Stool Consistency Research Articles

AI-Driven Defecation Analysis by Smart Healthcare Toilet: Exploring Biometric Patterns and Eu-Tenesmus.

Defecation, a fundamental physiological process, remains underexplored despite its importance in human health. To address this gap, a smart toilet system is developed that enables real-time monitoring of defecation behaviors. Analyzing 45 defecation events from 11 participants, key defecation parameters are identified, including stool dropping duration, stool thickness, and eu-tenesmus interval. Stool dropping duration follows a log-normal distribution, with longer durations (>5s) linked to lower Bristol Stool Form Scale (BSFS) scores, suggesting constipation (p=0.008 for BSFS1/2/3vs BSFS5/6/7). Stool thickness decreases with increasing BSFS scores (p=5×10⁻⁶ for BSFS1/2/3vs BSFS5/6/7), validating its role as an objective marker for bowel function. Eu-tenesmus is introduced, defined as the interval between the last stool drop and cleansing, averaging 74.8 s. It shows significant gender differences (p=0.014) but no correlation with stool consistency, suggesting its potential as an independent biomarker for gut health. Defecation behaviors between humans and animals is also compared in detail. Longitudinal monitoring demonstrates the potential for personalized health tracking and dietary recommendations. Furthermore, the feasibility of biometric identification is established using 11 defecation-related parameters, including stool properties and cleansing behavior. These features enable high participant differentiation, supporting non-invasive identity verification.

Effect of an 8-Week Bifidobacterium lactis HN019 Supplementation on Functional Constipation: A Multi-Center, Triple-Blind, Randomized, Placebo-Controlled Trial.

Functional constipation (FC) is characterized by difficult, infrequent, or incomplete bowel movements without clear physiological cause. Daily intake of Bifidobacterium lactis HN019 has been shown to reduce colonic transit time or increases bowel movement frequency in 2-4 weeks interventions. This triple-blind, randomized, placebo-controlled clinical trial assessed the effect of 8 weeks HN019 supplementation on complete spontaneous bowel movement (CSBMs) in adults with FC (diagnosed by Rome III criteria). Furthermore, stool consistency, degree of straining, abdominal pain severity, bloating severity, PAC-SYM, PAC-QoL, and use of rescue medication were assessed. Participants were screened at four clinical units in France for 2 weeks to confirm eligibility: no safety concerns, ≤3 CSBMs/week (recorded in daily diaries), followed by an 8-week intervention with daily supplementation of HN019 or placebo. HN019 was not found to be superior in managing FC compared to placebo. Fecal samples were collected from 50% of the participants for analyses of moisture content, microbiota, microbial metabolites, and calprotectin. These did not show any significant differences between the groups. This study did not support the expected effect of HN019 on improving CSBM frequency in participants with FC. No safety concerns related to B. lactis HN019 supplementation were identified. Trial Registration: ClinicalTrial.gov: NCT04231162.

Functional Foods in Gastrointestinal Health: The Role of Moringa, Artichoke, and Welsh Onion in Managing Diarrhea

ABSTRACTBackground and AimDiarrhea is a prevalent gastrointestinal disorder with significant global health implications, often associated with disruptions in intestinal motility, barrier function, and fluid homeostasis. This study investigates the anti‐diarrheal potential of three medicinal plants: Moringa oleifera, Cynara scolymus (artichoke), and Allium fistulosum (Welsh onion) sourced from organic farms in Tunisia, ensuring high‐quality, pesticide‐free material for experimental investigation in a rat model of castor oil–induced diarrhea.MethodsThe plants were evaluated for their dietary fiber, mineral, and fatty acid composition to elucidate their biochemical properties. Wistar rats were treated with plant‐based formulations before exposure to castor oil. Diarrhea severity, stool frequency, and intestinal motility were assessed. Biochemical analyses included oxidative stress markers and inflammatory cytokines, while histological examinations were performed to assess gut integrity.ResultsAll three plants demonstrated significant anti‐diarrheal effects, with reductions in stool frequency, improved stool consistency, and modulation of gut motility. Biochemical analyses revealed enhanced antioxidant activity and suppression of pro‐inflammatory cytokines, correlating with improved gut epithelial integrity. Moringa oleifera was particularly rich in potassium and magnesium, which are essential for fluid balance, while Cynara scolymus exhibited potent polyphenolic activity. Allium fistulosum provided a unique fatty acid profile that strengthened the gut barrier and mitigated inflammation.ConclusionThis study highlights the synergistic potential of Moringa oleifera, Cynara scolymus, and Allium fistulosum in alleviating diarrhea by targeting multiple pathological pathways, including oxidative stress, inflammation, and electrolyte imbalance. These findings support the development of plant‐based functional foods and nutraceuticals as innovative strategies for managing gastrointestinal disorders.

