Intestinal Research

Reviews

Functional disorder

Diagnostic strategy of irritable bowel syndrome: a low- and middle-income country perspective: Amal Arifi Hidayat, Langgeng Agung Waskito, Titong Sugihartono, Hafeza Aftab, Yudith Annisa Ayu Rezkitha, Ratha-korn Vilaichone, Muhammad Miftahussurur; Intest Res 2024;22(3):286-296. Published online March 26, 2024; DOI: https://doi.org/10.5217/ir.2023.00199

Abstract PDF PubReader ePub: Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder associated with substantial impairment which considerably burdens healthcare systems worldwide. Research on IBS has largely been conducted in high-income countries posing barriers to the application of diagnostic strategies in low- and middle-income countries (LMICs) due to differences in disease characteristics, healthcare resources, and socioeconomic factors. This review discusses the diagnostic issues associated with LMICs. We present a concise overview of the relevant approaches and propose a diagnostic strategy based on the latest evidence. A positive diagnostic strategy that relies on appropriate symptom-based criteria is crucial within the diagnostic framework. A combination of complete blood count, fecal occult blood test, and complete stool test may reliably identify individuals with suspected IBS who are more likely to have organic diseases, thus justifying the necessity for a colonoscopy. Eventually, we developed a diagnostic algorithm based on a limited setting perspective that summarizes the available evidence and may be applied in LMICs.

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Functional bowel disorder

An Asian perspective on irritable bowel syndrome: Kee Wook Jung, Seung-Jae Myung; Intest Res 2023;21(2):189-195. Published online May 31, 2022; DOI: https://doi.org/10.5217/ir.2021.00136

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Irritable bowel syndrome (IBS) is a prevalent chronic disorder, and its epidemiology depends on the diagnostic criteria used. Recently, the Rome IV criteria for IBS were published by changing the frequency of abdominal pain and excluding abdominal discomfort from the previously used Rome III criteria. However, the recent Asian consensus on IBS recommends the inclusion of abdominal discomfort and abdominal pain as diagnostic criteria. The low fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP) diet has been proven to be effective in Western patients. Moreover, recent well-designed studies reported its effectiveness and the microbial changes after implementing it in Asian patients with IBS. However, traditional Korean foods including kimchi, one of representative FODMAP-rich food, exhibited a poor correlation with the food-related symptoms of IBS. Therefore, the low FODMAP diet protocol should be cautiously applied to IBS patients, especially to Korean patients with IBS. In Asian countries, there are lots of traditional herbal medicines and treatments for IBS; however, these studies have limitations including the heterogeneity of herbal mixtures and relatively small sample size. Therefore, well-designed studies based on large samples are required to validate complementary and alternative medicine in the treatment of Asian patients with IBS.

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The Role of Diet in the Management of Irritable Bowel Syndrome: A Comprehensive Review
Maleesha Jayasinghe , Vinuri Karunanayake, Ali Mohtashim, Dilushini Caldera , Piyalka Mendis , Omesh Prathiraja, Fatemeh Rashidi, John A Damianos
Cureus.2024;[Epub] CrossRef
Downregulated APOD and FCGR2A correlates with immune infiltration and lipid-induced symptoms of irritable bowel syndrome
Yamei Ran, Kangqi Wu, Chenglin Hu, Renzheng Liang, Li Zhang, Juan Xiao, Yongmei Peng, Wenjing Sun
Scientific Reports.2023;[Epub] CrossRef
Technical Feasibility of Quantitative Measurement of Various Degrees of Small Bowel Motility Using Cine Magnetic Resonance Imaging
Ji Young Choi, Jihye Yun, Subin Heo, Dong Wook Kim, Sang Hyun Choi, Jiyoung Yoon, Kyuwon Kim, Kee Wook Jung, Seung-Jae Myung
Korean Journal of Radiology.2023; 24(11): 1093. CrossRef
Letter to the Editor: Survey-Based Analysis of Clinical Treatment Status of Irritable Bowel Syndrome in Korea: Suggestions for Future Research
Ji Young Chang
Journal of Korean Medical Science.2023;[Epub] CrossRef
Effectiveness of Medilac-S as an Adjuvant to Conventional Irritable Bowel Syndrome Treatments: A Systematic Review with Meta-Analysis
Annie Tremblay, Xiaoyu Xu, James Colee, Thomas A. Tompkins, Sylvie Binda
Gastroenterology Insights.2023; 14(4): 491. CrossRef
Comments on Efficacy of a Synbiotic Containing Lactobacillus paracasei DKGF1 and Opuntia humifusa in Elderly Patients with Irritable Bowel Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
Kwang Woo Kim
Gut and Liver.2023; 17(6): 954. CrossRef

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Original Articles

Functional bowel disorder

An evaluation of dietary adequacy among patients with constipation-predominant irritable bowel syndrome in Malaysia: Nor Hamizah Shafiee, Nurul Huda Razalli, Norfilza M. Mokhtar, Eunice Tan, Raja Affendi Raja Ali; Intest Res 2022;20(1):124-133. Published online January 22, 2021; DOI: https://doi.org/10.5217/ir.2020.00050

