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Gyamenah P, Burrows K, Rai D, Joinson C. Associations of Autistic Traits and Autism with Incontinence and Constipation in a UK Birth Cohort. J Autism Dev Disord 2024:10.1007/s10803-024-06663-1. [PMID: 39644411 DOI: 10.1007/s10803-024-06663-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2024] [Indexed: 12/09/2024]
Abstract
There is evidence that children with autism/autistic traits have higher risks of incontinence and constipation, but no studies have examined this in a large community-based cohort. Aim/Research question: are autistic traits and diagnosed autism prospectively associated with increased odds of incontinence and constipation in children and adolescents? This was a population-based cohort study based on data from the Avon Longitudinal Study of Parents and Children (n = 4233-4490 at age 9 years; n = 3403-3697 at age 14). We used multivariable logistic regression to examine associations of parent-reported autistic traits (sociability, repetitive behaviours, social-communication, coherence) (at ages 3-9 years) and autism with incontinence (bedwetting, daytime-wetting, soiling) and constipation (parent-reported at age 9, self-reported at age 14). We adjusted for parity, maternal age at delivery, child's sex and developmental level, maternal depression, and anxiety (antenatal and postnatal), and indicators of family socioeconomic status. Social-communication and speech coherence difficulties showed the strongest associations with incontinence, e.g., adjusted odds ratio (OR) and 95% confidence interval (CI) for the association between social-communication difficulties and daytime-wetting was 2.21 (1.47-3.32) and for coherence was 2.34 (1.60-3.43). The odds of soiling were also higher in children with social-communication (OR: 1.88, 95% CI 1.28-2.75) and coherence difficulties (OR: 2.04, 95% CI 1.43-2.93). Diagnosed autism was only associated with an increase in the odds of daytime-wetting (OR: 3.18, 95% CI 1.44-7.02). At 14 years, there was less evidence of associations between autistic traits and incontinence but there was evidence of associations between autistic traits and constipation: social-communication (OR: 1.68, 95% CI 1.13-2.49), coherence difficulties (OR: 1.64, 95% CI 1.11-2.41). Early assessment and treatment of incontinence/constipation should be considered for children with autistic traits.
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Affiliation(s)
- Prince Gyamenah
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | | | - Dheeraj Rai
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Carol Joinson
- Bristol Medical School, University of Bristol, Bristol, UK
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Usui S, Zhu Q, Komori H, Iwamoto Y, Nishiuchi T, Shirasaka Y, Tamai I. Apple-derived extracellular vesicles modulate the expression of human intestinal bile acid transporter ASBT/SLC10A2 via downregulation of transcription factor RARα. Drug Metab Pharmacokinet 2023; 52:100512. [PMID: 37517353 DOI: 10.1016/j.dmpk.2023.100512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 08/01/2023]
Abstract
PURPOSE Plant-derived extracellular vesicles (EVs) have been reported to exert biological activity on intestinal tissues by delivering their contents into intestinal cells. We previously reported that ASBT/SLC10A2 mRNA was downregulated by apple-derived extracellular vesicles (APEVs). ASBT downregulation is effective in the treatment of cholestasis and chronic constipation, similar to the beneficial effects of apples. Therefore, this study aimed to establish the mechanism of ASBT downregulation by APEVs, focusing on microRNAs present in APEVs. RESULTS APEVs downregulated the expression of ASBT, but no significant effect on SLC10A2-3'UTR was observed. Proteomics revealed that APEVs decreased the expression of RARα/NR1B1. The binding of RARα to SLC10A2 promoter was also decreased by APEVs. The stability of NR1B1 mRNA was attenuated by APEVs and its 3'UTR was found to be a target for APEVs. Apple microRNAs that were predicted to interact with NR1B1-3'UTR were present in APEVs, and their mimics suppressed NR1B1 mRNA expression. CONCLUSIONS Suppression of ASBT by APEVs was indirectly mediated by the downregulation of RARα, and its stability was lowered by microRNAs present in APEVs. This study suggested that macromolecules in food directly affect intestinal function by means of EVs that stabilize them and facilitate their cellular uptake.
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Affiliation(s)
- Shinya Usui
- Faculty of Pharmaceutical Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Qiunan Zhu
- Faculty of Pharmaceutical Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Hisakazu Komori
- Faculty of Pharmaceutical Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Yui Iwamoto
- Faculty of Pharmaceutical Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Takumi Nishiuchi
- Research Center for Experimental Modeling of Human Disease, Kanazawa University, Ishikawa, 920-0934, Japan
| | - Yoshiyuki Shirasaka
- Faculty of Pharmaceutical Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Ikumi Tamai
- Faculty of Pharmaceutical Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan.