Nutrition in Inflammatory Bowel Disease: Strategies to Improve Prognosis and New Therapeutic Approaches

Inflammatory Bowel Disease (IBD), encompassing Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic inflammatory condition of the gastrointestinal tract that significantly impacts nutritional status. Malnutrition is a frequent complication, resulting from reduced nutrient intake, malabsorption, and increased metabolic demands due to chronic inflammation. A comprehensive nutritional assessment encompassing anthropometric, biochemical, and dietary evaluations is crucial for informing personalized interventions. Several nutritional approaches have been explored to modulate inflammation and the gut microbiota, yielding promising results. The Mediterranean, anti-inflammatory, and low-FODMAP diets have shown potential benefits in symptom control. In contrast, diets high in ultra-processed foods and saturated fats are associated with worsened disease activity. Additionally, stool consistency, assessed using the Bristol Stool Scale, serves as a practical indicator for dietary adjustments, helping to regulate fiber intake and hydration strategies. When dietary modifications alone are insufficient, nutritional support becomes a critical component of IBD management. Enteral nutrition (EN) is preferred whenever possible because it maintains gut integrity and modulates immune responses. It has demonstrated efficacy in reducing postoperative complications and improving disease control. In cases where EN is not feasible, such as in intestinal obstruction, severe malabsorption, or high-output fistulas, parenteral nutrition (PN) is required. The choice between peripheral and central administration depends on treatment duration and osmolarity considerations. Despite growing evidence supporting nutritional interventions, further research is needed to establish standardized guidelines that optimize dietary and nutritional support strategies in managing IBD.

Anti-Inflammatory Effects of Spexin on Acetic Acid‑Induced Colitis in Rats via Modulating the NF-κB/NLRP3 Inflammasome Pathway.

Ulcerative colitis is a chronic inflammatory bowel disease characterized by inflammation and ulcers in the lining of the colon and rectum. Spexin is a novel peptide with antioxidant and anti-inflammatory properties. This study aims to elucidate the therapeutic effects and underlying mechanisms of spexin in mitigating acetic acid-induced colitis in rats. Male Sprague Dawley rats were assigned to control (n = 14) and colitis (n = 21) groups. Colitis was induced via 5% acetic acid (AA) administration (1 mL, intrarect). Post-induction, rats received subcutaneous saline (1 mL/kg), spexin (50 µg/kg/day), or oral sulfasalazine (500 mg/kg) for 5 days. Control groups received saline or spexin. After 24 h of the final treatment, colons were evaluated macroscopically, and levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-18 were determined by ELISA, oxidative stress markers myeloperoxidase (MPO), malondialdehyde (MDA) and glutathione (GSH) levels were measured spectrophotometrically and NOD-like receptor pyrin domain-containing 3 (NLRP3), nuclear factor-κB (NF-κB), caspase-1 proteins were analyzed with Western Blot alongside histopathological assessments. Colitis induction significantly elevated macroscopic damage scores, stool consistency, inflammatory cytokines, MDA, MPO, and NLRP3, NF-κB, caspase-1, while reducing GSH levels (p < 0.001-0.01). Microscopic evaluations confirmed increased necrosis, submucosal edema, and inflammatory cell infiltration (p < 0.001). Spexin reversed these effects by enhancing GSH levels (p < 0.01), reducing macroscopic/microscopic scores, cytokines, MDA, and MPO levels (p < 0.05-0.001), and suppressing NLRP3, NF-κB, and caspase-1 activation (p < 0.01-0.001). For the first time that spexin ameluates acetic acid-induced colitis in rats by modulating the NF-κB/NLRP3 signaling pathway, reducing oxidative damage, enhancing antioxidant capacity, and suppressing inflammation.

