Irritable Bowel Research Articles

Unveiling the intricacies of irritable bowel syndrome

Irritable bowel syndrome (IBS) remains a challenging condition both for patients and clinicians, characterized by its chronic nature and the elusive complexity of its underlying mechanisms. The multifaceted relationship between the neuroendocrine axis, gut microbiota, and inflammatory response has emerged as a focal point in recent research, offering new insights into the pathophysiology of IBS. The neuroendocrine axis plays a crucial role in maintaining the delicate balance between the brain and the gut, often referred to as the “gut-brain axis”. This bidirectional communication is essential for regulating gastrointestinal function, stress responses, and overall homeostasis. Dysregulation of this axis, as highlighted by elevated cortisol and serotonin levels in IBS patients, suggests that neuroendocrine imbalances may significantly contribute to the severity of gastrointestinal symptoms. These findings underscore the need for a broader understanding of how stress and emotional factors influence IBS, potentially guiding more effective, personalized treatment approaches. Equally important is the role of the gut microbiota, a diverse and dynamic ecosystem that directly impacts gut health. This dysbiosis disrupts gut function and appears to exacerbate the neuroendocrine and inflammatory responses. These findings align with the growing recognition that gut microbiota is a critical player in IBS, influencing both the disease's onset and progression.

Synthetic Biology-Enabled Engineering of Probiotics for Precision and Targeted Therapeutic Delivery Applications

Probiotics, defined as live microorganisms that offer health benefits when consumed in adequate amounts, have traditionally been used to maintain gastrointestinal (GI) health. They are effective in managing conditions such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and antibiotic-associated diarrhea. Recent research, however, has expanded their potential applications beyond the GI tract to include immune modulation, metabolic regulation, and mental health support. Despite these advances, conventional probiotics face limitations such as instability in harsh environments, lack of precise targeting, and ineffective control over drug release. This review explores the application of synthetic biology in addressing these limitations, emphasizing how tools such as CRISPR-Cas systems, synthetic gene circuits, and plasmid-based mechanisms enhance the stability, functionality, and specificity of engineered probiotics for therapeutic delivery. Applications of synthetic biology-enabled probiotics are examined across a range of health contexts, including GI health, cancer therapy, metabolic disorders, immune modulation, and mental well-being. Synthetic biology tools provide precise genetic modifications that improve the stability, viability, and functionality of engineered probiotics, enabling more targeted therapeutic delivery. Additionally, technologies such as encapsulation support probiotic survival, while gene circuits allow programmable, stimulus-responsive therapeutic release. As synthetic biology continues to advance, the development of programmable probiotics holds promise for personalized, targeted medicine, positioning probiotics as living therapeutics and patient-friendly alternatives to conventional therapeutic delivery systems.

Response of Irritable Bowel Syndrome to Abdominal Fat Reduction

Objectives: The study aimed to evaluate the response of Irritable Bowel Syndrome (IBS) among patients having central obesity to reducing abdominal fat using Focused Ultrasound (cavitation) in addition with aerobic exercise as well as a low calorie, low-FODMAPs diet. Methods: A total of 60 individuals, between the ages of 20 and 45, who were diagnosed with both irritable bowel syndrome (IBS) as well as abdominal obesity, having a body mass index (BMI) ranging from 30 to 39.9 kg/m², were divided into two groups of similar size by a random assignment process. Group A were given focused ultrasound cavitation accompanied by moderate aerobic exercise and a low calorie, low-FODMAPs diet over a period of three months, whereas Group B (control group) were given moderate aerobic exercise and a low calorie, low-FODMAPs diet only. Assessments of total body fat, abdominal fat, severity of IBS, as well as quality of life related to IBS were conducted prior to and after the study period. Results: Overall body fat mass, abdominal fat mass, IBS severity, and IBS quality of life were all significantly improved in both groups. All evaluated variables showed a highly significant improvement in favor of the study group when comparing the two groups. Conclusion: Focused Ultrasound (cavitation) in addition with aerobic exercise as well as a low calorie, low-FODMAPs diet cause more improvement of irritable bowel syndrome symptoms and quality of life.

