scholarly journals Efficacy of acupuncture in refractory irritable bowel syndrome: study protocol for a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e045655
Author(s):  
Jun Zhao ◽  
Min Chen ◽  
Xin Wang ◽  
Kun Ye ◽  
Suhua Shi ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Chinese Medicine ◽  
Social Adjustment ◽  
Depression Scale ◽  
Categorical Variables ◽  
Self Rating ◽  
Symptom Profile ◽  
Wilcoxon Rank Sum Test ◽  
Number Of Patients ◽  
Irritable Bowel

IntroductionIrritable bowel syndrome (IBS) is a common chronic functional gastrointestinal disorder that presents with abdominal pain/discomfort and altered bowel patterns. IBS has multiple potential causes for which conventional medicines have had limited success, resulting in a significant number of patients who do not sensitively respond to pharmacotherapy for a period of 12 months and who develop a continuing symptom profile (described as refractory IBS) and seek help through (non)pharmacological treatments. The aim of this study is to investigate the efficacy and safety of acupuncture therapy for refractory IBS on the basis of conventional treatments.Methods and analysisA total of 170 eligible patients who meet the Rome IV criteria for refractory IBS will be randomly allocated to receive acupuncture or sham acupuncture. Each patient will receive 12 sessions of acupuncture over 4 weeks and a 4-week follow-up. The primary outcome will be the IBS Symptom Severity Score. Secondary outcomes will include the proportion of participants experiencing adequate relief of global IBS symptoms, the weekly frequency of defecation, the stool properties assessed by the Bristol Grading Scale, the Work and Social Adjustment Scale, the IBS-Quality of Life score, and the Self-Rating Depression Scale and Self-Rating Anxiety Scale anxiety and depression scores. Outcome measures will be collected at baseline, 2 and 4 weeks of the intervention, and 6 and 8 weeks after the intervention. Categorical variables will be compared with Fisher’s exact test or the Wilcoxon rank-sum test, and continuous variables will be compared using Student’s t-test or the Wilcoxon rank-sum test.Ethics and disseminationThe entire project has been approved by the ethics committees of Beijing University of Chinese Medicine (2020BZYLL0507) and Sichuan Province Regional Institution for Conducting Research on Traditional Chinese Medicine (2020KL-025). The outcomes of the trial will be disseminated through peer-reviewed publications.Trial registration numberNCT04276961.

scholarly journals Efficacy of acupuncture based on acupoint combination theory for irritable bowel syndrome: study protocol for a multicenter randomized controlled trial

2021 ◽  
Author(s):  
Jing-wen Sun ◽  
Zhi-gang Li ◽  
Ming-liang Sun ◽  
Da Li ◽  
Jun Zhao ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Irritable Bowel Syndrome ◽  
Social Adjustment ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Self Rating ◽  
Multicenter Randomized Controlled Trial ◽  
Secondary Outcomes ◽  
Irritable Bowel

Abstract Background: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by abdominal pain, diarrhea or constipation, and changes in defecation patterns. No organic disease has been found to explain these symptoms by routine clinical examination. This study aims to investigate the efficacy and safety of acupuncture therapy for IBS patients based on conventional treatments. We also want to explore the optimal acupoint combination recommended for IBS and clarify the clinical advantage of "multi-acupoint co-effect and synergistic effect".Methods and analysis: A total of 204 eligible patients who meet the Rome IV criteria for IBS will be randomly allocated to receive different acupuncture. Each patient will receive 12 acupuncture treatments over four weeks and will be followed up for four weeks. The primary outcome is the IBS-symptom severity score (IBS-SSS). The secondary outcomes include the Bristol stool form scale(BSFS), the work and social adjustment score (WSAS), the IBS-quality of life (IBS-QOL), self-rating anxiety scale (SAS), and the self-rating depression scale (SDS). Both the primary outcome and the secondary outcomes measures are collected at baseline, 2 weeks, and 4 weeks of the intervention, 6 weeks, and 8 weeks after the intervention.Ethics and dissemination: The entire project has been approved by the ethics committee of Beijing University of Chinese Medicine ( 2020BZYLL0903 ) .Discussion: This is a multicenter randomized controlled trial for IBS in China. This may shed light on the efficacy of acupuncture as an alternative to IBS. The results of the trial will be disseminated in peer-reviewed publications. Trial registration: Chinese Clinical Trials Register, ID: ChiCTR2000041215.First registered on 12 December 2020. http://www.chictr.org.cn/.

scholarly journals Characterization of kynurenine pathway in patients with diarrhea-predominant irritable bowel syndrome

2020 ◽  
Author(s):  
Pingping Li ◽  
Jimin Zheng ◽  
Yun Bai ◽  
Dingxin Wang ◽  
Zijin Cui ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Mood Disorders ◽  
High Performance ◽  
Depression Scale ◽  
Kynurenine Pathway ◽  
Self Rating ◽  
Symptom Severity Scale ◽  
Liquid Chromatography Tandem Mass ◽  
Intestinal Symptoms ◽  
Irritable Bowel

