Daily Gastrointestinal Symptoms Research Articles

Changes in gut microbiota and lactose intolerance symptoms before and after daily lactose supplementation in individuals with the lactase nonpersistent genotype

BackgroundApproximately 70%–100% of the Asian adult population is lactase nonpersistent (LNP). The literature shows that many individuals with the LNP-genotype can consume ≤12 g of lactose without experiencing gastrointestinal discomfort. Repetitive consumption of lactose may reduce intolerance symptoms via adaptation of the gut microbiota. ObjectiveThis study aimed to assess the effects of daily consumption of incremental lactose doses on microbiota composition and function, and intolerance symptoms. MethodsTwenty-five healthy adults of Asian origin, carrying the LNP-genotype were included in this 12-wk before and after intervention trial. Participants consumed gradually increasing lactose doses from 3 to 6 g to 12 g twice daily, each daily dose of 6 g, 12 g, or 24 g being provided for 4 consecutive weeks. Participants handed-in repeated stool samples and underwent a 25 g lactose challenge hydrogen breath test (HBT) before and after the 12-wk intervention. Daily gastrointestinal symptoms and total symptom scores (TSSs) during the lactose challenge were recorded. ResultsA significant increase from 5.5% ± 7.6% to 10.4% ± 9.6% was observed in Bifidobacterium relative abundance after the intervention (P = 0.009), accompanied by a 2-fold increase (570 ± 269 U/g; P < 0.001) in fecal β-galactosidase activity compared with baseline (272 ± 158 U/g). A 1.5-fold decrease (incremental area under the curve; P = 0.01) in expired hydrogen was observed during the second HBT (38 ± 35 ppm·min), compared with the baseline HBT (57 ± 38 ppm·min). There was a nonsignificant decrease in TSS (10.6 ± 8.3 before compared with 8.1 ± 7.2 after intervention; P = 0.09). Daily consumption of lactose was well tolerated, with mild to no gastrointestinal complaints reported during the intervention. ConclusionsIncreased levels of Bifidobacterium indicate an adaptation of the gut microbiota upon repetitive consumption of incremental doses of lactose, which was well tolerated as demonstrated by reduced expired hydrogen concentrations during the second 25-g lactose HBT. Bifidobacteria metabolize lactose without gas production thereby potentially reducing intestinal gas formation in the gut of individuals with the LNP-genotype. This increased lactose tolerance possibly lifts the necessity to remove nutrient-rich dairy foods completely from the diet.The trial is registered at the International Clinical Trials Registry Platform: NL9516. The effect of dietary lactose in lactase nonpersistent individuals on gut microbiota.

Daily Gastrointestinal Symptoms And Weight Loss In A Young Female Athlete

HISTORY: 21-year-old female college ice hockey player with PMH of depression/anxiety on sertraline presents with a 3-month history of abdominal pain, nausea, vomiting, and diarrhea. This was accompanied by a 15-pound weight loss since freshman year of college. She states that she experiences emesis and diarrhea daily, however feels like she has a normal appetite and eats until she feels full. She presented to the ED, prior to our visit, for abdominal pain and vomiting, and was prescribed a PPI with no lab work at the time. At our visit, she did report feeling anxious as she had ended a 3-year long relationship which she described as being “toxic.” PHYSICAL EXAMINATION: General Appearance: Anxious appearing young Caucasian female in no acute distress with mild hand tremor Abdominal: Tenderness to palpation over the epigastric region without rebound tenderness. Prominent aortic pulse noted in abdomen. No lower quadrant or right upper quadrant tenderness to palpation. Resp: No acute respiratory distressCV: Regular rate and rhythm. No murmurs or clicks. No cyanosis of the fingers or lips. DIFFERENTIAL DIAGNOSIS: 1) Gastroesophageal reflux disease 2) Inflammatory Bowel Disease/Irritable Bowel Syndrome 3) Celiac disease4) H. Pylori TEST AND RESULTS: Fecal studies (calprotectin feces, stool culture, stool leukocytes, H Pylori stool, stool ova and parasites, FOBT) returned negative. TSH levels returned undetectable with free thyroxine levels returning elevated at 5.45. CMP returned borderline abnormal with mildly decreased CO2 and mildly increased BUN. CBC, ESR, CRP, celiac disease panel all negative. FINAL WORKING DIAGNOSIS: Thyrotoxicosis secondary to Grave’s disease TREATMENT AND OUTCOMES: The athlete was held from sporting activity due to concern for caloric deficiency as well as increased cardiac load to due hypermetabolic state. She was referred to Endocrinology where her thyrotropin receptor antibody returned positive consistent with Grave’s disease. She was initiated on atenolol for symptomatic control.

