Assessment of a 4-Week Starch- and Sucrose-Reduced Diet and Its Effects on Gastrointestinal Symptoms and Inflammatory Parameters among Patients with Irritable Bowel Syndrome

Dietary advice constitutes a treatment strategy for irritable bowel syndrome (IBS). We aimed to examine the effect of a starch- and sucrose-reduced diet (SSRD) on gastrointestinal symptoms in IBS patients, in relation to dietary intake and systemic inflammatory parameters. IBS patients (n = 105) were randomized to a 4-week SSRD intervention (n = 80) receiving written and verbal dietary advice focused on starch and sucrose reduction and increased intake of protein, fat and dairy, or control group (n = 25; habitual diet). At baseline and 4 weeks, blood was sampled, and participants filled out IBS-SSS, VAS-IBS, and Rome IV questionnaires and dietary registrations. C-reactive protein and cytokines TNF-α, IFN-γ, IL-6, IL-8, IL-10, and IL-18 were analyzed from plasma. At 4 weeks, the intervention group displayed lower total IBS-SSS, ‘abdominal pain’, ‘bloating/flatulence’ and ‘intestinal symptoms´ influence on daily life’ scores (p ≤ 0.001 for all) compared to controls, and a 74%, responder rate (RR = ΔTotal IBS-SSS ≥ −50; RRcontrols = 24%). Median values of sucrose (5.4 vs. 20 g), disaccharides (16 vs. 28 g), starch (22 vs. 82 g) and carbohydrates (88 vs. 182 g) were lower for the intervention group compared to controls (p ≤ 0.002 for all), and energy percentages (E%) of protein (21 vs. 17 E%, p = 0.006) and fat (47 vs. 38 E%, p = 0.002) were higher. Sugar-, starch- and carbohydrate-reductions correlated weakly-moderately with total IBS-SSS decrease for all participants. Inflammatory parameters were unaffected. IBS patients display high compliance to the SSRD, with improved gastrointestinal symptoms but unaltered inflammatory parameters. In conclusion, the SSRD constitutes a promising dietary treatment for IBS, but needs to be further researched and compared to established dietary treatments before it could be used in a clinical setting.

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

Scientific Reports ◽

10.1038/s41598-021-87158-2 ◽

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.

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Clinical Response and Changes of Cytokines and Zonulin Levels in Patients with Diarrhoea-Predominant Irritable Bowel Syndrome Treated with Bifidobacterium Longum ES1 for 8 or 12 Weeks: A Preliminary Report

Journal of Clinical Medicine ◽

10.3390/jcm9082353 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2353

Author(s):

Gian Paolo Caviglia ◽

Alessandra Tucci ◽

Rinaldo Pellicano ◽

Sharmila Fagoonee ◽

Chiara Rosso ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Clinical Response ◽

Bifidobacterium Longum ◽

Gastrointestinal Symptoms ◽

Intestinal Barrier ◽

Response To Therapy ◽

Intestinal Barrier Function ◽

Control Group ◽

Placebo Control ◽

Irritable Bowel

Bifidobacterium longum (B. longum) ES1 is a probiotic strain capable of modulating microbiome composition, anti-inflammatory activity and intestinal barrier function. We investigated the use of B. Longum ES1 in the treatment of patients with diarrhoea-predominant irritable bowel syndrome (IBS-D). Sixteen patients were treated for 8 or 12 weeks with B. Longum ES1 (1 × 109 CFU/day). Serum zonulin and cytokines were measured at baseline (T0) and at the end of therapy (T1). Clinical response to therapy was assessed by IBS Severity Scoring System. Interleukin (IL)-6, IL-8, IL-12p70 and tumor necrosis factor (TNF) α levels decreased from T0 to T1, irrespective of treatment duration (p < 0.05), while zonulin levels diminished only in patients treated for 12 weeks (p = 0.036). Clinical response was observed in 5/16 patients (31%): 4/8 (50%) treated for 12 weeks and 1/8 (13%) treated for 8 weeks. Abdominal pain improved only in patients treated for 12 weeks (5/8 vs. 0/8, p = 0.025), while stool consistency improved regardless of therapy duration (p < 0.001). In conclusion, the results of this pilot study showed, in IBS-D patients treated for 12 weeks with B. longum ES1, a reduction in the levels of pro-inflammatory cytokines, and intestinal permeability as well as an improvement in gastrointestinal symptoms, but further studies including a placebo-control group are necessary to prove a causal link.

