scholarly journals Sex-Bias in Irritable Bowel Syndrome: Linking Steroids to the Gut-Brain Axis

2021 ◽  
Vol 12 ◽  
Author(s):  
Sik Yu So ◽  
Tor C. Savidge
Keyword(s):  
Irritable Bowel Syndrome ◽  
Sex Steroids ◽  
Disease Onset ◽  
Gastrointestinal Disorder ◽  
Underlying Disease ◽  
Disease Mechanism ◽  
Psychological Conditions ◽  
Nervous System Function ◽  
Irritable Bowel ◽  
Insight Into

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is more common in females. Despite its high global incidence, the disease mechanism is still unclear and therapeutic options remain limited. The sexual dimorphism in IBS incidence suggests that sex steroids play a role in disease onset and symptoms severity. This review considers sex steroids and their involvement in IBS symptoms and the underlying disease mechanisms. Estrogens and androgens play important regulatory roles in IBS symptomology, including visceral sensitivity, gut motility and psychological conditions, possibly through modulating the gut-brain axis. Steroids are regulators of hypothalamic-pituitary-adrenal activity and autonomic nervous system function. They also modulate gut microbiota and enteric nervous systems, impacting serotonin and mast cell signaling. Sex steroids also facilitate bidirectional cross-talk between the microbiota and host following bacterial transformation and recycling of steroids by the intestine. The sex-specific interplay between sex steroids and the host provides neuroendocrinology insight into the pathophysiology, epigenetics and treatment of IBS patients.

scholarly journals The Prevalence of Anti-Zein Antibodies: A Comparative Study between Celiac Disease and Irritable Bowel Syndrome

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 649
Author(s):  
Luis Alberto Sánchez-Vargas ◽  
Karina Guadalupe Hernández-Flores ◽  
Francisco Javier Cabrera-Jorge ◽  
José María Remes-Troche ◽  
Job Reyes-Huerta ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Celiac Disease ◽  
Gastrointestinal Disorder ◽  
Newly Diagnosed ◽  
Disease Group ◽  
Immune Mediated ◽  
Healthy Control ◽  
Gliadin Peptides ◽  
Irritable Bowel ◽  
First Time

Celiac disease (CD) is a chronic immune-mediated enteropathy triggered by exposure to dietary gluten in genetically predisposed individuals. In contrast, irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder affecting the large intestine, without an autoimmune component. Here, we evaluated the prevalence of IgA and IgG antibodies to maize zeins (AZA) in patients with CD and IBS. Using an in-house ELISA assay, the IgA and IgG anti-zein antibodies in the serum of 37 newly diagnosed CD (16 biopsy proved and 21 serological diagnosis) and 375 IBS patients or 302 healthy control (HC) subjects were measured. Elevated levels of IgA AZA were found in CD patients compared with IBS patients (p < 0.01) and HC (p < 0.05). CD patients had the highest prevalence (35.1%), followed by IBS (4.3%) and HCs (2.3%) (p < 0.0001). IgG AZA antibodies were not found in any CD patients, IBS patients, or HC subjects. A significant positive correlation was found between IgA AZA with IgA anti-gliadin (AGA, r = 0.34, p < 0.01) and IgA anti-deaminated gliadin peptides (DGP, r = 0.42, p < 0.001) in the celiac disease group. Taken together, our results show for the first time a higher prevalence of AZA IgA antibodies in newly diagnosed CD patients than in IBS patients, confirming a biased immune response to other gliadin-related prolamins such as maize zeins in genetically susceptible individuals.

scholarly journals Diarrhea Predominant-Irritable Bowel Syndrome (IBS-D): Effects of Different Nutritional Patterns on Intestinal Dysbiosis and Symptoms

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1506
Author(s):  
Annamaria Altomare ◽  
Claudia Di Rosa ◽  
Elena Imperia ◽  
Sara Emerenziani ◽  
Michele Cicala ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Intestinal Microbiota ◽  
Gastrointestinal Disorder ◽  
Additional Energy ◽  
Nutritional Advice ◽  
Intestinal Dysbiosis ◽  
Gi Symptoms ◽  
Mutualistic Relationship ◽  
Irritable Bowel ◽  
Fodmap Diet

Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by abdominal pain associated with defecation or a change in bowel habits. Gut microbiota, which acts as a real organ with well-defined functions, is in a mutualistic relationship with the host, harvesting additional energy and nutrients from the diet and protecting the host from pathogens; specific alterations in its composition seem to play a crucial role in IBS pathophysiology. It is well known that diet can significantly modulate the intestinal microbiota profile but it is less known how different nutritional approach effective in IBS patients, such as the low-FODMAP diet, could be responsible of intestinal microbiota changes, thus influencing the presence of gastrointestinal (GI) symptoms. The aim of this review was to explore the effects of different nutritional protocols (e.g., traditional nutritional advice, low-FODMAP diet, gluten-free diet, etc.) on IBS-D symptoms and on intestinal microbiota variations in both IBS-D patients and healthy subjects. To date, an ideal nutritional protocol does not exist for IBS-D patients but it seems crucial to consider the effect of the different nutritional approaches on the intestinal microbiota composition to better define an efficient strategy to manage this functional disorder.

scholarly journals Rational Use of Fecal Calprotectin in Irritable Bowel Syndrome and Inflammatory Bowel Disease

2021 ◽  
Author(s):  
Roberto Catanzaro ◽  
Alfio Maugeri ◽  
Morena Sciuto ◽  
Fang He ◽  
Baskar Balakrishnan ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Irritable Bowel Syndrome ◽  
Differential Diagnosis ◽  
Bowel Disease ◽  
Intestinal Inflammation ◽  
Gastrointestinal Disorder ◽  
Fecal Calprotectin ◽  
Mean Values ◽  
Inflammatory Bowel ◽  
Irritable Bowel

The gastrointestinal pathologies have increased over the last years. The clinical pictures of inflammatory and irritable bowel disease might overlap, leading to expensive and invasive tests. Our study aims to investigate fecal calprotectin as an effective tool for differential diagnosis of gastrointestinal disorders. Two hundred fifty-six patients with the diagnosis of the gastrointestinal disorder and subjected to colonoscopy were collected for the statistical analysis of fecal calprotectin. The differential diagnosis of intestinal inflammation or non-inflammation was performed according to the Receiver Operating Characteristic (ROC) curve that outlines the Area Under Curve (AUC), Sensitivity (Se), Specificity (Sp). Fecal calprotectin was significantly elevated in patients with inflammatory bowel disease compared with patients with irritable bowel syndrome. Especially, the mean values of fecal calprotectin were 522 g/g (IQR=215-975) and 21 g/g (IQR=14-34.5) in patients with and without inflammation, respectively (P<0.0001). AUC value of fecal calprotectin was 0.958 (Se=88.9%, Sp=91.1%, with a cut-off value of 50 g/g) for differentiating between inflammatory bowel disease and irritable bowel syndrome. Fecal calprotectin seems to be a non-invasive and inexpensive biomarker useful for the purpose of a differential diagnosis between inflammatory bowel disease and irritable bowel syndrome.

scholarly journals Probiotics in Irritable Bowel Syndrome: An Up-to-Date Systematic Review

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2048 ◽  
Author(s):  
Hanna Fjeldheim Dale ◽  
Stella Hellgren Rasmussen ◽  
Özgün Ömer Asiller ◽  
Gülen Arslan Lied
Keyword(s):  
Systematic Review ◽  
Irritable Bowel Syndrome ◽  
Gut Microbiota ◽  
Gastrointestinal Disorder ◽  
Inclusion Criteria ◽  
Probiotic Supplementation ◽  
Beneficial Effects ◽  
Randomized Controlled ◽  
Irritable Bowel ◽  
Gut Microbiota Composition

Irritable bowel syndrome (IBS) is a frequent functional gastrointestinal disorder, and alterations in the gut microbiota composition contributes to symptom generation. The exact mechanisms of probiotics in the human body are not fully understood, but probiotic supplements are thought to improve IBS symptoms through manipulation of the gut microbiota. The aim of this systematic review was to assess the latest randomized controlled trials (RCTs) evaluating the effect of probiotic supplementation on symptoms in IBS patients. A literature search was conducted in Medline (PubMed) until March 2019. RCTs published within the last five years evaluating effects of probiotic supplements on IBS symptoms were eligible. The search identified in total 35 studies, of which 11 met the inclusion criteria and were included in the systematic review. Seven studies (63.6%) reported that supplementation with probiotics in IBS patients significantly improved symptoms compared to placebo, whereas the remaining four studies (36.4%) did not report any significant improvement in symptoms after probiotic supplementation. Of note, three studies evaluated the effect of a mono-strain supplement, whereas the remaining eight trials used a multi-strain probiotic. Overall, the beneficial effects were more distinct in the trials using multi-strain supplements with an intervention of 8 weeks or more, suggesting that multi-strain probiotics supplemented over a period of time have the potential to improve IBS symptoms.

scholarly journals Mast Cell Regulation and Irritable Bowel Syndrome: Effects of Food Components with Potential Nutraceutical Use