Abstract PDF PubReader ePub

Background/Aims
Substantial proportions of patients with constipation-predominant irritable bowel syndrome (IBS-C) linked their symptoms with particular intake of foods. However, there is lack of current data regarding the intake among IBS-C patients before any dietary interventions. Thus, this study aimed to evaluate the dietary adequacy among IBS-C against the standard recommended nutrient intake (RNI) and healthy controls.
Methods
A retrospective case-control study was conducted involving IBS-C patients and healthy control subjects. A validated 126-food items frequency questionnaire was administered to all the subjects to assess their dietary intake, guided by dietitians. The calculated nutrients intake for IBS-C patients was then compared against the standard RNI and healthy controls.
Results
A total of 306 subjects were recruited, among which 218 were diagnosed with IBS-C and 88 were included as healthy controls. IBS-C patients had significantly lower intake of wholegrain products, fried foods, dairy products, fruits, and vegetables compared to healthy controls. The daily intake of energy, certain macronutrients, and micronutrients among IBS-C patients was significantly lower than the healthy subjects. Less than 5% of IBS-C patients and healthy subjects achieved the standard recommendation for dietary fiber. Also, various vitamin intake (B₁, B₂, B₆, folate, B₁₂, E, K, and potassium) among IBS-C patients did not meet the standard RNI.
Conclusions
Dietary intakes of IBS-C patients did not meet the recommended intake for Malaysian and showed the nutritional inadequacies compared to the control subjects. Our study highlighted the importance of dietary evaluation prior to planning strategies for dietary intervention targeting IBS-C patients.

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Association between dietary vitamin E intake and constipation: NHANES 2005–2010
Junfeng Cai, Danqing Li, Ruijun Xie, Xiaoling Yu, Yuning Wu, Feng Sun, Chenxiong Zhang
Frontiers in Nutrition.2024;[Epub] CrossRef
Systematic review and meta-analysis of habitual intake of fermentable oligo-, di-, mono- saccharides and polyols in the general population and revisiting the low FODMAP diet concept
Yoghatama Cindya Zanzer, Stephan Theis
Journal of Functional Foods.2024; 112: 105914. CrossRef
A randomized, double-blinded, placebo-controlled clinical trial on Lactobacillus-containing cultured milk drink as adjuvant therapy for depression in irritable bowel syndrome
Marlynna Sarkawi, Raja Affendi Raja Ali, Norhazlina Abdul Wahab, Norshafila Diana Abdul Rathi, Norfilza Mohd Mokhtar
Scientific Reports.2024;[Epub] CrossRef
An Asian perspective on irritable bowel syndrome
Kee Wook Jung, Seung-Jae Myung
Intestinal Research.2023; 21(2): 189. CrossRef
Adult‐onset megacolon with focal hypoganglionosis: A detailed phenotyping and prospective cohort study
Jiyoung Yoon, Kee Wook Jung, Nam Seok Ham, Jihun Kim, Yoon Suh Do, Seon Ok Kim, Sang Hyun Choi, Dong Wook Kim, Sung Wook Hwang, Sang Hyoung Park, Dong‐Hoon Yang, Byong Duk Ye, Jeong‐Sik Byeon, Yong Sik Yoon, Chan Wook Kim, Chang Sik Yu, Hwoon‐Yong Jung, S
Neurogastroenterology & Motility.2023;[Epub] CrossRef
Downregulated APOD and FCGR2A correlates with immune infiltration and lipid-induced symptoms of irritable bowel syndrome
Yamei Ran, Kangqi Wu, Chenglin Hu, Renzheng Liang, Li Zhang, Juan Xiao, Yongmei Peng, Wenjing Sun
Scientific Reports.2023;[Epub] CrossRef
Letter to the Editor: Survey-Based Analysis of Clinical Treatment Status of Irritable Bowel Syndrome in Korea: Suggestions for Future Research
Ji Young Chang
Journal of Korean Medical Science.2023;[Epub] CrossRef
Comments on Efficacy of a Synbiotic Containing Lactobacillus paracasei DKGF1 and Opuntia humifusa in Elderly Patients with Irritable Bowel Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
Kwang Woo Kim
Gut and Liver.2023; 17(6): 954. CrossRef
Correlation Between Zinc Nutritional Status with Serum Zonulin and Gastrointestinal Symptoms in Diarrhea-Predominant Irritable Bowel Syndrome: A Case–Control Study
Mahsa Rezazadegan, Maryam Soheilipour, Mohammad Javad Tarrahi, Reza Amani
Digestive Diseases and Sciences.2022; 67(8): 3632. CrossRef

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Functional bowel disorders

Psychological profiles of irritable bowel syndrome patients with different phenotypes: Michel Bouchoucha, Ghislain Devroede, Noëlle Girault-Lidvan, Maria Hejnar, Florence Mary, Robert Benamouzig; Intest Res 2020;18(4):459-468. Published online October 26, 2020; DOI: https://doi.org/10.5217/ir.2019.09171

