on diet and exercise, medications and psychological therapies. IBS can be extremely debilitating to patients' quality of life and is usually diagnosed as a process of elimination of other gastrointestinal conditions that can have similar symptoms, such as inflammatory bowel disease. Medications to manage IBS include laxatives, antispasmodics, antimotility agents and neuromodulators, as IBS is believed to be a disorder of the gut–brain axis.

Is the microbiome the cause of irritable bowel syndrome and inflammatory bowel disease? Lessons to consider from odontology.

A substantial amount of research is pointing to the disrupted microbiome and dysfunctional host-microbiome interaction as potential causes of Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). The true cause of the diseases is still not fully elucidated, and the various treatments used are not truly effective in the long run, especially for IBD, since a true cure is not known to exist. Treatment failure and surgery are common for IBD, many times leading to a perceived lower quality of life, not to mention the enormous cost for society for treatment up until that point and after. Although it is clear that the microbiome has a major role in the disease, it seems the majority of the research and treatments are still focused on treating and understanding the inflammation and not the primary cause of the inflammation in the first place. This was also the case for many decades in the search for the cause of periodontitis (PD) and gingivitis (GV), a destructive and non-destructive inflammatory disorder, respectively, the first resulting in loss of tissue supporting the teeth. There was much uncertainty and confusion until it was fully established that the microbiome was the cause. PD treatments primarily nowadays reflect the cause, i.e. the removal of microbes. There is no doubt, however, that the inflammatory pathways are important in both diseases and the purpose of this text is not to dispute this in respect to gastrointestinal disorders too. However, a different view on inflammation and associated disorders is explored to explain the nature of extraintestinal manifestations. The aim of this report is not to systematically fully review the literature to try to strengthen causality, as there are many reviews that explore the microbial aspects of IBS and IBD. Instead, the objective is to above all reflect on what has been learned in the field of odontology/stomatology and discuss relevant gastrointestinal research in order to propose tentative hypotheses and questions regarding IBS and IBD aetiology. Perhaps it could help soften the confusion regarding the microbial aetiology and dysbiosis concept, while guiding future research and treatments, primarily regarding microbial transplants, antibiotics, and diet.

The traditional herbal medicines mixture, Banhasasim-tang, relieves the symptoms of irritable bowel syndrome via modulation of TRPA1, NaV1.5 and NaV1.7 channels

Ethnopharmacological relevance: The cause of irritable bowel syndrome (IBS), a functional gastrointestinal (GI) disorder, remains unclear. Banhasasim-tang (BHSST), a traditional herbal medicines mixture, mainly used to treat GI-related diseases, may have a potential in IBS treatment. IBS is characterized by abdominal pain as the main clinical symptom, which seriously affects the quality of life. Aim of the study: We conducted a study to evaluate the effectiveness of BHSST and its mechanisms of action in treating IBS. Materials and methods: We evaluated the efficacy of BHSST in a zymosan-induced diarrhea-predominant animal model of IBS. Electrophysiological methods were used to confirm modulation of transient receptor potential (TRP) and voltage-gated Na+ (NaV) ion channels, which are associated mechanisms of action. Results: Oral administration of BHSST decreased colon length, increased stool scores, and increased colon weight. Weight loss was also minimized without affecting food intake. In mice administered with BHSST, the mucosal thickness was suppressed, making it similar to that of normal mice, and the degree of tumor necrosis factor-α was severely reduced. These effects were similar to those of the anti-inflammatory drug—sulfasalazine—and antidepressant—amitriptyline. Moreover, pain-related behaviors were substantially reduced. Additionally, BHSST inhibited TRPA1, NaV1.5, and NaV1.7 ion channels associated with IBS-mediated visceral hypersensitivity. Conclusions: In summary, the findings suggest that BHSST has potential beneficial effects on IBS and diarrhea through the modulation of ion channels.

