scholarly journals ANALYSIS OF LACTOSE INTOLERANCE IN STUDENTS WITH SUGGESTIVE SYMPTOMS OF IRRITABLE BOWEL SYNDROME

2019 ◽  
Vol 56 (3) ◽  
pp. 304-311
Author(s):  
Cleise de Jesus SILVA ◽  
Ingrid Dantas Sampaio LEITE ◽  
José Weberton RODRIGUES ◽  
Samara Pereira de ALMEIDA ◽  
Bruna Pessoa NÓBREGA ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Breath Test ◽  
Gastrointestinal Symptom ◽  
Lactose Intolerance ◽  
Gastrointestinal Symptoms ◽  
Bacterial Overgrowth ◽  
Irritable Bowel ◽  
Carbohydrate Intolerance

ABSTRACT BACKGROUND: Irritable bowel syndrome is a clinical condition presenting pain, distension and abdominal fullness, diarrhea, constipation, and other symptoms. It generates significant impacts on the quality of life of those affected. The pathophysiology is uncertain, but the role of various food types has been established in bowel sensitivity and its clinical manifestations. Carbohydrate intolerance, particularly to lactose, generates similar and sometimes indistinguishable symptoms from irritable bowel syndrome, and in clinical practice is both a frequent and underdiagnosed condition. Carbohydrate intolerance is related to enzymatic deficiencies, alterations of intestinal microbiota and even genetic change. The principal test for a diagnosis of lactose intolerance is the breath test, which measures hydrogen emission (produced only by bacteria), after ingestion of the corresponding substrate. OBJECTIVE: The present work aims to verify the prevalence of lactose intolerance in university students, presenting gastrointestinal symptoms suggestive of irritable bowel syndrome. METHODS: In a transversal study, to screen for those with suggestive symptoms, 124 medicine students participated by responding to a form. Those with abdominal pain were referred for anti-parasite treatment in order to exclude intestinal parasites as a secondary cause. Subsequently, using the hydrogen breath test, bacterial overgrowth was investigated, and if negative, lactose intolerance testing would be performed. Patients presenting high hydrogen concentrations of ≥20 ppm above the basal level were considered lactose intolerant. RESULTS: Of the total of students researched (n=124), 7 were excluded because they did not completing all study phases. From those 117 individuals effectively included in the survey; 8 (6.8%) were diagnosed with lactose intolerance and 2 (1.7%) with bacterial overgrowth. Intolerance was more frequent in; female individuals (75%), age range 18 to 25 years (62.5%), being colored (50%), and in their 5th semester of studies (37.5%). The presence of at least one gastrointestinal symptom among those presenting intolerance (100%), and those not presenting intolerance (42.2%) was found (P=0.002). In addition to abdominal pain (100%) (P<0.001), the most recurrent gastrointestinal symptom in the lactose intolerant students was the distension/flatulence (62.5%) (P=0.026). In relation to life habits and food patterns, there was no statistical difference between lactose tolerant and intolerant individuals, or for symptom frequencies. The more advanced students, completing more periods towards graduation, demonstrated more occurrences of gastrointestinal symptoms, yet without presenting significant statistical discrepancies. CONCLUSION: In view of the test sample quantity (n=21), a high prevalence of lactose intolerance (6.8%) in the academic environment, with epidemiological characteristics compatible to those found the literature is demonstrated, generating knowledge with understanding to prevent, diagnose, alleviate and treat lactose intolerant university students, and generate positive impacts towards well-being, improving the quality of life of these individuals.

scholarly journals Digestive symptoms in daily life of chronic adrenal insufficiency patients are similar to irritable bowel syndrome symptoms

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
L. Quénéhervé ◽  
D. Drui ◽  
J. Blin ◽  
M. Péré ◽  
E. Coron ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Adrenal Insufficiency ◽  
Gastrointestinal Symptoms ◽  
Control Group ◽  
Non Profit ◽  
Acute Adrenal Insufficiency ◽  
Irritable Bowel ◽  
Rome Iv