Challenges and insights in detecting early inflammation in DSS-induced colitis using chemiluminescence.

Ulcerative colitis (UC) is a complex inflammatory condition with limited non-invasive tools to monitor early-stage inflammation. This study aimed to investigate the early stages of inflammation in acute and chronic murine models of dextran sulfate sodium (DSS)-induced colitis using in vivo and ex vivo chemiluminescence imaging. Two DSS-induced colitis models were used: an acute model over 7days and a chronic model over 6weeks. Body weight, stool consistency, and fecal occult blood (FOB) tests were monitored. Chemiluminescence imaging was used to assess inflammation in vivo and ex vivo, complemented by colonoscopy in the chronic model. In the acute model, DSS-treated mice exhibited weight loss, colon shortening, and positive FOB tests by day 7. Ex vivo chemiluminescence signals exhibited a significant increase as early as day 5 (p < 0.001), while in vivo imaging showed minimal changes. In the chronic model, periodic DSS exposure resulted in recurrent inflammation, with positive FOB tests and significantly elevated ex vivo and in vivo chemiluminescence signals during the final DSS cycle (p < 0.05). Colonoscopy confirmed inflammation progression. This study demonstrates the progression of inflammation in acute and chronic colitis models. However, in vivo chemiluminescence imaging did not reliably detect the onset of inflammation, limiting its application for early-stage disease detection. Ex vivo chemiluminescence and FOB tests provided more consistent insights into inflammation dynamics, addressing the need for improved non-invasive monitoring tools in UC research.

Association Between Caffeine Intake and Stool Frequency- or Consistency-Defined Constipation: Data From the National Health and Nutrition Examination Survey 2005-2010.

The association between caffeine intake and constipation remains inconclusive. This study aims to investigate whether caffeine intake is associated with constipation. This cross-sectional study included 13 941 adults from the 2005-2010 National Health and Nutrition Examination Survey. The weighted logistic regression analyses were exerted to evaluate the association between caffeine intake and constipation. Besides, stratified analyses and interaction tests were conducted to determine the potential modifying factors. After adjusting for confounders, increased caffeine intake by 100 mg was not associated with constipation, as defined by stool frequency (OR, 1.01; 95% CI, 0.94-1.10) or stool consistency (OR, 1.01; 95% CI, 0.98-1.05). Subgroup analyses showed that cholesterol intake modified the relationship between increased caffeine by 100 mg and stool frequency-defined constipation (P for interaction = 0.037). Each 100 mg increase in caffeine intake was associated with a 20% decreased risk of constipation defined by stool frequency in participants who consumed high cholesterol (OR, 0.80; 95% CI, 0.64-1.00), but no association in the other 2 cholesterol level groups. Furthermore, the association between caffeine intake and stool consistency-defined constipation was not found in different cholesterol groups. Caffeine consumption is not associated with stool frequency or consistency-defined constipation. Nevertheless, increased caffeine intake may decrease the risk of constipation (defined by stool frequency) among participants in the high-cholesterol intake group.

Efficacy and quality of life in laparoscopic right hemicolectomy with different extent of lymph node dissection