Molecules ◽  
2020 ◽  
Vol 25 (18) ◽  
pp. 4314 ◽  
Author(s):  
José Antonio Uranga ◽  
Vicente Martínez ◽  
Raquel Abalo
Keyword(s):  
Mast Cell ◽  
Irritable Bowel Syndrome ◽  
Mast Cells ◽  
Gastrointestinal Disorder ◽  
Inflammatory Reactions ◽  
Food Components ◽  
Daily Food ◽  
Release Histamine ◽  
Irritable Bowel

Mast cells are key actors in inflammatory reactions. Upon activation, they release histamine, heparin and nerve growth factor, among many other mediators that modulate immune response and neuron sensitization. One important feature of mast cells is that their population is usually increased in animal models and biopsies from patients with irritable bowel syndrome (IBS). Therefore, mast cells and mast cell mediators are regarded as key components in IBS pathophysiology. IBS is a common functional gastrointestinal disorder affecting the quality of life of up to 20% of the population worldwide. It is characterized by abdominal pain and altered bowel habits, with heterogeneous phenotypes ranging from constipation to diarrhea, with a mixed subtype and even an unclassified form. Nutrient intake is one of the triggering factors of IBS. In this respect, certain components of the daily food, such as fatty acids, amino acids or plant-derived substances like flavonoids, have been described to modulate mast cells’ activity. In this review, we will focus on the effect of these molecules, either stimulatory or inhibitory, on mast cell degranulation, looking for a nutraceutical capable of decreasing IBS symptoms.

scholarly journals Irritable Bowel Syndrome between Molecular Approach and Clinical Expertise—Searching for Gap Fillers in the Oxidative Stress Way of Thinking

Medicina ◽  
2020 ◽  
Vol 56 (1) ◽  
pp. 38 ◽  
Author(s):  
Ioana-Miruna Balmus ◽  
Ovidiu-Dumitru Ilie ◽  
Alin Ciobica ◽  
Roxana-Oana Cojocariu ◽  
Carol Stanciu ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Irritable Bowel Syndrome ◽  
Gastrointestinal Disorder ◽  
Functional Gastrointestinal Disorder ◽  
Clinical Expertise ◽  
Related Disorder ◽  
Genetic Features ◽  
Exogenous Factors ◽  
Irritable Bowel ◽  
Patient Studies

Irritable bowel syndrome (IBS) remains to date an intriguing functional gastrointestinal disorder. Recent studies described a multitude of exogenous factors that work together in IBS, gradually impairing intestinal lining cellular metabolism, including oxidative status balance, with or without a genetic background. Although the current biomarkers support the differentiation between IBS subtypes and other functional gastrointestinal disorder, they are mostly non-specific, referring to clinical, biochemical, and inflammatory imbalances. Since IBS could be also the result of deficient signaling pathways involving both gastrointestinal secretion and neuro-vegetative stimulation, IBS makes no exception from the oxidative hypothesis in the pathological mechanisms. Regarding the oxidative stress implication in IBS, the previous research efforts showed controversial results, with some animal models and patient studies reporting clear oxidative imbalance both on systemic and local levels, but still with no concrete evidence to point to a direct correlation between oxidative stress and IBS. Additionally, it seems that a major role could be also attributed to gut microbiota and their ability to shape our bodies and behaviors. Moreover, the genetic features study in IBS patients showed that several genetic similarities point to a possible correlation of IBS with affective spectrum disorders. Thus, we focus here the discussion on the assumption that IBS could in fact be more likely a stress-related disorder rather than a gastrointestinal one.

scholarly journals Mechanism of action and therapeutic benefit of rifaximin in patients with irritable bowel syndrome: a narrative review

2020 ◽  
Vol 13 ◽  
pp. 175628481989753 ◽  
Author(s):  
William D. Chey ◽  
Eric D. Shah ◽  
Herbert L. DuPont
Keyword(s):  
Irritable Bowel Syndrome ◽  
Gut Microbiota ◽  
Mechanism Of Action ◽  
Bacterial Overgrowth ◽  
Gastrointestinal Disorder ◽  
Small Intestinal Bacterial Overgrowth ◽  
The United States ◽  
Clinical Effects ◽  
Healthy Individuals ◽  
Irritable Bowel