AbstractGastrointestinal symptoms are frequent in acute adrenal insufficiency. Although digestive symptoms can significantly reduce quality of life, they are rarely described in patients with treated chronic adrenal insufficiency (CAI). We aimed to characterize digestive symptoms in CAI patients. We used the section pertaining functional bowel disorders of the Rome IV questionnaire. A questionnaire was published on the website of the non-profit patient association “Adrenals” (NPPA of CAI patients) for five months. Information on demographics, characteristics of adrenal insufficiency, digestive symptoms and quality of life was collected. The relatives of CAI patients served as a control group. We analyzed responses of 33 control subjects and 119 patients (68 primary adrenal insufficiency (PAI), 30 secondary adrenal insufficiency (SAI) and 21 congenital adrenal hyperplasia (CAH)). Abdominal pain at least once a week over the past 3 months was reported by 40%, 47% and 33% of patients with PAI, SAI and CAH respectively versus 15% for the controls (p = 0.01). Symptoms were consistent with the Rome IV criteria for irritable bowel syndrome in 27%, 33% and 33% of patients respectively versus 6% for the controls (p < 0.0001). Quality of life was described as poor or very poor in 35%, 57% and 24% of patients respectively versus 5% for the controls (p < 0.0001). In conclusion, digestive symptoms are frequent and incapacitating in CAI patients and similar to symptoms of irritable bowel syndrome in 30% of CAI patients. Assessment and management of digestive symptoms should be considered a priority for physicians treating patients with CAI.

scholarly journals TPH Gene Polymorphisms Are Associated With Disease Perception and Quality of Life in Women With Irritable Bowel Syndrome

2012 ◽  
Vol 16 (1) ◽  
pp. 95-104 ◽  
Author(s):  
Sang-Eun Jun ◽  
Ruth Kohen ◽  
Kevin C. Cain ◽  
Monica E. Jarrett ◽  
Margaret M. Heitkemper
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Gene Polymorphisms ◽  
Tryptophan Hydroxylase ◽  
Univariate Analysis ◽  
Gastrointestinal Symptoms ◽  
Tph2 Gene ◽  
Irritable Bowel ◽  
The Impact

The aims of this exploratory study were to examine whether tryptophan hydroxylase ( TPH) gene polymorphisms are associated with psychosocial factors in women with irritable bowel syndrome (IBS). TPH is the rate-limiting enzyme in the biosynthesis of serotonin and has two isoforms, TPH1 and TPH2. Four single nucleotide polymorphisms (SNPs) in the TPH1 gene and one SNP in the TPH2 gene were selected based on previous studies investigating associations between these SNPs and psychiatric or behavioral disorders. One hundred ninety-nine Caucasian women with IBS were included. Results of univariate analysis showed no association between TPH1and TPH2 gene SNPs and current level of psychological distress or psychiatric illness. However, TPH1 gene SNPs were associated with IBS-related cognitions (rs4537731 and rs21105) and quality of life (rs684302 and rs1800532), in particular the mental health and energy subscales. These associations were independent of the subjects’ levels of gastrointestinal symptoms. These results suggest that patients’ perception of their illness, and of the impact it has on their lives, may be subject to genetic influences, in this case sequence variants in TPH1. However, caution should be used in interpreting these results given the large number of hypothesis tests performed in this exploratory hypothesis-generating study, and the results should be considered tentative until confirmed in an independent sample.

scholarly journals Effectiveness of Two Dietary Approaches on the Quality of Life and Gastrointestinal Symptoms of Individuals with Irritable Bowel Syndrome

2020 ◽  
Vol 9 (1) ◽  
pp. 125 ◽  
Author(s):  
Maria Margarida Guerreiro ◽  
Zélia Santos ◽  
Elisabete Carolino ◽  
Julieta Correa ◽  
Marilia Cravo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Irritable Bowel Syndrome ◽  
Gastrointestinal Symptoms ◽  
Standard Diet ◽  
Before And After ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
Third Moment

To evaluate the effectiveness of a low FODMAP (fermentable oligosaccharides, monosaccharaides, disaccharides and polyols) diet in the relief of symptoms and an improvement of the quality of life in individuals with irritable bowel syndrome in comparison to a standard diet according to the British Dietetic Association’s guidelines. A non-randomized clinical trial of adult patients with IBS was compared two diet interventions. An assessment of symptoms, quality of life, and nutritional status was performed before and after the four-week mark of intervention. Individuals from the Low FODMAP Diet (LFD) group were evaluated on a third moment, after the controlled reintroduction of FODMAPs. A total of 70 individuals were divided in two groups: Low FODMAP Diet (LFD; n = 47) and Standard Diet (SD; n = 23). 57 individuals completed the four-week intervention (LFD; n = 39; SD; n = 18). At the completion of four weeks, the symptoms improved in both groups (LFD: p < 0.01; DC: p < 0.05) but LFD led to a higher relief (p < 0.05), primarily with respect to abdominal pain and diarrhoea. Quality of life improved significantly in both groups, with no significant differences between SD vs LFD (p > 0.05). In the LFD group, the relief of symptoms observed at the four-week mark remained constant after reintroduction of FODMAPs. Both interventions seem to be effective for the relief of symptoms and quality of life, however LFD had higher effectiveness in the former. The results with LFD suggest it can be a preferred approach in individuals with diarrhoeal profile.

