Effect of Combined Live Probiotics Alleviating the Gastrointestinal Symptoms of Functional Bowel Disorders

Objective. Changes of the gut microbiota are related to the pathogenesis of functional bowel disorders (FBDs), and probiotic supplementation may be an effective treatment option. Therefore, we aimed to investigate the effect of combined live probiotics on the gastrointestinal symptoms of FBDs via altering the gut microbiota. Methods. Patients with the gastrointestinal symptoms of FBDs attending the Outpatient Department, from July to November 2019, were recruited. After the bowel preparation with polyethylene glycol electrolyte powder and colonoscopy, patients with normal result of colonoscopy were randomly divided into the probiotics group and control group. Patients in the probiotics group were prescribed with combined live Bacillus subtilis and Enterococcus faecium enteric-coated capsules for 4 weeks. Small intestinal bacteria overgrowth (SIBO) was measured by lactulose hydrogen breath test, and the microbial DNA was extracted from the fecal samples and the bacteria were classified by 16S rDNA gene amplicon sequencing. Results. Twenty-five patients of each group were recruited, and there was no significant difference between the probiotics and control groups on baseline gastrointestinal symptom rating scale (GSRS), positive rate of SIBO, and relative abundances of the gut microbiota at the phylum level. After 4 weeks of treatment, the values of the probiotics and control groups were as follows: GSRS 1.4±1.4 and 3.6±1.6 and positive rate of SIBO 28.0% and 56.0%, respectively. The median relative abundances of the gut microbiota were 1.01% and 5.03% Actinobacteria and 43.80% and 35.17% Bacteroidetes at the phylum level; 0.76% and 3.29% Bifidobacterium, 0.13% and 0.89% Cillinsella, 0.03% and 0.01% Enterococcus, 0.18% and 0.36% Lachnospiraceae, 0.10% and 0.16% Ruminococcus torques group, 1.31% and 2.44% Blautia, and 0.83% and 2.02% Fusicatenibacter at the genus level (P<0.05), respectively. Conclusion. Combined live probiotic supplementation after the bowel preparation can alter the gut microbiota, decontaminate SIBO, and alleviate the gastrointestinal symptoms of FBDs. This trial is registered with ChiCTR1900026472.

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Symptoms compatible with functional bowel disorders are common in patients with quiescent ulcerative colitis and influence the quality of life but not the course of the disease

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284819827689 ◽

2019 ◽

Vol 12 ◽

pp. 175628481982768 ◽

Cited By ~ 5

Author(s):

Georgios Mavroudis ◽

Magnus Simren ◽

Börje Jonefjäll ◽

Lena Öhman ◽

Hans Strid

Keyword(s):

Quality Of Life ◽

Ulcerative Colitis ◽

Psychological Symptoms ◽

Negative Impact ◽

Gastrointestinal Symptoms ◽

Functional Bowel Disorders ◽

Mayo Score ◽

Bowel Disorders ◽

Total Burden

Background: Whether patients with inactive ulcerative colitis (UC) have symptoms compatible with functional bowel disorders (FBDs) other than irritable bowel syndrome (IBS) is unclear. Our aim was to investigate the prevalence and burden of these symptoms and determine impact on the UC course. Methods: We used Mayo score, sigmoidoscopy and calprotectin (f-cal) to define remission in 293 UC patients. Presence of symptoms compatible with FBD, severity of gastrointestinal, extraintestinal and psychological symptoms, stress levels and quality of life (QoL) were measured with validated questionnaires. At 1 year later, remission was determined by modified Mayo score and f-cal in 171 of these patients. They completed the same questionnaires again. Results: A total of 18% of remission patients had symptoms compatible with FBD other than IBS, and 45% subthreshold symptoms compatible with FBD. The total burden of gastrointestinal symptoms in patients with symptoms compatible with FBD was higher than in patients without FBD ( p < 0.001), which had negative impact on QoL ( p = 0.02). These symptoms were not correlated with psychological distress, systemic immune activity or subclinical colonic inflammation and were not a risk factor for UC relapse during follow up. Conclusion: Symptoms compatible with FBD other than IBS are common during UC remission influencing patients’ QoL but not the UC course.