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Abnormal psychological profiles are frequently found in patients with functional gastrointestinal disorders (FGIDs). The present study aimed to evaluate the psychological profiles of FGID patients with irritable bowel syndrome (IBS), and IBS phenotypes.
Methods
In 608 FGID patients, including 235 with IBS, have filled a Rome III questionnaire and the French version of the Minnesota Multiphasic Personality Inventory 2. Data analysis was performed using univariate analysis and multivariate logistic regression.
Results
This study shows that IBS patients have abnormal psychological profiles with more significant symptom exaggeration and decreased test defensiveness than non-IBS patients. They have a significantly higher score for all clinical scales. Logistic regression analysis showed in IBS patients a decrease of body mass index (P= 0.002), and test defensiveness score K (P= 0.001) and an increase of Hypochondriasis (P< 0.001) and Masculinity-Femininity scale (P= 0.018). By comparison with non-IBS patients, IBS-constipation, IBS-diarrhea, and mixed IBS patients have increased Hypochondriasis value and Depression score, mixed IBS patients have higher Psychasthenia score and higher Hypomania score. No item was significantly different in the IBS-unspecified group.
Conclusions
This study shows that IBS patients have different psychological profiles than other FGID patients and that psychological characteristics are associated with IBS phenotypes except for patients with unsubtyped IBS.

Citations

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The role of psychological factors in functional gastrointestinal disorders: a systematic review and meta-analysis
Liyanran Yan, Xueli Zhang, Yan Li, Chengjiang Liu, Hua Yang, Chunchun Yang
International Journal of Colorectal Disease.2023;[Epub] CrossRef
An Asian perspective on irritable bowel syndrome
Kee Wook Jung, Seung-Jae Myung
Intestinal Research.2023; 21(2): 189. CrossRef
Limited evidence of moderation of the association between gastrointestinal symptoms and prospective healthcare utilisation by quality of life
David T. McNaughton, Anna Andreasson, Brjánn Ljótsson, Alissa P. Beath, Julia M. Hush, Gunnar Ljunggren, Peter T. Schmidt, Nicholas J. Talley, Lars Agréus, Michael P. Jones
Alimentary Pharmacology & Therapeutics.2022; 55(3): 311. CrossRef
Compositional Changes in the Gut Microbiota of Responders and Non-responders to Probiotic Treatment Among Patients With Diarrhea-predominant Irritable Bowel Syndrome: A Post Hoc Analysis of a Randomized Clinical Trial
Seung Yong Shin, Sein Park, Jung Min Moon, Kisung Kim, Jeong Wook Kim, Jongsik Chun, Tae Hee Lee, Chang Hwan Choi
Journal of Neurogastroenterology and Motility.2022; 28(4): 642. CrossRef
Psychopathological and neuropsychological disorders associated with chronic primary visceral pain: Systematic review
Alejandro Arévalo-Martínez, Juan Manuel Moreno-Manso, María Elena García-Baamonde, Macarena Blázquez-Alonso, Pilar Cantillo-Cordero
Frontiers in Psychology.2022;[Epub] CrossRef
Impact of Psychological Comorbidity on the Prognosis of Irritable Bowel Syndrome
Vivek C. Goodoory, Antonina Mikocka-Walus, Yan Yiannakou, Lesley A. Houghton, Christopher J. Black, Alexander C. Ford
American Journal of Gastroenterology.2021; 116(7): 1485. CrossRef

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Functional bowel disorder

Proinflammatory cytokines in irritable bowel syndrome: a comparison with inflammatory bowel disease: Antigony Mitselou, Vasileios Grammeniatis, Anna Varouktsi, Stamatis S Papadatos, Konstantinos Katsanos, Vasiliki Galani; Intest Res 2020;18(1):115-120. Published online January 30, 2020; DOI: https://doi.org/10.5217/ir.2019.00125

Abstract PDF PubReader ePub

Background/Aims
Irritable bowel syndrome (IBS) is a common disease often considered as a functional intestinal disorder. Inflammation in IBS is a quite intriguing theory. The aim of this study was to investigate tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6 expression in inflammatory bowel disease (IBD) patients, IBS patients and normal controls.
Methods
IBS and IBD patients along with normal controls were recruited in the study. In all groups, 2 pinch biopsies were taken at each of 3 anatomical sites (terminal ileum, cecum, and rectum). IBS patients were also subcategorized according to the syndrome clinical manifestations. Two monoclonal antibodies (mAb), TNF-α mAb and IL-6 mAb, and one polyclonal antibody IL-1β mAb were applied for immunohistochemical analysis.
Results
In IBD patients intensity of TNF-α and IL-1β were lower than in IBS patients or controls, while IL-6 was significantly increased comparing to the aforementioned groups. In IBS patients TNF-α was increased comparing to IBD patients or controls, while IL-6 and IL-1β were similar to controls. In IBS subgroups, TNF-α was lower in diarrhea predominant IBS patients and higher constipation predominant IBS patients. Differences among IBS subgroups regarding IL-6 and IL-1β were nonsignificant.
Conclusions
IL-6 seems to be the most important proinflammatory cytokine in IBD patients, while TNF-α could play a more significant role in IBS pathogenesis.