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Singh B, Kumar A, Rohit. Gamma radiation formation of sterculia gum-alginate-carbopol hydrogel dressing by grafting method for use in brain drug delivery. Chem Phys Lett 2021. [DOI: 10.1016/j.cplett.2021.138875] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Raba G, Adamberg S, Adamberg K. Acidic pH enhances butyrate production from pectin by faecal microbiota. FEMS Microbiol Lett 2021; 368:6232156. [PMID: 33864456 DOI: 10.1093/femsle/fnab042] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 04/15/2021] [Indexed: 12/17/2022] Open
Abstract
Environmental pH and gut transit rate are the key factors determining the dynamics of colonic microbiota. In this study, the effect of changing pH on the composition and metabolism of pooled faecal microbiota was elucidated at physiologically relevant dilution rates Dhigh = 0.2 and Dlow = 0.05 1/h. The results showed the best adaptability of Bacteroides ovatus within the pH range 6.0-8.0 at both dilution rates. The butyrate producing Faecalibacterium and Coprococcus comes were extremely sensitive to pH > 7.5, while the abundance of Akkermansia muciniphila increased significantly at pH >7 at Dhigh, causing a pH-dependant shift in the dynamics of mucin degrading species. Increased gas formation was observed at pH < 6.5. Substantially more CO2 was produced at Dlow than at Dhigh (18-29 vs 12-23 mmol per L medium, respectively). Methane was produced only at Dlow and pH > 7, consistent with the simultaneous increased abundance of Methanobrevibacter smithii. Our study confirmed the importance of pH in the development of faecal microbiota in pectin-supplemented medium. Fermentation of other dietary fibres can be studied using the same approach. The significance of pH should be more emphasized in gut research and diagnostics.
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Affiliation(s)
- Grete Raba
- Department of Chemistry and Biotechnology, Tallinn University of Technology, Akadeemia tee 15, Tallinn, Estonia
| | - Signe Adamberg
- Department of Chemistry and Biotechnology, Tallinn University of Technology, Akadeemia tee 15, Tallinn, Estonia
| | - Kaarel Adamberg
- Department of Chemistry and Biotechnology, Tallinn University of Technology, Akadeemia tee 15, Tallinn, Estonia.,Center of Food and Fermentation Technologies, Akadeemia tee 15A, Tallinn, Estonia
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Monro JA, Paturi G. Kiwifruit Skin and Flesh Contributions to Fecal Bulking and Bacterial Abundance in Rats. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2020; 75:525-531. [PMID: 32761416 DOI: 10.1007/s11130-020-00839-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Changes in fecal bulk and bacterial abundance due to separately consumed skin and flesh of four kiwifruit cultivars was determined using a rat model designed to estimate the fecal bulking potential of human foods. Dry matter contribution by skin to 100 g of fresh kiwifruit was less than 5% in all cultivars, whereas flesh dry matter contributed up to 20% of fresh fruit weight. Dietary fiber was 35-49% of skin compared with 8-23% of flesh on a dry weight basis. The skin significantly increased whole fruit fecal bulking, but the total bulk per 100 g kiwifruit was less than 10% of daily fecal bulk recommended for optimal gut health. Kiwifruit (skin or flesh) substantially increased the abundance of Lachnospiraceae and Lactobacillus spp. within the gut. Fermentation and prebiosis therefore probably play a greater role than fermentation-resistant dietary fiber in gut health benefits of kiwifruit.
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Affiliation(s)
- John A Monro
- The New Zealand Institute for Plant and Food Research Limited, Private Bag 11600, Palmerston North, 4442, New Zealand
| | - Gunaranjan Paturi
- The New Zealand Institute for Plant and Food Research Limited, Private Bag 92169, Auckland, 1142, New Zealand.