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Characterization of gut microbiota associated with clinical parameters in intrahepatic cholestasis of pregnancy

BMC Gastroenterology ◽

10.1186/s12876-020-01510-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Rong Li ◽

Xuehai Chen ◽

Zhongzhen Liu ◽

Yan Chen ◽

Chuan Liu ◽

...

Keyword(s):

Gut Microbiota ◽

Pregnant Women ◽

Intrahepatic Cholestasis ◽

Premature Delivery ◽

Clinical Parameters ◽

Intrahepatic Cholestasis Of Pregnancy ◽

Control Groups ◽

And Control ◽

Cholestasis Of Pregnancy

Abstract Background Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder that specifically occurs in pregnancy. Elevated levels of liver transaminases aspartate aminotransferase, alanine aminotransferase and serum bilirubin levels are common biochemical characteristics in ICP. The disorder is associated with an increased risk of premature delivery and stillbirth. The characterization of the potential microbiota in ICP could go a long way in the prevention and treatment of this pregnancy disease. Methods A total of 58 patients were recruited for our study: 27 ICP patients and 31 healthy pregnant subjects with no ICP. The V3 and V4 regions of the 16S rDNA collected from fecal samples of both diseased and control groups were amplified. 16S rRNA gene amplicon sequencing was then performed on gut microbiota. Sequencing data were analyzed and the correlation between components of microbiota and patient ICP status was found. Related metabolic pathways, relative abundance and significantly different operational taxonomic units (OTUs) between ICP and controls were also identified. Results Elevated levels of total bile acid, ALT, AST, Dbil and Tbil were recorded or observed in ICP subjects as compared to the control. Gut microbiota in pregnant women was dominated by four major phyla and 27 core genera. PCoA analysis results indicated that there was no significant clustering in Bray–Curtis distance matrices. Our results showed that there was a correlation between specific OTUs and measured clinical parameters of pregnant women. Comparison at the different taxonomy levels revealed high levels of abundance of Blautia and Citrobacter in ICP patients. At the family level, Enterobacteriaceae and Leuconostocaceae were higher in ICP patients. 638 KEGG Orthologs and 138 pathways significantly differed in the two groups. PLS-DA model with VIP plots indicated a total of eight genera and seven species were key taxa in ICP and control groups. Conclusions Our research indicated that although there was no significant clustering by PCoA analysis, patients with ICP have increased rare bacteria at different phylogenetic levels. Our results also illustrated that all 638 KEGG Orthologs and 136 in 138 KEGG pathways were less abundant in ICP patients compared to the controls.

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011 Shiftwork, Functional Bowel Symptoms and the Microbiome

SLEEP ◽

10.1093/sleep/zsab072.010 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A6-A6

Author(s):

Ann Rogers ◽

Yijuan Hu ◽

Ye Yue ◽

Emily Wessel ◽

Jennifer Christie ◽

...

Keyword(s):