Nutritional Decline in Scleroderma Patients Data from a single Romanian center

Malnutrition has been known to provide poor survival outcomes in systemic sclerosis (SSc). We recruited a series of 40 consecutive SSc patients, 22 (55%) with limited cutaneous involvement and 18 (45%) with the diffuse form of disease. The study group was evaluated using the modified Rodnan skin score (mRSS), anthropometric measurements, the EPIC-Norfolk Food Frequency Questionnaire, the Malnutrition Universal Screening Tool (MUST) as well as circulating albumin and vitamin D. MUST scores were correlated with mRSS and serum albumin (R=0.40, p=0.010, and R=-0.46, p=0.003, respectively). Serum vitamin D values were inversely related to mRSS (R=-0.35, p=0.026). We recorded a greater number of daily gastrointestinal symptoms associated with diets rich in sodium, fat, sugars and snacks, carotene, and �-tocopherol equivalents (vitamin E) in our study population. Scleroderma patients might benefit from nutritional counseling in order to follow a diet tailored to their specific needs.

Low FODMAP: A Preliminary Strategy to Reduce Gastrointestinal Distress in Athletes.

Gastrointestinal (GI) distress in endurance athletes is prevalent and detrimental to performance. Adverse GI symptomatology can be analogous with irritable bowel syndrome, where fermentable oligosaccharide, disaccharide, monosaccharide, and polyols (FODMAP) reduction has demonstrated efficacy. This study investigated the effects of low FODMAP (LFOD) diet on GI distress parameters in runners with a history of nonclinical exercise-associated GI symptoms. Eleven recreationally competitive runners (five men, six women; 5-km personal best 23:00 ± 4:02 min:s) participated in the study. Runners were allocated to a randomized 6-d LFOD or high FODMAP (HFOD) diet separated by a 1-d wash-out in a controlled, single-blinded cross-over study. In each period participants completed two strenuous running sessions consisting of 5 × 1000 m and a 7-km threshold run. GI symptoms (during-exercise and daily) and the Daily Analysis of Life Demand for Athletes questionnaires were completed. Area under the curve was calculated for daily GI symptoms across each dietary period and analysis was conducted using multilevel mixed-effects linear regression for comparison between the two diets. A significantly smaller area under the curve for daily GI symptoms 6 d during the LFOD compared with HFOD (mean difference, -13.4; 95% confidence interval, -22 to -4.60; P = 0.003) was observed. The daily GI symptoms that were significantly lower during LFOD were flatulence (P < 0.001), urge to defecate (P = 0.04), loose stool (P = 0.03), and diarrhea (P = 0.004). No significant differences in during exercise symptoms or Daily Analysis of Life Demand for Athletes responses were observed between diets (P > 0.05). Preliminary findings suggest that short-term FODMAP reduction may be a beneficial intervention to minimize daily GI symptoms in runners with exercise-related GI distress.

Tu1676 - Clinical Characteristics and Daily Gastrointestinal Symptoms in Chemosensitive Functional Dyspepsia

Tu1676 - Clinical Characteristics and Daily Gastrointestinal Symptoms in Chemosensitive Functional Dyspepsia

The relationship between daily life stress and gastrointestinal symptoms in women with irritable bowel syndrome.

Research on irritable bowel syndrome (IBS), a functional disorder of the gastrointestinal (GI) system, has linked GI symptoms to stress. This study examined the relationship between daily stress and GI symptoms across women and within woman in IBS patients (n = 26), IBS nonpatients (IBS-NP; n = 23), and controls (n = 26), controlling for menstrual cycle phase. Women (ages 20-45) completed daily health diaries for two cycles in which they monitored daily GI symptoms and stress levels. The Life Event Survey (LES) was used as a retrospective measure of self-reported stress. The across-women analyses showed higher mean GI symptoms and stress in the IBS and IBS-NP groups relative to controls but no group differences in LES scores. The within-woman analyses found a significant and positive relationship between daily stress and daily symptoms in both the IBS-NP and the IBS groups. Controlling for menstrual cycle had no substantial impact on the results.

Daily gastrointestinal symptoms in women with and without a diagnosis of IBS

This study compared daily gastrointestinal symptoms and stool characteristics across two menstrual cycles, and recalled bowel symptoms and psychological distress in women with irritable bowel syndrome (IBS, N = 22), IBS nonpatients (IBS-NP, N = 22), and controls (N = 25). Daily reports of abdominal pain, bloating, intestinal gas, constipation, and diarrhea did not differ significantly between the IBS and IBS-NP groups but both groups reported significantly higher symptoms than the control group. Stool consistencies was significantly looser in the IBS group relative to the control group. Menstrual cycle effects on symptoms were noted in all the groups. There were no significant differences in psychological distress between women with IBS and IBS-NP, but both groups reported significantly higher global distress than the control group. The lack of difference between the IBS and IBS-NP groups in contrast to the results of others, can be understood in terms of differences in recruitment strategies.