Functional Bowel Disease Research Articles

FMT and TCM to treat diarrhoeal irritable bowel syndrome with induced spleen deficiency syndrome- microbiomic and metabolomic insights

BackgroundDiarrheal irritable bowel syndrome (IBS-D) is a functional bowel disease with diarrhea, and can be associated with common spleen deficiency syndrome of the prevelent traditional Chinese medicine (TCM) syndrome. Fecal microbiota transplantation (FMT) could help treating IBS-D, but may provide variable effects. Our study evaluated the efficacy of TCM- shenling Baizhu decoction and FMT in treating IBS-D with spleen deficiency syndrome, with significant implications on gut microbiome and serum metabolites.MethodsThe new borne rats were procured from SPF facility and separated as healthy (1 group) and IBS-D model ( 3 groups) rats were prepared articially using mother’s separation and senna leaf treatment. 2 groups of IBS-D models were further treated with TCM- shenling Baizhu decoction and FMT. The efficacy was evaluated by defecation frequency, bristol stool score, and intestinal tight junction proteins (occludin-1 and claudin-1) expression. Microbiomic analysis was conducted using 16 S rRNA sequencing and bioinformatics tools. Metabolomics were detected in sera of rats by LC-MS and annotated by using KEGG database.ResultsSignificant increment in occludin-1 and claudin-1 protein expression alleviated the diarrheal severity in IBS-D rats (P < 0.05) after treatment with FMT and TCM. FMT and TCM altered the gut microbiota and regulated the tryptophan metabolism, steroid hormone biosynthesis and glycerophospholipid metabolism of IBS-D rats with spleen deficiency syndrome.The microbial abundance were changed in each case e.g., Monoglobus, Dubosiella, and Akkermansia and othe metabolic profiles.ConclusionFMT and TCM treatment improved the intestinal barrier function by regulating gut microbiota and improved metabolic pathways in IBS-D with spleen deficiency syndrome.

Mechanisms of Electroacupuncture in Alleviating Visceral Hypersensitivity in Post-Infectious Irritable Bowel Syndrome Mice: The Role of GDNF Signaling Pathway and Gut Microbiota

Introduction: Post-infectious irritable bowel syndrome (PI-IBS) is a functional bowel disease that develops following an acute gastrointestinal infection. Electroacupuncture (EA) can regulate the gut microbiota and alleviate visceral hypersensitivity. Glial cell-derived neurotrophic factor (GDNF) is a potential factor in visceral hypersensitivity reactions. The aim of this study was to explore whether EA could alleviate visceral hypersensitivity in PI-IBS by regulating gut microbiota through GDNF signaling. Methods: 2,4,6-trinitrobenzene sulfonic acid was used to induce visceral hypersensitivity in PI-IBS mice. Intestinal visceral sensitivity was assessed by using the abdominal withdrawal reflex (colorectal distention). 16S ribosomal RNA sequencing profiles the gut microbiome community. Results: GDNF can exacerbate the imbalances of the gut microbiota and increase visceral hypersensitivity compared with the model group. Whereas EA treatment increases the richness and diversity of the gut microbiota, decreases differences among species and alleviates visceral sensitivity. Conclusion: EA can alleviate visceral hypersensitivity in PI-IBS by regulating the gut microbiota via GDNF signaling, providing new insights for mechanistic research on EA in PI-IBS treatment.

S827 Global Insights: Glucagon-Like Peptide-1 Receptor Agonists are Linked to Gastrointestinal Functional Disorders ACG Outstanding Research Award in the Functional Bowel Disease Category (Trainee)

S827 Global Insights: Glucagon-Like Peptide-1 Receptor Agonists are Linked to Gastrointestinal Functional Disorders ACG Outstanding Research Award in the Functional Bowel Disease Category (Trainee)

The role of repetitive transcranial magnetic stimulation therapy in functional bowel disease.