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Effect of Multispecies Probiotic Supplementation on Irritable Bowel Syndrome

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2019/v28i630221 ◽

2019 ◽

pp. 1-9

Author(s):

Saeed Yazdani Ashtiani ◽

Mersad Amery

Keyword(s):

Quality Of Life ◽

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Therapeutic Option ◽

Intervention Group ◽

Control Group ◽

Controlled Clinical Trial ◽

Probiotic Supplementation ◽

Irritable Bowel

Background: Irritable bowel syndrome (IBS) is a common, chronic and sometimes disabling functional disorder of the gastrointestinal system and its treatment remains as health problem. Thus the aim of this study was to evaluate the Effect of multispecies probiotic supplementation, as a novel and Controversial therapeutic method on Irritable bowel syndrome. Materials and Methods: In this randomized double blind Placebo-controlled clinical trial, 60 patients with IBS were enrolled. The patients were divided randomly into two groups. Patients in intervention group received two 500 mg probiotic capsules (Familact®) and in control group, received two 500 mg placebo capsules daily for 30 consecutive days. The symptoms and quality of life were measured and compared at the beginning and just after the end of study for each case. Results: Results showed the mean score of Abdominal pain after 1 month of treatment in the probiotic group was significantly lower than the control group (1.76 ± 2.04 vs. 2.88 ± 2.25, P=0.049, respectively). While, other symptoms and quality of life did not change significantly (P>0.05). Furthermore, defecation habit and global symptoms improvement was similar after intervention in both groups and we did not observe significant differences in these items (P>0.05). Conclusion: The results of this study showed the beneficial effects of multispecies probiotic supplementation in controlling IBS patients’ abdominal pain. thus it can be prescribed as a therapeutic option in addition to standard therapy and significantly lead to better control of this symptom in the short term.

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Metabolic Profiling of Plasma in Patients with Irritable Bowel Syndrome after a 4-Week Starch- and Sucrose-Reduced Diet

Metabolites ◽

10.3390/metabo11070440 ◽

2021 ◽

Vol 11 (7) ◽

pp. 440

Author(s):

Hans Stenlund ◽

Clara Nilholm ◽

Elin Chorell ◽

Bodil Roth ◽

Mauro D’Amato ◽

...

Keyword(s):

Mass Spectrometry ◽

Irritable Bowel Syndrome ◽

Dietary Intervention ◽

Fatty Acid Biosynthesis ◽

Gastrointestinal Symptoms ◽

Metabolic Effects ◽

Gas Chromatography Mass Spectrometry ◽

Control Group ◽

Chromatography Mass Spectrometry ◽

Irritable Bowel

A 4-week dietary intervention with a starch- and sucrose-restricted diet (SSRD) was conducted in patients with irritable bowel syndrome (IBS) to examine the metabolic profile in relation to nutrient intake and gastrointestinal symptoms. IBS patients were randomized to SSRD intervention (n = 69) or control continuing with their ordinary food habits (n = 22). Food intake was registered and the questionnaires IBS-symptoms severity scale (IBS-SSS) and visual analog scale for IBS (VAS-IBS) were completed. Metabolomics untargeted analysis was performed by gas chromatography mass spectrometry (GC-MS) and liquid chromatography mass spectrometry (LC-MS) in positive and negative ionization modes. SSRD led to marked changes in circulating metabolite concentrations at the group level, most prominent for reduced starch intake and increased polyunsaturated fat, with small changes in the control group. On an individual level, the correlations were weak. The marked reduction in gastrointestinal symptoms did not correlate with the metabolic changes. SSRD was observed by clear metabolic effects mainly related to linoleic acid metabolism, fatty acid biosynthesis, and beta-oxidation.