Gut Microbiota ◽

Beta Diversity ◽

Time Of Day ◽

Full Time ◽

Functional Bowel Disorders ◽

Shift Workers ◽

Intestinal Microbes ◽

Two Samples ◽

Bowel Disorders ◽

Night Shifts

Abstract Introduction There are about 15 million Americans working full-time on evening, night, or rotating shifts. Between 48% and 81.9% of those working rotating or night shifts report abdominal pain, constipation, diarrhea and other symptoms of functional bowel disorders. The basis for this high prevalence of functional bowel disorders, including irritable bowel syndrome (IBS), among shift workers is unknown. Animal studies, however, suggest that circadian disruption, similar to that in shift workers, may contribute to the development of GI complaints among shift workers by altering the composition and normal diurnal rhythmicity of the resident intestinal microbes. Methods Fifty-one full time staff nurses who worked either 12-hour day or night shifts completed demographic information, the Rome III IBS module, daily symptoms diaries for 14 days. They also collected two samples of gut microbiota before the beginning and at the end of their last work shift on day 14, using validated field-tested methods consistent with the Human Microbiome Project. After DNA extraction, 16S rRNA sequencing and assignment to the genus level was completed, samples were then compared to determine if there were 1) differences in the diversity and profile of the microbiome by shift type; 2) if there were differences in the microbiome by time of day for collection; and 3) whether there were differences in the diversity and profile of the microbiome of nurses with IBS and those without IBS. Results There were no differences in alpha or beta diversity of gut microbiota when specimens from day and night shift nurses were compared. There were however marginal differences in beta diversity when specimens collected at the beginning and end of the shifts were compared, with seven OTUs being differentially abundant when collected from day shift workers in the evening. There were also three OTUs to be differentially abundant in participants reporting IBS symptoms. Conclusion These data did not reveal strong effects of circadian alterations in gut microbiota related to shiftwork. Other factors, such as insufficient sleep and dietary intake during the data-gathering period, need to be explored Support (if any) Emory University Synergy Grant Program

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A 5Ad Dietary Protocol for Functional Bowel Disorders

Nutrients ◽

10.3390/nu11081938 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1938 ◽

Cited By ~ 3

Author(s):

Fandi Ibrahim ◽

Philippa Stribling

Keyword(s):

Repeated Measures ◽

Symptom Relief ◽

Gastrointestinal Symptoms ◽

Activity Level ◽

Stool Consistency ◽

Future Research ◽

Functional Bowel Disorders ◽

Novel Approach ◽

Baseline Status ◽

Bowel Disorders

Functional bowel disorders (FBDs) affect around 20% of the population worldwide and are associated with reduced quality of life and high healthcare costs. Dietary therapies are frequently implemented to assist with symptom relief in these individuals, however, there are concerns regarding their complexity, restrictiveness, nutritional adequacy, and effectiveness. Thus, to overcome these limitations, a novel approach, the 5Ad Dietary Protocol, was designed and tested for its efficacy in reducing the severity of a range of gastrointestinal symptoms in 22 subjects with FBDs. The protocol was evaluated in a repeated measures MANOVA design (baseline week and intervention week). Measures of stool consistency and frequency were subtyped based on the subject baseline status. Significant improvements were seen in all abdominal symptom measures (p < 0.01). The effect was independent of body mass index (BMI), age, gender, physical activity level, and whether or not the subjects were formally diagnosed with irritable bowel syndrome (IBS) prior to participation. Stool consistency and frequency also improved in the respective contrasting subtypes. The 5Ad Dietary Protocol proved to be a promising universal approach for varying forms and severities of FBDs. The present study paves the way for future research encompassing a longer study duration and the exploration of underlying physiological mechanisms.

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Effect of probiotics in the treatment of gastrointestinal symptoms in patients with scleroderma

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20161467 ◽

2016 ◽

Vol 2 (5) ◽

pp. 94 ◽

Cited By ~ 2

Author(s):

Afsaneh Enteshari-Moghaddam ◽

Shafieh Movassaghi ◽

Abdolrahman Rostamian

Keyword(s):

Clinical Trial ◽

Systemic Sclerosis ◽

Gastrointestinal Tract ◽

Statistical Methods ◽

Gastrointestinal Symptoms ◽

Control Groups ◽

Gastric Distention ◽

Emotional Function ◽

Gastrointestinal Reflux ◽

And Control

Background: Treatment of gastrointestinal symptoms in patients with systemic sclerosis has been a challenge for years. Drugs, immunosuppressive or anti-fibrotic have always been associated with complications. The effectiveness of probiotics as live microorganisms of nonpathogenic always was to treat the symptoms.Methods:In this clinical trial, 37 patients with systemic sclerosis with mild to severe symptoms in the intervention and control groups were studied. Inventory (UCLA SCTC GIT 2.0) was used for rating the severity of the gastrointestinal tract. Collected data was analysed by statistical methods using SPSS.19.Results: Improvement was seen in total score after the use of probiotics in gastrointestinal reflux condition ((P=0.001), gastric distention (P =0.001), emotional function ((P=0.001), social.Conclusions:This study showed that probiotics were significantly effective in treatment of gastrointestinal symptoms in patients with systemic sclerosis.