Citations

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Guardians at the Gate: Immune System in Gastrointestinal Diseases
Elena Layunta, Jose Emilio Mesonero, Eva Latorre
International Journal of Molecular Sciences.2024; 25(11): 5933. CrossRef
Novel Dairy Fermentates Have Differential Effects on Key Immune Responses Associated with Viral Immunity and Inflammation in Dendritic Cells
Dearbhla Finnegan, Claire Connolly, Monica A. Mechoud, Jamie A. FitzGerald, Tom Beresford, Harsh Mathur, Lorraine Brennan, Paul D. Cotter, Christine E. Loscher
Foods.2024; 13(15): 2392. CrossRef
The Latest Data Concerning the Etiology and Pathogenesis of Irritable Bowel Syndrome
Vlad Alexandru Ionescu, Gina Gheorghe, Teodor Florin Georgescu, Nicolae Bacalbasa, Florentina Gheorghe, Camelia Cristina Diaconu
Journal of Clinical Medicine.2024; 13(17): 5124. CrossRef
Morphological Changes of the Pituitary Gland in Patients with Irritable Bowel Syndrome Using Magnetic Resonance Imaging
Jessica Abou Chaaya, Jennifer Abou Chaaya, Batoul Jaafar, Lea Saab, Jad Abou Chaaya, Elie Al Ahmar, Elias Estephan
Journal of Imaging.2024; 10(9): 226. CrossRef
Evaluation of two laboratory model methods for diarrheal irritable bowel syndrome
Qian Chen, Hua Zhang, Chang-Yue Sun, Qing-Ying He, Rui-Rong Zhang, Bin-Fei Luo, Zi-Hao Zhou, Xiao-Fan Chen
Molecular Medicine.2023;[Epub] CrossRef
Structural properties and anti-inflammatory activity of purified polysaccharides from Hen-of-the-woods mushrooms (Grifola frondosa)
Xiaoyi Liu, Shuai Chen, Huijuan Liu, Jiao Xie, K. M. Faridul Hasan, Qibing Zeng, Shaofeng Wei, Peng Luo
Frontiers in Nutrition.2023;[Epub] CrossRef
An Asian perspective on irritable bowel syndrome
Kee Wook Jung, Seung-Jae Myung
Intestinal Research.2023; 21(2): 189. CrossRef
Molecular Mechanisms of the Antitumor Effects of Mesalazine and Its Preventive Potential in Colorectal Cancer
Joanna Słoka, Marcel Madej, Barbara Strzalka-Mrozik
Molecules.2023; 28(13): 5081. CrossRef
Structure and Metabolic Activity of the Gut Microbiota in Diarrhea-Predominant Irritable Bowel Syndrome Combined with Functional Dyspepsia
Aleksandra Kovaleva, Elena Poluektova, Roman Maslennikov, Oxana Zolnikova, Oleg Shifrin, Anna Kudryavtseva, George Krasnov, Maria Fedorova, Anna Karchevskaya, Vladimir Ivashkin
Gastrointestinal Disorders.2023; 5(3): 296. CrossRef
NK cells vs. obesity: A tale of dysfunction & redemption
Conor De Barra, Donal O'Shea, Andrew E. Hogan
Clinical Immunology.2023; 255: 109744. CrossRef
Non-invasive neuromodulation: an emerging intervention for visceral pain in gastrointestinal disorders
Md Jahangir Alam, Jiande D. Z. Chen
Bioelectronic Medicine.2023;[Epub] CrossRef
Gut–Brain Axis, Microbiota and Probiotics—Current Knowledge on Their Role in Irritable Bowel Syndrome: A Review
Cristina Maria Marginean, Mihaela Popescu, Andrei Ioan Drocas, Sergiu Marian Cazacu, Radu Mitrut, Iulia Cristina Marginean, George Alexandru Iacob, Marian Sorin Popescu, Anca Oana Docea, Paul Mitrut
Gastrointestinal Disorders.2023; 5(4): 517. CrossRef
Comparative treatment of Sulfasalazine+Ezetimibe combination and Sulfasalazine in a rat model with induced colitis
Farrah Rasool Jaafar, Ahmed Abu-Raghif
Journal of Medicine and Life.2023; 16(8): 1165. CrossRef
Screening and Evaluation of Probiotics for Reducing Intestinal Inflammation
雅君陈
Hans Journal of Food and Nutrition Science.2022; 11(01): 44. CrossRef
Protection against ulcerative colitis and colorectal cancer by evodiamine via anti‑inflammatory effects
Yongfeng Zhang, Yaqin Zhang, Yang Zhao, Wanyue Wu, Weiqi Meng, Yulin Zhou, Ye Qiu, Chenliang Li
Molecular Medicine Reports.2022;[Epub] CrossRef
The Role of Neuro-Immune Interaction in Chronic Pain Conditions; Functional Somatic Syndrome, Neurogenic Inflammation, and Peripheral Neuropathy
Elaine Meade, Mary Garvey
International Journal of Molecular Sciences.2022; 23(15): 8574. CrossRef
Ameliorating effects of electroacupuncture on the low‐grade intestinal inflammation in rat model of diarrhea‐predominant irritable bowel syndrome
Xuemei Li, Kuiyu Ren, Xiaojuan Hong, Sha Guo, Shuguang Yu, Sha Yang
Journal of Gastroenterology and Hepatology.2022; 37(10): 1963. CrossRef
Healthy Sleep Every Day Keeps the Doctor Away
Cailan Lindsay Feingold, Abbas Smiley
International Journal of Environmental Research and Public Health.2022; 19(17): 10740. CrossRef
Compositional Changes in the Gut Microbiota of Responders and Non-responders to Probiotic Treatment Among Patients With Diarrhea-predominant Irritable Bowel Syndrome: A Post Hoc Analysis of a Randomized Clinical Trial
Seung Yong Shin, Sein Park, Jung Min Moon, Kisung Kim, Jeong Wook Kim, Jongsik Chun, Tae Hee Lee, Chang Hwan Choi
Journal of Neurogastroenterology and Motility.2022; 28(4): 642. CrossRef
Overlap of Functional Gastrointestinal Disorders: Common Mechanisms of Pathogenesis as a Key to Rational Therapy
S. N. Mekhdiyev, O. A. Mekhdieva, O. M. Berko
Russian Journal of Gastroenterology, Hepatology, Coloproctology.2022; 32(4): 95. CrossRef
Effect of Heat-Killed Lactobacillus casei DKGF7 on a Rat Model of Irritable Bowel Syndrome
Gyeol Seong, Seungbaek Lee, Yang Won Min, Yeon Sil Jang, Hong Seog Kim, Eui-Joong Kim, So-Young Park, Cheol-Hyun Kim, Dong Kyung Chang
Nutrients.2021; 13(2): 568. CrossRef
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Brianna M. Quinville, Natalie M. Deschenes, Alex E. Ryckman, Jagdeep S. Walia
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Lactiplantibacillus plantarum 299v (LP299V®): three decades of research
E. Arvidsson Nordström, C. Teixeira, C. Montelius, B. Jeppsson, N. Larsson
Beneficial Microbes.2021; 12(5): 441. CrossRef
Immunohistochemical Study of Adhesion Molecules in Irritable Bowel Syndrome
Antigony Mitselou, Vasileios Grammeniatis, Anna Varouktsi, Stamatis S. Papadatos, Antonios Klaroudas, Konstantinos Katsanos, Vasiliki Galani
Advanced Biomedical Research.2021; 10(1): 21. CrossRef
TNF-α, IL-17, and IL-22 production in the rectal mucosa of nonceliac wheat sensitivity patients: role of adaptive immunity
Pasquale Mansueto, Diana Di Liberto, Francesca Fayer, Maurizio Soresi, Girolamo Geraci, Antonio Giulio Giannone, Aurelio Seidita, Alberto D’Alcamo, Francesco La Blasca, Marianna Lo Pizzo, Ada Maria Florena, Francesco Dieli, Antonio Carroccio
American Journal of Physiology-Gastrointestinal and Liver Physiology.2020; 319(3): G281. CrossRef
Sudachinoid- and Ichangensin-Type Limonoids from Citrus junos Downregulate Pro-Inflammatory Cytokines
Jihun Shin, Hwa Young Song, Mina Lee
International Journal of Molecular Sciences.2020; 21(18): 6963. CrossRef
Differential clusterization of soluble and extracellular vesicle-associated cytokines in myocardial infarction
Anna Lebedeva, Wendy Fitzgerald, Ivan Molodtsov, Alexander Shpektor, Elena Vasilieva, Leonid Margolis
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Lactoferrin in the Prevention and Treatment of Intestinal Inflammatory Pathologies Associated with Colorectal Cancer Development
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Cancers.2020; 12(12): 3806. CrossRef