The role of acupuncture on the autonomic nervous system in irritable bowel syndrome

Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by recurrent abdominal pain, bloating, and irregular bowel movements with complex pathogenesis. Due to its high prevalence and reoccurring symptoms, it seriously impacts patients’ quality of life. One of the causes of IBS is turbulence of gastrointestinal motility and intestinal secretion due to dysfunction of the autonomic nervous system (ANS), which the includes the sympathetic nervous system, parasympathetic nervous system, and enteric nervous system. Current research has proven that acupuncture, a traditional Chinese therapy, is useful and effective for treating IBS. The ANS is a key pathway for bidirectional information transmission between the gastrointestinal tract and the central nervous system, which plays an important role in IBS treatment with acupuncture. Research on the mechanisms of acupuncture for IBS is receiving more attention, and the use of contemporary methods has made significant progress. Evidence suggests that acupuncture may mitigate the negative consequences of IBS, as seen by reduced inflammatory signaling, neurotransmitter levels in the colon and central neural tissues, and balanced gut flora. We review and discuss acupuncture’s possible mechanisms of action for IBS treatment via the ANS, including modulation of gastrointestinal motility, improvement of visceral hypersensitivity, and innervation of the gut-brain-microbiota axis. Our review demonstrates the available evidence for acupuncture treatment of IBS in clinical settings; however, we also observe that the relationship between the ANS and the gut-brain-microbiota axis is unclear, and further research is needed. Graphical abstract: http://links.lww.com/AHM/A57

Metabotropic glutamate receptor-8 relieves neonatal maternal separation-induced visceral hypersensitivity in rats by regulating expression of TNF-α.

Visceral hypersensitivity (VH) is one of the most common causes of irritable bowel syndrome (IBS). The anti-hyperalgesic effects of metabotropic glutamate receptor 8 (mGluR8) has been identified in the central nervous system (CNS). However, whether this receptor has a similar function in the gastrointestinal tract has not been well studied. The present study aimed to explore the role of this receptor in a visceral hypersensitivity-related IBS rat model. Neonatal rats were separated from their mothers for 3 hours daily from postnatal day 2 to day 14 to establish neonatal maternal separation (NMS) models. The mGluR8 agonist (S)-3,4-DCPG (10 mg/kg) and the mGluR8 antagonist (RS)-α- methylserine-O-phosphate (MSOP) (10 mg/kg) were used to examine the role of mGLuR8 in the NMS rats. The expression of mGluR8, related inflammatory factors, and inflammatory signal pathways were assessed in colon tissues. Our data showed that mGluR8 expression was increased in the colonic mucosa of NMS rats compared to controls. In addition, selective activation of mGluR8 ameliorated visceral hypersensitivity, whereas antagonization of mGluR8 aggravated visceral hypersensitivity. Treatment with (S)-3,4-DCPG (10 mg/kg) reduced the expression of myeloperoxidase (MPO) in intestinal mucosa of NMS rats. Furthermore, activating mGluR8 reduced the expression of tumor necrosis factor-α (TNF-α), whereas antagonizing mGluR8 promoted that. The expressions of toll-like receptor 4 (TLR4) and nuclear factor-κB (NF-κB) did not significantly change upon activation or antagonization of mGluR8 receptor. The activation of mGluR8 receptor ameliorates visceral hypersensitivity in NMS rats, and the underlying mechanisms may be associated with the inhibition of TNF-α and the suppression of colonic inflammatory response.

Bile Acid and Gut Microbiota in Irritable Bowel Syndrome.

