Browsing by Subject "IBS"

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  • Modabbernia, Mohamad-Jafar; MansourGhanaei, Fariborz; Imani, Ali; MirsafaMoghaddam, SeyedAlireza; SedighRahimabadi, Massih; YousefiMashhour, Mahmoud; Joukar, Farahnaz; AtrkarRoushan, Zahra; Bidel, Siamak (2012)
    BACKGROUND: Psychiatric disorders are common in irritable bowel syndrome (IBS) patients. The prevalence of psychiatric disorders in IBS patients varies in different cultures. We conducted this study to determine the prevalence of psychiatric disorders METHODS: In a cross-sectional study, 256 IBS patients were selected (using the criteria of Rome III) and evaluated for psychiatric disorders. In the first phase, subjects were screened using the General Health Questionnaire 28 (GHQ28). In the second phase, those who had scores ≥ 23 were assessed through semi-structured psychiatric interviews. RESULTS: Thirty out of 256 subjects had no significant psychiatric symptoms after performing GHQ28. In further psychiatric evaluation of the remaining subjects (226) who suffered from some degree of a psychiatric problem, 36 were diagnosed without Anxiety/Depressive disorder. Thus 66 subjects (25.8%) were known as a group without any significant psychiatric problem. A total of 190 subjects (74.2%) with anxiety-depressive problems were diagnosed; 89 were suffering from pure anxiety disorders, 41 were suffering from depressive disorders and 60 had co-morbid anxiety-depressive disorders. When comparing anxiety-depressive patients (n = 190) with normal subjects (n = 66), gender (P = 0.016), occupation (P = 0.002) and intensity of IBS (P < 0.001) showed statistically significant differences. CONCLUSION: The high prevalence of anxiety-depressive disorders in this study indicates the necessity of psychiatric assessment, early diagnosis and treatment of the patients with IBS. It may improve management of the patients suffering from IBS.
  • Jalanka, Jonna; Lam, Ching; Bennett, Andrew; Hartikainen, Anna; Crispie, Fiona; Finnegan, Laura A.; Cotter, Paul D.; Spiller, Robin (2021)
    Background/Aims Diarrhea-predominant irritable bowel syndrome (IBS-D) has been previously associated with evidence of immune activation and altered microbiota. Our aim is to assess the effect of the anti-inflammatory agent, mesalazine, on inflammatory gene expression and microbiota composition in IBS-D. Methods We studied a subset of patients (n = 43) from a previously published 12-week radomized placebo-controlled trial of mesalazine. Mucosal biopsies were assessed by immunohistochemistry and reverse transcription-polymerase chain reaction for a range of markers of inflammation, altered permeability, and sensory receptors including Toll-like receptors (TLRs) at randomization after treatment. All biopsy data were compared to 21 healthy controls. Patient's stool microbiota composition was analysed through 16S ribosomal RNA sequencing. Results We found no evidence of increased immune activation compared to healthy controls. However, we did find increased expression of receptors in both sensory pathways and innate immune response including TLR4. Higher TLR4 expression was associated with greater urgency. TLR4 expression correlated strongly with the expression of the receptors bradykinin receptor B2, chemerin chemokine-like receptor 1, and transient receptor potential cation channel, subfamily A, member 1 as well as TLR4's downstream adaptor myeloid differentiation factor 88. Mesalazine had minimal effect on either gene expression or microbiota composition. Conclusions Biopsies from a well-characterized IBS-D cohort showed no substantial inflammation. Mesalazine has little effect on gene expression and its previous reported effect on fecal microbiota associated with much greater inflammation found in inflammatory bowel diseases is likely secondary to reduced inflammation. Increased expression of TLR4 and correlated receptors in IBS may mediate a general increase in sensitivity to external stimuli, particularly those that signal via the TLR system.
  • Hynönen, Ulla; Zoetendal, Erwin G.; Virtala, Anna-Maija K.; Shetty, Sudarshan; Hasan, Shah; Jakava-Viljanen, Miia; de Vos, Willem M.; Palva, Airi (2020)
    In our previous studies on irritable bowel syndrome (IBS) –associated microbiota by molecular methods, we demonstrated that a particular 16S rRNA gene amplicon was more abundant in the feces of healthy subjects or mixed type IBS (IBS-M) –sufferers than in the feces of individuals with diarrhea-type IBS (IBS-D). In the current study, we demonstrated that this, so called Ct85-amplicon, consists of a cluster of very heterogeneous 16S rRNA gene sequences, and defined six 16S rRNA gene types, a to f, within this cluster, each representing a novel species-, genus- or family level taxon. We then designed specific PCR primers for these sequence types, mapped the distribution of the Ct85-cluster sequences and that of the newly defined sequence types in several animal species and compared the sequence types present in the feces of healthy individuals and IBS sufferers using two IBS study cohorts, Finnish and Dutch. Various Ct85-cluster sequence types were detected in the fecal samples of several companion and production animal species with remarkably differing prevalences and abundances. The Ct85 sequence type composition of swine closely resembled that of humans. One of the five types (d) shared between humans and swine was not present in any other animals tested, while one sequence type (b) was found only in human samples. In both IBS study cohorts, one type (e) was more prevalent in healthy individuals than in the IBS-M group. By revealing various sequence types in the widespread Ct85-cluster and their distribution, the results improve our understanding of these uncultured bacteria, which is essential for future efforts to cultivate representatives of the Ct85-cluster and reveal their roles in IBS.