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Functional bowel disorders

Is fecal calprotectin always normal in children with irritable bowel syndrome?: You Jin Choi, Su Jin Jeong; Intest Res 2019;17(4):546-553. Published online September 4, 2019; DOI: https://doi.org/10.5217/ir.2019.00009

Abstract PDF PubReader ePub

Background/Aims
Fecal calprotectin (FC) is a marker of intraluminal intestinal inflammation. Intestinal inflammation may contribute to the pathophysiology of irritable bowel syndrome (IBS). This study evaluated FC levels in children with IBS and differences in FC levels in children stratified by IBS subtype and healthy controls (HCs).
Methods
A total of 157 children with IBS and 56 HCs aged 4–16 years (119 boys, 94 girls, mean age of 9.48 years) were included in this prospective study. Children with IBS were diagnosed using the Rome III criteria and classified into 4 subtypes: IBS with constipation (IBS-C, n=37), IBS with diarrhea (IBS-D, n=54), IBS with alternating constipation and diarrhea (IBS-M, n=49), and IBS unsubtyped (IBS-U, n=17); postinfectious IBS (PI-IBS) was also considered. The FC concentration in stool samples was analyzed using an enzyme-linked immunosorbent assay. All participants answered a questionnaire regarding several demographic and clinical characteristics.
Results
Children with IBS had significantly higher levels of FC than the HCs (88.71 μg/g vs. 17.77 μg/g). Among the 4 IBS subtypes, the FC concentration was highest in children with IBS-D, followed by those with IBS-M, IBS-C, and IBS-U (169.94 μg/g vs. 45.04, 31.22, and 33.52 μg/g, respectively), and these differences were statistically significant. For PI-IBS, 90% of cases were in the IBS-D group.
Conclusions
The FC level was significantly higher in children with IBS than in HCs and differed depending on the IBS subtype, supporting the notion that IBS is a type of low-grade bowel inflammation.