Gut microbiota and their metabolites like bile acid (BA) have been investigated as causes of irritable bowel syndrome (IBS) symptoms. Primary BAs are synthesized and conjugated in the liver and released into the duodenum. BA biotransformation by gut microbiota begins in the intestine and results in production of a broad range of secondary BAs. Deconjugation is considered the gateway reaction for further modification and is mediated by bile salt hydrolase, which is widely expressed by the gut microbiota. However, gut bacteria that convert primary BAs to secondary BAs belong to a limited number of species, mainly Clostridiales. Like gut microbiota modify BA profile, BAs can shape gut microbiota via direct and indirect actions. BAs have prosecretory effects and regulates gut motility. BAs can also affect gut sensitivity. Because of the vital role of the gut microbiota and BAs in gut function, their bidirectional relationship may contribute to the pathophysiology of IBS. Individuals with IBS have been reported to have altered microbial profiles and modified BA profiles. A significant increase in fecal primary BA and a corresponding decrease in secondary BA have been observed in IBS with predominant diarrhea. In addition, primary BA was positively correlated with IBS symptoms. In IBS with predominant diarrhea, bacteria with reduced abundance mainly belonged to the genera in Ruminococcaceae and exhibited a negative correlation with primary BAs. Integrating the analysis of the gut microbiota and BAs could better understanding of IBS pathophysiology. The gap in this field needs to be further filled in the future.

Translational Gap between Guidelines and Clinical Medicine: The Viewpoint of Italian General Practitioners in the Management of IBS.

Irritable bowel syndrome (IBS) guidelines are generally developed by experts, with the possibility of a translational gap in clinical medicine. The aim of our study was to assess an Italian group of general practitioners (GPs) for their awareness and use of criteria for the diagnosis and management of IBS. For this purpose, a survey was carried out involving 235 GPs, divided into two groups according to their years of activity: 65 “junior general practitioners” (JGPs) (≤10 years) and 170 “senior general practitioners” (SGPs) (>10 years). JGPs were more familiar with the Rome IV Criteria and Bristol Scale than SGPs. Abdominal pain, bowel movement frequency and bloating were the symptoms most frequently used to make a diagnosis. The most probable causes of IBS were reported to be abnormal gastrointestinal motility and psychological triggers. SGPs reported more frequently than JGPs that challenging management and patient’s request were motivations for a gastroenterological consultation. The practice of clinical medicine is still far from the guidelines provided by the specialists. Abdominal pain related to defecation and changes in bowel frequency are considered to be the more important symptoms for IBS diagnosis, but most GPs, both JGPs and SGPs, like to consider abdominal bloating as another useful symptom. Involving both gastroenterologists and GPs in developing shared guidelines would be highly desirable in order to improve IBS management strategies in everyday clinical practice.

Modern views on the mechanisms of pathogenesis and tactics of management of patients with overlap of irritable bowel syndrome and functional dyspepsia. Review

Such widespread functional gastrointestinal disorders as irritable bowel syndrome (IBS) and functional dyspepsia (FD), although not represented by any obvious structural lesions of the gastrointestinal tract, but they seriously affect quality of life of many patients. According to epidemiological data, 26.7 — 48.7 % of IBS patients and 20.0 — 42.1 % of patients with FD have a crossover of symptoms, also known as overlap IBS/FD syndrome. Overlap syndrome usually leads to more serious clinical manifestations, deterioration of quality of life and complications. Chronic low‑intensity post‑infectious inflammation or non‑infectious microinflammation and the immune response play an important role in the pathogenesis of both IBS and FD, leading to visceral hypersensitivity, dysfunction of «brain‑gut» axis and intestinal mucosal barrier, which are usually the cause of IBS or FD. However, whether inflammation has the same mechanism in the syndrome of the overlap of IBS and FD (IBS/FD) remains unclear. The presented review considers the latest advances in the study of inflammatory mechanisms in IBS/FD and proposes new treatment tactics. Current data on the role of gastrointestinal infection, secondary chronic inflammation and immune response, intestinal mucosal barrier damage associated with gastrointestinal infection, effects of gastrointestinal infections on the enteric nervous system and the «gut‑brain» axis, possible role of Helicobacter pylori infection at the overlap of IBS/FD are discussed. The role of non‑infectious inflammation, in particular, bacterial overgrowth syndrome, food allergy, psychological or mental stress in the pathogenesis of IBS, FD and IBS/FD overlapping is also considered. The modern tactics of treatment and management of such patients, which is based on the impact on inflammatory mechanisms also are presented.