This study investigates the effectiveness of repetitive transcranial magnetic stimulation (rTMS) as a biophysical therapy for alleviating symptoms of functional bowel disorder (FBD) and associated psychological symptoms by targeting the brain-gut axis. We conducted a comparative analysis involving 226 subjects, comprising the FBD group (n = 113) and a healthy control group (n = 113). Within the FBD group, participants were further divided into those who received rTMS therapy (FBD treatment group, n = 63) and those who did not (FBD control group, n = 50). The FBD treatment group was subcategorized based on the number of rTMS treatments received. We evaluated various factors, including gender, age, monthly household income, daily activity level, and sleep quality, as potential risk factors for FBD. Severity assessments of FBD and associated symptoms (constipation, anxiety, depression, and somatization disorders) were conducted using validated scales before and after treatment. Our findings revealed a higher incidence of FBD in women, with most cases emerging at age 50 or older. We identified lower monthly household income, reduced daily activity levels, and poorer sleep quality as factors associated with a higher likelihood of FBD. FBD patients exhibited higher scores for constipation, anxiety, depression, and somatization disorders compared to healthy controls. rTMS therapy was effective in reducing gastrointestinal symptoms, anxiety, depression, and somatization disorders among FBD patients. Notably, the extent of improvement was positively correlated with the number of rTMS sessions. No adverse effects were observed during the study. Our study underscores the efficacy of biophysical therapy, specifically repetitive transcranial magnetic stimulation, in mitigating FBD symptoms and associated psychological distress. The treatment's effectiveness is positively linked to the frequency of rTMS sessions.

The Effects of Artificial Sweeteners on Intestinal Nutrient-Sensing Receptors: Dr. Jekyll or Mr. Hyde?

The consumption of artificial and low-calorie sweeteners (ASs, LCSs) is an important component of the Western diet. ASs play a role in the pathogenesis of metabolic syndrome, dysbiosis, inflammatory bowel diseases (IBDs), and various inflammatory conditions. Intestinal nutrient-sensing receptors act as a crosstalk between dietary components, the gut microbiota, and the regulation of immune, endocrinological, and neurological responses. This narrative review aimed to summarize the possible effects of ASs and LCSs on intestinal nutrient-sensing receptors and their related functions. Based on the findings of various studies, long-term AS consumption has effects on the gut microbiota and intestinal nutrient-sensing receptors in modulating incretin hormones, antimicrobial peptides, and cytokine secretion. These effects contribute to the regulation of glucose metabolism, ion transport, gut permeability, and inflammation and modulate the gut-brain, and gut-kidney axes. Based on the conflicting findings of several in vitro, in vivo, and randomized and controlled studies, artificial sweeteners may have a role in the pathogenesis of IBDs, functional bowel diseases, metabolic syndrome, and cancers via the modulation of nutrient-sensing receptors. Further studies are needed to explore the exact mechanisms underlying their effects to decide the risk/benefit ratio of sugar intake reduction via AS and LCS consumption.

Therapeutic effects of curcumin on constipation-predominant irritable bowel syndrome is associated with modulating gut microbiota and neurotransmitters.

Constipation-predominant irritable bowel syndrome (IBS-C) is a functional bowel disease that affects 10-20% of the population worldwide. Curcumin (CUR) is widely used in traditional Chinese medicine to treat IBS, but its mechanism of action needs further investigation. In this study, we used mosapride (MOS) as a positive control to evaluate the changes in gut microbiota in IBS-C rat models after treatment with CUR or MOS by analyzing 16S rDNA variation. In addition, we used enzyme immunoassay kits and immunohistochemical analysis to investigate whether CUR or MOS influenced serotonin (5-HT), substance P (SP), and vasoactive intestinal peptide (VIP) levels in the serum and colon of IBS-C rats. The study showed that rats supplemented with CUR showed significantly increased fecal weight, fecal water content, small intestine transit rate and significantly decreased serum levels of 5-HT, VIP and SP compared to the IBS group (p < 0.05). In addition, treatment with CUR changed the relative abundance of Blautia, Sutterella, Acetanaerobacterium and Ruminococcus2 in the gut microbiota. This study showed that the efficacy of CUR on IBS-C was possibly by modulating the microbiota and lowering the serum levels of HT, SP, and VIP.