Shared genetic architecture between COVID-19 and irritable bowel syndrome: a large-scale genome-wide cross-trait analysis

BackgroundIt has been reported that COVID-19 patients have an increased risk of developing IBS; however, the underlying genetic mechanisms of these associations remain largely unknown. The aim of this study was to investigate potential shared SNPs, genes, proteins, and biological pathways between COVID-19 and IBS by assessing pairwise genetic correlations and cross-trait genetic analysis.Materials and methodsWe assessed the genetic correlation between three COVID-19 phenotypes and IBS using linkage disequilibrium score regression (LDSC) and high-definition likelihood (HDL) methods. Two different sources of IBS data were combined using METAL, and the Multi-trait analysis of GWAS (MTAG) method was applied for multi-trait analysis to enhance statistical robustness and discover new genetic associations. Independent risk loci were examined using genome-wide complex trait analysis (GCTA)-conditional and joint analysis (COJO), multi-marker analysis of genomic annotation (MAGMA), and functional mapping and annotation (FUMA), integrating various QTL information and methods to further identify risk genes and proteins. Gene set variation analysis (GSVA) was employed to compute pleiotropic gene scores, and combined with immune infiltration algorithms, IBS patients were categorized into high and low immune infiltration groups.ResultsWe found a positive genetic correlation between COVID-19 infection, COVID-19 hospitalization, and IBS. Subsequent multi-trait analysis identified nine significantly associated genomic loci. Among these, eight genetic variants were closely related to the comorbidity of IBS and COVID-19. The study also highlighted four genes and 231 proteins associated with the susceptibility to IBS identified through various analytical strategies and a stratification approach for IBS risk populations.ConclusionsOur study reveals a shared genetic architecture between these two diseases, providing new insights into potential biological mechanisms and laying the groundwork for more effective interventions.

A machine learning approach to stratify patients with hypermobile Ehlers-Danlos syndrome/hypermobility spectrum disorders according to disorders of gut brain interaction, comorbidities and quality of life.

A high prevalence of disorders of gut-brain interaction (DGBI) exist in patients with hypermobile Ehlers-Danlos Syndrome (hEDS) and hypermobility spectrum disorders (HSD). However, it is unknown if clusters of hEDS/HSD patients exist which overlap with different DGBIs and whether this overlap influences presence of comorbidities and quality of life. We aimed to study these knowledge gaps. A prospectively collected hEDS/HSD cohort of 1044 individuals were studied. We undertook Uniform Manifold Approximation and Projection-enabled (UMAP) dimension reduction to create a representation of nonlinear interactions between hEDS/HSD and DGBIs, from which individuals were stratified into clusters. Somatization, Postural Tachycardia Syndrome (PoTS), autonomic symptoms, psychological factors and quality of life were statistically compared between clusters. The mean age of patients was 40 ± 13.2 years; 87.8% were female. Patients segregated into three clusters: Cluster 0 (n = 466): hEDS/HSD+ functional foregut disorders (FFD) + irritable bowel syndrome (IBS); Cluster 1 (n = 180): hEDS/HSD+ IBS and Cluster 2 (n = 337): hEDS/HSD alone. In cluster 0, we demonstrated increased somatization (p <0.0001), anxiety (p <0.0001), depression (p <0.0001), PoTS prevalence (p = 0.003), autonomic symptoms (p <0.0001) and reduced quality of life (p <0.0001) compared to cluster 2. Cluster 0 had greater comorbidity burden than cluster 1. Within hEDS/HSD, subgroups exist with a high prevalence of FFD and IBS. These subgroups have a higher prevalence of psychological disorders, dysautonomia and poorer quality of life compared with hEDS/HSD alone. Further research should focus on healthcare utilization, management and prognosis in hEDS/HSD and DGBI overlap.

Why Symptoms Linger in Quiescent Crohn's Disease: Investigating the Impact of Sulfidogenic Microbes and Sulfur Metabolic Pathways.