  • De bruyn, Michelle; Ceuleers, Hannah; Hanning, Nikita; Berg, Maya; De Man, Joris G.; Hulpiau, Paco; Hermans, Cedric; Stenman, Ulf Håkan; Koistinen, Hannu; Lambeir, Anne Marie; De Winter, Benedicte Y.; De Meester, Ingrid (2021)
    The protease activity in inflammatory bowel disease (IBD) and irritable bowel syndrome has been studied extensively using synthetic fluorogenic substrates targeting specific sets of proteases. We explored activities in colonic tissue from a 2,4,6-trinitrobenzenesulfonic acid (TNBS)-induced colitis rat model by investigating the cleavage of bioactive peptides. Pure trypsin-and elastase-like proteases on the one hand and colonic tissue from rats with TNBS-induced colitis in the acute or post-inflammatory phase on the other, were incubated with relevant peptides to identify their cleavage pattern by mass spectrometry. An increased cleavage of several peptides was observed in the colon from acute colitis rats. The tethered ligand (TL) sequences of peptides mimicking the N-terminus of protease-activated receptors (PAR) 1 and 4 were significantly unmasked by acute colitis samples and these cleavages were positively correlated with thrombin activity. Increased cleavage of β-endorphin and disarming of the TL-sequence of the PAR3-based peptide were observed in acute colitis and linked to chymotrypsin-like activity. Increased processing of the enkephalins points to the involvement of proteases with specificities different from trypsin-or chymotrypsin-like enzymes. In conclusion, our results suggest thrombin, chymotrypsin-like proteases and a set of proteases with different specificities as potential therapeutic targets in IBD.
  • Laatikainen, R.; Koskenpato, J.; Hongisto, S. -M.; Loponen, J.; Poussa, T.; Hillilä, Markku; Korpela, R. (2016)
    BackgroundGrains are high in FODMAPs (Fermentable Oligo-, Di-, Monosaccharides And Polyols) and often considered as triggers of IBS symptoms. AimTo evaluate if rye bread low in FODMAPs would be better tolerated than regular rye bread in subjects with IBS. MethodsThe study was conducted as a randomised double blind controlled cross-over study (n=87). Participants were supplied with both regular rye bread and low-FODMAP rye bread for 4weeks. Symptoms were measured with a symptom severity scoring system (IBS-SSS) and visual analogue scale (VAS) assessments of individual symptoms. Quality of life was monitored. Colonic fermentation was measured by the breath hydrogen test and dietary intake by food diaries. ResultsDietary fibre intake increased during both study periods compared to baseline. Many signs of IBS i.e. flatulence, abdominal pain, cramps and stomach rumbling were milder on the low-FODMAP rye bread (P-values: 0.04; 0.049; 0.01 and 0.001). The mean of VAS measurements was favourable towards LF bread [-3 (95% CI): -6 to -1, P=0.02] but no differences were detected in IBS-SSS or quality of life. The AUC of breath hydrogen values was significantly lower during the low-FODMAP bread period (median 52.9 vs. 72.6; P=0.01). ConclusionsLow-FODMAP rye bread helps IBS patients to control their symptoms and reduces gastrointestinal gas accumulation. However, replacing regular rye bread by low-FODMAP bread without concomitant broader dietary changes does not improve quality of life or IBS-SSS. Nonetheless, inclusion of low-FODMAP rye bread in diet might be one way that IBS patients could increase their fibre intake.