A Revitalising Approach towards Aging: Unveiling the Potential Use of Probiotics for Wellness in Elderly Populations

Probiotics have emerged as a potential alternative for treating various diseases affecting general population. Mounting data suggests that probiotics can be beneficial for older individuals, who often have weakened immune systems and are more susceptible to illnesses. Dysbiosis commonly occurs in elderly individuals, which is implicated as a major reason for various diseases. The effectiveness of probiotics is influenced by the specific strain and the dosage administered. Extensive studies have shown how probiotics affect prevalent issues, such as functional bowel diseases and other gastrointestinal disorders. Probiotics exert their effects by synthesizing different microbial peptides, such as bacteriocins, antibiotics, lipopolysaccharides, short-chain fatty acids, butyric acid, propionic acid and other specific secretory metabolites. The common probiotics that are found to benefit the health of elderly populations include Lactobacillus, Bifidobacterium lactis, Bacillus subtilis, Bifidobacterium longum and Bifidobacterium breve Further research is necessary to delve into the mechanism of action for both existing and novel probiotic strains for use in combating or aiding in diseases. Genetically, modified probiotics can be potentially used in the future to deliver immunity-restoring genes and as oral mode of vaccination in humans. Fecal microbiota transplantation has been gaining interest, used to restore gut conditions, and has also been linked to alleviating neurodegenerative diseases. The focus of this review was to present the available evidence on the immunomodulatory effects of probiotics in the elderly population; aiming to gain a better understanding of their mechanism of action and to assess the progress made in utilizing probiotics as therapeutic interventions.

Abdominal pain syndrome in patients with irritable bowel syndrome: features of selection of therapy

Irritable bowel syndrome (IBS) is an important social problem, since it is often diagnosed in people of young working age, significantly affects the quality of life of patients and causes economic damage to society. IBS is a chronic functional bowel disease, the main manifestation of which is pain combined with changes in bowel movements, frequency and character of stool. The mechanism of formation of abdominal pain syndrome is due to a disruption in the interaction along the brain-gut axis, which leads to changes in the regulation of intestinal motor function and the development of visceral hypersensitivity (VH). Abdominal pain as a manifestation of IBS is primarily associated with spasm of intestinal smooth muscles. The first-line drugs for pain relief are antispasmodics, which reduce the tone and contractility of intestinal smooth muscles, effectively coping with abdominal pain. The domestic pharmaceutical market is represented by different groups of muscle relaxants, among which calcium channel blockers are of particular relevance for patients with IBS. Representative of the latter is the drug Otilonium bromide, which is widely used throughout the world, is effective and safe, well tolerated and superior to placebo in reducing symptoms and preventing relapse of pain in patients with IBS. The effectiveness of otilonium bromide is due to a triple mechanism of action: blockade of calcium channels (relief of spasm), antagonism of tachykinone NK2 receptors (effect on HHV) and inhibition of acetylcholine muscarinic receptors (M3-ChR) (reduction of intestinal secretion). This article presents a short review of the literature on the causes and mechanism of development of pain in IBS, as well as the possibilities of its relief, primarily with the use of smooth muscle relaxants, namely otilonium bromide.

Intestinal Barrier and Gut Microbiota in Patients with Overlapping Irritable Bowel Syndrome and Functional Dyspepsia.