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Arevalo I, Guzmán-Maldonado SH, Sanchez SMM, Acosta-Gallegos JA. Steaming and Toasting Reduce the Nutrimental Quality, Total Phenols and Antioxidant Capacity of Fresh Kabuli Chickpea (Cicer arietinum L.). PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2020; 75:628-634. [PMID: 33025393 DOI: 10.1007/s11130-020-00857-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 06/11/2023]
Abstract
Kabuli chickpea is traditionally consumed in Mexico. It is currently exported to countries including United States where its demand has recently increased. In order to demonstrate the effect of thermal processes on the quality of fresh chickpea, the objective of the present work was to evaluate some nutrimental and functional characteristics of raw, steamed and toasted chickpea. The partial chemical composition, total phenols, oligosaccharides, and antioxidant capacities were measured in five genotypes of chickpea. Steamed and toasted chickpea showed up to 8.4 and 25.8% less protein, respectively, than that of raw samples. Oligosaccharides, in general decreased in steamed and toasted fresh grain; however, verbascose increased on average 30.6 and 37.9% in steamed and toasted samples, respectively. Minor changes in total phenolic content were observed a result of the process. Trolox equivalent antioxidant capacity increased up to 3.5 times compared to that of antioxidant capacity of raw samples. Fresh chickpea grain, raw or processed, shows attractive nutritional and antioxidant properties that can contribute to the diet and health of the person who consumes it.
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Affiliation(s)
- Isabel Arevalo
- Department of Biochemistry, National Technological Institute, Campus Celaya. Tecnológico de Celaya, Antonio García Cubas Pte. No. 600 esq. Av. Tecnológico, C.P. 38010 Celaya, Guanajuato, Mexico
| | - Salvador Horacio Guzmán-Maldonado
- Food Science Laboratory, Experimental Station El Bajío (CIRCE-INIFAP), Km. 6.5 Carretera Celaya-San Miguel de Allende, C. P. 38010 Celaya, Guanajuato, Mexico.
| | - Sara Meyeth Mata Sanchez
- Indiana University Department of Chemistry, 800 E Ave. Bloomington IN, Kirkwood, 47405-7102, USA
| | - Jorge Alberto Acosta-Gallegos
- Food Science Laboratory, Experimental Station El Bajío (CIRCE-INIFAP), Km. 6.5 Carretera Celaya-San Miguel de Allende, C. P. 38010 Celaya, Guanajuato, Mexico
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7
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Kim MG, Jo K, Chang YB, Suh HJ, Hong KB. Changes in the Gut Microbiome after Galacto-Oligosaccharide Administration in Loperamide-Induced Constipation. J Pers Med 2020; 10:jpm10040161. [PMID: 33050434 PMCID: PMC7711924 DOI: 10.3390/jpm10040161] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/07/2020] [Accepted: 10/08/2020] [Indexed: 01/02/2023] Open
Abstract
Unbalanced dietary habits and the consumption of high protein and instant foods cause an increase in constipation. Here, we evaluated the effects of galacto-oligosaccharide (GOS) on a rat model of loperamide-induced constipation by measuring various biological markers and cecal microbiota. The fecal water content and intestinal transit ratio significantly increased in the GOS-administered (GL and GH) groups than in the control group (p < 0.05, p < 0.01, and p < 0.001, respectively). The length of intestinal mucosa (p < 0.05 and p < 0.01, respectively) and area of crypt cells were (p < 0.01, both) significantly increased in the GOS-administered groups compared to the control group. The distribution of interstitial cells of Cajal, which is related to the intestinal movement, showed a significant increase in GOS-administered groups than in the control group (p < 0.01, both). The relative abundance of lactic acid bacteria (LAB), especially Lactobacillus and Lactococcus, significantly increased in the GL group than in the control group. Furthermore, there was a positive correlation between short chain fatty acids (SCFAs) and the gut microbiota in the GL groups. These results demonstrated that GOS administration effectively alleviates constipation by increasing LAB proliferation in the intestinal microbiota and SCFA production.