Objective: To investigate the efficacy of laparoscopic right hemicolectomy using the left edge of the superior mesenteric artery (SMA) as the medial boundary for lymph node dissection, and its impact on patients' quality of life. Methods: Patients were included who had been clearly diagnosed with primary right colon cancer (located in the ileocecal region, ascending colon, and hepatic flexure of the colon) through endoscopic histopathological examination, were aged 80 years or younger, had completed laparoscopic complete mesocolic excision plus D3 radical resection for right colon cancer, and had complete quality of life assessments and follow-up records.A retrospective cohort study method was used. Clinical data of patients undergoing laparoscopic right hemicolectomy at Shengjing Hospital of China Medical University from January 2018 to December 2022 were collected.Based on the different medial boundaries of lymph node dissection, patients were divided into an arterial group (bounded by the left edge of the SMA, 119 cases) and a venous group (bounded by the left edge of the superior mesenteric vein, 89 cases).There were no statistically significant differences in baseline characteristics between the two groups (all P>0.05), and use theQuality of Life Questionnaire for Colorectal Cancer - 38 (QLQ-CR38) and the Diarrhea Assessment Scale(DAS)to evaluate the quality of life and diarrhea of patients one month, three months, and six months after surgery. Results: Compared with the venous group, more lymph nodes were dissected at the third station than in the arterial group (4.2±2.0 vs. 3.3±1.6, t=3.320, P<0.001). Additionally, the rates of positive lymph nodes at the third station (10.9% [13/119] vs. 3.4% [3/89], χ2 =2.007, P=0.038) and the rates of positive lymph nodes at the third station among patients with Stage III disease (32.5% [13/40] vs. 8.6% [3/35], χ2=2.507, P=0.012) were both significantly higher in the arterial group. These differences are all statistically significant (P<0.05). There were no significant differences in the other perioperative data assessed between the two groups (all P<0.05). Application of generalized estimating equation analysis showed statistically significant differences between the two groups in terms of timing of gastrointestinal issues (P=0.024) and defecation problems (P<0.001). Further simple effects analysis of each of the assessed variables revealed that, one month after surgery, patients in the venous group had significantly less severe gastrointestinal symptoms (M [Q1, Q3]: 9 [7,13] vs. 11 [9,13], Z=2.416, P=0.016) and defecation dysfunction (M [Q1, Q3]: 13 [8,14] vs. 19 [16,22], Z=8.813, P<0.001) compared with the arterial group; these differences are all statistically significant (all P<0.05). Three months after surgery, the venous group showed significantly better defecation function than did the arterial group (M [Q1, Q3]:10 [6,13] vs. 11 [6,14], Z=2.591, P<0.001); this difference is statistically significant (P<0.05). However, 6 months after surgery, there were no statistically significant differences between the two groups in any of the assessed variables (all P>0.05).Generalized estimating equation analysis revealed statistically significant differences between the two groups in terms of bowel frequency (P=0.027), stool consistency (P=0.046), urgency to defecate (P=0.008), and total score (P<0.001) with regard to the group-by-time interaction (all P<0.05). Further simple effects analysis of each of the assessed variables showed that 1 month after surgery, patients in the venous group had better outcomes than those in the arterial group in terms of bowel frequency (M [Q1, Q3]:0 [0,2] vs. 2 [1,3]) points, Z=3.479, P<0.001), stool consistency (M [Q1, Q3]:0 [0,1] vs. 1 [0,2] points, Z=3.377, P<0.001), urgency to defecate (M [Q1, Q3]:0 [0,2] vs. 2 [1,3] points, Z=2.798, P=0.005), and total score (M [Q1, Q3]:3 [2,5] vs. 5 [4,7] points, Z=5.318, P<0.001); all of these differences are statistically significant (all P<0.05). Three months after surgery, outcomes in patients in the venous group remained superior to those in the arterial group in terms of bowel frequency (M [Q1, Q3]: 1 [0,1] vs. 1 [0,2] points, Z=2.230, P=0.026), stool consistency (M [Q1, Q3]: 0 [0,1] vs. 1 [0,1] points, Z=2.699, P=0.007), and total score (M [Q1, Q3]:3 [2,4] vs. 3 [2,4] points, Z=2.530, P=0.011); all of these differences are statistically significant (all P<0.05). However, 6 months after surgery, there were no statistically significant differences between the two groups in any of the four assessed variables or the total score. The median duration of follow-up was 41 (9-64) months. The 3-year overall survival rates were 93.3% and 95.8% in the venous and arterial groups, respectively; this difference is not statistically significant (P=0.403). However, the 3-year disease-free survival rate was 86.5% in the venous group, which is significantly lower than that in the arterial group (95.0%, P=0.027). Conclusion: Laparoscopic D3 lymph node dissection of the right colon using the left margin of the superior mesenteric artery as the medial boundary for lymph node dissection is safe and necessary, which can improve the disease-free survival time of patients. This surgical procedure affects the patient's quality of life in the short term,but gradually improves six months after surgery.