Even in the absence of inflammation, persistent symptoms in patients with Crohn's disease (CD) are prevalent and worsen quality of life. We previously demonstrated enrichment in sulfidogenic microbes in quiescent Crohn's disease patients with (qCD + S) vs without persistent GI symptoms (qCD-S). Thus, we hypothesized that sulfur metabolic pathways would be enriched in stool while differentially abundant microbes would be associated with important sulfur metabolic pathways in qCD + S. We performed a multicenter observational study nested within SPARC IBD. Quiescent inflammation was defined by fecal calprotectin level < 150 mcg/g. Persistent symptoms were defined by CD-PRO2. Active CD (aCD) and non-IBD diarrhea-predominant irritable bowel syndrome (IBS-D) were included as controls. Thirty-nine patients with qCD + S, 274 qCD-S, 21 aCD, and 40 IBS-D underwent paired shotgun metagenomic sequencing and untargeted metabolomic profiling. The fecal metabolome in qCD + S was significantly different relative to qCD-S and IBS-D but not aCD. Patients with qCD + S were enriched in sulfur-containing amino acid pathways, including cysteine and methionine, as well as serine, glycine, and threonine. Glutathione and nicotinate/nicotinamide pathways were also enriched in qCD + S relative to qCD-S, suggestive of mitochondrial dysfunction, a downstream target of H2S signaling. Multi-omic integration demonstrated that enriched microbes in qCD + S were associated with important sulfur metabolic pathways. Bacterial sulfur metabolic genes, including CTH, isfD, sarD, and asrC, were dysregulated in qCD + S. Finally, sulfur metabolites with and without sulfidogenic microbes showed good accuracy in predicting the presence of qCD + S. Microbial-derived sulfur pathways and downstream mitochondrial function are perturbed in qCD + S, which implicate H2S signaling in the pathogenesis of this condition. Future studies will determine whether targeting H2S pathways results in improved quality of life in qCD + S.

Substantial non-compliance of online pharmacy catalogues with guidelines.

Online pharmacies are popular worldwide. In Germany, there were 150 active online pharmacies in 2022. As the competition is therefore fierce and new customers need to be acquired, some of these online pharmacies create catalogues that advertise products in self-medication to attract the interest of potential customers. This study analyzed the allergy, cold, and gastrointestinal tract categories from the summer/spring 2023 catalogues of two different online pharmacies in Germany. A comparison of the active ingredients in both catalogues and an analysis of the product's conformity with the German AWMF (Association of the Scientific Medical Societies in Germany) guidelines as well as international guidelines were carried out. In medicine, guidelines serve as evidence-based decision-making aids tools to ensure adequate patient care. The online catalogue of online pharmacy 1 showed conformity of 65% with AWMF guidelines, and the online catalogue of online pharmacy 2 showed conformity of 59% with AWMF guidelines. The online catalogue of online pharmacy 1 showed conformity of 44% with international guidelines, and the online catalogue of online pharmacy 2 showed conformity of just only 17% with international guidelines. Thus, there is a substantial lack of conformity of online pharmacy self-medication catalogues with national and international guidelines. For several indication areas including market-relevant rhinosinusitis and irritable bowel syndrome, consensus between AWMF and international guidelines was poor. The lack of evidence-based presentation of online pharmacy catalogues constitutes a risk for consumer safety. This risk must be assessed in future studies, for example by studies on intoxications caused by self-medication that is non-compliant with guidelines. Our results also underline the necessity of a stricter surveillance of the German self-medication market.

Unveiling three accessory spleens in one patient: a rare case report and literature review.

During embryogenesis, the spleen undergoes intricate developmental processes, originating from mesenchymal cells in the dorsal mesentery. An accessory spleen, a common anomaly found in autopsies and abdominal CT scans, can often be mistaken for different types of tumors. To the best of our knowledge, this is the first case in Syria documenting the occurrence of 3 accessory spleens in a patient who had previously undergone splenectomy. A 33-year-old male presented with right hypochondrium pain, sharp and radiating to the right flank, exacerbated by movement and large meals. Past medical history included mild Irritable Bowel Syndrome (IBS) and splenectomy due to a traumatic accident in childhood. On admission, vital signs were stable, with abdominal tenderness in the right upper quadrant. Laboratory investigations showed normal values. Ultrasound revealed a lobulated mass at the right adrenal gland (4.5 × 5cm) with an isoechoic to hypoechoic texture. Multi-slice computed tomography (MSCT) Scan showed multiple nodules in the right adrenal gland, regular in shape, exerting a compressive mass effect, and significant lymphadenopathy around the abdominal aorta. Elevated metanephrine levels raised suspicion of an extra-adrenal pheochromocytoma. Laparoscopic surgery was performed, revealing accessory spleens and normal adrenal tissue with no malignancy. Healthcare providers should consider accessory spleens as a differential diagnosis for masses near the adrenal glands. Multiple accessory spleens in the adrenal region can complicate cases. Accessory spleens in uncommon locations like the adrenal glands can be challenging to diagnose and manage.