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Comparison of Laughter Yoga and Anti-Anxiety Medication on Anxiety and Gastrointestinal Symptoms of Patients with Irritable Bowel Syndrome

Middle East Journal of Digestive Diseases ◽

10.15171/mejdd.2019.151 ◽

2019 ◽

Vol 11 (4) ◽

pp. 211-217 ◽

Cited By ~ 1

Author(s):

Tahmine Tavakoli ◽

Navid Davoodi ◽

Toktam Sadat Jafar Tabatabaee ◽

Zeinab Rostami ◽

Homa Mollaei ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Gastrointestinal Symptoms ◽

Symptomatic Treatment ◽

Control Group ◽

Controlled Clinical Trial ◽

Yoga Group ◽

Gi Symptoms ◽

Before And After ◽

The Difference ◽

Irritable Bowel

BACKGROUND Irritable bowel syndrome (IBS) is the most common chronic gastrointestinal (GI) disorder. Patients with IBS usually suffer from anxiety and depression. A combination of psychological approaches and pharmacological treatments can be a significantly effective treatment for IBS. The main objective of the present study was to provide a therapeutic plan based on laughter yoga and anti-anxiety medication, employed for the very first time, and to determine the effectiveness of these treatments on the anxiety and GI symptoms of patients with IBS. METHODS In this randomized, controlled, clinical trial, the participants were 60 patients selected from those who referred to the GI clinic of Vali-asr Hospital (Birjand, Iran) during the study period (April 2017 to March 2017) and were diagnosed as having IBS based on ROME III criteria. The participants were randomly assigned to either the laughter yoga group, the anti-anxiety medication group, or the symptomatic treatment (control) group. Severity levels of anxiety and GI symptoms before and after intervention were determined and compared among these three groups according to approved protocols. RESULTS The severity of IBS symptoms after the interventions was more greatly reduced in the laughter yoga group than in the anti-anxiety medication and control groups (p = 0.006). The severity of anxiety after interventions decreased in all three groups, especially in the yoga treatment group, but the difference was not statistically significant (p = 0.1). CONCLUSION Laughter yoga is more effective than anti-anxiety medication in reducing the GI symptoms of patients with IBS. Therefore, applying laughter yoga along with common pharmacological therapies for patients with IBS might be strongly advised.

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Igg Food Antibody Guided Elimination-Rotation Diet Was More Effective than FODMAP Diet and Control Diet in the Treatment of Women with Mixed IBS—Results from an Open Label Study

Journal of Clinical Medicine ◽

10.3390/jcm10194317 ◽

2021 ◽

Vol 10 (19) ◽

pp. 4317

Author(s):

Lucyna Ostrowska ◽

Diana Wasiluk ◽

Camille F. J. Lieners ◽

Mirosława Gałęcka ◽

Anna Bartnicka ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Control Diet ◽

Dietary Treatment ◽

Control Group ◽

Open Label ◽

Open Label Study ◽

Label Study ◽

Irritable Bowel ◽

Fodmap Diet

Irritable bowel syndrome (IBS) is a chronic disease with recurrent abdominal pain, disturbed bowel emptying, and changes in stool consistency. We compared the effectiveness of three different dietary treatment plans (G1-FM-low FODMAP diet, G2-IP IgG based elimination-rotation-diet, and as control group, the G3-K control diet recommended by an attending gastroenterologist) in treating patients diagnosed with mixed irritable bowel syndrome. A total of seventy-three female patients diagnosed with a mixed form of irritable bowel syndrome (IBS-M) were enrolled in the study. The diet of each patient in Group 1 (G1-FM) and 2 (G2-IP) was determined individually during a meeting with a dietitian. Patients from Group 3 (G3-K) received nutrition advice from a gastroenterologist. Significant differences in the reduction of IBS symptoms were found between the groups. IBS symptoms as well as comorbid symptoms significantly improved or disappeared completely in the G2-IP group (idiopathic abdominal pain, p < 0.001; abdominal pain after a meal, p < 0.001; abdominal pain during defecation, p = 0.008), while in the G1-FM group, some of the IBS symptoms significantly improved (mucus in stool, p = 0.031; bloating, p < 0.001). In group G3-K no significant improvement was seen. Based on the results of this open-label study, it was concluded that various dietary interventions in the treatment of IBS-M patients do not uniformly affect the course and outcomes of disease management. Rotation diets based on IgG show significantly better results compared to other diets.