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Affiliation(s)
| | | | | | | | - Ki-Bae Hong
- Correspondence: ; Tel.: +82-2-940-2853; Fax: +82-2-921-7207
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Adamberg K, Jaagura M, Aaspõllu A, Nurk E, Adamberg S. The composition of faecal microbiota is related to the amount and variety of dietary fibres. Int J Food Sci Nutr 2020; 71:845-855. [DOI: 10.1080/09637486.2020.1727864] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Kaarel Adamberg
- Center of Food and Fermentation Technologies, Tallinn, Estonia
- Department of Chemistry and Biotechnology, Tallinn University of Technology, Tallinn, Estonia
| | - Madis Jaagura
- Center of Food and Fermentation Technologies, Tallinn, Estonia
- Department of Chemistry and Biotechnology, Tallinn University of Technology, Tallinn, Estonia
| | - Anu Aaspõllu
- National Institute for Health Development, Tallinn, Estonia
| | - Eha Nurk
- National Institute for Health Development, Tallinn, Estonia
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Signe Adamberg
- Department of Chemistry and Biotechnology, Tallinn University of Technology, Tallinn, Estonia
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9
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Kim JE, Yun WB, Lee ML, Choi JY, Park JJ, Kim HR, Song BR, Hong JT, Song HK, Hwang DY. Synergic Laxative Effects of an Herbal Mixture of Liriope platyphylla, Glycyrrhiza uralensis, and Cinnamomum cassia in Loperamide-Induced Constipation of Sprague Dawley Rats. J Med Food 2019; 22:294-304. [PMID: 30724689 DOI: 10.1089/jmf.2018.4234] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Constipation is an acute or chronic illness attributed to various causes, ranging from lifestyle habits to side effects of a disease. To improve the laxative effects of some traditional medicines, herbal mixtures of Liriope platyphylla, Glycyrrhiza uralensis, and Cinnamomum cassia (LGC) were evaluated for their mechanism of action and therapeutic effects in loperamide (Lop)-induced constipated Sprague Dawley rats by examining alterations in excretion parameters, histological structure, mucin secretion, and related protein levels. Food intake and water consumption were constant for all animals. We observed that the Lop+LGC-treated group had significantly greater excretion of stool and urine than was observed in the Lop+Vehicle-treated group. Administration of LGC in the constipation model restored the intestinal transit ratio to normal levels, and increased the number of goblet cells, mucosal layer, and muscle thickness. Mucin secretion was greater in the Lop+LGC-treated group than in the Lop+Vehicle-treated group, and the expression of MUC2 and AQP8 genes were also increased. In addition, reverse transcription polymerase chain reaction and Western blot revealed an increase in the muscarinic acetylcholine receptors (mAChRs) in the Lop+LGC-treated group compared to the Lop+Vehicle-treated group. Furthermore, compared with the Lop+Vehicle-treated group, treatment with LGC reduced the phosphorylation of PKC and PI3K, and expression of Gα protein, but increased levels of IP3. Our results suggest that the traditional herbal mixture of LGC induces a potent laxative effect in Lop-induced constipation through mucosal tissue changes and mucin production. We also demonstrated that the laxative effect of LGC is closely related to the expression of mAChR and its downstream signals, suggesting the possibility of developing a constipation-laxative agent using LGC.
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Affiliation(s)
- Ji Eun Kim
- 1 Department of Biomaterials Science, College of Natural Resources & Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang, Korea
| | - Woo Bin Yun
- 1 Department of Biomaterials Science, College of Natural Resources & Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang, Korea
| | - Mi Lim Lee
- 1 Department of Biomaterials Science, College of Natural Resources & Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang, Korea
| | - Jun Young Choi
- 1 Department of Biomaterials Science, College of Natural Resources & Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang, Korea
| | - Jin Ju Park
- 1 Department of Biomaterials Science, College of Natural Resources & Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang, Korea
| | - Hye Ryeong Kim
- 1 Department of Biomaterials Science, College of Natural Resources & Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang, Korea
| | - Bo Ram Song
- 1 Department of Biomaterials Science, College of Natural Resources & Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang, Korea
| | - Jin Tae Hong
- 2 College of Pharmacy, Chungbuk National University, Chungju, Korea
| | - Hyun Keun Song
- 3 Biomedical Science Institute, Changwon National University, Changwon-si, Gyeongsangnam-do, Korea
| | - Dae Youn Hwang
- 1 Department of Biomaterials Science, College of Natural Resources & Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang, Korea
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10
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Chuah KH, Mahadeva S. Cultural Factors Influencing Functional Gastrointestinal Disorders in the East. J Neurogastroenterol Motil 2018; 24:536-543. [PMID: 30153722 PMCID: PMC6175561 DOI: 10.5056/jnm18064] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/16/2018] [Accepted: 07/21/2018] [Indexed: 01/06/2023] Open
Abstract
Culture forms an integral aspect of environmental factors which influences disease presentation and clinical outcomes in functionalgastrointestinal disorders (FGIDs). In this review, the role of culture in FGIDs in the East is briefly explored with regards to symptompresentation and diagnostic issues, lifestyle and cultural habits, epidemiology, and healthcare seeking behavior. In both functionaldyspepsia and irritable bowel syndrome, symptom presentation and disease sub-typing in Asians are known to differ from their Western counterparts, possibly relating to cultural dietary practices and from cultural perception of symptoms. Dietary patterns, together with defecating practices are explored as factors contributing to a lower prevalence of constipation in the East. An urban-rural difference in the prevalence of FGIDs in Asia is attributed to a change in dietary patterns in rapidly developing urban communities, together with an increased level of psychological morbidity. Lastly, cultural attitudes towards traditional/local remedies, variation in healthcare systems, anxiety regarding organic disease, and religious practices have been shown to influence healthcare seeking behavior among FGID patients in the East.