Telomere is shortened in patients with irritable bowel syndrome in the Chinese population.

Telomere shortening is an accepted indicator of aging. Many studies have investigated an association between leukocyte telomere length (LTL) and psychiatric disorders. Mental or psychological factors could be an important cause of irritable bowel syndrome (IBS). However, there are currently few research evaluating correlations between LTL and IBS. We examined associations between LTL and IBS using quantitative polymerase chain reaction in independent cohorts, including 205 patients with IBS and 189 healthy controls. Furthermore, we examined whether mental or psychological factors, types of IBS, duration of IBS and antidepressants had an association with LTL in patients with IBS. Among total samples, patients with IBS presented shorter LTL when compared to healthy controls (P<0.0001). Moreover, in subgroup analyses of patients with IBS, not only the LTL in patients with IBS caused by mental or psychological factors was shorter (P<0.0001), but also in patients with IBS that were caused by other factors (P=0.0082). Furthermore, LTL in patients with IBS who had taken antidepressants for more than 1month was longer than that in patients with IBS who did not take antidepressants or took for less than 1month (P<0.0001). This is the first study to describe the relationship between LTL and IBS. This study showed significantly shorter telomeres in patients with IBS. Our findings suggest that LTL may hold the potential to serve as a predictor of IBS diagnosis.

Study on the Role of Gastrointestinal Parasite in Irritable Bowel Syndrome Patients in a Tribal Region of India.

BackgroundIrritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder in which abdominal pain is associated with a change in bowel habits. Gut inflammation might be one of the mechanisms of pathogenesis. However, the cause of IBS is not clearly understood. Post-infectious IBS (PI-IBS) is the onset of IBS after an episode of infectious gastroenteritis. While the exact pathophysiology of PI-IBS is not established, the mechanism might be an altered serotonin signaling activity, inflammation, malabsorption, and small intestinal bacterial overgrowth. Various parasites such as Blastocystis hominis and Dientamoeba fragilis have a possible role in the etiology of IBS. Entamoeba histolytica is one of the predominant GI parasites in developing regions of the world, and the symptoms of non-dysenteric amebic colitis may mimic those of IBS, which makes them difficult to distinguish from each other. Our study will address the relationship between the different gastrointestinal protozoan parasites in IBS and the role of antiparasitic therapy in PI-IBS. This study also aimed to determine the prevalence of GI protozoan parasites in patients with IBS in a tribal region of India.MethodsWe conducted a descriptive facility-based cross-sectional study of patients presenting with IBS to Saheed Laxman Nayak Medical College and Hospital, Koraput, Odisha, from 2017 to 2021. We collected stool samples for histopathological analysis using direct wet mount and formal-ether concentration microscopy techniques if diarrhea persisted beyond the antidiarrheal therapy. The samples from IBS patients were compared against 80 healthy control patient stool samples. We used IBM SPSS Statistics for Windows, Version 24.0 (IBM Corp., Armonk, NY,) to analyze the data.ResultsOur study included 120 patients with IBS, of whom 67 (56%) were infected with GI parasites. In the control group, 16 (20%) were infected with GI parasites, which was significantly fewer than the test group (p<0.001).ConclusionWe found a widespread infestation with GI parasites in patients with diarrhea-predominate IBS. A parasitological stool test should be included in the diagnostic approach to IBS. Initiating early diagnosis and treatment can reduce the chance of post-infectious IBS.

Bifidobacteria Was Decreased in Adult Patients With Irritable Bowel Syndrome Based on PCR and Bacterial Culture: A Systematic Review and Meta-Analysis.