Disturbances in the intestinal barrier and gut dysbiosis have been observed in patients with functional bowel diseases. To investigate the correlation between biomarkers of intestinal barrier disorders at different layers and the severity of symptoms in patients with overlapping diarrhea-predominant irritable bowel syndrome and functional dyspepsia (IDFO), as well as with gut microbiota taxa. This study included 45 patients with IDFO and 16 healthy controls. Endoscopy with biopsy of the duodenum and sigmoid colon (SC) was performed to count intraepithelial lymphocytes (IELs) and mucosal eosinophils (subepithelial layer), assess fatty acid binding protein (FABP; epithelial layer) level, and stain for mucin-2 (MUC-2; pre-epithelial layer). Composition of the gut microbiota was evaluated using 16S rRNA gene sequencing. Patients with IDFO exhibited an increase in biomarkers of intestinal barrier disorders at all layers studied. IEL count in the duodenum was correlated with the severity of bloating (r = 0.336; p = 0.024) and, in the SC, was correlated with tenesmus severity (r = 0.303; p = 0.042). FABP-1 level in the SC was correlated with the severity of diarrhea (r = 0.577; p = 0.001), and FABP-5 concentration in the SC was correlated with abdominal distension (r = 0.477; p = 0.010). MUC-2 concentration in the duodenum was correlated with the severity of heartburn (r = 0.572; p = 0.025) and burning sensation in the epigastrium (r = 0.518; p = 0.048). All biomarkers of intestinal barrier permeability were correlated with the abundance of some gut microbiota taxa. Patients with IDFO exhibited disrupted intestinal barrier function in all layers, which was associated with clinical symptom severity and changes in the gut microbiota.

Impact of closed management on gastrointestinal function and mental health of Chinese university students during COVID-19

BackgroundThe innovative closed management of universities may have influenced the physical and mental health of students during the fourth stage of the COVID-19 pandemic in China. The study aimed to assess the gastrointestinal and mental health status of students in this stage and to explore the possible risk factors and mechanisms to provide a reference for future school responses to similar stressful events.MethodA multicenter, cross-sectional survey was administered to 598 college students from 10 Chinese universities. The study used the 7-item Generalized Anxiety Disorder Scale (GAD-7), 9-item Patient Health Questionnaire (PHQ-9), Fear of COVID-19 Scale (FCV-19 S), and the Diagnostic Tendency of Functional Bowel Disease Scale (DT-FBD) to evaluate anxiety, depression, fear of COVID-19 and likelihood of being diagnose diagnosed with functional bowel disease (FBD), respectively.ResultsA total of 516 college students completed the questionnaire. The proportions of students with more severe anxiety, more severe depression, greater fear of COVID-19, and a greater likelihood of being diagnosed with FBD were 49.8%, 57.0%, 49%, and 49%, respectively. These symptoms were significantly and positively correlated with the frequency of irregular sleep and eating (p < 0.05). Students in high-risk areas were more likely to experience anxiety and depression than students in areas with low/medium risk (odds ratio [OR] = 1.90, 95% confidence interval [CI]: 1.12–3.24, p = 0.017; OR = 2.14, 95% CI: 1.11–4.11, p = 0.022). A high likelihood of being diagnosed with FBD was positively associated with the severity of anxiety and depression symptoms and fear of COVID-19 (all p < 0.001). Moreover, mediation analysis revealed the following pathway in college students: fear of COVID-19 → depression and anxiety → poor diet → likelihood of being diagnosed with FBD.ConclusionCollege students generally exhibited higher more severe anxiety and depression symptoms and psychological symptoms with a greater higher propensity likelihood of being to be diagnosed with FBD. Good lifestyle habits, especially adequate sleep and a regular diet, can alleviate these problems. In addition, appropriate psychological intervention is very important.

Clinical application of transcranial magnetic stimulation for functional bowel disease.

