Role of psychological questionnaires in clinical practice and research within functional gastrointestinal disorders

Author(s):  
Yuying Luo ◽  
Laurie Keefer
2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Nick Smith ◽  
Paul Shorten ◽  
Eric Altermann ◽  
Nicole Roy ◽  
Warren McNabb

Abstract Objectives The role of hydrogen cross-feeding microbes in digestive function is unclear, but several such organisms have been implicated in functional gastrointestinal disorders. In order to study the dynamics of hydrogen cross-feeders, we require a computational model that provides realistic predictions of food metabolism and metabolite cross-feeding by the human intestinal microbiota. The goal is to produce a model that captures the relationships between the concentrations of all major metabolites in the colon and the microbial population. Methods We adapted the existing model microPop [Kettle et al., Methods in Ecology and Evolution, 9, 399–409, (2017)] to the human colonic environment. The model divides the microbiota into functional groups, determined by the metabolites that they feed upon and produce. We introduced alterations to the bacterial functional groups in the original model, including the addition of sulphate-reducing bacteria (SRB), which have an important role in hydrogen cross-feeding. Further adaptions included running the model through three sequentially connected compartments representing the proximal, transverse and distal colon. To enhance the applicability of the model to the colon, the production of sulphated colonic mucins by the host was included. Results The model predicts comparable conditions to those found in experimental work. The sulphated mucins were degraded by saccharolytic members of the microbiota to smaller molecules, including hydrogen, short-chain sugars and free sulphate. These metabolites formed a food source for hydrogen cross-feeders, including SRB, as has been seen in rodent models. Cross-feeding for sulphate released from mucins may be more significant in the metabolism of SRB than dietary sulphate. Conclusions The model may be used to make predictions about the consequences of certain diets on the production of microbial-derived metabolites and the composition of the microbiota. It also provides predictions about the availability of nutrients in the colon to the host. Finally, the model allows us to perform theoretical studies on the role of hydrogen cross-feeders and the metabolites they secrete in digestive function. Funding Sources This work was funded by the Riddet Institute, a New Zealand Centre of Research Excellence.


2009 ◽  
Vol 7 (4) ◽  
pp. 438-445 ◽  
Author(s):  
Cristina Almansa ◽  
Enrique Rey ◽  
Raquel García Sánchez ◽  
Ángel Álvarez Sánchez ◽  
Manuel Díaz–Rubio

CNS Spectrums ◽  
2005 ◽  
Vol 10 (11) ◽  
pp. 891-896 ◽  
Author(s):  
Kevin W. Olden

ABSTRACTSince their introduction 50 years ago, antidepressants have been used in a wide variety of settings involving gastrointestinal (GI) disease. In the 1950s, antidepressants were shown to have some efficacy for the treatment of peptic ulcer disease. This is most likely due to their antihistaminic and anticholinergic effects. Since then, more efficacious and more disease-specific treatments have become available. In the last 20 years, antidepressants have been increasingly used for the treatment of functional gastrointestinal disorders such as irritable bowel syndrome, noncardiac chest pain, and other functional GI disorders. This article will review the rationale for the use of antidepressant drugs for the treatment of functional GI disorders. The role of psychiatric comorbidity in functional GI disorders, the impact of antidepressants on GI motility and visceral sensation, and the ability of these agents to produce improvements in the global well-being and overall quality of life will be reviewed. Finally, guidelines for prescribing and barriers to a patient's acceptance of these agents will be discussed.


2017 ◽  
Vol 35 (1) ◽  
pp. 46-54
Author(s):  
Y. S. Tsimmerman

The author shares his thoughts about exaggerating the role of infection with Helicobacter pylori in etiology and pathogenesis of chronic gastritis, peptic ulcer disease, gastric cancer. Arguments against the common concept of functional gastrointestinal disorders, formulation of syndromic rather than nosological diagnosis are represented. Particular attention is paid to the moral and ethical aspects of the use of placebo in clinical trials. The shortcomings and errors of the terms that are used in modern gastroenterology are analyzed in detail.


2021 ◽  
Vol 17 (1) ◽  
pp. 22-26
Author(s):  
Marlena Górska ◽  
◽  
Ewa Toporowska-Kowalska ◽  

The most common problems that paediatricians and paediatric gastroenterologists encounter in their practice include functional gastrointestinal disorders. These are a group of chronic and/or recurrent conditions caused by any combination of gastrointestinal motility disturbances and visceral hypersensitivity with abnormal processing of stimuli in the central nervous system which manifest with abdominal pain, nausea and vomiting or disorders of defecation, among other problems. The symptoms cannot be assigned to any other clinical condition despite proper diagnostic investigation. The aetiology of functional gastrointestinal disorders is multifactorial. Recently, the role of the intestinal microbiota as an important environmental factor in the pathogenesis of such disorders has been investigated. In this article, the latest data regarding the composition of the microbiome (a collection of microbiota genes) of the human gastrointestinal tract are discussed and the methods used to determine it in detail are described. Currently, molecular biology techniques have the highest diagnostic value, which are based on genetic material sequencing. Due to their extraordinary efficacy, they are superseding classic microbiological tests. In addition, the publication presents factors which affect the composition of the gastrointestinal microbiome. These include, for example, mode of birth, method of infant feeding, diet at later stages of life, place of residence, physical activity and antibiotics intake. The research to date demonstrated that dysbiosis is one of the factors contributing to the pathogenesis of many diseases, including irritable bowel syndrome. Attempts at modifying the composition of the microbiome by, for example, the administration of probiotics, should therefore have a distinctly positive effect on patients with functional gastrointestinal disorders.


2017 ◽  
Vol 35 (Suppl. 1) ◽  
pp. 30-35 ◽  
Author(s):  
Tatiana L. Lapina ◽  
Alexander S. Trukhmanov

Background: The most common functional gastrointestinal disorders (FGID) are functional dyspepsia (FD) and irritable bowel syndrome (IBS), with a prevalence in the general population of 15–20% (FD) and 10% (IBS), respectively. The complexity of pathophysiologic mechanisms and limitations in therapeutic options make the management of FD and IBS patients a challenge in routine clinical practice. Summary: Syndromes classified as FGID frequently overlap, and coexist with gastroesophageal reflux disease (GERD). Patients with overlapping symptoms are more likely to seek medical care. The challenge for routine clinical practice is to find the best approach for treatment of multiple symptoms. STW 5, a combination of 9 herbal extracts, was shown to have multi-target effects: it normalizes the disturbed gastrointestinal motility, alleviates hypersensitivity, inhibits inflammation, suppresses gastric hypersecretion, and modulates the microbiota. Controlled randomized studies proved STW 5 to be efficacious both in FD and IBS, with control over the full spectrum of upper and lower gastrointestinal symptoms. STW 5 reduced concomitant heartburn in FD patients. STW 5 was well tolerated in the examined populations, independent of concomitant diseases and concomitant medication. Key Messages: The clinical use of the herbal preparation STW 5 in FD and IBS is evidence-based. STW 5 is an example for the concept of multi-target therapy. It offers treatment opportunities in routine clinical practice with high prevalence of overlap of FGID and concomitant GERD. Considering that FD and IBS are typically chronic and recurrent conditions, the clinically observed good tolerability and safety of STW 5 is an advantage.


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