Looking Inside of the Intestinal Permeability Regulation by Protein-Derivatives from Bovine Milk.

The prime function of the epithelium is to regulate the intestinal permeability; the latter is a quantitative parameter that refers to the measurement of the rate of passage of solutes through the epithelial monolayer. Function of epithelial monolayer depends on the expression of protein complexes known as tight junction proteins; whose function and expression can be disrupted under conditions of inflammation including irritable bowel disease (IBD), intestinal infections, and high-fat diets, among others. This manuscript is focused to outline the effects of bovine milk protein derivatives on the intestinal permeability addressed mostly in animal models in which the intestinal barrier is disrupted. At present, the properties of bovine milk protein derivatives on intestinal permeability have been scarcely documented in humans, but evidence raised from clinical trials provides promising findings of potential application of colostrum to control of the intestinal permeability in critically ill patients, users of non-steroid anti-inflammatory drugs, like athletes and militia members.

Pomegranate Peel Extract Mitigates Diarrhea-Predominant Irritable Bowel Syndromes via MAPK and NF-κB Pathway Modulation in Rats

Background: Diarrhea-predominant irritable bowel syndrome (IBS-D) is a common chronic functional gastrointestinal disorder that causes diarrheal and intestinal barrier disruptions. Although pomegranate peel extract (PPE) has been reported for the treatment of diarrheal and intestinal inflammation, its effectiveness and mechanisms specifically for the treatment of IBS-D remain unknown. Objectives: This study aimed to explore the therapeutic effect of PPE on IBS-D and elucidate its underlying mechanisms. Methods: A high-fat diet, restraint stress, and senna gavage were combined to establish a rat model mimicking IBS-D, to evaluate the therapeutic effects of PPE. Network pharmacology analysis, serum medicinal chemistry, and transcriptomics were employed to investigate potential downstream signaling pathways. Findings were further validated through molecular docking and Western blot analysis. Results: The findings revealed that PPE significantly improved the symptoms of IBS-D, ameliorated intestinal inflammation, and promoted intestinal barrier function. The target genes in the MAPK and NF-κB signaling pathways were significantly enriched and down-regulated. Molecular docking and Western blot assays were performed to verify that PPE had a high affinity for the protein candidates in these pathways, and significantly down-regulated the expression of p-IκB, p-p65, p-JNK, p-p38, and p-ERK1/2. Conclusions: The present study is the first to demonstrate that PPE alleviates diarrheal and intestinal damage in IBS-D, potentially by inhibiting MAPK and NF-κB signaling pathways. These findings suggest that PPE may provide a novel therapeutic option for IBS-D.

Impact of low FODMAP sourdough bread on gut microbiota using an in vitro colonic fermentation model

This study explores the development of whole-grain sourdough bread with reduced FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) content to offer dietary solutions for individuals with irritable bowel syndrome (IBS). Three sourdough breads were prepared using different lactic acid bacteria (LAB) strains including Lactiplantibacillus plantarum FST1.7 (SD-FST1.7), Lacticaseibacillus paracasei R3 (SD-R3), and Pediococcus pentosaceus RYE106 (SD-RYE106). A control sourdough bread was prepared using baker’s yeast (SD-control). In vitro digestion and in vitro colonic fermentation were employed on bread samples with cellulose (negative control) and inulin (positive control), followed by 16S rRNA sequencing and short-chain fatty acid (SCFA) analysis to evaluate the impact on gut microbiota and SCFA levels. Alpha and beta diversity did not reveal any significant differences within the groups following in vitro colonic fermentation (FDR &amp;gt; 0.05). Taxonomic analysis displayed Firmicutes as the predominant phylum across all fecal samples at the end of colonic fermentation. Actinobacteriota was significantly lower in cellulose fermented fecal samples compared to samples fermented with SD-Control (ANCOMBC, FDR = 0.02) and inulin (ANCOMBC, FDR = 0.0001). Fecal samples fermented with inulin had significantly higher Bacteroidota levels compared to those fermented with cellulose (ANCOMBC, FDR =0.002). Acetate levels were higher in fecal samples fermented with SD-FST1.7 compared to those fermented with SD-R3 and SD-RYE106 (p = 0.03 for both). Positive correlations between butyrate and Lachnospira, Agathobacter, and Bifidobacterium were observed, demonstrating the potential of sourdough fermentation to influence gut health and support IBS management.