Citations

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Markers of Intestinal Permeability and Inflammation in Enterally Fed Children with Cerebral Palsy
Dorota Mickiewicz-Góra, Katarzyna Sznurkowska, Karolina Skonieczna-Żydecka, Arleta Drozd, Anna Borkowska, Maciej Zagierski, Joanna Troch, Agnieszka Szlagatys-Sidorkiewicz
Nutrients.2024; 16(15): 2447. CrossRef
Role of inflammation in pediatric irritable bowel syndrome
Giovanni Di Nardo, Cesare Cremon, Annamaria Staiano, Vincenzo Stanghellini, Osvaldo Borrelli, Caterina Strisciuglio, Claudio Romano, Saverio Mallardo, Elena Scarpato, Giovanni Marasco, Silvia Salvatore, Letizia Zenzeri, Enrico Felici, Licia Pensabene, Sim
Neurogastroenterology & Motility.2023;[Epub] CrossRef
The Role of Bovine Kappa-Casein Glycomacropeptide in Modulating the Microbiome and Inflammatory Responses of Irritable Bowel Syndrome
Yunyao Qu, Si Hong Park, David C. Dallas
Nutrients.2023; 15(18): 3991. CrossRef
Evaluating the Potential of Casein Glycomacropeptide in Adult Irritable Bowel Syndrome Management: A Pilot Study
Yunyao Qu, Si Hong Park, David C. Dallas
Nutrients.2023; 15(19): 4174. CrossRef
Association between body mass index and fecal calprotectin levels in children and adolescents with irritable bowel syndrome
Jun Hwan Kim, Dae Yong Yi, Yoo Min Lee, You Jin Choi, Ju Young Kim, Yong Hee Hong, Ji Young Park, Su Yeong Kim, Na Mi Lee, Sin Weon Yun, Soo Ahn Chae, In Seok Lim, Eung Sang Choi, In Sook Jeong
Medicine.2022; 101(32): e29968. CrossRef
Infantile Colic and the Subsequent Development of the Irritable Bowel Syndrome
Ju Hee Kim, Seung Won Lee, Yoowon Kwon, Eun Kyo Ha, Jaewoo An, Hye Ryeong Cha, Su Jin Jeong, Man Yong Han
Journal of Neurogastroenterology and Motility.2022; 28(4): 618. CrossRef
Irritable bowel syndrome in Indonesian adolescents
Yudianita Kesuma, Rini Sekartini, Ina S. Timan, Agnes Kurniawan, Saptawati Bardosono, Agus Firmansyah, Yvan Vandenplas
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Craig Friesen, Jennifer M Colombo, Amanda Deacy, Jennifer V Schurman
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Increasing Evidence That Irritable Bowel Syndrome and Functional Gastrointestinal Disorders Have a Microbial Pathogenesis
Caterina Carco, Wayne Young, Richard B. Gearry, Nicholas J. Talley, Warren C. McNabb, Nicole C. Roy
Frontiers in Cellular and Infection Microbiology.2020;[Epub] CrossRef

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Functional bowel disorders

Evaluation of symptoms and symptom combinations in histamine intolerance: Wolfgang J. Schnedl, Sonja Lackner, Dietmar Enko, Michael Schenk, Sandra J. Holasek, Harald Mangge; Intest Res 2019;17(3):427-433. Published online March 7, 2019; DOI: https://doi.org/10.5217/ir.2018.00152

Abstract PDF PubReader ePub

Background/Aims
Food intolerance/malabsorption, particularly histamine intolerance (HIT), may cause nonspecific functional gastrointestinal and extraintestinal symptoms. We evaluated gastrointestinal and extraintestinal symptoms in patients with HIT.
Methods
In an analysis of outpatients’ charts we identified 133 patients, who presented with recurring nonspecific functional gastrointestinal, extraintestinal symptoms, and a diamine oxidase value <10 U/mL, indicative of HIT. A standardized anonymous questionnaire with symptoms of HIT based on known symptoms and the 4 histamine receptors including gastrointestinal, cardiovascular, respiratory and skin complaints was developed, and sent by mail to the patients.
Results
In the 62 patients that completed the questionnaire bloating was the most common and most serious symptom. Other commonly reported gastrointestinal symptoms were postprandial fullness, diarrhea, abdominal pain, and constipation. The presence of 2 from a list of 24 symptoms resulted in 276 various symptom combinations. From calculated 2.024 possible combinations of 3 symptoms the patients with HIT presented 1.975 combinations.
Conclusions
The knowledge of this wide variability of symptoms and complex symptom combinations in patients with HIT may help to clinically recognize and diagnose HIT.