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Affiliation(s)
- Kee-Huat Chuah
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur,
Malaysia
| | - Sanjiv Mahadeva
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur,
Malaysia
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11
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Gill PA, van Zelm MC, Muir JG, Gibson PR. Review article: short chain fatty acids as potential therapeutic agents in human gastrointestinal and inflammatory disorders. Aliment Pharmacol Ther 2018; 48:15-34. [PMID: 29722430 DOI: 10.1111/apt.14689] [Citation(s) in RCA: 330] [Impact Index Per Article: 47.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/09/2018] [Accepted: 04/06/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Butyrate, propionate and acetate are short chain fatty acids (SCFA), important for maintaining a healthy colon and are considered as protective in colorectal carcinogenesis. However, they may also regulate immune responses and the composition of the intestinal microbiota. Consequently, their importance in a variety of chronic inflammatory diseases is emerging. AIMS To review the physiology and metabolism of SCFA in humans, cellular and molecular mechanisms by which SCFA may act in health and disease, and approaches for therapeutic delivery of SCFA. METHODS A PubMed literature search was conducted for clinical and pre-clinical studies using search terms: 'dietary fibre', short-chain fatty acids', 'acetate', 'propionate', 'butyrate', 'inflammation', 'immune', 'gastrointestinal', 'metabolism'. RESULTS A wide range of pre-clinical evidence supports roles for SCFA as modulators of not only colonic function, but also multiple inflammatory and metabolic processes. SCFA are implicated in many autoimmune, allergic and metabolic diseases. However, translating effects of SCFA from animal studies to human disease is limited by physiological and dietary differences and by the challenge of delivering sufficient amounts of SCFA to the target sites that include the colon and the systemic circulation. Development of novel targeted approaches for colonic delivery, combined with postbiotic supplementation, may represent desirable strategies to achieve adequate targeted SCFA delivery. CONCLUSIONS There is a large array of potential disease-modulating effects of SCFA. Adequate targeted delivery to the sites of action is the main limitation of such application. The ongoing development and evaluation of novel delivery techniques offer potential for translating promise to therapeutic benefit.
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Affiliation(s)
- P A Gill
- Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Vic., Australia.,Department of Immunology and Pathology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Vic, Australia
| | - M C van Zelm
- Department of Immunology and Pathology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Vic, Australia
| | - J G Muir
- Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Vic., Australia
| | - P R Gibson
- Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Vic., Australia
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13
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Liu ZM, Xu ZY, Han M, Guo BH. Efficacy of pasteurised yoghurt in improving chronic constipation: A randomised, double-blind, placebo-controlled trial. Int Dairy J 2015. [DOI: 10.1016/j.idairyj.2014.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Scholtens PAMJ, Goossens DAM, Staiano A. Stool characteristics of infants receiving short-chain galacto-oligosaccharides and long-chain fructo-oligosaccharides: A review. World J Gastroenterol 2014; 20:13446-13452. [PMID: 25309075 PMCID: PMC4188896 DOI: 10.3748/wjg.v20.i37.13446] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 05/09/2014] [Accepted: 06/13/2014] [Indexed: 02/06/2023] Open
Abstract
Human milk is considered to be the optimal source of infant nutrition. Some of the benefits of breastfeeding have been ascribed to human milk oligosaccharides (HMO). For instance, HMO can affect faecal characteristics such as stool consistency and stool frequency. Such effects on stool characteristics can be beneficial for young infants as hard stools and even constipation is common in that age group. Prebiotics in infant milk formulas have been introduced to exert similar functionalities. A specific mixture of prebiotics consists of a combination of short chain galacto-oligosaccharides and long-chain fructo-oligosaccharides (scGOS/lcFOS) in a ratio of 9:1. This specific mixture has been developed to closely resemble the molecular size composition of HMO. Many studies have been done with scGOS/lcFOS, and indicators for digestive comfort have often been included as secondary outcomes. This review summarizes the effects of scGOS/lcFOS (9:1) on stool consistency, stool frequency and transit time in healthy term and preterm infants. In several of the studies with scGOS/lcFOS in a ratio of 9:1 in infant milk formulas, positive effects of this mixture on stool characteristics such as stool consistency and stool frequency were observed. As stool consistency was shown to be correlated to whole gut transit time, scGOS/lcFOS can be hypothesised to have a role in reducing the risk of constipation.