Comparisons of different electrical stimulation modalities for treating visceral pain in a rodent model of irritable bowel syndrome

The purpose of this study was to investigate the effects of different electrical stimulation methods (bilateral electroacupuncture (BEA), unilateral EA (UEA), transcutaneous electrical acustimulation (TEA, stimulation via surface electrodes placed at acupoints), and sacral nerve stimulation (SNS)) on visceral pain in a rodent model of irritable bowel syndrome (IBS). Ten-day-old male and female pups were treated with 0.2 ml of 0.5% acetic acid (AA) solution. Visceral sensitivity was assessed using an electromyogram (EMG) in response to graded colorectal distension. In the first experiment, bilateral EA at ST36 acupoint was performed with different parameters in male rats to determine the best stimulation parameters. In the second experiment, male rats were randomly assigned into the Sham, BEA, UEA, TEA, and SNS groups to determine the best stimulation method. Lastly, the AA-treated female rats were randomly assigned into the BEA and sham groups to investigate a potential treatment difference between the sexes. Two distinct sets of stimulation parameters were used: Set 1 (100 Hz, 0.5 ms pulse width, 0.1 s ON, 0.4 s OFF, 0.4–3.0 mA current) and Set 2 (25 Hz, 0.5 ms pulse width, 2 s ON, 3 s OFF, 0.4–3.0 mA current).Results (1) The parameter set of 100Hz was found to be most effective in reducing visceral pain. (2) Both acute UEA and TEA effectively relieved visceral pain, whereas acute SNS did not exhibit such an effect. (3) Acute BEA improved visceral pain in both male and female rats.Conclusions These findings suggest that transcutaneous ST36 stimulation is as effective as direct ST36 stimulation and unilateral ST36 stimulation is comparable to bilateral stimulation. Development of a novel therapy using unilateral transcutaneous ST36 stimulation is warranted.

The cellular-differential composition of the intestinal epithelium in various phases of inflammatory bowel diseases

BACKGROUND: The steady increase in the number of inflammatory bowel diseases and the absence of reliably significant diagnostic markers require the search for new morphological criteria for differential diagnosis. AIM: This study aimed to determine the cellular-differential composition of the intestinal epithelium in the phases of exacerbation and remission in Crohn’s disease and ulcerative colitis. MATERIALS AND METHODS: Tissue samples of 60 patients with inflammatory bowel diseases (Crohn’s disease, n=30; ulcerative colitis, n=30) and with irritable bowel syndrome (control group, n=15) were studied using histological, immunohistochemical, morphometric and statistical methods. RESULTS: Distinct features of the cellular-differential composition of the epithelium in the mucous membrane of the ileum, ascending colon, sigmoid colon, and rectum were identified across these conditions, with differences observed during exacerbation and remission in inflammatory bowel diseases. The proportion of goblet cells in the epithelial lining varied by intestinal region and disease type and phase. Goblet cell differentiation: 25.0% more goblet cells of the superficial epithelium between the crypts of the ileum in acute Crohn’s disease compared with remission (p=0.0002); 42.9% more goblet cells in the superficial epithelium of the ascending colon compared with irritable bowel syndrome (p=0.0001); 23.0% more goblet cells crypt in the sigmoid colon compared with ulcerative colitis in the acute stage (p=0.0024). There were no significant differences in the differentiation of Paneth cells. There was a threefold increase in endocrinocytes in the sigmoid colon in acute Crohn’s disease compared with irritable bowel syndrome (p=0.0238). Nonepithelial differon cells: fewer interepithelial lymphocytes in Crohn’s disease in remission compared with Crohn’s disease in the acute stage by 2.4 times in the sigmoid colon, 4.0 times in the rectum (p 0,0001); compared with irritable bowel syndrome by 4.8 times in the ileum, 2.7 times in the ascending intestine, 4.0 times in the sigmoid colon (p 0,05); 8.0 times in the rectum compared with ulcerative colitis in remission (p=0,0004). Additionally, the study found proliferative activity of crypt cells (mainly goblet-shaped) increased by 4.2 times in the sigmoid colon in acute Crohn’s disease compared with acute ulcerative colitis (p=0,0016). CONCLUSIONS: Morphometric parameters of the cellular-differential composition of the intestinal epithelium can serve as potential differential diagnostic criteria. Acute Crohn’s disease is characterized by a higher proliferation index in the sigmoid colon compared with acute ulcerative colitis, while Crohn’s disease in remission shows a lower number of interepithelial lymphocytes in the rectum compared with ulcerative colitis in remission.