Our objectives are to demonstrate whether the kynurenine pathway is activated in diarrhea-type irritable bowel syndrome (IBS-D) patients, and whether the neurotoxic metabolite quinolinic acid (QUIN) is out of balance with the neuroprotective metabolite kynurenic acid (KYNA), and further explore whether this can lead to increase of N-methyl D-aspartate receptor 2B (NMDAR2B) expression in the enteric nervous system and in turn leads to intestinal symptoms and mood disorders. All enrolled healthy controls and patients accepted IBS symptom severity scale (IBS-SSS) score, Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) anxiety and depression scores, and also underwent colonoscopy to collect ileum and colonic mucosa specimens. The expression of NMDAR2B in intestinal mucosa was detected by immunofluorescence, and fasting serum was collected to detect the tryptophan (Trp), kynurenine (KYN), KYNA and QUIN by high performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS). Our results showed that the kynurenine pathway of IBS-D patients was activated. The production of QUIN and KYNA was imbalanced and resulting in an increased NMDAR2B for patients with IBS-D, which may be involved in intestinal symptoms and mood disorders of IBS-D.

scholarly journals Clinical Application of Dietary Therapies in Irritable Bowel Syndrome

2018 ◽  
Vol 27 (3) ◽  
pp. 307-316 ◽  
Author(s):  
Anupam Rej ◽  
Amanda Avery ◽  
Alexander Charles Ford ◽  
Anne Holdoway ◽  
Matthew Kurien ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Randomized Trials ◽  
Individual Therapy ◽  
Dietary Therapy ◽  
Round Table Discussion ◽  
Mesh Terms ◽  
Number Of Patients ◽  
Significant Difference ◽  
Irritable Bowel ◽  
Fodmap Diet

Background & Aims: Diet appears to play a pivotal role in symptom generation in Irritable Bowel Syndrome (IBS). First line dietary therapy for IBS has focused on advice concerning healthy eating and lifestyle management. Research recently has focused on the role of a diet low in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs), gluten free (GFD) and wheat free (WFD) diets for the relief of symptoms in IBS.Methods: A round table discussion with gastroenterologists and dietitians with a specialist interest in dietary therapies in IBS was held in Sheffield, United Kingdom in May 2017. Existing literature was reviewed. PubMed and EMBASE were searched with the MeSH terms irritable bowel syndrome/diet/diet therapy/gluten/low FODMAP in different combinations to identify relevant articles. A consensus on the application of these dietary therapies into day-to-day practice was developed. Results: Fourteen randomized trials in IBS evaluating the low FODMAP diet (n studies = 9), GFD (n = 4) and WFD (n = 1) were included in this review. The total number of patients recruited from randomized trials reviewed was: n=580 low FODMAP diet (female, n=430), n=203 GFD (female, n=139), n=276 WFD (female, n=215). There was no significant difference in the gender of patients recruited for both the low FODMAP and GFD randomized studies (p=0.12). The response rate in the literature to a low FODMAP diet ranged between 50-76%, and to GFD ranged between 34-71%. Percentage of IBS patients identified as wheat sensitive was reported as 30% in the literature. Conclusion: There are no head-to-head trials to date utilizing the low FODMAP diet, GFD and WFD for dietary treatment of IBS and still a number of concerns for diets, including nutritional inadequacy and alteration of the gut microbiota. The consensus suggests that there is evidence for the use of the low FODMAP diet, GFD and WFD as dietary therapies for IBS; the decision-making process for using each individual therapy should be directed by a detailed history by the dietitian, involving the patient in the process.

scholarly journals Stress Reactivity in Traditional Chinese Medicine–Based Subgroups of Patients with Irritable Bowel Syndrome

2014 ◽  
Vol 20 (4) ◽  
pp. 276-283 ◽  
Author(s):  
Megan C. Chang ◽  
David Shapiro ◽  
Aditi Joshi ◽  
Leila Shahabi ◽  
Steven Tan ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Stress Reactivity ◽  
Irritable Bowel

Bifidobacterium infantis M-63 improves mental health in victims with irritable bowel syndrome developed after a major flood disaster

2019 ◽  
Vol 10 (2) ◽  
pp. 111-120 ◽  
Author(s):  
Z.F. Ma ◽  
N. Yusof ◽  
N. Hamid ◽  
R.M. Lawenko ◽  
W.M.Z. Wan Mohammad ◽  
...  
Keyword(s):  
Mental Health ◽  
Irritable Bowel Syndrome ◽  
Bodily Pain ◽  
Depression Scale ◽  
Bacterial Overgrowth ◽  
Well Being ◽  
Bifidobacterium Infantis ◽  
Before And After ◽  
Irritable Bowel ◽  
Lower Ratio

