No description available.

IBS (irritable bowel syndrome) is a functional gastrointestinal disorder which is estimated to affect one in ten individuals. It affects bowel function and leads to discomfort and pain for the patient. IBS can be subdivided into three separate groups named after the symptoms they bring: IBS-C (constipation), IBS-D (diarrhea) and IBS-M (mix). Today, there are no diagnostic markers for the disorder. The small and large intestine are regularly exposed to foreign substances and microorganisms; hence they contain a large number of immune cells of all sorts. Mastcells (MC) are pro-inflammatory cells and can be found in vast numbers in the intestine wall. They are thought to play an important role in the development of IBS. Studies has also shown that the neuropeptide vasoactive intestinal polypeptide (VIP) alter the function of the intestine and increased amount of VIP have been detected in plasma from IBS-patients. The purpose of this study was to compare the number of MCs and MCs containing VIP in colonic biopsies from: 6 healthy women, 6 women with IBS-D and 6 women with IBS-C. VIP in plasma was also measured in order to compare the amount between healthy and IBS-patients. MCs and VIP containing MCs were quantified using immunohistochemical techniques where the colonic tissue was double stained with antibodies directed towards mast cell tryptase and VIP. Evaluation of the immunostained tissue was performed using fluorescent microscopy. VIP in plasma was analysed using enzyme immunoassay (EIA). No significant difference in the number of MCs nor in MCs containing VIP was detected between the groups. However, significant differences in the amount of VIP in plasma was detected between healthy women and women with IBS-D. More studies are needed to elucidate the role of MC and VIP in the pathogenesis of IBS.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder. Cortical thinning of the anterior mid-cingulate cortex (aMCC) and insula has been previously reported in IBS (Davis et al., 2008). The aim of the present study was to examine cortical and subcortical structural gray matter integrity in IBS with particular attention to individual disease symptoms and personality characteristics such as pain catastrophizing. Eleven IBS patients and 16 age-matched healthy subjects (female, right-handed) underwent structural MRI. Voxel Based Morphometry and Cortical Thickness Analysis revealed that the IBS group had increased gray matter density in the hypothalamus, cortical thinning in the aMCC, strong (r = -66; p=0.015), a negative correlation between dorsolateral prefrontal cortex and pain catastrophizing and anterior insula thickness was positively correlated to pain duration (r = 0.77, p=0.003) when controlling for age. These abnormalities may contribute to chronic pain in IBS.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder. Cortical thinning of the anterior mid-cingulate cortex (aMCC) and insula has been previously reported in IBS (Davis et al., 2008). The aim of the present study was to examine cortical and subcortical structural gray matter integrity in IBS with particular attention to individual disease symptoms and personality characteristics such as pain catastrophizing. Eleven IBS patients and 16 age-matched healthy subjects (female, right-handed) underwent structural MRI. Voxel Based Morphometry and Cortical Thickness Analysis revealed that the IBS group had increased gray matter density in the hypothalamus, cortical thinning in the aMCC, strong (r = -66; p=0.015), a negative correlation between dorsolateral prefrontal cortex and pain catastrophizing and anterior insula thickness was positively correlated to pain duration (r = 0.77, p=0.003) when controlling for age. These abnormalities may contribute to chronic pain in IBS.