Perspectives on the sustained engagement with digital health tools: protocol for a qualitative interview study among people living with Inflammatory Bowel Disease or irritable bowel syndrome

IntroductionDigital health tools can be beneficial in the care of patients with chronic conditions and have the potential for widespread impact as readily scalable and cost-effective health interventions. However, benefits...

Efficacy of Nigella sativa seed oil against psychophysical stress induced irritable bowel syndrome and anxiety-like symptoms in Wistar rats.

Stressors play a critical role in the progression of irritable bowel syndrome (IBS). Heterogenous stress causes alterations in our bowel movements which can further cause anxiety and depression-like symptoms, decreasing the ability of individuals worldwide to function in social, academic, and employment settings. This study was aimed to investigate the effect of orally administered Nigella sativa (0.2mL/kg b.wt.) seed oil (NSSO) on stress-induced IBS, anxiety, and depression-like symptoms in Wistar rats. In the present study, modelling IBS induced anxiety and depression-like symptoms in rodents have been employed to correlate the pathophysiological mechanisms behind this disorder. Moreover, evaluation of ameliorative potential of traditionally used NSSO in IBS was also carried out. Present investigation indicated that acute stress of 1.5h daily for 20days induced hyper cortisol, gastrointestinal (GI) hypermotility, diarrhoea, altered levels of short chain fatty acids (SCFAs), and inflammation which are common symptoms of IBS. Furthermore, depression and anxiety-like symptoms were validated in test groups by various behavioral tests and decreased levels of 5-HT-Transporter mRNA gene expression, which are clear indicators of cognitive impairment. It is possible that these IBS-like symptoms may have contributed to the pathogenesis of cognitive deficits and depression. However, the anti-oxidative, anti-inflammatory, anti-spasmodic, and possibly the anti-anxiolytic properties of NSSO helped in the mitigation of altered gut-brain axis. Because the concurrent treatment of NSSO alleviated the symptoms of modified GI function and consequently, the anxious & depressive behavior of the animals. Overall, this research explored the protective efficacy of NSSO against stress-induced IBS and depression-like symptoms, shedding light on the potential of this natural compound as a therapeutic option in the field of gastroenterology and psychiatry.

Multiple Aspects of Irritable Bowel Syndrome and the Role of the Immune System: An Overview of Systematic Reviews with a Focus on Polyphenols

Irritable bowel syndrome (IBS) is a complex and often debilitating condition that significantly impacts the gastrointestinal system and the overall quality of life of those affected. IBS is characterized by a variety of distressing symptoms, including cramping, abdominal pain, and irregular bowel movements, underlined by an intricate interplay of immune system dysfunction in its pathology. Numerous studies highlight an increased cellular immune response, with elevated levels of proinflammatory cytokines, mucosal alterations due to immune imbalance, and visceral hypersensitivity. Notably, studies indicate increased levels of proinflammatory cytokines, immune imbalances that lead to mucosal changes, and heightened visceral sensitivity. The roles of effector and regulatory T cells are particularly intriguing, as their modification appears to amplify inflammation and may even contribute to autoimmune disorders. This overview of systematic reviews explores the connections between IBS and immune responses, with a focus on immune cell alterations and proliferation of lymphocytes and mast cells in affected individuals. Furthermore, we explore various aspects of IBS management, including its pharmacological approaches. A systematic search of PubMed and Web of Science yielded 676 articles, which were ultimately narrowed down to 9 key studies that met our inclusion criteria. These studies collectively underscore the activation of the immune system with the degranulation of the mast cells in patients with IBS, where the release of inflammatory mediators can compromise intestinal permeability, exacerbating symptoms further. Additionally, we examine the multifaceted management strategies for IBS, emphasizing the potential therapeutic benefits of dietary polyphenols as antioxidants. The present study aims to enhance our understanding of IBS and offer insights into more effective treatment strategies for this challenging condition.