Individuals in a community who developed irritable bowel syndrome (IBS) after major floods have significant mental health impairment. We aimed to determine if Bifidobacterium infantis M-63 was effective in improving symptoms, psychology and quality of life measures in flood-affected individuals with IBS and if the improvement was mediated by gut microbiota changes. Design was non-randomised, open-label, controlled before-and-after. Of 53 participants, 20 with IBS were given B. infantis M-63 (1×109 cfu/sachet/day) for three months and 33 were controls. IBS symptom severity scale, hospital anxiety and depression scale, SF-36 Questionnaire, hydrogen breath testing for small intestinal bacterial overgrowth and stools for 16S rRNA metagenomic analysis were performed before and after intervention. 11 of 20 who were given probiotics (M-63) and 20 of 33 controls completed study as per-protocol. Mental well-being was improved with M-63 vs controls for full analysis (P=0.03) and per-protocol (P=0.01) populations. Within-group differences were observed for anxiety and bodily pain (both P=0.04) in the M-63 per-protocol population. Lower ratio of Firmicutes/Bacteroidetes was observed with M-63 vs controls (P=0.01) and the lower ratio was correlated with higher post-intervention mental score (P=0.04). B. infantis M-63 is probably effective in improving mental health of victims who developed IBS after floods and this is maybe due to restoration of microbial balance and the gut-brain axis. However, our conclusion must be interpreted within the context of limited sample size. The study was retrospectively registered on 12 October 2017 and the Trial Registration Number (TRN) was NCT03318614.

scholarly journals Efficacy and Safety of Acupoint Catgut Embedding for Diarrhea-Predominant Irritable Bowel Syndrome and Constipation-Predominant Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Jing Wu ◽  
Qinwei Fu ◽  
Shasha Yang ◽  
Hui Wang ◽  
Yaofeng Li
Keyword(s):  
Systematic Review ◽  
Irritable Bowel Syndrome ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Recurrence Rate ◽  
Western Medicine ◽  
Effective Rate ◽  
Efficacy And Safety ◽  
Irritable Bowel ◽  
Meta Analyses

In this study, we aim to evaluate the efficacy and safety of acupoint catgut embedding for the treatment of diarrhea-predominant irritable bowel syndrome and constipation-predominant irritable bowel syndrome. We searched seven online databases to collect studies published up to Feb 29th, 2020. Study quality of each included article was evaluated by the Cochrane Collaboration Risk of Bias Tool. Systematic reviews and meta-analyses were conducted based on the Cochrane systematic review method by using RevMan 5.3 software. Among the included trials, acupoint catgut embedding alone or plus oral western medicine or plus other acupoint-based therapies, or plus oral traditional Chinese medicine were the main therapies in the experimental groups. Interventions in control groups mainly include oral western medicine alone, other acupoint-based therapies alone, or other acupoint-based therapies alone. Primary outcomes in this study include recovery rate, accumulative marked effective rate, accumulative effective rate, and recurrence rate. Finally, 30 trials involving 1889 participants were included. The results of systematic reviews and meta-analyses show that acupoint catgut embedding alone or plus oral western medicine or plus other acupoint-based therapy or plus oral traditional Chinese medicine was significantly better compared with using oral western medicine alone in terms of efficacy for IBS-C and IBS-D. In addition, acupoint catgut embedding alone or plus oral western medicine or plus other acupoint-based therapy or plus oral traditional Chinese medicine could improve the effective rate and decrease the recurrence rate for IBS-D compared with using oral western medicine, other acupoint-based therapies, or oral traditional Chinese medicine alone. Adverse events of acupoint catgut embedding include local induration, redness, swelling, and itchiness, but they were all mild and disappeared swiftly with ordinary local interventions. There is an urgent need for RCTs of high quality and large sample size and with longer treatment duration and follow-up periods of acupoint catgut embedding for IBS.

scholarly journals Mechanisms Underlying the Analgesic Effect of Moxibustion on Visceral Pain in Irritable Bowel Syndrome: A Review

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Renjia Huang ◽  
Jimeng Zhao ◽  
Luyi Wu ◽  
Chuanzi Dou ◽  
Huirong Liu ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Visceral Pain ◽  
Epidemiological Data ◽  
Neuroendocrine System ◽  
Functional Bowel Disorder ◽  
Number Of Patients ◽  
Potential Problems ◽  
Irritable Bowel ◽  
Bowel Disorder