Functional bowel disorder (FBD) is a common gastrointestinal disease syndrome characterized by dysmotility and secretion without known organic lesions. The pathogenesis of FBD is still unclear. In recent years, with the rise of neurogastroenterology, it has initially revealed its close relationship with the "brain-gut axis." Transcranial magnetic stimulation (TMS) is a technique for detecting and treating the nervous system, that is characterized by non-invasiveness and painlessness. TMS plays an important role in the diagnosis and treatment of diseases, and provides a new method for the treatment of FBD. In this paper, we summarized and analyzed the research progress of using TMS therapy applied to patients with irritable bowel syndrome and functional constipation by domestic and foreign scholars in recent years by means of literature search, and found that TMS therapy could improve the intestinal discomfort and accompanying mental symptoms in patients with FBD.

Overlap of some forms of functional pathology of organs of digestion in children

Introduction. In the adult population, a high prevalence of the gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS) can vary from 3 to 79%. As for children, there are a few works on the overlap between functional dyspepsia and IBS, GERD and functional constipation. &#x0D; Aim. To determine the prevalence of overlap of the GERD syndrome with irritable bowel syndrome and functional dyspepsia in school-age children. &#x0D; Materials and methods. The study included ninety eight cases including 71 boy and 27 girls, aged of 7 to 17 years (mean age 11.4 ± 2.1 years) suffered from erosive GERD. The comparison group consisted of 30 patients (11 boys and 19 girls), of mean age of 12.7 ± 1.8 years without erosive GERD). The criterion for inclusion in the main group was the presence of erosive changes in the esophagus according to fibrogastroduodenoscopy, in the comparison group the — manifestation of heartburn, with occurrence, at least twice a week over the past three months and the absence of erosive changes in the esophagus according to fibrogastroduodenoscopy. The exclusion criterion was the presence of organic pathology with sides of the upper (peptic ulcer, etc.) and lower parts of the digestive tract (ulcerative colitis, Crohn’s disease, etc.) &#x0D; Results. Every fourth GERD patient (25.8%) has an overlap with functional bowel diseases, while GERD is more often combined with IBS with diarrhea (15.6%) than IBS with constipation/functional constipation (10.2%). Overlap of IBS with postprandial distress syndrome is much less common — only in 7.0% of children. &#x0D; Conclusion. School-age GERD children are characterized by frequent overlap with functional bowel diseases, the frequency of which reaches 25.8%. The combination of all three diseases (IBS, GERD and postprandial distress syndrome) was observed in 2.3% of cases. These patterns are typical for patients with both erosive and non-erosive forms of GERD.

Current understanding on pathogenesis and effective treatment of glycogen storage disease type Ib with empagliflozin: new insights coming from diabetes for its potential implications in other metabolic disorders.

Glycogen storage type Ib (GSDIb) is a rare inborn error of metabolism caused by glucose-6-phosphate transporter (G6PT, SLC37A4) deficiency. G6PT defect results in excessive accumulation of glycogen and fat in the liver, kidney, and intestinal mucosa and into both glycogenolysis and gluconeogenesis impairment. Clinical features include hepatomegaly, hypoglycemia, lactic acidemia, hyperuricemia, hyperlipidemia, and growth retardation. Long-term complications are liver adenoma, hepatocarcinoma, nephropathy and osteoporosis. The hallmark of GSDIb is neutropenia, with impaired neutrophil function, recurrent infections and inflammatory bowel disease. Alongside classical nutritional therapy with carbohydrates supplementation and immunological therapy with granulocyte colony-stimulating factor, the emerging role of 1,5-anhydroglucitol in the pathogenesis of neutrophil dysfunction led to repurpose empagliflozin, an inhibitor of the renal glucose transporter SGLT2: the current literature of its off-label use in GSDIb patients reports beneficial effects on neutrophil dysfunction and its clinical consequences. Surprisingly, this glucose-lowering drug ameliorated the glycemic and metabolic control in GSDIb patients. Furthermore, numerous studies from big cohorts of type 2 diabetes patients showed the efficacy of empagliflozin in reducing the cardiovascular risk, the progression of kidney disease, the NAFLD and the metabolic syndrome. Beneficial effects have also been described on peripheral neuropathy in a prediabetic rat model. Increasing evidences highlight the role of empagliflozin in regulating the cellular energy sensors SIRT1/AMPK and Akt/mTOR, which leads to improvement of mitochondrial structure and function, stimulation of autophagy, decrease of oxidative stress and suppression of inflammation. Modulation of these pathways shift the oxidative metabolism from carbohydrates to lipids oxidation and results crucial in reducing insulin levels, insulin resistance, glucotoxicity and lipotoxicity. For its pleiotropic effects, empagliflozin appears to be a good candidate for drug repurposing also in other metabolic diseases presenting with hypoglycemia, organ damage, mitochondrial dysfunction and defective autophagy.