Pharmacologic Treatment of Irritable Bowel Syndrome with Predominant Constipation

Irritable bowel syndrome with predominant constipation (IBS-C) is a functional gastrointestinal disorder characterized by abdominal pain with chronic constipation and abdominal bloating, which could significantly impair the quality of life of patients and bring substantial socio-economic burdens. Pharmacology treatment is central to managing patients with IBS-C, aiming to alleviate symptoms and improve patient treatment outcomes. Guanylate cyclase-C agonists (linaclotide and plecanatide) enhance intestinal fluid secretion and motility, normalize bowel movements, and reduce abdominal pain. Na+/H+ exchanger inhibitors (e.g., tenapanor) decrease sodium absorption, increase fluid secretion, and alleviate visceral pain. Lubiprostone activates the chloride channels to facilitate bowel movements, while polyethylene glycol laxatives regulate osmotic pressure to improve stool consistency and ease defecation. Highly selective 5-HT4 agonists, such as prucalopride, accelerate gastrointestinal and colonic transit and improve stool frequency and consistency without increasing the cardiovascular risks raised in earlier agents such as tegaserod. Neuromodulators, including selective serotonin reuptake inhibitors and tricyclic antidepressants, help manage visceral hypersensitivity and chronic abdominal pain in selected patients. These pharmacology agents have shown efficacy and safety in clinical studies, but drug availability, adverse effects, and variable patient responses are still challenging. Effective strategies to manage IBS-C require a personalized approach, considering the patient's symptom profile, treatment goals, and safety concerns.

Study protocol for a prospective, investigator-initiated clinical trial on the vascular effects of acupuncture in the abdomen and lower limbs for patients with diarrhea-predominant irritable bowel syndrome

BackgroundPhysicians classify irritable bowel syndrome with diarrhea symptoms under the label IBS-D which represents a gastrointestinal disorder that meets specific functional diagnostic criteria. Studies show acupuncture helps manage IBS-D symptoms though researchers do not understand if specific treatment points in the abdomen provide better outcomes than standard acupuncture points in the lower body regions. The study investigates the effects acupuncture treatments using local and systemic needling techniques have on IBS-D symptom expression and gut microbial diversity features.MethodsThe study employs a randomized controlled single-blinded exploratory clinical trial design which includes 36 participants diagnosed with IBS-D via Rome IV criteria. Participants are randomly allocated to one of three groups: abdominal acupuncture, lower limb acupuncture, or standard treatment. Participants who receive acupuncture treatment receive eight sessions which are distributed throughout 4 weeks as clinicians activate specific points connected to gastrointestinal function. Lifestyle education and approved medications with symptom management make up the standard treatment provided to participants. The main outcome measures assess IBS Symptom Severity Scale (IBS-SSS) score changes from baseline at Week 5. Additional evaluation measures in this study comprise stool consistency examination alongside patient global assessments and cold-heat surveys along with EQ-5D-5L quality of life assessment and gut microbiota examination as secondary outcomes.ResultsResearch has been designed to evaluate how abdominal and lower limb acupuncture techniques compare in symptom relief and microbiota adaptation outcomes. The preliminary data is expected to reveal distinct patterns between local and wide-reaching effects which suggests that IBS-D treatment should be tailored on a personal basis.ConclusionThe comparison of abdominal and lower limb acupuncture treatment efficacy adds to our understanding of acupuncture therapy benefit for IBS-D. The results will help guide clinical practice and support the creation of tailored acupuncture treatments.

Evaluating high dose laxatives via nasogastric tube versus enemas in children with severe constipation: a prospective cohort study