  • Laatikainen, Reijo; Jalanka, Jonna; Loponen, Jussi; Hongisto, Sanna-Maria; Hillilä, Markku; Koskenpato, Jari; Korpela, Riitta; Salonen, Anne (BioMed Central, 2019)
    Abstract Background A low intake of Fermentable, Oligo-, Di-, Mono-saccharides and Polyols (FODMAPs) is effective in the symptom control of irritable bowel syndrome (IBS) patients but may exert negative effects on the intestinal microbiota. The microbial effects of increasing regular or non-FODMAP fibre sources are largely unknown. Furthermore, it is not known if the baseline microbiota composition is associated with individual symptom control during the consumption of different rye products in IBS patients. Our objective was to evaluate whether increased consumption of low-FODMAP rye bread or regular rye bread for 4 weeks would alter the intestinal microbiota composition of IBS patients following their habitual diet, and whether these changes associate to symptoms and/or the baseline microbiota. Methods The study was conducted as a randomized double blind controlled cross-over study (n = 50). Microbiota was analysed by 16S rRNA gene sequencing and associated with gastrointestinal symptoms. Both microbial changes and their associations to symptoms were secondary outcomes. Results The consumption of the test breads did not alter microbiota diversity. Compared to baseline, consumption of the low FODMAP rye bread decreased the abundance of Bacteroides, Flavonifractor, Holdemania, Parasutterella and Klebsiella and showed a trend towards increased bifidobacteria, whereas the regular rye bread decreased the abundance of Flavonifractor. When comparing between the two test breads, Klebsiella was decreased after low-FODMAP rye bread intake. Patients whose symptoms decreased during the low-FODMAP rye bread displayed more Blautia and less Barnesiella at baseline. Conclusions Consumption of low-FODMAP rye bread had modest, potentially beneficial effects on patients’ microbiota while increasing their intake of fibre substantially. The baseline microbiota composition was associated with the variable degrees of symptom relief experienced by the patients. Consumption of a low-FODMAP rye bread might be one way to increase dietary fibre intake and improve the mild dysbiosis often observed among patients with IBS. Trial registration ClinicalTrials.gov: NCT02161120 . Retrospectively registered 11 June 2014.
  • Lahtinen, Perttu; Jalanka, Jonna; Hartikainen, Anna; Mattila, Eero; Hillilä, Markku; Punkkinen, Jari; Koskenpato, Jari; Anttila, Veli-Jukka; Tillonen, Jyrki; Satokari, Reetta; Arkkila, Perttu (2020)
    Summary Background Irritable bowel syndrome (IBS) has been associated with microbial dysbiosis. Aim To investigate the efficacy of faecal microbiota transplantation (FMT) in the treatment of IBS. Methods Forty-nine IBS patients were randomised to receive autologous or allogenic FMT via colonoscopy. The primary endpoint was a sustained, minimum of 50-point, reduction in the IBS Symptom Severity Score. The secondary outcomes were levels of anxiety and depression, changes in quality of life, gut microbiota and faecal water content as assessed with validated questionnaires, intestinal microbiota composition and stool dry weight. Results The primary endpoint was not achieved in either group. However, there was a transient reduction in the mean IBS Symptom Severity Score in the FMT group at 12 weeks after treatment as compared to baseline (P = 0.01). The groups did not differ in the number of patients achieving clinical response at 12 weeks. In the FMT-treated patients, microbial composition had changed to resemble that of the donor and the stool water content decreased significantly compared to baseline. The depression score decreased in patients with a reduction in IBS symptoms after FMT, but not in those placebo-treated patients who experienced a reduction in IBS symptoms. Conclusions FMT provided only a transient relief of symptoms, although it induced a sustained alteration in the microbiota of IBS patients. Therefore, FMT delivered by a single infusion via colonoscopy cannot be recommended as a treatment for IBS in clinical practice. ClinicalTrials.Org, Trial registration number: NCT03561519.
  • Laatikainen, Reijo; Salmenkari, Hanne; Sibakov, Timo; Vapaatalo, Heikki; Turpeinen, Anu (2020)