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15
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Effect of a snack with high fibre content on defecation frequency in a stipsi-affected cohort of volunteers. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2013. [DOI: 10.1007/s12349-013-0128-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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16
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Drummond L, Gearry RB. Kiwifruit modulation of gastrointestinal motility. ADVANCES IN FOOD AND NUTRITION RESEARCH 2013; 68:219-32. [PMID: 23394990 DOI: 10.1016/b978-0-12-394294-4.00012-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Disorders of gastrointestinal motility are common, resulting in a decreased quality of life of individuals, and an economic burden. Gastrointestinal motility is categorized according to location within the gastrointestinal tract: stomach, small intestine, and colon, with the colon being the dominant compartment in determining overall gastrointestinal transit. Constipation results from gastrointestinal dysmotility and is a significant chronic health issue globally. Clinical studies in a range of adult populations consistently indicate that kiwifruit are a highly effective dietary option to promote laxation. This, together with emerging evidence for the putative effects of kiwifruit in beneficially promoting gastric emptying and digesta mixing, suggests that kiwifruit are physiologically active throughout the gastrointestinal tract. Although the mechanisms of this action remain unknown, the unique behavior of kiwifruit fiber during digestion and the potential action of bioactive components in kiwifruit may contribute to the effectiveness of kiwifruit in modulating gastrointestinal motility.
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Hu JL, Nie SP, Min FF, Xie MY. Polysaccharide from seeds of Plantago asiatica L. increases short-chain fatty acid production and fecal moisture along with lowering pH in mouse colon. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2012; 60:11525-11532. [PMID: 23113806 DOI: 10.1021/jf302169u] [Citation(s) in RCA: 124] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Mice (20.0 ± 2.0 g, n = 48 per group) were given 30 days oral administration of polysaccharide from Plantago asiatica L. seeds at the dose of 0.4 g/kg body weight by gavage to investigate the effects of the polysaccharide on mouse colon. Results showed that the concentrations of total short-chain fatty acids (SCFA), acetic, propionic, and n-butyric acids in mouse colonic content of polysaccharide treated group were all significantly higher than that of control group (water) (p < 0.05). In addition, moisture of mouse colonic content of polysaccharide treated group was also notably higher than that of the control group (p < 0.05) indicating the intake of polysaccharide from P. asiatica L. resulted in a stronger water-holding capacity for colonic content throughout the experimental period. Furthermore, a decreased pH (from 7.5 ± 0.1 to 7.2 ± 0.1) was observed in mouse colon of the polysaccharide treated group compared with the control group (pH from 7.5 ± 0.1 to 7.5 ± 0.1). These results suggested that the intake of the polysaccharide from P. asiatica L. might be beneficial for the colon health.
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Affiliation(s)
- Jie-Lun Hu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
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Abstract
The bacterial colonization is defined immediately after birth, through direct contact with maternal microbiota and may be influenced during lactation. There is emerging evidence indicating that quantitative and qualitative changes on gut microbiota contribute to alterations in the mucosal activation of immune system leading to intra- or extra-intestinal diseases. A balance between pathogenic and beneficial microbiota throughout childhood and adolescence is important to gastrointestinal health, including protection against pathogens, inhibition of pathogens, nutrient processing (synthesis of vitamin K), stimulation of angiogenesis, and regulation of host fat storage. Probiotics can promote an intentional modulation of intestinal microbiota favoring the health of the host. This paper is a review about modulation of intestinal microbiota on prevention and adjuvant treatment of pediatric gastrointestinal diseases.