Integrated omics analysis reveals the epigenetic mechanism of visceral hypersensitivity in IBS-D.

Background and objective: IBS-D is a common functional bowel disease with complex etiology and without biomarker. The pathological and physiological basis of IBS-D focuses on visceral hypersensitivity. However, its epigenetic mechanism remains elusive. Our study aimed to integrate the relationship between differentially expressed miRNAs, mRNAs and proteins in IBS-D patients in order to reveal epigenetic mechanism of visceral hypersensitivity from transcription and protein levels and provide the molecular basis for discovering biomarkers of IBS-D. Methods: The intestinal biopsies from IBS-D patients and healthy volunteers were obtained for high-throughput sequencing of miRNAs and mRNAs. The differential miRNAs were selected and verified by q-PCR experiment followed by target mRNA prediction. Biological functions were respectively analyzed for target mRNAs, differential mRNAs and the previously identified differential proteins in order to explore the characteristic involved visceral hypersensitivity. At last, interaction analysis of miRNAs, mRNAs and proteins was performed for the epigenetic regulation mechanism from transcription and protein levels. Results: Thirty-three miRNAs were found to be differentially expressed in IBS-D and five of them were further confirmed, including upregulated hsa-miR-641, hsa-miR-1843, hsa-let-7d-3p and downregulated hsa-miR-219a-5p, hsa-miR-19b-1-5p. In addition, 3,812 differential mRNAs were identified. Thirty intersecting molecules were found from the analysis on the target mRNAs of miRNAs and mRNAs. Fourteen intersecting molecules were obtained from the analysis on the target mRNAs and proteins, and thirty-six intersecting molecules were identified from analysis on the proteins and different mRNAs. According to the integrated analysis of miRNA-mRNA-protein, we noticed two new molecules COPS2 regulated by hsa-miR-19b-1-5p and MARCKS regulated by hsa-miR-641. Meanwhile some critical signaling pathways in IBS-D were found such as MAPK, GABAergic synapse, Glutamatergic synapse, and Adherens junction. Conclusion: The expressions of hsa-miR-641, hsa-miR-1843, hsa-let-7d-3p, hsa-miR-219a-5p, and hsa-miR-19b-1-5p in the intestinal tissues of IBS-D patients were significantly different. Moreover, they could regulate a variety of molecules and signaling pathways, which were involved in the multifaceted and multilevel mechanism of visceral hypersensitivity of IBS-D.

Fecal Calprotectin Elevations Associated with Food Intolerance/Malabsorption Are Significantly Reduced with Targeted Diets.