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Exploring the Relationship between Diamine Oxidase and Psychotropic Medications in Fibromyalgia Treatment, Finding No Reduction in Diamine Oxidase Levels and Activity except with Citalopram
Yaiza Tobajas, Marc Alemany-Fornés, Iris Samarra, Jordi Romero-Giménez, Jordi Cuñé-Castellana, Maria Tintoré, Antoni del Pino, Núria Canela, Josep M. del Bas, Nàdia Ortega-Olivé, Carlos de Lecea, Xavier Escoté
Journal of Clinical Medicine.2024; 13(3): 792. CrossRef
Nahrungsmittelallergie und Histaminintoleranz
Yurdagül Zopf, Walburga Dieterich
Die Gastroenterologie.2024; 19(1): 3. CrossRef
Prevalence and Clinical Picture of Diamine Oxidase Gene Variants in Children and Adolescents with Attention Deficit Hyperactivity Disorder: A Pilot Study
Hilario Blasco-Fontecilla, Marcos Bella-Fernández, Ping Wang, Marina Martin-Moratinos, Chao Li
Journal of Clinical Medicine.2024; 13(6): 1659. CrossRef
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Colonic dysmotility and morphological abnormality frequently detected in Japanese patients with irritable bowel syndrome: Takeshi Mizukami, Shinya Sugimoto, Tatsuhiro Masaoka, Hidekazu Suzuki, Takanori Kanai; Intest Res 2017;15(2):236-243. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.236

Abstract PDF PubReader ePub

Background/Aims

Colonoscopy and computed tomography (CT) are used primarily to exclude organic diseases in patients with irritable bowel syndrome (IBS), rather than to assess the pathophysiology of IBS. We aimed to evaluate colonic dysmotility and morphology in Japanese patients with IBS.

Methods

One hundred eighty-four patients with IBS and 49 asymptomatic controls who underwent colonoscopy in combination with CT colonography or barium enema were retrospectively reviewed between 2008 and 2012. Water-aided colonoscopy was performed without sedation by a single endoscopist. The duration and pattern of colonic movement and cecal intubation time were recorded. To assess colonic morphology, barium enema or CT colonography were performed immediately after colonoscopy.

Results

Colonic dysmotility was more frequent in the IBS group (28.8% vs. 2.0% in controls, P<0.001), especially in cases of IBS with diarrhea (IBS-D) (IBS with constipation [IBS-C] 28.8% vs. IBS-D 60.0% vs. mixed IBS [IBS-M] 5.1%, P<0.001). Colonic morphological abnormality was more frequent in the IBS group than in the control group (77.7% vs. 24.5%, P<0.001), especially in IBS-M and IBS-C groups (IBS-C 77.5% vs. IBS-D 48.9% vs. IBS-M 100%, P<0.001). Most patients with IBS with colonic dysmotility had experienced stress related to their symptoms. Cecal intubation time was significantly longer in the IBS group than in the control group (12.1±6.9 minutes vs. 4.6±1.9 minutes, P<0.001).

Conclusions

Unsedated colonoscopy, combined with radiographic findings, can detect colonic dysmotility and morphological abnormality. Technical difficulties observed during cecal intubation may partially explain the pathophysiology of IBS.

Citations

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Efficacy of Glycicumarin and Isoliquiritigenin in Suppressing Colonic Peristalsis in Both an Animal Model and a Clinical Trial
Reo Kobayashi, Ken Inoue, Satoshi Sugino, Ryohei Hirose, Toshifumi Doi, Akihito Harusato, Osamu Dohi, Naohisa Yoshida, Kazuhiko Uchiyama, Takeshi Ishikawa, Tomohisa Takagi, Hideyuki Konishi, Yasuko Hirai, Katsura Mizushima, Yuji Naito, Yoshito Itoh
Biological and Pharmaceutical Bulletin.2024; 47(2): 373. CrossRef
Diagnostic Ability of Ultrasonography Compared with Computed Tomography for Assessing Rectal Feces
Noboru Misawa, Masaru Matsumoto, Momoko Tsuda, Shigeki Tamura, Tsutomu Yoshihara, Keiichi Ashikari, Takaomi Kessoku, Hidenori Ohkubo, Takuma Higurashi, Hiromi Sanada, Mototsugu Kato, Atsushi Nakajima
Journal of the Anus, Rectum and Colon.2024; 8(2): 126. CrossRef
Evidence-Based Clinical Guidelines for Chronic Constipation 2023
Eikichi Ihara, Noriaki Manabe, Hidenori Ohkubo, Naotaka Ogasawara, Haruei Ogino, Kazuki Kakimoto, Motoyori Kanazawa, Hidejiro Kawahara, Chika Kusano, Shiko Kuribayashi, Akinari Sawada, Tomohisa Takagi, Shota Takano, Toshihiko Tomita, Toshihiro Noake, Mari
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Symptomatic improvement with gluten restriction in irritable bowel syndrome: a prospective, randomized, double blinded placebo controlled trial: Vinay G Zanwar, Sunil V Pawar, Pravir A Gambhire, Samit S Jain, Ravindra G Surude, Vinaya B Shah, Qais Q Contractor, Pravin M Rathi; Intest Res 2016;14(4):343-350. Published online October 17, 2016; DOI: https://doi.org/10.5217/ir.2016.14.4.343