scholarly journals Pharmacological Therapies and Their Clinical Targets in Irritable Bowel Syndrome With Diarrhea

2021 ◽  
Vol 11 ◽  
Author(s):  
Esther Colomier ◽  
Joost Algera ◽  
Chloé Melchior
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Pharmacological Treatment ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Gastrointestinal Symptoms ◽  
Bowel Habits ◽  
Irritable Bowel

Irritable bowel syndrome (IBS) is one of the most common disorders of the gut-brain axis, which affects approximately 4% of the global population. The Rome IV criteria define IBS as chronic or recurrent abdominal pain associated with altered bowel habits. Patients can be categorized in four subtypes: IBS with predominant constipation (IBS-C), predominant diarrhea (IBS-D), mixed bowel habits (IBS-M), and unclassified (IBS-U). IBS is associated with a lower quality of life, reduced work productivity, and high healthcare costs. When comparing subtypes, patients with IBS-D report lower disease related quality of life. Due to the scope of this review, we have solely focused on patients with IBS-D. Choosing the right pharmacological treatment in these patients remains challenging due to the heterogeneous patient population, patients’ expectation of the treatment outcome, unavailability of efficacious drugs, and the multifactorial and incompletely understood underlying pathophysiology. Currently, pharmacological treatment options target individual symptoms, such as abdominal pain, altered bowel habits, and bloating. In this review, we aimed to summarize the current and recent pharmacological treatment options in IBS-D, targeting the predominant gastrointestinal symptoms. Additionally, we proposed a pharmacological treatment algorithm which healthcare professionals could use when treating individual patients with IBS-D.

scholarly journals A Randomised, Cross-Over, Placebo-Controlled Study of Aloe vera in Patients with Irritable Bowel Syndrome: Effects on Patient Quality of Life

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
H. A. Hutchings ◽  
K. Wareham ◽  
J. N. Baxter ◽  
P. Atherton ◽  
J. G. C. Kingham ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Short Form ◽  
Aloe Vera ◽  
Gastrointestinal Symptoms ◽  
Controlled Study ◽  
Double Blind ◽  
Irritable Bowel ◽  
Drop Outs

Background. Irritable bowel syndrome (IBS) is a chronic, difficult to treat condition. The efficacy of Aloe vera in treating IBS symptoms is not yet proven. The purpose of this study was to determine if Aloe vera is effective in improving quality of life. Methods. A multicentre, randomised, double-blind, cross-over placebo controlled study design. Patients were randomised to Aloe vera, wash-out, placebo or placebo, washout, Aloe vera. Each preparation (60 mL) was taken orally twice a day. Patient quality of life was measured using the Gastrointestinal Symptoms Rating Score, Irritable Bowel Syndrome Quality of Life, EuroQol and the Short-Form-12 at baseline and treatment periods 1 and 2. Results. A total of 110 patients were randomised, but only 47 completed all questionnaires and both study arms. Statistical analysis showed no difference between the placebo and Aloe vera treatment in quality of life. Discussion. This study was unable to show that Aloe vera was superior to placebo in improving quality of life. Drop outs and other confounding factors may have impacted on the power of the study to detect a clinically important difference. Conclusion. This study failed to find Aloe vera superior to placebo in improving quality of life proven Irritable Bowel Syndrome patients.

scholarly journals Fermentable carbohydrate intake and food avoidance behaviour in elderly patients with irritable bowel syndrome: A case report

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Shanti Krishnasamy ◽  
Mohan Arumugam ◽  
Jane Jimson Simon ◽  
Ain Syahidah Ismail ◽  
Nur Amira Syahhirah Kamarulzaman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Nutrient Intake ◽  
Dietary Intervention ◽  
Gastrointestinal Symptoms ◽  
Chinese Patients ◽  
Published Data ◽  
Food Avoidance ◽  
Irritable Bowel