The causes of irritable bowel syndrome remain unknown. Studies and meta-analyses revealed that intestinal microbiota disturbance was one of the causes of irritable bowel syndrome, but the results remained controversial. Therefore, we performed a systematic review and meta-analysis to identify the association between them. We performed a systematic meta-analysis of case-control studies from January 2000 to December 2020 to compare fecal microbes based on polymerase chain reaction and bacterial cul- ture between adult irritable bowel syndrome patients and healthy controls. The standardized mean difference value and a 95% CI were calculated. Two professional researchers used Newcastle-Ottawa Scale to reassess selected literature and extract high- quality studies. Six studies were included in our analysis. When all eligible studies were pooled into the meta-analysis, compared with healthy controls, the standardized mean differences of Bifidobacteria (standardized mean difference = -1.01, 95% CI =: -2.01 to -0.01) in irritable bowel syndrome patients decreased significantly, whereas the standardized mean differences of Enterococcus, Enterobacter, Lactobacillus, Bacteroides, and Escherichia coli did not change significantly in irritable bowel syndrome patients. However, heterogeneity was significant to perform sensitivity analysis and stratified analysis in all these special intestinal microbes. In summary, this study indicated that only Bifidobacteria was decreased in irritable bowel syndrome patients compared with healthy controls using Newcastle-Ottawa Scale standards to extract high-quality literature. Future studies are warranted to further dem- onstrate the relationship between them.

Serum Diamine Oxidase Values, Indicating Histamine Intolerance, Influence Lactose Tolerance Breath Test Results.

Lactose intolerance (LIT) is one of the major causes of irritable bowel syndrome (IBS) spectrum complaints. Differences in inadequate lactose digestion are described as various LIT phenotypes with basically unknown pathophysiology. In LIT patients, we retrospectively assessed the effect of histamine intolerance (HIT) on expiratory hydrogen (H2) during H2 lactose breath tests. In a retrospective evaluation of charts from 402 LIT patients, 200 patients were identified as having only LIT. The other 202 LIT patients were found to additionally have diamine oxidase (DAO) values of <10 U/mL, which indicates histamine intolerance (HIT). To identify HIT, standardized questionnaires, low serum DAO values and responses to a histamine-reduced diet were used. Patients were separated into three diagnostic groups according to the result of H2 breath tests: (1) LIT, with an H2 increase of >20 parts per million (ppm), but a blood glucose (BG) increase of >20 mg/dL, (2) LIT with an H2 increase of 20 ppm in combination with a BG increase of <20 mg/dL, and (3) LIT with an exhaled H2 increase of <20 ppm and BG increase of <20 mg/dL. Pairwise comparison with the Kruskal Wallis test was used to compare the areas under the curve (AUC) of LIT and LIT with HIT patients. Exhaled H2 values were significantly higher in H2 > 20 ppm and BG < 20 mg/dL patients with LIT and HIT (p = 0.007). This diagnostic group also showed a significant higher number of patients (p = 0.012) and a significant higher number of patients with gastrointestinal (GI) symptoms during H2 breath tests (p < 0.001). Therefore, low serum DAO values, indicating HIT, influence results of lactose tolerance breath tests.

Gluten-free Diet Reduces the Risk of Irritable Bowel Syndrome: A Mendelian Randomization Analysis.

Background: Whether a gluten-free diet (GFD) is a cause of irritable bowel syndrome (IBS) remains controversial. We aim at exploring the causal relationship between gluten intake and IBS within Mendelian randomization (MR) design. Methods: We conducted a two-sample MR and selected single-nucleotide polymorphisms (SNPs) associated with GFD as instrumental variables (IVs). SNPs and genetic associations with GFD and IBS were obtained from the latest genome-wide association studies (GWAS) in Europeans (GFD: cases: 1,376; controls: 63,573; IBS: cases:1,121; controls: 360,073). We performed inverse variance weighting (IVW) as the primary method with several sensitivity analyses like MR-Egger and MR-PRESSO for quality control. The above analyses were re-run using another large dataset of IBS, as well as changing the p-value threshold when screening IVs, to verify the stability of the results. Results: The final estimate indicated significant causal association [per one copy of effect allele predicted log odds ratio (OR) change in GFD intake: OR = 0.97, 95% confidence interval (CI) 0.96 to 0.99, p < 0.01] without heterogeneity statistically (Q = 2.48, p = 0.78) nor horizontal pleiotropy biasing the causality (p = 0.92). Consistent results were found in validation analyses. Results of MR Steiger directionality test indicated the accuracy of our estimate of the causal direction (Steiger p < 0.001). Conclusion: GFD might be a protective factor of IBS. Therefore, we suggest taking a diet of lower gluten intake into account in IBS prevention and clinical practice.