Abstract PDF PubReader

Background/Aims

The existence of non-celiac gluten sensitivity has been debated. Indeed, the intestinal and extra-intestinal symptoms of many patients with irritable bowel syndrome (IBS) but without celiac disease or wheat allergy have been shown to improve on a gluten-free diet. Therefore, this study set out to evaluate the effects of gluten on IBS symptoms.

Methods

We performed a double-blind randomized placebo-controlled rechallenge trial in a tertiary care hospital with IBS patients who fulfilled the Rome III criteria. Patients with celiac disease and wheat allergy were appropriately excluded. The participants were administered a gluten-free diet for 4 weeks and were asked to complete a symptom-based questionnaire to assess their overall symptoms, abdominal pain, bloating, wind, and tiredness on the visual analog scale (0-100) at the baseline and every week thereafter. The participants who showed improvement were randomly assigned to one of two groups to receive either a placebo (gluten-free breads) or gluten (whole cereal breads) as a rechallenge for the next 4 weeks.

Results

In line with the protocol analysis, 60 patients completed the study. The overall symptom score on the visual analog scale was significantly different between the two groups (P<0.05). Moreover, the patients in the gluten intervention group scored significantly higher in terms of abdominal pain, bloating, and tiredness (P<0.05), and their symptoms worsened within 1 week of the rechallenge.

Conclusions

A gluten diet may worsen the symptoms of IBS patients. Therefore, some form of gluten sensitivity other than celiac disease exists in some of them, and patients with IBS may benefit from gluten restrictions.

Citations

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Accuracy of three different fecal calprotectin tests in the diagnosis of inflammatory bowel disease: Hui Won Jang, Hyun Sook Kim, Soo Jung Park, Sung Pil Hong, Tae Il Kim, Won Ho Kim, Jae Hee Cheon; Intest Res 2016;14(4):305-313. Published online October 17, 2016; DOI: https://doi.org/10.5217/ir.2016.14.4.305

Abstract PDF PubReader

Background/Aims

Several studies have found that the measurement of fecal calprotectin is useful for the early diagnosis of inflammatory bowel disease (IBD). We compared the effectiveness of three different fecal calprotectin kits for initial diagnosis in patients with suspected IBD.

Methods

We enrolled 31 patients with IBD (18 Crohn's disease [CD], 11 ulcerative colitis [UC], and two intestinal Behçet's disease), five with irritable bowel syndrome (IBS), and five with other colitis (four infectious colitis and one intestinal tuberculosis). Diagnosis was based on clinical, laboratory, and endoscopic examinations. Fecal samples were obtained at the first diagnosis and calprotectin levels were measured using three different kits (Quantum Blue® Calprotectin, EliA™ Calprotectin, and RIDASCREEN® Calprotectin).

Results

The overall accuracy for differentiating IBD from IBS or other colitis was 94% and 91%, respectively, for Quantum Blue® (cutoff, 50 µg/g); 92% and 89%, respectively, for EliA™ (cutoff, 50 µg/g); and 82% and 76%, respectively, for RIDASCREEN® (cutoff, 50 µg/g). In patients with CD, the results of Quantum Blue® Calprotectin and EliA™ Calprotectin correlated significantly with levels of the Crohn's disease activity index (Spearman's rank correlation coefficient, r=0.66 and r=0.49, respectively). In patients with UC, the results of EliA™ Calprotectin correlated significantly with the Mayo score (r=0.70).

Conclusions

Fecal calprotectin measurement is useful for the identification of IBD. The overall accuracies of the three fecal calprotectin kits are comparable.

Citations

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Review

Irritable bowel syndrome and inflammatory bowel disease overlap syndrome: pieces of the puzzle are falling into place: Rafiz Abdul Rani, Raja Affendi Raja Ali, Yeong Yeh Lee; Intest Res 2016;14(4):297-304. Published online October 17, 2016; DOI: https://doi.org/10.5217/ir.2016.14.4.297

Abstract PDF PubReader

Irritable bowel syndrome (IBS), a common gastrointestinal disorder involving the gut-brain axis, and inflammatory bowel disease (IBD), a chronic relapsing inflammatory disorder, are both increasing in incidence and prevalence in Asia. Both have significant overlap in terms of symptoms, pathophysiology, and treatment, suggesting the possibility of IBS and IBD being a single disease entity albeit at opposite ends of the spectrum. We examined the similarities and differences in IBS and IBD, and offer new thoughts and approaches to the disease paradigm.

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