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Gélinas P. Preventing constipation: a review of the laxative potential of food ingredients. Int J Food Sci Technol 2012. [DOI: 10.1111/j.1365-2621.2012.03207.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Pierre Gélinas
- Food Research and Development Centre; Agriculture and Agri-Food Canada; 3600 Casavant Blvd. West; Saint-Hyacinthe; Quebec; J2S 8E3; Canada
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Kim JY, Son BK, Lee SS. Effects of adlay, buckwheat, and barley on transit time and the antioxidative system in obesity induced rats. Nutr Res Pract 2012; 6:208-12. [PMID: 22808344 PMCID: PMC3395785 DOI: 10.4162/nrp.2012.6.3.208] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 05/13/2012] [Accepted: 05/24/2012] [Indexed: 11/30/2022] Open
Abstract
In the present study, we examined whether four grains including adlay (AD), buckwheat (BW), glutinous barley (GB), and white rice (WR) affect the duration of food residence in the gastrointestinal tract and hepatic enzyme activities in rats fed different combinations of the grains. The rats were raised for 4 weeks on a high fat diet based on the American Institute of Nutrition-93 (AIN-93G) diets containing 1% cholesterol and 20% dietary lipids. Forty male rats were divided into four groups and raised for 4 weeks with a diet containing one of the grains. Corresponding to the dietary fiber contents of the experimental grains, gut transit time was shortest in the rats fed GB and increased in the order of BW, AD, and WR. In addition, the accumulated shortest transit time occurred in the GB group. Gut transit time affected weight gain and major organ weight, as it was closely related to the absorption of nutrients. The level of thiobarbituric acid reactive substance (TBARS) in liver was higher in rats fed WR, AD, BW, and GB, indicating that the other grains decreased oxidative stress in vivo more than WR. Glutathione, glutathione peroxidase, and glutathione S-transferase levels in the AD, BW, and GB groups were significantly higher than those in the WR group. In conclusion, reduced colonic transit time has been implicated in reducing the incidence of colon cancer, as evidenced by populations consuming diets rich in fiber. Whole grains such as AD, BW, and GB may contribute to a significant supply of antioxidants to prevent oxidative stress if they are consumed in large amounts.
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Affiliation(s)
- Jung Yun Kim
- Department of Food and Nutrition, Bucheon University, Bucheon 420-735, Korea
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New prebiotic blend of polydextrose and galacto-oligosaccharides has a bifidogenic effect in young infants. J Pediatr Gastroenterol Nutr 2012; 54:343-52. [PMID: 21946836 DOI: 10.1097/mpg.0b013e318237ed95] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the effect of infant formula with polydextrose (PDX) and galacto-oligosaccharides (GOS) on fecal microbiota and secretory IgA (sIgA). MATERIALS AND METHODS In the present double-blind, randomized study, term infants received control (Enfamil Lipil) or the same formula with PDX/GOS (4 g/L, 1:1 ratio; PDX/GOS) for 60 days; a reference breast-fed group was included. Formula intake, tolerance, and stool characteristics were collected via electronic diary and analyzed by repeated measures analysis of variance. Anthropometric measurements and stool samples were obtained at baseline and after 30 and 60 days of feeding. Fecal sIgA was measured by enzyme-linked immunosorbent assay and fecal bacteria by fluorescent in situ hybridization and quantitative real-time polymerase chain reaction (qPCR); both were analyzed by Wilcoxon rank sum test. RESULTS Two hundred thirty infants completed the study. Infants consuming PDX/GOS had softer stools than control at all times (P < 0.001). Using qPCR, counts in PDX/GOS were closer to the breast-fed group, tended to be higher than control for total bifidobacteria (P = 0.069) and Bifidobacterium longum (P = 0.057) at 30 days, and were significantly higher for total bifidobacteria and B longum at 60 days and B infantis at 30 days (P = 0.002). No significant differences were detected between PDX/GOS and control in changes from baseline to 30 or 60 days for sIgA or total bifidobacteria by fluorescent in situ hybridization or qPCR; however, significantly higher changes from baseline were detected between PDX/GOS and control for B infantis at 30 days and B longum at 60 days (P ≤ 0.035). CONCLUSIONS Infant formula with PDX/GOS produces soft stools and a bifidogenic effect closer to breast milk than formula without PDX/GOS.
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Stool pattern changes in toddlers consuming a follow-on formula supplemented with polydextrose and galactooligosaccharides. J Pediatr Gastroenterol Nutr 2012; 54:288-90. [PMID: 22002482 DOI: 10.1097/mpg.0b013e31823a8a4c] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Healthy 9- to 48-month-old children (n = 133) were randomized to receive a cow's-milk-based follow-on formula (control) or the same formula with polydextrose and galactooligosaccharides (PDX/GOS) for 108 days. Pediatricians assessed diarrheal disease, stool pattern, acute respiratory infection, systemic antibiotic use, and growth. The 2 groups had similar weight-for-length/height z score and similar odds of having diarrheal disease, acute respiratory infection, and systemic antibiotic use; however, PDX/GOS had greater odds of increased defecation than control (P ≤ 0.01). Addition of PDX and GOS to a follow-on formula was well tolerated and induced a pattern of more frequent and softer stools in toddlers.