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Mechanism of QingHuaZhiXie Prescription Regulating TLR4-IECs Pathway in the Intervention of Diarrhea Predominant Irritable Bowel Syndrome

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/5792130 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Hua Huang ◽

Ping Zhao ◽

Meijuan Xi ◽

Fang Li ◽

Lijiang Ji

Keyword(s):

Irritable Bowel Syndrome ◽

Intervention Group ◽

Immunohistochemical Analysis ◽

Inflammatory Factors ◽

Control Group ◽

Model Group ◽

Expression Levels ◽

Protein Levels ◽

Intestinal Hypersensitivity ◽

Irritable Bowel

To investigate the effect and mechanism of QingHuaZhiXie prescription on diarrhea predominant irritable bowel syndrome (D-IBS), animal models of rats were used in this study. 48 rats were randomly divided into 6 groups, containing one control group, one animal model group (D-IBS group), and four drug intervention groups (low, medium, and high dosage of QingHuaZhiXie prescription and trimebutine maleate intervention group). Abdominal withdrawal reflex (AWR) and Bristol stool form scale were recorded; the expression levels of inflammatory factors (TNF-α and IFN-γ), pathway proteins TLR4, MyD88, NF-κB, and key proteins of tight junction between intestinal epithelial cells (IECs) were detected; the microstructure of intestinal mucosal was observed by hematoxylin and eosin (H&E) staining; MPO activity was detected with immunohistochemical analysis to reflect the inflammation of tissues. Results show that QingHuaZhiXie prescription reduced diarrhea index and intestinal hypersensitivity and intestinal tissue integrity after intervention. MPO activity in QingHuaZhiXie prescription-treated rats was significantly lower relative to their model group. The expression levels of inflammatory factors and TLR4/MyD88/NF-κB pathway proteins were repressed, and the protein levels of occludin and claudin-1 increased. Meanwhile, this study also found that the remission effect of QingHuaZhiXie prescription on D-IBS increased with its dosage increase. Hence, as a therapeutic prescription for D-IBS, QingHuaZhiXie prescription could relieve D-IBS symptoms through balancing the inflammatory factors expression by inhibiting the TLR4/MyD88/NF-κB pathway and maintaining the function and structure of IECs by improving the protein levels of JAM, occludin, claudin-1, and ZO-1.

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A Randomized Trial of Yoga for Adolescents with Irritable Bowel Syndrome

Pain Research and Management ◽

10.1155/2006/731628 ◽

2006 ◽

Vol 11 (4) ◽

pp. 217-224 ◽

Cited By ~ 106

Author(s):

Leora Kuttner ◽

Christine T Chambers ◽

Janine Hardial ◽

David M Israel ◽

Kevan Jacobson ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Functional Disability ◽

Randomized Study ◽

Gastrointestinal Symptoms ◽

Control Group ◽

Wait List ◽

Wait List Control Group ◽

Wait List Control ◽

Yoga Intervention ◽

Irritable Bowel

BACKGROUND: Adolescents with irritable bowel syndrome (IBS) frequently experience interference with everyday activities. Mind-body approaches such as yoga have been recommended as interventions for patients with IBS. Despite promising results among adult samples, there have been limited studies exploring the efficacy of yoga with pediatric patients.OBJECTIVE: To conduct a preliminary randomized study of yoga as treatment for adolescents with IBS.METHODS: Twenty-five adolescents aged 11 to 18 years with IBS were randomly assigned to either a yoga or wait list control group. Before the intervention, both groups completed questionnaires assessing gastrointestinal symptoms, pain, functional disability, coping, anxiety and depression. The yoga intervention consisted of a 1 h instructional session, demonstration and practice, followed by four weeks of daily home practice guided by a video. After four weeks, adolescents repeated the baseline questionnaires. The wait list control group then received the yoga intervention and four weeks later completed an additional set of questionnaires.RESULTS: Adolescents in the yoga group reported lower levels of functional disability, less use of emotion-focused avoidance and lower anxiety following the intervention than adolescents in the control group. When the pre- and postintervention data for the two groups were combined, adolescents had significantly lower scores for gastrointestinal symptoms and emotion-focused avoidance following the yoga intervention. Adolescents found the yoga to be helpful and indicated they would continue to use it to manage their IBS.CONCLUSIONS: Yoga holds promise as an intervention for adolescents with IBS.

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Vitamin D3 Supplementation in Diarrhea-Predominant Irritable Bowel Syndrome Patients: The Effects on Symptoms Improvement, Serum Corticotropin-Releasing Hormone, and Interleukin-6 – A Randomized Clinical Trial

Complementary Medicine Research ◽

10.1159/000506149 ◽

2020 ◽

Vol 27 (5) ◽

pp. 302-309 ◽

Cited By ~ 1

Author(s):

Masoumeh Khalighi Sikaroudi ◽

Marjan Mokhtare ◽

Leila Janani ◽

Amir Hossein Faghihi Kashani ◽

Mohsen Masoodi ◽

...