ObjectivesChildren with severe constipation often require disimpaction when standard treatments fail, typically involving high doses of oral laxatives or rectal enemas. Practice guidelines for nurses lack clear directives. This study compared the effectiveness of nasogastric laxatives versus rectal enemas in children aged 0–18 years and aimed to assess the pain and burden experienced by children and parents.MethodsA prospective cohort study was conducted between December 2018 and June 2022 at a Dutch pediatric outpatient clinic. Of 111 children with severe constipation, 70 participated: 51 (73%) received rectal enemas and 19 (27%) received nasogastric laxatives. Treatment choice was made by the pediatrician in consultation with the parents and, when possible, the child.ResultsAfter eight weeks, 98% (50/51) of enema-treated children and 89% (17/19) of those receiving nasogastric laxatives achieved effective stool consistency (Bristol Stool Scale 3–5), with no significant difference in overall effectiveness (p = 0.177). Pain scores were higher for children treated with nasogastric laxatives, but not statistically significant. No significant differences were found in the reported burden for children or parents.Fecal incontinence was lower in the enema group (33% vs. 47%) but not statistically different.ConclusionsBoth nasogastric laxatives and rectal enemas were effective for disimpaction in children with severe constipation, with no significant difference in efficacy. Although enemas appeared to cause less pain and burden in children under twelve, this was not statistically significant. Further research is needed to address the effect of interprofessional approach and education on compliance and admission of this specific population.

Pancreatic Enzyme Replacement Therapy Improves Exclusive Enteral Nutrition Related Diarrhea in Crohn's Disease: A Prospective Randomized Trial.

Previous results showed that combined treatment of biologics and exclusive enteral nutrition (EEN) brought moderate-to-severe Crohn's disease patients significant improvements in clinical and endoscopic outcomes. Despite its essential role and favorable safety profile, EEN in the treatment of adult Crohn's disease is frequently underestimated because of lower compliance and several side effects, including EEN-related diarrhea (EEND). In this prospective, single-center randomized clinical trial, 147 eligible patients with actively moderate-to-severe Crohn's disease treated with biologics and concomitant 16-week EEN were included. Sixty-one patients without EEND were enrolled in the ND group (without EEN-related diarrhea), and other patients with EEND who received pancreatic enzyme replacement therapy (PERT) (43 patients) or not (43 patients) were recruited in PERT and NPERT groups, respectively. The clinical outcomes, biologic outcomes, and endoscopic outcomes were evaluated. Quality of life (QoL) and psychological status were also assessed at baseline and endpoints (week 16). Bowel movements (daily frequency decreased by 5.3 times) and stool consistency (reduced watery and loose stool) were greatly improved in PERT group at week 16. At week 16, patients in the ND and PERT groups achieved similar clinical responses (93% in ND group and 94.7% in PERT group, p=0.731) and clinical remission (86.0% in ND group and 86.8% in PERT group, p=0.90) while patients in the NPERT group had significantly lower proportions of these clinical outcomes (67.9% clinical response and 57.1% clinical remission). No significant difference was observed in endoscopic outcomes between each group (p=0.904). QoL and mental status including anxiety and depression in PERT group had great improvement compared with the NPERT group. Our prospective results provided invaluable evidence that PERT supplementation efficiently improved EEND in Crohn's disease patients with combined treatment of biologics and 16-week EEN, which had a promising effect in active Crohn's disease induction. ChiCTR2200058343.

Evaluating Vancomycin Monotherapy and Dual Therapy with Nifuroxazide for Medium-Severe Clostridioides Difficile Infection.

All currently used therapeutic protocols and drugs for Clostridioides difficile infection (CDI) treatment do not have a satisfying success and usually cost a lot. To compare the efficacy of vancomycin monotherapy vs modified dual therapy with vancomycin + nifuroxazide as a therapeutic protocol for a medium-severe form of CDI. In addition, the effects of a modified therapeutic protocol with standard monotherapy on the number of stools and stool consistency in a medium-severe CDI will be compared. A prospective, randomized, controlled clinical trial that included 60 patients divided into two groups was conducted. One group of patients was treated with vancomycin monotherapy. The other group was treated with the modified therapeutic protocol (vancomycin + nifuroxazide). The modified therapy with vancomycin + nifuroxazide demonstrated enhanced pharmacological efficacy in the management of CDI compared to the standard vancomycin monotherapy. Patients treated with dual therapy reported a significantly lower number of stools in first, second and third control; first control (4.47 ± 2.20 compared to 5.70 ± 1.91 in vancomycin group (p = 0.024)), second control (2.37 ± 0.85 compared to 3.13 ± 0.90 in vancomycin group (p = 0.001)), and third control (1.53 ± 0.51 compared to 1.80 ± 0.61 in vancomycin group (p = 0.035)). Also, the first and third controls noted significant improvements in stool consistency, measured as a decrease in the number of completely watery stools (p = 0.011 and p < 0.001, respectively). Nifuroxazide and vancomycin have demonstrated accelerated improvement in patient status and hold promise as a novel dual therapeutic regimen for managing patients diagnosed with a medium-severe form of CDI.