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder with a multifactorial pathophysiology. The gut microbiota differs between patients with IBS and healthy individuals. After a bout of acute gastroenteritis, postinfection IBS may result in up to approximately 10% of those affected. Small intestinal bacterial overgrowth (SIBO) is more common in patients with IBS than in healthy individuals, and eradication of SIBO with systemic antibiotics has decreased symptoms of IBS in some patients with IBS and SIBO. The nonsystemic (i.e. low oral bioavailability) antibiotic rifaximin is indicated in the United States and Canada for the treatment of adults with IBS with diarrhea (IBS-D). The efficacy and safety of 2-week single and repeat courses of rifaximin have been demonstrated in randomized, placebo-controlled studies of adults with IBS. Rifaximin is widely thought to exert its beneficial clinical effects in IBS-D through manipulation of the gut microbiota. However, current studies indicate that rifaximin induces only modest effects on the gut microbiota of patients with IBS-D, suggesting that the efficacy of rifaximin may involve other mechanisms. Indeed, preclinical data reveal a potential role for rifaximin in the modulation of inflammatory cytokines and intestinal permeability, but these two findings have not yet been examined in the context of clinical studies. The mechanism of action of rifaximin in IBS is likely multifactorial, and further study is needed.

scholarly journals Mass spectrometry-based metabolomics for irritable bowel syndrome biomarkers

2019 ◽  
Vol 12 ◽  
pp. 175628481988642 ◽  
Author(s):  
Qihong Yu ◽  
Xinru Liu ◽  
Haojie Huang ◽  
Xingfeng Zheng ◽  
Xue Pan ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Irritable Bowel Syndrome ◽  
Gastrointestinal Disorder ◽  
Ultra Performance Liquid Chromatography ◽  
Healthy Controls ◽  
Multivariate Statistical ◽  
Clinical Trial Registration ◽  
Flight Mass Spectrometry ◽  
Hormone Biosynthesis ◽  
Irritable Bowel

Background: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder without obvious structural abnormalities or consistent associated biomarkers, making its diagnosis difficult. In the present study, we used a urine-based metabolomics approach to identify IBS biomarkers. Methods: We used an ultra-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) on urine samples from patients suffering from IBS and healthy controls. Data were coupled for multivariate statistical analysis methods. Results: We selected 30 differential metabolites associated with IBS and found steroid hormone biosynthesis and histidine metabolism alterations in patients with IBS that may be involved in the pathogenesis of the disease. In addition, we identified a panel of five metabolite markers composed of cortisone, citric acid, tiglylcarnitine, N6,-N6,-N6-trimethyl-L-lysine and L-histidine that could be used to discriminate between patients and healthy controls and may be appropriate as IBS diagnosis biomarkers. Conclusion: Our findings indicate that metabolomics combined with pattern recognition can be useful to identify disease diagnostic IBS markers. Clinical trial registration: ChiCTR1800020072

scholarly journals Rational investigations in irritable bowel syndrome

2019 ◽  
Vol 11 (2) ◽  
pp. 140-147 ◽  
Author(s):  
Christopher J Black ◽  
Alexander C Ford
Keyword(s):  
Irritable Bowel Syndrome ◽  
Bacterial Overgrowth ◽  
Gastrointestinal Disorder ◽  
Small Intestinal Bacterial Overgrowth ◽  
Routine Practice ◽  
Faecal Calprotectin ◽  
Lactose Malabsorption ◽  
Alarm Features ◽  
Irritable Bowel ◽  
Hydrogen Breath Tests

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder which accounts for a substantial proportion of a gastroenterologist’s time in the outpatient clinic. However, there is variability in approaches to diagnosis and investigation between physicians, dependent on expertise. Many patients express disappointment over the lack of a patient-centred approach. Consequently, there have been calls for the care of patients with IBS to be standardised, a process which aims to promote high-quality and high-value care. Making an early diagnosis, based on a clinical assessment of symptoms, while limiting use of investigations, are key tenets of this process. Exhaustive investigation to exclude all organic pathology is unnecessary, and may be counterproductive. Routine blood tests in suspected IBS have low yield, but are an acceptable part of routine practice. All patients should have coeliac serology tested, regardless of their predominant stool form. Patients with diarrhoea should have a faecal calprotectin measured, and should proceed to colonoscopy to exclude inflammatory bowel disease (IBD) if this is positive. Beyond this, the need for investigations should be made on a case-by-case basis, contingent on the reporting of known risk factors for organic pathology. Colonoscopy should be considered in any patient with alarm features for colorectal cancer, and in those whose clinical features are suggestive of microscopic colitis. A 23-seleno-25-homotaurocholic acid (SeHCAT) scan should be considered in patients with IBS-D, a third of whom may actually have bile acid diarrhoea. There is no role for routine hydrogen breath tests for lactose malabsorption or small intestinal bacterial overgrowth.

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