Keyword(s):

Vitamin D ◽

Irritable Bowel Syndrome ◽

Serum Level ◽

Vitamin D Deficiency ◽

Vitamin D3 ◽

Interleukin 6 ◽

Intervention Group ◽

Control Group ◽

Vitamin D3 Supplementation ◽

Irritable Bowel

Objectives: This study aimed to evaluate whether vitamin D deficiency is associated with the severity of symptoms of irritable bowel syndrome (IBS) patients. Stress and gut inflammation can increase the serum level of corticotropin-releasing hormone (CRH) and interleukin-6 (IL-6), leading to a change in bowel movements. The aim of this study was to evaluate the anti-inflammatory and psychological effects of vitamin D3 supplementation on the symptom improvement of patients with a diarrhea-predominant form of IBS (IBS-D). Methods: Eighty-eight IBS-D patients (age: 18–65 years) based on Rome IV criteria who suffered from vitamin D deficiency and/or insufficiency were enrolled in this randomized, placebo-controlled trial from February 2017 to May 2018 at Rasoul-e-Akram Hospital, Tehran, Iran. Participants were randomly divided into two groups. The intervention group received 50,000 IU vitamin D3 weekly and the control group received a placebo for 9 weeks. All patients received Mebeverine 135 mg twice a day besides supplementation. The IBS Severity Score System (IBS-SSS), serum 25(OH) vitamin D3, CRH, and IL-6 were measured before and after interventions. Results: Seventy-four patients completed the study. The severity of IBS symptoms (p < 0.01) and IL-6 (p = 0.02) decreased significantly in the intervention group as compared to the control group, but there was no significant difference in the serum level of CRH. Also, in the treatment group, IBS-SSS and IL-6 were significantly reduced at the end of the study from baseline (p < 0.01 and p < 0.03, respectively). Conclusion: Our findings indicate that vitamin D3 supplementation can modulate the serum level of CRH and IL-6 and can improve symptoms in IBS-D patients. Vitamin D3 supplementation should be considered in IBS-D patients who suffer from vitamin D deficiency and/or insufficiency.

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Irregular Dietary Habits with a High Intake of Cereals and Sweets Are Associated with More Severe Gastrointestinal Symptoms in IBS Patients

Nutrients ◽

10.3390/nu11061279 ◽

2019 ◽

Vol 11 (6) ◽

pp. 1279 ◽

Cited By ~ 6

Author(s):

Clara Nilholm ◽

Ewa Larsson ◽

Bodil Roth ◽

Rita Gustafsson ◽

Bodil Ohlsson

Keyword(s):

Irritable Bowel Syndrome ◽

Dietary Habits ◽

Eating Habits ◽

Gastrointestinal Symptoms ◽

Well Being ◽

Irritable Bowel Syndrome Symptom ◽

Dietary Advice ◽

Blood Levels ◽

Gi Symptoms ◽

Irritable Bowel

Dietary advice constitutes one of the first choices of treatment for irritable bowel syndrome (IBS). We have recognized an increased prevalence of sucrase-isomaltase (SI) gene variants in IBS patients, possibly rendering starch- and sucrose-intolerance. The aims were to examine participants’ dietary habits at baseline, to correlate habits with gastrointestinal (GI) symptoms and blood levels of minerals and vitamins, and to examine the effect of a starch- and sucrose-reduced diet (SSRD) on GI symptoms. In the study 105 IBS patients (82 women, 46.06 ± 13.11 years), irritable bowel syndrome-symptom severity scale (IBS-SSS)>175, were randomized to SSRD for 2 weeks or continued ordinary eating habits. Blood samples, visual analog scale for irritable bowel syndrome (VAS-IBS), IBS-SSS, and 4-day food diaries were collected at baseline and after 2 weeks. Patients with irregular dietary habits exhibited higher IBS-SSS than patients with regular habits (p = 0.029). Women already on a diet had lower ferritin levels than others (p = 0.029). The intervention led to 66.3% of patients being responders, with differences in the change of IBS-SSS (p < 0.001), abdominal pain (p = 0.001), diarrhea (p = 0.002), bloating and flatulence (p = 0.005), psychological well-being (p = 0.048), and intestinal symptoms’ influence on daily life (p < 0.001), compared to controls. Decreased intake of cereals and sweets/soft drinks correlated with decreased scores.

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