Impact of Probiotic Formula (Lacto-5X) on Constipation: Improvements in Gastrointestinal Symptoms, Gut Microbiome, and Metabolites.

Constipation is characterized by low frequent stools and difficult stool passage. Approximately 16% of the global population experiences these symptoms. Probiotics have shown promise in improving constipation symptoms by modulating the gut microbiome. This study aims to evaluate the effects of a probiotic formula (Lacto-5X) on bowel habits, gastrointestinal symptoms, gut microbiome, and metabolites in adults with mild constipation using a randomized, double-blind, placebo-controlled clinical trial design. At the 4-week endpoint, the Probiotic group had significant improvements in stool consistency, stool frequency, abdominal pain, and straining compared to the Placebo group. Satisfaction with bowel habits and improvement in overall intestinal health were significantly higher in the Probiotic group. Microbiome analysis revealed a significant increase in the abundance of Lactobacillus and L. plantarum in the Probiotic group at the 4-week endpoint. Metabolome analysis showed that L-proline level in the Probiotic group decreased, while threonic acid level increased at the 4-week endpoint compared to the Placebo group. However, these improvements were not sustained at the 8-week follow-up point. Lacto-5X changes the gut microbiome, leading to changes in metabolites, and it induced improved constipation symptoms. Continuous intake may be necessary to maintain these effects. Further studies are needed to explore the long-term efficacy of Lacto-5X.

Alleviating Effect of Lactiplantibacillus plantarum HYY-S10 on Colitis in Mice Based on an Analysis of the Immune Axis in the Intestine.

The pathogenesis of ulcerative colitis (UC) has been fundamentally associated with intestinal microbiota dysbiosis and disruption of immune homeostasis. This study systematically investigates the therapeutic potential of Lactiplantibacillus plantarum HYY-S10 (HYY-S10), a novel strain isolated from De'ang sour tea in Yun an, China, with a focus on its mechanisms for alleviating colitis through the modulation of gut microbiota. Using a dextran sulfate sodium (DSS)-induced colitis model in C57BL/6J mice, our findings demonstrated that seven days of oral supplementation with HYY-S10 (1 × 108 CFU/mL, 0.2 mL/10 g body weight) significantly improved Disease Activity Index (DAI) scores and attenuated characteristic colitis symptoms, including progressive weight loss, rectal bleeding, and abnormal stool consistency. Administration of HYY-S10 exhibited significant immunomodulatory effects characterized by the downregulation of pro-inflammatory mediators (such as IL-1β, IL-6, IFN-γ, and LPS) while concomitantly upregulating anti-inflammatory IL-10 expression. Additionally, the strain enhanced intestinal antioxidant capacity by increasing GSH-Px activity, which collectively contributed to the reduction in intestinal inflammation. Furthermore, HYY-S10 demonstrated multifaceted protective effects by ameliorating oxidative stress through the restoration of redox homeostasis and modulation of gut microbial ecology. Probiotic intervention significantly increased short-chain fatty acids (SCFAs) production and notably enhanced the relative abundance of beneficial taxa, including Akkermansia and Ruminococcus_B, while restoring microbial diversity and ecological stability. Collectively, our results demonstrate that HYY-S10 alleviates experimental colitis by modulating the intestinal immune axis and microbiota composition, providing mechanistic insights to support its potential as a probiotic-based therapeutic strategy for UC.

Developing a core outcome set for nutrition care in adult outpatients with irritable bowel syndrome (COS-RD-IBS study).

Developing a core outcome set for nutrition care in adult outpatients with irritable bowel syndrome (COS-RD-IBS study).

Effect of Daily Consumption of a Fermented Milk Containing Lacticaseibacillus paracasei Strain Shirota (LcS) on Stool Consistency in United States Adults with Hard or Lumpy Stools: A Randomized Controlled Trial.