Inflammatory bowel disease (IBD) involves two clinically defined entities, namely Crohn's disease and ulcerative colitis. Fecal calprotectin (FCAL) is used as a marker to distinguish between organic IBD and functional bowel disease in disorders of the irritable bowel syndrome (IBS) spectrum. Food components may affect digestion and cause functional abdominal disorders of the IBS spectrum. In this retrospective study, we report on FCAL testing to search for IBD in 228 patients with disorders of the IBS spectrum caused by food intolerances/malabsorption. Included were patients with fructose malabsorption (FM), histamine intolerance (HIT), lactose intolerance (LIT), and H. pylori infection. We found elevated FCAL values in 39 (17.1%) of 228 IBS patients with food intolerance/malabsorption and H. pylori infection. Within these, fourteen patients were lactose intolerant, three showed fructose malabsorption, and six had histamine intolerance. The others had combinations of the above conditions: five patients had LIT and HIT, two patients had LIT and FM, and four had LIT and H. pylori. In addition, there were individual patients with other double or triple combinations. In addition to LIT, IBD was suspected in two patients due to continuously elevated FCAL, and then found via histologic evaluation of biopsies taken during colonoscopy. One patient with elevated FCAL had sprue-like enteropathy caused by the angiotensin receptor-1 antagonist candesartan. When screening for study subjects concluded, 16 (41%) of 39 patients with initially elevated FCAL agreed to voluntarily control FCAL measurements, although symptom-free and -reduced, following the diagnosis of intolerance/malabsorption and/or H. pylori infection. After the initiation of a diet individualized to the symptomatology and eradication therapy (when H. pylori was detected), FCAL values were significantly lowered or reduced to be within the normal range.

Dietary Fiber Intake Influences Changes in Ankylosing Spondylitis Disease Status

The objectives of this study were to characterize dietary fiber (DF) intake in patients with ankylosing spondylitis (AS), to assess whether DF intake affects disease activity in AS, and to investigate the effect of DF intake on disease activity in AS in the context of functional bowel disease (FBD) symptoms. We recruited 165 patients with AS and divided them into two groups according to whether they had a high DF intake > 25 g/d to investigate the characteristics of people with high DF intake. Some 72 of the 165 AS patients (43%) met the criteria for high DF intake, which was more common in patients with negative FBD symptoms (68%). Data analysis revealed that DF intake was negatively associated with AS disease activity and did not differ statistically significantly from FBD symptoms. Multivariate adjusted models were used to explore the effect of DF intake on AS disease activity. ASDAS-CRP and BASDAI were stable and negatively correlated across models in both groups with and without FBD symptoms. Thus, DF intake positively affected disease activity in patients with AS. ASDAS-CRP and BASDAI were negatively correlated with DF intake.

Recurrent Lower Abdominal Pain, Altered Bowel Habits, and Malaise: Conservative or Surgical Approach to a Common Disorder

Recurrent Lower Abdominal Pain, Altered Bowel Habits, and Malaise: Conservative or Surgical Approach to a Common Disorder

Da li je fekalni kalprotektin pouzdan marker kod inflamatornih bolesti creva?

Introduction/Aim: Fecal calprotectin (FCP) is an S100 protein bio-marker used in diagnostic and monitoring algorithms of inflammato-ry bowel diseases (IBD). The role of FCP is established in differentiating inflammatory from functional bowel diseases, predicting relapse of IBD, and monitoring response to IBD therapy. The therapeutic strategy "treat-to-target" includes the normalization of laboratory biomarkers including FCP to attain mucosal healing (MH) as a result of effective Crohn's disease (CD) and ulcerative colitis (UC) treatment. Our research aimed to assess the relationship of FCP values in IBD patients with endoscopic and histological scores of disease activity. Material and methods: We performed a cross-sectional study at the Clinic for Gastroenterohepatology, University Clinical Center of Ser-bia, encompassing 223 diagnosed IBD patients (110 CD and 113 UC). The concentration of FCP was analyzed from the first morning stool. The endoscopic activity of IBD was evaluated using the endoscopic Mayo score for UC, Simple Endoscopic Score (SES-CD) for CD, and Rut-geerts score in case of a prior operation. The Geboes grading score was used to evaluate IBD histological activity. Due to discontinuous bowel involvement in CD, histopathological grading was limited. Results: Our results did not identify any statistically significant relationship between FCP and histological scores in patients with Crohn's disease (FCP median 950.98, PH median 3.57; p= 0.22). While FCP values did not show a correlation with the Rutgeerts score, we did observe a notable correlation between FCP and the SES-CD. In UC patients, values of FCP strongly correlated with endoscopic and his-tological grading (FCP median 1162.62, PH median 3.67; p = 0.011). Conclusion: FCP has shown to be a useful and reliable biomarker for assessing UC disease activity, while its applicability is restricted when it comes to CD.