    Unspecific gastrointestinal symptoms associated with milk consumption are common. In addition to lactose, also other components of milk may be involved. We studied whether the partial hydrolysation of milk proteins would affect gastrointestinal symptoms in subjects with functional gastrointestinal disorders. In a randomised, placebo-controlled crossover intervention, subjects (n = 41) were given ordinary or hydrolysed high-protein, lactose-free milkshakes (500 mL, 50 g protein) to be consumed daily for ten days. After a washout period of ten days, the other product was consumed for another ten days. Gastrointestinal symptoms were recorded daily during the study periods, and a validated irritable bowel syndrome-symptom severity scale (IBS-SSS) questionnaire was completed at the beginning of the study and at the end of both study periods. Blood and urine samples were analysed for markers of inflammation, intestinal permeability and immune activation. Both the IBS-SSS score (p = 0.001) and total symptom score reported daily (p = 0.002) were significantly reduced when participants consumed the hydrolysed product. Less bloating was reported during both study periods when compared with the baseline (p < 0.01 for both groups). Flatulence (p = 0.01) and heartburn (p = 0.03) decreased when consuming the hydrolysed product but not when drinking the control product. No significant differences in the levels of inflammatory markers (tumor necrosis factor alpha, TNF-α and interleukin 6, IL-6), intestinal permeability (fatty acid binding protein 2, FABP2) or immune activation (1-methylhistamine) were detected between the treatment periods. The results suggest that the partial hydrolysation of milk proteins (mainly casein) reduces subjective symptoms to some extent in subjects with functional gastrointestinal disorders. The mechanism remains to be resolved. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
  • Pirkola, Laura (Helsingfors universitet, 2016)
    Johdanto: Ärtyvän suolen oireyhtymä on toiminnallinen vatsavaiva, johon liittyy kipu tai epämiellyttävä tunne vatsassa ja muuttunut ulostustiheys tai ulosteen koostumus. Viime aikoina on saatu tutkimusnäyttöä paksusuolessa herkästi fermentoituvia FODMAP-hiilihydraatteja (fermentable oligo , di- and monosaccharides and polyols) rajoittavan ruokavalion tehosta ärtyvän suolen oireyhtymän hoidossa. Ruisleipä on keskeinen kuidun ja folaatin lähde suomalaisille, mutta se sisältää runsaasti FODMAP-hiilihydraatteja ja voi sen vuoksi aiheuttaa oireita herkkävatsaisille. Ruisleivän valmistusprosessia muuttamalla voidaan tehdä vähemmän FODMAP-hiilihydraatteja sisältävää ruisleipää. Tavoitteet: Tutkimuksen päätavoitteena oli verrata kahden, FODMAP-hiilihydraattien määrän suhteen toisistaan eroavan ruisleivän vaikutuksia IBS-potilaiden aterianjälkeisiin vatsaoireisiin, uloshengitysilman vetypitoisuuteen ja mahasuolikanavan läpikulkuaikoihin, happamuuteen ja paineeseen. Muina tavoitteina oli saada tietoa SmartPill®-laitteen toimivuudesta vatsaoireiden mittausmenetelmänä ja tutkia vatsaoireiden voimakkuuden ja uloshengitysilman vetypitoisuuden välistä yhteyttä. Aineisto ja menetelmät: Tutkittavana olivat normaalipainoiset ja ylipainoiset naiset, joilla oli IBS (n=7). Tutkimus oli kaksoissokkoutettu, satunnaistettu, vaihtovuoroinen ateriakoe kahdella eri ruisleivällä. Tutkittavat söivät satunnaisessa järjestyksessä kumpaakin leipää erillisillä koejaksoilla, minkä jälkeen heiltä mitattiin vatsaoireita, uloshengitysilman vetypitoisuutta ja suoliston sisäisiä olosuhteita. Suoliston lämpötilaa, painetta ja pH:ta mitattiin SmartPill®-laitteella, joka on pienikokoinen nieltävä kapseli. Kapselin mittaamista tiedoista saadaan läpikulkuajat, pH:n mediaanit, keskipaine ja supistuksien määrät mahasuolikanavan eri osille. Tutkimuksen tulokset esitettiin mm. käyrän alaisina pinta-aloina ja maksimiarvoina. Mittausjaksojen välisiä eroja analysoitiin tilastollisesti Wilcoxonin merkittyjen sijalukujen testillä. Vatsaoireiden voimakkuuden yhteyttä suoliston paineeseen ja uloshengitysilman vetypitoisuuteen analysoitiin Spearmanin järjestyskorrelaatiokertoimen avulla. Tulokset: Uloshengitysilman vetypitoisuuden käyrän alainen pinta-ala (AUC0-630min) erosi koejaksojen välillä (p=0,028). Uloshengitysilman vetypitoisuus oli matalampi tutkittavien syödessä vähemmän FODMAP-hiilihydraatteja sisältävää ruisleipää verrattuna tavalliseen ruisleipään. Ilmavaivojen voimakkuuden maksimiarvo oli suurempi tavallisella ruisleivällä (p=0,034). SmartPill®-kapselilla mitatut läpikulkuajat, pH, paine ja supistuksien määrä eivät eronneet koejaksojen välillä. Vatsaoireiden yhteenlaskettu voimakkuus oli positiivisesti yhteydessä paksusuolen keskipaineeseen toisella koejaksolla (ρ=0,786, p=0,036). Vatsaoireiden voimakkuuden ja uloshengitysilman vetypitoisuuden välillä ei havaittu yhteyttä. Johtopäätökset: Ruisleivän FODMAP-hiilihydraattien määrä saattaa vaikuttaa paksusuolessa tapahtuvaan mikrobifermentaatioon, joka lisää vetykaasun muodostumista suolistossa. Lisääntynyt kaasun määrä suolessa voi aiheuttaa ilmavaivoja ja nostaa paksusuolen painetta, mikä saattaa aiheuttaa myös muita vatsaoireita. Vähemmän fermentoituvia hiilihydraatteja sisältävä ruisleipä voi auttaa hillitsemään kaasun tuotantoa ja siihen liittyviä oireita IBS-potilailla, jotka saavat vatsaoireita tavallisesta ruisleivästä. SmartPill®-kapselin soveltuvuudesta vatsaoireiden mittausmenetelmäksi tarvitaan huomattavasti enemmän tutkimustietoa.