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Shiftwork, functional bowel symptoms, and the microbiome

PeerJ ◽

10.7717/peerj.11406 ◽

2021 ◽

Vol 9 ◽

pp. e11406

Author(s):

Ann E. Rogers ◽

Yi-Juan Hu ◽

Ye Yue ◽

Emily F. Wissel ◽

Robert A. Petit III ◽

...

Keyword(s):

Gut Microbiota ◽

Beta Diversity ◽

Night Shift ◽

Time Of Day ◽

Full Time ◽

Functional Bowel Disorders ◽

Shift Workers ◽

Bowel Symptoms ◽

Bowel Disorders ◽

Night Shifts

Background There are about 15 million Americans working full-time on evening, night, or rotating shifts. Between 48% and 81.9% of those working rotating or night shifts report abdominal pain, constipation, diarrhea and other symptoms of functional bowel disorders. The basis for this high prevalence of functional bowel disorders, including irritable bowel syndrome (IBS), among shift workers is unknown. Animal studies, however, suggest that circadian disruption, similar to that in shift workers, may contribute to the development of GI complaints among shift workers by altering the composition and normal diurnal rhythmicity of the resident intestinal microbes. Therefore, the present study was designed to determine if there were differences in (1) composition and diversity of the microbiome of night shift workers compared to day shift workers; and (2) the composition and diversity of the microbiome among shift workers experiencing functional bowel symptoms compared to shift workers who did not experience functional bowel symptoms. Methods Fifty-one full time staff nurses who worked either 12-hour day or night shifts completed demographic information, and the Rome III IBS module. They also collected two samples of gut microbiota before the beginning and at the end of their last work shift on day 14, using validated field-tested methods consistent with the Human Microbiome Project. After DNA extraction, 16S rRNA sequencing and assignment to the genus level was completed, samples were then compared to determine if there were (1) differences in the diversity and profile of the microbiome by shift type; (2) if there were differences in the microbiome by time of day for collection; and (3) whether there were differences in the diversity and profile of the microbiome of nurses with IBS and those without IBS. Results There were no differences in alpha or beta diversity of gut microbiota when specimens from day and night shift nurses were compared. There were however marginal differences in beta diversity when specimens collected at the beginning and end of the shifts were compared, with seven OTUs being differentially abundant when collected from day shift workers in the evening. There were also three OTUs to be differentially abundant in participants reporting IBS symptoms.

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Associations of clinical features of functional bowel disorders with gut microbiota characteristics in adolescents: A pilot study

Acta biomedica scientifica ◽

10.29413/abs.2021-6.6-2.8 ◽

2021 ◽

Vol 6 (6-2) ◽

pp. 73-81

Author(s):

A. I. Romanitsa ◽

U. M. Nemchenko ◽

A. V. Pogodina ◽

E. V. Grigorova ◽

N. L. Belkova ◽

...

Keyword(s):

Gut Microbiota ◽

Clinical Manifestations ◽

Enzymatic Properties ◽

Functional Bowel Disorders ◽

Obese Adolescents ◽

E Coli ◽

Bowel Movements ◽

Bowel Disorders ◽

The Relationship ◽

Clostridium Spp

Background. Obesity is a multifactorial disease that is one of the important public health problems in the 21st century. Functional bowel disorders in obese children and adolescents are one of the most common pathologies of the digestive tract. The aim: to characterize the bacteriological composition of the colon microbiota in obese adolescents and identify its associations with the clinical manifestations of functional bowel disorders.Materials and methods. The study included 20 adolescents aged 11–17 years. Stool consistency was assessed using the Bristol Stool Scale. The study of biological material was carried out using standard bacteriological methods. To assess the strength of the relationship between the nominal variables, Cramer’s V test was used.Results. It has been shown that in adolescents with obesity and functional bowel disorders, there is a decrease in the number of representatives of bifidoflora, an increase in the microbial density of Escherichia coli with altered enzymatic properties and an excessive growth of potentially pathogenic enterobacteria. In obese adolescents with functional bowel disorders, abdominal pain associated with the act of defecation is associated with the presence of enterobacteria and E. coli with altered enzymatic properties. Rare bowel movements are associated with an increased abundance of Enterococcus spp. and the presence of opportunistic Enterobacteriaceae microorganisms. Frequent bowel movements are associated with the presence of E. coli with altered enzymatic properties and Clostridium spp. In the presence of loose stool, Clostridium spp. is present; unstable stool (alternation of hard and liquid stools in one patient) is associated with a decrease in the number of lactobacilli and E. coli with normal enzymatic properties, the appearance of E. coli with altered enzymatic properties, opportunistic microorganisms of Enterobacteriaceae family and Clostridium spp. Conclusion. The relationship between the clinical symptoms of functional bowel disorders and changes in the composition of the gut microbiota in obese adolescents may be a justification for conducting in-depth studies aimed at finding early predictors of functional bowel diseases associated with obesity in the adult cohort.