Anxiety and Depression Among Patients With Irritable Bowel Syndrome in Hail, Saudi Arabia: Towards a Better Understanding of the Psychological Role

Anxiety and Depression Among Patients With Irritable Bowel Syndrome in Hail, Saudi Arabia: Towards a Better Understanding of the Psychological Role

Microbiota alterations are related to migraine food triggers and inflammatory markers in chronic migraine patients with medication overuse headache

ObjectiveChronic migraine (CM) patients with medication overuse headache (MOH) were recently shown to be associated with leaky gut and inflammation. We aimed to investigate gut microbiota profiles of CM patients with MOH, and their correlations with inflammatory serum parameters, migraine food triggers, and comorbid anxiety and depression.Materials and methodsThe study included women participants (32 CM patients with NSAID overuse headache, and 16 healthy non-headache sufferers). Migraine duration, monthly migraine headache days, presence of irritable bowel syndrome symptoms, and HADS-D and HADS-A scores were recorded. Serum samples were collected to measure circulating LPS, HMGB1, HIF-1α, and IL-6. The gut microbiota profiles of the patients were evaluated using fecal samples.ResultsSerum LPS, HMGB1, HIF-1α, and IL-6 levels were significantly higher in the CM + MOH group compared to the healthy controls. HADS-A and HADS-D scores were considerably higher in the CM + MOH group compared to the healthy controls. In the microbiota analysis, alpha and beta diversities were similar between the two groups. The class Clostridia, the order Eubacteriales, and the genus Ruminococcus were less abundant in the CM + NSAID overuse headache group compared to the control group. At the genus level Desulfovibrio, Gemmiger, and Dialister and at the species level, Clostridium fessum, Blautia luti, Dorea longicatena, Eubacterium coprostanoligenes, and Gemmiger formicilis were more abundant in the CM + NSAID overuse headache group compared to the control group. Desulfovibrio, Gemmiger, Dialister, Ethanoligenens harbinense, Eubacterium coprostanoligenes, Dorea longicatena, and Thermoclostridium stercorarium showed positive correlations and Clostridia bacteria showed negative correlations with migraine food triggers. Positive correlations were found between LPS and Hapalosiphonaceae, HMGB1 and Melghirimyces, HIF1-α and Rouxeilla and Blautia luti, IL-6 and Melghirimyces and Ruminococcus.ConclusionIn CM patients with MOH, we have revealed the presence of dysbiosis towards an inflammatory state, and positive correlations were shown between altered gut microbiota and inflammatory serum parameters and migraine food triggers.

Holistic approaches to living well with endometriosis

Endometriosis is a common chronic non curable neuro-inflammatory condition, which can cause endometriosis-related pelvic pain (ERPP). Sufferers may struggle with side effects and/or risks from conventional medical and surgical treatments, or not get pain relief. Increasing numbers of endometriosis patients wish to explore holistic management with fewer side effects, however it is important that medical professionals maintain an evidence-based practice for recommended treatments. We present up-to-date evidence of holistic strategies used for managing ERPP including nutrition, body and mind therapies, acupuncture, traditional Chinese medicine (TCM) and the use of adjunct devices such as phallus length reducers and transcutaneous electrical nerve stimulation (TENS). Recent findings: Nutrition: Gluten-free, low-nickel and high intake of omega-3 polyunsaturated fatty acids diets improve ERPP. Low FODMAP (fermentable oligo-, di-, monosaccharides and polyols), plant-based diet and antioxidant vitamin supplementation is helpful including those with concurrent irritable bowel syndrome. Body and Mind: Cognitive behaviour therapy (CBT) is beneficial in postoperative pain reduction, whilst mindfulness has been shown to reduce pain scores and dyschezia. Progressive muscle relaxation therapy and regular yoga sessions improve ERPP and Quality of life. Acupuncture: Acupuncture and moxibustion show improved pain scores compared to conventional therapies alone. Adjunct devices: TENS improves deep dyspareunia and reduces the number of days pain is experienced. Summary: Holistic management strategies for ERPP should be incorporated into routine counselling when discussing conservative, medical and or surgical treatments for endometriosis. The growing evidence presented for the use of holistic management strategies gives hope to those patients who cannot have, or don’t respond to conventional approaches and as an adjunct alongside standard treatments. These findings should be incorporated into the routine counselling when seeing patients in the gynaecology outpatient setting presenting with chronic pelvic pain.

StepFit-18K: Improving Irritable Bowel Syndrome (IBS) Symptoms with a Simple, Structured Walking Intervention

StepFit-18K: Improving Irritable Bowel Syndrome (IBS) Symptoms with a Simple, Structured Walking Intervention