Эффективность примененияпрепарата Колонзак у пациентов с различными клиническими вариантами синдрома раздраженного кишечника

Актуальность. На сегодняшний день этиология симптомов синдрома раздраженного кишечника (СРК) полностью не установлена. Отсутствие четкого понимания патогенетических механизмов развития того или иного функционального заболевания кишечника, в том числе СРК, с учетом наличия разнообразных структурно-морфологических нарушений в стенке кишки диктует необходимость поиска новых препаратов, действие которых будет направлено на разные звенья патогенеза кишечных заболеваний. Цель исследования — изучить эффективность и безопасность применения препарата Колонзак у пациентов с различными клиническими вариантами синдрома раздраженного кишечника. Материалы и методы. Обследованы 42 пациента с верифицированным диагнозом СРК (14 — СРК тип 1; 14 — СРК тип 2; 9 — СРК тип 3; 5 — СРК тип 4) в возрасте от 25 до 45 лет (средний возраст 35,0 ± 1,7 года). У всех пациентов с СРК органическая кишечная патология была исключена при проведении колоноскопии. ­Диагноз СРК установлен в соответствии с Римскими критериями IV. Кроме модификации образа жизни и соблюдения правил питания в зависимости от типа СРК, все пациенты (независимо от варианта СРК) получали средство Колонзак по 1 капсуле 2 раза в день, утром и вечером перед едой 30 дней. Все пациенты заполняли опросник по оценке степени тяжести симптомов СРК до и после курса лечения. Полученные результаты были статистически обработаны при помощи программ Excel 2017 (Microsoft) и Statistica 13. Результаты. Проведенное исследование показало, что Колонзак, содержащий пробиотические штаммы бифидобактерий, пребиотик инулин и масляную кислоту, можно рассматривать как безопасное, хорошо переносимое и высокоэффективное средство для пациентов с разными вариантами СРК. У пациентов с СРК применение препарата Колонзак сопровождалось статистически значимым улучшением состояния. Выводы. Наше исследование подтвердило клиническую эффективность средства Колонзак как мультикомпонентного колонопротектора при СРК. Полученные результаты позволяют рекомендовать широкое применение препарата Колонзак у пациентов с разными вариантами СРК.

Integrative analysis of the gut microbiome and metabolome in a rat model with stress induced irritable bowel syndrome

Stress is one of the major causes of irritable bowel syndrome (IBS), which is well-known for perturbing the microbiome and exacerbating IBS-associated symptoms. However, changes in the gut microbiome and metabolome in response to colorectal distention (CRD), combined with restraint stress (RS) administration, remains unclear. In this study, CRD and RS stress were used to construct an IBS rat model. The 16S rRNA gene sequencing was used to characterize the microbiota in ileocecal contents. UHPLC-QTOF-MS/MS assay was used to characterize the metabolome of gut microbiota. As a result, significant gut microbial dysbiosis was observed in stress-induced IBS rats, with the obvious enrichment of three and depletion of 11 bacterial taxa in IBS rats, when compared with those in the control group (q < 0.05). Meanwhile, distinct changes in the fecal metabolic phenotype of stress-induced IBS rats were also found, including five increased and 19 decreased metabolites. Furthermore, phenylalanine, tyrosine and tryptophan biosynthesis were the main metabolic pathways induced by IBS stress. Moreover, the altered gut microbiota had a strong correlation with the changes in metabolism of stress-induced IBS rats. Prevotella bacteria are correlated with the metabolism of 1-Naphthol and Arg.Thr. In conclusion, the gut microbiome, metabolome and their interaction were altered. This may be critical for the development of stress-induced IBS.