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Characterization of Gut Microbiota Associated with Clinical Parameters in Intrahepatic Cholestasis of Pregnancy

10.21203/rs.2.18873/v3 ◽

2020 ◽

Author(s):

Rong Li ◽

xuehai chen ◽

Zhongzhen Liu ◽

Yan Chen ◽

Chuan Liu ◽

...

Keyword(s):

Gut Microbiota ◽

Pregnant Women ◽

Intrahepatic Cholestasis ◽

Premature Delivery ◽

Clinical Parameters ◽

Intrahepatic Cholestasis Of Pregnancy ◽

Control Groups ◽

And Control ◽

Cholestasis Of Pregnancy

Abstract Background: Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder that specifically occurs in pregnancy. Elevated levels of liver transaminases aspartate aminotransferase, alanine aminotransferase and serum bilirubin levels are common biochemical characteristics in ICP. The disorder is associated with an increased risk of premature delivery and stillbirth. The characterization of the potential microbiota in ICP could go a long way in the prevention and treatment of this pregnancy disease.Methods: A total of 58 patients were recruited for our study: 27 ICP patients and 31 healthy pregnant subjects with no ICP. The V3 and V4 regions of the 16S rDNA collected from fecal samples of both diseased and control groups were amplified. 16S rRNA gene amplicon sequencing was then performed on gut microbiota. Sequencing data were analyzed and the correlation between components of microbiota and patient ICP status was found. Related metabolic pathways, relative abundance and significantly different OTUs (Operational Taxonomic Units) between ICP and controls were also identified.Results: Elevated levels of total bile acid, ALT, AST, Dbil and Tbil were recorded or observed in ICP subjects as compared to the control. Gut microbiota in pregnant women was dominated by four major phyla and 27 core genera. PCoA analysis results indicated that there was no significant clustering in Bray-Curtis distance matrices. Our results showed that there was a correlation between specific OTUs and measured clinical parameters of pregnant women. Comparison at the different taxonomy levels revealed high levels of abundance of Blautia and Citrobacter in ICP patients. At the family level, Enterobacteriaceae and Leuconostocaceae were higher in ICP patients. 638 KEGG Orthologs and 138 pathways significantly differed in the two groups; ICP patients and control group and PLS-DA model with VIP plots indicated a total of eight genera and seven species were key taxa in ICP and control groups.Conclusions: Our research indicated that although there was no significant clustering by PCoA analysis, patients with ICP have increased rare bacteria at different phylogenetic levels. Our results also illustrated that all 638 KEGG Orthologs and 136 in 138 KEGG pathways were less abundant in ICP patients compared to the controls.

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Prebiotics in irritable bowel syndrome and other functional bowel disorders in adults: a systematic review and meta-analysis of randomized controlled trials

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqy376 ◽

2019 ◽

Vol 109 (4) ◽

pp. 1098-1111 ◽

Cited By ~ 23

Author(s):

Bridgette Wilson ◽

Megan Rossi ◽

Eirini Dimidi ◽

Kevin Whelan

Keyword(s):