Background: Diet therapies may be recommended for pediatric functional gastrointestinal disorders (FGIDs). However, little is known about the frequency with which diet therapy is recommended in FGIDs. Our aims were to determine and contrast the frequency and types of diet recommendations provided to children with FGIDs by pediatric gastroenterologists (PGIs) versus primary care pediatricians (PCPs). Methods: A retrospective chart review was performed using data from a large, metropolitan children's academic healthcare system to identify subjects meeting Rome IV criteria for functional abdominal pain, functional dyspepsia, irritable-bowel syndrome (IBS), and/or abdominal migraine over a period of 23 months. Results: Of 1929 patient charts reviewed, 268 were included for further analyses. Of these, 186 patients (69%) were seen by a PGI and 82 (31%) by a PCP. The most common diagnosis was IBS (49% for PGIs and 71% for PCPs). Diet recommendations were provided to 115 (43%) patients (PGI group: 86 [75%] vs PCP group: 29 [25%]; P <.1). The most frequent recommendations were high fiber (PGI: 15%; PCP: 14%) and low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) diet (PGI: 12%; PCP: 4%). Of those provided with diet recommendations, only 20% (n = 23) received an educational consult by a dietitian. Provision of diet recommendations was not affected by years in practice. Conclusion: Despite increasing awareness of the role of diet in the treatment of childhood FGIDs, a minority of patients receive diet recommendations in tertiary care or primary care settings. When diet recommendations were given, there was great variability in the guidance provided.

Bakgrund: IBS (Irritable bowel syndrome) är en funktionell mag-tarmsjukdom med en oklar orsak och patofysiologi. IBS förekommer mest hos kvinnor och karakteriseras av buksmärta, uppblåsthet, diarré och/eller förstoppning samt ökad gasbildning. I nuläget finns inga läkemedel som botar sjukdomstillståndet, och den senaste tiden har intresset för probiotika som behandling av IBS ökat. Probiotika innehåller levande mikroorganismer som anses ha en gynnsam effekt på tarmflorans sammansättning, samt kan tros ha en symtomatisk effekt vid IBS. Syfte: Syftet med detta litteraturarbete är att ta reda på om kosttillskott som innehåller bakteriearten Lactobacillus plantarum har en positiv effekt för att lindra symtomen hos patienter som lider av en diarrépredominant IBS. Metod: Sex randomiserade, dubbelblinda och placebo-kontrollerade studier granskades. Studierna utvärderade effekten av den enskilda bakteriearten L. plantarum eller en kombination av probiotika som innehöll L. plantarum för symtomlindring hos IBS-patienter. Artikelsökning utfördes i databasen PubMed via Linnéuniversitetets bibliotek. Resultat: Tre av de fyra studierna som undersökte L. plantarum i kombination med andra bakteriestammar påvisade en statistiskt signifikant förbättring av symtomen buksmärta hos IBSpatienter. En av de två studierna som undersökte enbart L. plantarum visade en signifikant förbättring av symtomen buksmärta. Två av sex studier visade ingen signifikant förbättring av symtomlindring mellan probiotika- och placebo gruppen. Slutsats: Utifrån sammanställningen påvisades att effekten uppnåddes framförallt i gruppen med måttliga IBS besvär. Dock gav inte behandling med L. plantarum alltid en statistisk signifikant förbättring av symtomlindring hos diarré predominanta IBS-patienter. Vidare studier behövs på subtypen diarré predominant IBS för att stärka och fastställa L. plantarums effekt.

Fibromyalgia is a chronic pain disorder characterized by multiple symptoms including severe fatigue, headache, muscle pain, cognitive dysfunction, and paresthesias. Up to 81% of patients with fibromyalgia (FM) also suffer from irritable bowel syndrome (IBS). The objectives of this study were: 1) to evaluate the effect of a 4-week excitotoxin additive free diet on symptoms of fibromyalgia (FM) and irritable bowel syndrome (IBS), and then further, to use a randomized double blind crossover challenge to determine: 2) whether FM symptoms would return more frequently when subjects were challenged with MSG as compared to placebo, and 3) whether IBS symptoms returned upon MSG challenge more frequently than placebo. Subjects were recruited from the Portland, OR area, and attended a 2-hour group diet training session and individual clinic appointment before starting a one-month excitotoxin additive free diet. At the end of the month, subjects reporting greater than 30% symptom improvement went onto a 2-week double blind crossover challenge period where they were randomized to receive either MSG in juice for 3 days or placebo for 3 days. The following week they received whatever they did not receive the first week. Eighty-four percent of those who finished the diet reported >30% symptom improvement and pre-post diet analysis demonstrated highly significant difference scores for all major outcome measures. Total symptom scores (11.4, p<0.0001), fibromyalgia impact questionnaire-revised scores (FIQR) (22, p<0.0001), and IBS quality of life (IBS-QOL) questionnaire scores (11, p<0.0001) were all significantly reduced, as were visual analog pain (VAS) change scores for FM (5.4, p<0.0001) and IBS (4.6, p<0.0001). Challenge results demonstrated that diet responders got significantly worse when challenged with MSG as compared to placebo in most measures (total symptom score, p<0.02; FIQR, p<0.03; and IBS-QOL, p<0.05). VAS for IBS and FM both worsened, but to a lesser degree (mean change of 2.1 (p<0.19) and 2.5 (p<0.07) respectively). The majority of responders were still following the diet at 2 months post study which suggests feasibility and benefit. Results suggest that the excitotoxin additive free dietary intervention may provide significant symptom relief equal to or greater than current pharmacological strategies for fibromyalgia patients with IBS.