Effect of Daily Consumption of a Fermented Milk Containing Lacticaseibacillus paracasei Strain Shirota (LcS) on Stool Consistency in United States Adults with Hard or Lumpy Stools: A Randomized Controlled Trial.

COMPARISON OF EFFICACY OF RACECADOTRIL VERSUS PROBIOTICS IN THE TREATMENT OF CHILDREN WITH ACUTE WATERY DIARRHOEA

Background: Acute watery diarrhea remains one of the leading causes of mortality and morbidity in children under five years of age, particularly in low- and middle-income countries. Rapid fluid loss can result in severe dehydration, necessitating effective management to reduce complications. Although oral rehydration therapy is the cornerstone of treatment, adjunct therapies such as antisecretory agents are being explored to improve outcomes. Racecadotril has emerged as a promising option; however, its local efficacy remains under-evaluated. Objective: To assess the effectiveness of racecadotril compared to probiotics in the treatment of acute watery diarrhea in children under five years of age. Methods: A randomized controlled trial was conducted at the Department of Pediatrics, Khyber Teaching Hospital, from January 3 to July 2, 2024. A total of 178 children aged 3 to 59 months with acute watery diarrhea were randomly assigned into two groups: Group A received racecadotril 1.5 mg/kg orally three times daily for five days, while Group B received 5 drops of Lactobacillus-based probiotic (100 million CFUs) once daily for the same duration. Efficacy was defined as normalization of stool frequency and consistency by day five. Data were analyzed using SPSS version 26 with a chi-square test; p ≤ 0.05 was considered statistically significant. Results: Mean age of participants in the racecadotril group was 28.89 ± 3.15 months, and in the probiotic group 29.99 ± 2.30 months. Male children comprised 67.4% in the racecadotril group and 53.9% in the probiotic group. Clinical efficacy was observed in 89.9% (n = 80) of patients receiving racecadotril, compared to 73.0% (n = 65) in the probiotic group. The difference was statistically significant (p = 0.004). Conclusion: Racecadotril demonstrated superior clinical efficacy over probiotics in the treatment of acute watery diarrhea in children under five years, indicating its potential role as an effective adjunct therapy.

G-310 Tenapanor-Treated Patients Using Over-the-Counter Antidiarrheal Agents Saw Decreased Stool Frequency and Improved Stool Consistency

G-310 Tenapanor-Treated Patients Using Over-the-Counter Antidiarrheal Agents Saw Decreased Stool Frequency and Improved Stool Consistency

Association of constipation with suicidal ideation among US adults and the partial mediating role of depression

The association between constipation and suicidal ideation remains inadequately explored. This study aims to investigate the potential correlation between constipation and suicidal ideation in US adults, while assessing the mediating role of depression.For this cross-sectional study, a total of 13,493 adults aged 20 years and older were included from the National Health and Nutrition Examination Survey 2005–2010. The definition of constipation was defined by considering the consistency or frequency of stool. The ninth item on the Patient Health Questionnaire-9 (PHQ-9) evaluated suicidal ideation, and depression was evaluated using the PHQ-8 score. Adjusted odds ratios (ORs) were calculated using multivariate logistic regression models. Sensitivity analysis was performed to ensure stable results. Furthermore, study employed mediation analysis to examine the effect of constipation on suicidal ideation through depression. The bootstrapping method was used to assess the significance of the mediation effect. After controlling for demographic factors, risk behaviors, comorbidities, dietary intake, and relevant medications, constipation was associated with an increased risk of suicidal ideation (OR 1.41, 95%CI 1.08–1.83, P = 0.011). Sensitivity analyses showed the stability of the results. Moreover, mediation analysis demonstrated a significant direct effect of constipation on suicidal ideation (P = 0.016), with depression playing a partial mediating role in this interaction (40.81%, P < 0.0001). In conclusion, this study demonstrated a significant association between constipation and suicidal ideation, with depression serving as a partial mediator in this relationship. Further prospective longitudinal studies are essential to establish a definitive causal relationship between these factors so as to guide the development and implementation of targeted intervention strategies.