Background: Fermentable carbohydrates or FODMAPs (Fermentable Oligo-, Di-, Monosaccharides, and Polyols) are short-chained, poorly absorbed carbohydrates which trigger gastrointestinal symptoms causing pain, bloating, distension, diarrhea, and constipation in Irritable Bowel Syndrome (IBS) patients. This debilitating condition has an impact on the quality of life of patients. In addition, due to lack of dietary intervention, it can result in food restriction to alleviate symptoms as patients avoid a wide variety of food and beverages. Objective: To compare FODMAP and nutrient intake, food avoidance behavior and quality of life in 2 long standing patients with IBS. Methods: Patients were selected on the basis of being diagnosed with IBS by a gastroenterologist. A 24-hour dietary recall with multiple pass method was used to assess intake. FODMAP intake was determined using published data. Symptom severity and quality of life was measured using a validated questionnaire. Meanwhile, food avoidance was assessed using a dietary trigger piloted questionnaire. Results: Two female Chinese patients with severe gastrointestinal symptoms were selected for this case series. Patient 1 was a 75-year-old female presenting with constipation-predominant IBS and patient 2 was a 61-year-old presenting with diarrhea-predominant IBS. Patient 1 had a higher energy intake: 2198 kcal, and FODMAP intake 10.6g/d, compared to patient 2 with an energy and FODMAP intake of 1800 kcal and 3.6g/d respectively. Both patients avoided a wide of range of food groups including cereals and grains, animal products, dairy and spicy foods. They also reported reduced scores for quality of life. Conclusion: Both patients had low intake of calcium as a result of food avoidance. This highlights the importance of appropriate and timely dietary intervention to this group of patients, to promote improved symptom management without compromising nutrient intake.

Avaliação do Uso do Lactobacillus reuteri em Pacientes Portadores da Síndrome de Supercrescimento Bacteriano Diagnosticados por Teste Respiratório / Evaluation of the Use of Lactobacillus reuteri in Patients with Bacterial Overgrowth Syndrome Diagnosed

1970 ◽  
Vol 3 (2) ◽  
pp. 5-17
Author(s):  
Juliana Totti De Souza ◽  
Jussara Coelho Rosa ◽  
Thalita Amaral Amaro Adami
Keyword(s):  
Irritable Bowel Syndrome ◽  
Breath Test ◽  
Lactobacillus Reuteri ◽  
Gastrointestinal Symptoms ◽  
Bacterial Overgrowth ◽  
Small Intestinal Bacterial Overgrowth ◽  
Test Methods ◽  
Overgrowth Syndrome ◽  
Abdominal Symptoms ◽  
Irritable Bowel

Objetivo: Avaliar a ação de probiótico constituído pelo Lactobacillus reuteri em pacientes selecionados como portadores da síndrome do supercrescimento bacteriano do intestino delgado (SSCBID), através do teste respiratório da lactulose. Métodos: Foram incluídos 21 pacientes que apresentavam sintomas gastrointestinais inespecíficos, mas sugestivos de SSCBID. Foram selecionados através do questionário específico, para serem submetidos ao teste respiratório para lactulose. Os indivíduos com teste positivo foram convocados para iniciarem tratamento com probiótico composto por 100.000.000 UFC de Lactobacillus reuteri por quatro semanas e posterior reavaliação dos sintomas. Resultados: O resultado do teste respiratório foi positivo em 13 (61,90%) participantes (p=0,0391). A principal queixa foi a dor e/ou desconforto abdominal, com 46,15% (6/13) dos casos. A síndrome do intestino irritável representou o diagnóstico prévio de 30,77% (4/13) dos casos. 9 dos 13 pacientes tratados (69,23%) obtiveram melhora do quadro clínico inicial com o uso do probiótico. Conclusão: As evidências indicam que novos estudos devem ser realizados sobre os probióticos, para que sua aplicação clínica na síndrome do supercrescimento bacteriano seja definida. Neste estudo, o probiótico reduziu a sintomatologia abdominal em pacientes com SSCBID, com impacto na qualidade de vida destes indivíduos.  Palavras chave: supercrescimento bacteriano, teste respiratório, síndrome do intestino irritável, probióticos.   ABSTRACT Objective: To assess the efficacy of probiotic Lactobacillus reuteri made by patients selected as having syndrome of small intestinal bacterial overgrowth (SSCBID) through the lactulose breath test. Methods: We included 21 patients who had nonspecific gastrointestinal symptoms, but suggestive of SSCBID, who were selected through specific questionnaire to be submitted to the breath test lactulose. Individuals with a positive test were called for starting treatment with probiotic composed of Lactobacillus reuteri UFC 100 million for four weeks and subsequent reassessment of symptoms. Results: The results of the breath test was positive in 13 (61.90%) participants (p=0.0391). The main complaint was pain and/or abdominal discomfort, with 46.15% (6/13) of cases. The irritable bowel syndrome represented the previous diagnosis of 30.77% (4/13) of cases. Nine out of the 13 patients (69.23%) had clinical improvement starting with the use of probiotics. Conclusion: Evidence indicates that further studies should be conducted on probiotics, so its clinical application in bacterial overgrowth syndrome is defined. In this study, the probiotic reduced abdominal symptoms in patients with SSCBID, with impact on the quality of life of these individuals.  Keywords: bacterial overgrowth, breath test, irritable bowel syndrome, probiotics.

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