Comorbidity of functional bowel disorders and obesity in terms of microbiome

Bacterial ecosystem of the gut plays a fundamental role in the normal functioning of the metabolic and immune systems. Functional bowel disease and obesity are highly prevalent in the population and place a heavy burden on healthcare system. Both comorbidity and multimorbidity are considered to be common for obesity and intestinal functional disorders. Changes in the microbiota can be both the cause and consequence of each disease: intestinal functional disorder changes the composition of the microbiota, resulting in obesity, and vice versa. Intestinal functional disorders and obesity are characterized by a similar type of dysbiosis.The aim of the review is to analyze the research findings available to date in order to establish the relationship between the gut microbiome, functional bowel disease and obesity. The researches have shown that patients with intestinal functional disorders have a different gut microbiome than healthy individuals. For intestinal functional disorders, the general patterns of the intestinal microbiota composition were described, and the characteristic taxonomic groups of bacteria were identified. On the other side, it must be noted that there is no clear correlation between intestinal functional disorders and obesity in terms of the microbiota. This can be explained by the high heterogeneity of intestinal functional disorders, as well as by the lack of a unified approach to creating a study design, by different sizes of population samples and also by different diagnostic criteria. The necessity to determine the criteria in the development of the design of future studies is discussed.

The use of a combined herbal remedy for some functional bowel diseases is the implementation of the concept of multitarget therapy

Aim of investigation: to evaluate the effectiveness and safety of the use of dietary supplement "Tummy ease" in the treatment of patients with functional constipation and IBS with a predominance of constipation. Materials and methods: The treatment of 33 patients was analyzed. 18 patients with FС (2 men and 16 women, mean age 50.6 ± 4.0 g) and 15 patients with IBS-C (2 men, 13 women, mean age 51.8 ± 4.5 years). Patients received Tummy ease 2-3 capsules/day for 28 days. The safety of treatment was assessed by the dynamics of biochemical parameters, the frequency and presence of side effects. To evaluate the effectiveness, we studied: the time of the carbolenic test, the dynamics of constipation symptoms according to the sum of points of the counting scale for assessing the severity of constipation and the PAC-SYM questionnaire, the dynamics of symptoms of the gastrointestinal tract according to the GIS questionnaire, the dynamics of quality of life according to the GSRS questionnaire. Results of the study: in patients with FC and IBS, there was a significant decrease in the symptoms of constipation (difficulty/pain during defecation, feeling of incomplete emptying, abdominal pain, time spent in the toilet, assistance with defecation, unsuccessful attempts to empty) and an increase in the frequency of defecation. According to the PAC-SYM questionnaire, patients with FC and IBS-C showed a significant decrease in abdominal discomfort, bloating, straining, feeling of incomplete emptying, defecation scarcity and difficulty, and the total symptom score. Patients with IBS-C additionally noted a decrease in abdominal pain, painful bowel movements and the number of false urges. The time of the carbolenic test significantly decreased in patients with FC from 49.4 ± 3.8 to 30.0 ± 2.3 hours (p = 0.00003), in patients with IBS-C from 62.7 ± 6.9 to 43.8 ± 6.4 hours (p= 0.002). In patients with FC and IBS-C, there was a significant positive dynamics of the symptoms of the gastrointestinal tract according to the GIS questionnaire and a significant improvement in the quality of life according to the GSRS questionnaire. Conclusion: The drug (BAA) Tummy ease is effective and safe in the treatment of patients with functional constipation and IBS-C and can be used as an alternative therapy.