Irritable bowel syndrome (IBS) is a functional bowel disorder that causes recurrent abdominal (visceral) pain. Epidemiological data show that the incidence rate of IBS is as high as 25%. Most of the medications may lead to tolerance, addiction and toxic side effects. Moxibustion is an important component of traditional Chinese medicine and has been used to treat IBS-like abdominal pain for several thousand years in China. As a mild treatment, moxibustion has been widely applied in clinical treatment of visceral pain in IBS. In recent years, it has played an irreplaceable role in alternative medicine. Extensive clinical studies have demonstrated that moxibustion for treatment of visceral pain is simple, convenient, and inexpensive, and it is being accepted by an increasing number of patients. There have not been many studies investigating the analgesic mechanisms of moxibustion. Studies exploring the analgesic mechanisms have mainly focused on visceral hypersensitivity, brain-gut axis neuroendocrine system, and immune system. This paper reviews the latest developments in moxibustion use for treatment of visceral pain in IBS from these perspectives. It also evaluates potential problems in relevant studies on the mechanisms of moxibustion therapy to promote the application of moxibustion in the treatment of IBS.

scholarly journals Functional constipation masked as irritable bowel syndrome

2020 ◽  
Author(s):  
Monica Tosto ◽  
Paola D’Andrea ◽  
Ignazio Salamone ◽  
Salvatore Pellegrino ◽  
Stefano Costa ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Functional Gastrointestinal Disorders ◽  
Functional Constipation ◽  
Control Group ◽  
Number Of Patients ◽  
Erroneous Diagnosis ◽  
Irritable Bowel ◽  
Mixed Pattern ◽  
Rome Iv

Abstract Background: Rome IV criteria for functional gastrointestinal disorders state that children suspected of having Irritable Bowel Syndrome (IBS) with Constipation (IBS-C) should be preliminarily treated for constipation. We aimed at verifying if functional constipation may indeed lead to an erroneous diagnosis of IBS with diarrhea (IBS-D) or IBS with mixed pattern of diarrhea and constipation (IBS-M). Methods: We prospectively enrolled in an unblinded fashion 10 and 16 consecutive children referred to our center who met Rome IV criteria for a diagnosis of IBS-D and IBS-M, respectively. Patients who fulfilled criteria for suspect “occult constipation” were then given a bowel cleaning regimen with Polyethylene glycol 3350, re-evaluated at 2 months and followed up for at least 6 months. Sixteen additional patients with IBS with Constipation (IBS-C) referred in the same period served as control. The endpoints were: 1) a decrease of more than 50% in abdominal pain intensity and frequency scores; and 2) for patients with IBS-D and IBS-M: resolution of diarrhea. Results: The endpoints were met by 8 (80%) and 14 (87%) of the patients with IBS-D and IBS-M, respectively, with decrease of abdominal pain and resolution of “diarrhea”. The response was not significantly different from that observed in 15 (93%) of the IBS-C control group. Conclusion: Acknowledging the limitations of the small number of patients and of the uncontrolled nature of the study, we suggest that a possibly large number of patients labeled as IBS-D or IBS-M may actually simply present functional constipation and should be managed as such.

scholarly journals CHRONIC PELVIC PAIN

2018 ◽  
Vol 25 (02) ◽  
pp. 173-179
Author(s):  
Syeda Rabia ◽  
Naeem Akhtar Qureshi ◽  
Afsha Shahid ◽  
Hira Afreen
Keyword(s):  
Irritable Bowel Syndrome ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
P Value ◽  
Standard Tool ◽  
The Mean ◽  
Irritable Bowel ◽  
Associated Risk Factors

Objectives: To determine the frequency and associated risk factors of chronicpelvic pain (CPP) in educated women under 30 years of age. Study Design: A cross sectionalstudy. Setting: North Naziabad and Gulshan e Iqbal towns of Karachi. Period: January to July2017. Method: Data was collected through convenient sampling. Informed verbal consentwas taken before data collection. A questioner was used to collect demographic and obstetricdata. Screening of Anxiety and depression was done using standard tool Hospital basedanxiety and depression scale (HADS).Result were analyzed on SPSS. Result: The mean ageof women were 25 years, SD = 4.31. The frequency of chronic pelvic pain was 29% (116).Gynecological cause was found in 68.9% (80). Irritable bowel syndrome was seen in 9% (36)women. Significant association of CPP was noted with Dysmenorrhoea (p-value=000,OR=.207), Dyspareunia (p-value = .000, OR = .166), Heavy menstrual flow (p-value = .033, OR= .333), married (p-value = .000, OR = .414), Vaginal discharge (p-value = .000, OR = .260),Anxiety (p-value = .000, OR = .300), depression (p-value = .002, OR = .452), Normal mentalstatus (p-value = .000, OR = 2.488), Irritable bowel syndrome (p-value = .000, OR = .169)and PMS (p-value = .000, OR = .438). Conclusion: Frequency of chronic pelvic pain is high inyoung educated women. Gynecological causes, irritable bowel syndrome and psychologicaldisorder are significantly associated with CPP. 

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