Systematic Review ◽

Irritable Bowel Syndrome ◽

Meta Analysis ◽

Gastrointestinal Symptoms ◽

Controlled Trials ◽

Functional Bowel Disorders ◽

Randomized Controlled ◽

Bowel Disorders ◽

Mean Differences ◽

Irritable Bowel

ABSTRACT Background Irritable bowel syndrome (IBS) and other functional bowel disorders (FBDs) are prevalent disorders with altered microbiota. Prebiotics positively augment gut microbiota and may offer therapeutic potential. Objectives The aim of this study was to investigate the effect of prebiotics compared with placebo on global response, gastrointestinal symptoms, quality of life (QoL), and gut microbiota, via systematic review and meta-analysis of randomized controlled trials (RCTs) in adults with IBS and other FBDs. Methods Studies were identified using electronic databases, back-searching reference lists, and hand-searching abstracts. RCTs that compared prebiotics to placebo in adults with IBS or other FBDs were included. Two reviewers independently performed screening, data extraction, and bias assessment. Outcome data were synthesized as ORs, weighted mean differences (WMDs) or standardized mean differences (SMDs) with the use of a random-effects model. Subanalyses were performed for type of FBD and dose, type, and duration of prebiotic. Results Searches identified 2332 records, and 11 RCTs were eligible (729 patients). The numbers responding were 52/97 (54%) for prebiotic and 59/94 (63%) for placebo, with no difference between groups (OR: 0.62; 95% CI: 0.07, 5.69; P = 0.67). Similarly, no differences were found for severity of abdominal pain, bloating and flatulence, and QoL score between prebiotics and placebo. However, flatulence severity was improved by prebiotics at doses ≤6 g/d (SMD: –0.35; 95% CI: –0.71, 0.00; P = 0.05) and by non-inulin-type fructan prebiotics (SMD: –0.34; 95% CI: –0.66, –0.01; P = 0.04), while inulin-type fructans worsened flatulence (SMD: 0.85; 95% CI: 0.23, 1.47; P = 0.007). Prebiotics increased absolute abundance of bifidobacteria (WMD: 1.16 log10 copies of the 16S ribosomal RNA gene; 95% CI: 0.06, 2.26; P = 0.04). No studies were at low risk of bias across all bias categories. Conclusions Prebiotics do not improve gastrointestinal symptoms or QoL in patients with IBS or other FBDs, but they do increase bifidobacteria. Variations in prebiotic type and dose impacted symptom improvement or exacerbation. This review was registered at PROSPERO as CRD42017074072.

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Dysbiosis in Functional Bowel Disorders

Annals of Nutrition and Metabolism ◽

10.1159/000488773 ◽

2018 ◽

Vol 72 (4) ◽

pp. 296-306 ◽

Cited By ~ 14

Author(s):

Paul Enck ◽

Nazar Mazurak

Keyword(s):

Gut Microbiota ◽

Fecal Microbiota Transplantation ◽

Healthy Person ◽

Fecal Microbiota ◽

Functional Bowel Disorders ◽

Microbial Composition ◽

Bowel Disorders ◽

Irritable Bowel ◽

Benign Disorders

Functional bowel disorders (FBD) resemble a group of diseases of the gastrointestinal (GI) tract that are without a clear pathogenesis; the best known is probably the “irritable bowel syndrome” (IBS). Only recently we have been able to explore the role of the gut microbiota in FBD due to progress in microbiological analytic techniques. There are different ways to explore the role of the gut microbiota and its dysbiosis in FBD. Comparison of the microbial composition in a group of patients with FBD, for example, with IBS to a group of healthy volunteers is one way. Studies have shown that the microbiota in FBD is different from that of healthy controls, but the recorded differences are not necessarily specific for FBD, they may also occur in other diseases. Another approach to explore the role of the gut microbiota in FBD is to challenge the existing “flora” with novel bacteria (probiotics) or with nutritional substrates that stimulate bacterial growth (prebiotics). More than 60 such trials including several thousand patients have been performed in IBS. These studies have produced mixed outcome: some probiotics appear to be better than others, and some appear to work only for a part of the IBS symptoms and not for all. An extreme form of this approach is the transfer of an entire microbiota from 1 healthy person to another, called fecal microbiota transplantation. This has rarely been tested in FBD but is not without risk in benign disorders.

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