IBS är en av de vanligaste mag- tarmsjukdomarna i västvärlden. Trots hög prevalens saknas kunskap kring effektiva behandlingsmetoder. Då sjukdomen är kronisk berörs den drabbade på lidandets olika nivåer. Eftersom IBS innebär ett lidande för den drabbade som kan medföra sämre livkvalitet väcks frågor kring hur personer som lever med IBS upplever det att leva med sjukdomen Syftet med denna studie är att nå kunskap kring den subjektiva upplevelsen av att leva med IBS med vardagen i fokus. En kvalitativ innehållsanalys med en induktiv ansats har legat till grund för studien. Datamaterialet består av bloggtexter av personer med sjukdomen IBS. Datamaterialet utgörs av sju blogginlägg av skribenter mellan 20-60 år. Vidare har ett ändamålsenligt urval tillämpats för att besvara studiens syfte. Att lida av IBS medför en rad begränsningar och kan bidra till en känsla av identitetsförlust i och med att de inte kan utföra samma meningsfulla aktiviteter längre. Sjukdomen medför daglig trötthet tillsammans med symtom såsom akut diarré och illamående, vilket tar ut sin rätt både fysiskt samt psykiskt. I perioder upplevs därav hopplöshet över sin situation, dels över de begränsningar sjukdomen orsakar samt på grund av en maktlöshet som infinns i och med oförutsägbara symtom.

No description available.

ABSTRACT   Background Irritable bowel syndrome is the most common functional gastrointestinal disease affecting an average of 5-10% of the population. IBS cannot be cured, but proper treatment can alleviate the symptoms. FODMAP diet has proven to be the most effective treatment, which means reducing the intake of foods that the intestine has difficulty to digest. Objective The study aims at investigating IBS patients' experiences of following FODMAP dietary treatment. Method Six individual qualitative interviews were conducted with patients at a clinic in a suburb north of Stockholm. The purpose of the interviews was to get a person's view of their experiences with FODMAP dietary treatment. The interviews were recorded electronically and then verbally transcribed. The transcripts were then analyzed according to Granheim and Lundman's content analysis. Results Individuals who suffer from IBS have various kinds of constraints, their symptoms hindered their everyday lives and their social life, which affected relationships with relatives negatively. Those who did not get enough support from their close relatives experienced loneliness and found the FODMAP treatment more difficult to follow. FODMAP treatment required drastic dietary changes and symptoms were obtained when wrong food was consumed and it made that treatment felted difficult sometimes. Planning and purchasing were experienced as time consuming and complicated. The participants mentioned that they felt a sense of uncertainty for trying new foods, which meant that the diet often became monotonous.Conclusion It was clear that this patient group is in need of support from several different directions. With frequent healthcare contact, patients would gain increased knowledge about their illness. This would contribute to reduced risk of recurrent symptoms and the compliance of treatment would be increased. More support would help patients find tools to simplify their everyday lives. Healthcare professionals could also be able to provide adequate education for relatives, which would increase understanding of the disease and its treatment.