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Choi SM, Yang S, Song HH. A Composite Trend Test with Symptom Occurrence and Severity Symptom Scores. KOREAN JOURNAL OF APPLIED STATISTICS 2011. [DOI: 10.5351/kjas.2011.24.6.1045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
Constipation in children is an often long-lasting pediatric functional gastrointestinal disorder with a worldwide prevalence varying between 0.7% and 29.6%, and estimated health-care costs of US$3.9 billion per year in the USA alone. The pathophysiology of childhood constipation is multifactorial and remains incompletely understood; however, withholding of stools, starting after an experience of a hard, painful, or frightening bowel movement is the most common cause found in children. A thorough medical history and physical examination, including a rectal examination in combination with a bowel diary, is sufficient in the majority of cases to diagnose constipation. The current standard treatment consists of education, toilet training, disimpaction, maintenance therapy and long-term follow-up. In the past decade, well-designed treatment trials in the pediatric population have emerged and long-term outcome studies have been completed. This Review summarizes the current knowledge of the clinical aspects of childhood constipation, including pathogenesis, diagnosis and treatment, with particular emphasis on the latest available data.
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Clinical Nutrition University: Nutrition in the prevention and management of irritable bowel syndrome, constipation and diverticulosis. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.eclnm.2011.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Kim DG, Jin YG, Jin JY, Kim SC, Kim SC, Han CH, Lee YJ. Effects of the Actindia chinensis on Loperamide-induced Constipation in Rat. ACTA ACUST UNITED AC 2011. [DOI: 10.7732/kjpr.2011.24.1.061] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Quigley EMM. The enteric microbiota in the pathogenesis and management of constipation. Best Pract Res Clin Gastroenterol 2011; 25:119-26. [PMID: 21382583 DOI: 10.1016/j.bpg.2011.01.003] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 01/05/2011] [Indexed: 01/31/2023]
Abstract
For centuries, fiber has been recommended on an empirical basis for the management of constipation; it has only been in recent decades that the mechanisms whereby fiber and related products may influence colonic function have begun to be elucidated. The interaction between fiber and the microbiota of the human colon appears to play a major role in generating the beneficial effects of fiber. The microbiota is also the target for the other therapeutic interventions discussed in this chapter: prebiotics and probiotics. While a scientific basis for a role for these approaches in the management of constipation continues to develop, evidence from high-quality clinical trials to support their use in daily practice continues to lag far behind. While benefits for fiber and, perhaps, for certain prebiotic and probiotic preparations in constipation appear to be extant there is a real need for large well-conducted clinical trials in this important area of human medicine.
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Affiliation(s)
- E M M Quigley
- Department of Medicine, Clinical Sciences Building, Cork University Hospital, Alimentary Pharmabiotic Centre, Ireland.
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Abstract
AbstractAim: To assess the efficacy of a probiotic preparation on the prevention of radiation-induced diarrhoea in cancer patients.Methods: Group of 42 radio-oncology patients who had undergone adjuvant post-operative radiation therapy (RT) after abdominal and pelvic cancer were randomised to receive either the probiotic preparation “5” Strain Dophilus (twice per day; L-Group), or the preparation Hylak Tropfen Forte (40 drops, three times per day; H-Group). Supplementation started on the first day and lasted until the end of RT. Efficacy endpoints were the incidence and the severity of the radiation-induced diarrhoea. All patients received a paper form in which they recorded monitored parameters on a daily basis during RT.Results: The mean daily number of bowel movements during the whole period was 4.16 in the L-Group and 2.52 in the H-Group; 62.5% of patients in L-Group and 81% in H-Group had a mean daily number of bowel movements of ≤4/day. Abdominal pain was recorded in 25% of the patients in L-Group and 22% of the patients in H-Group. Blood in the bowel movement was found in one patient from H-Group (9 days). Of patients in L-Group, 27% required diphenoxylate treatment during pelvic radiotherapy, compared with 55% in H-Group. Of patients from L-Group, 9% required antibiotics administration, compared with 25% in H-Group.Conclusion: We concluded that the prophylactic probiotic therapy produced a highly favourable benefit/risk ratio. Supplementation with the probiotic preparation is an easy and safe approach to protect cancer patients from the risk of radiation-induced diarrhoea and carry out improvement in their quality of life.
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Effect of dietary fibre mixture on growth and intestinal iron absorption in rats recovering from iron-deficiency anaemia. Br J Nutr 2010; 104:1471-6. [DOI: 10.1017/s0007114510002497] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
There is concern regarding the possible negative effects of ingestion of dietary fibre on growth and intestinal Fe absorption in infants. The aim of the present study was to compare the effect of a fibre mixture on the growth and the intestinal absorption of Fe in rats with Fe-deficiency anaemia with that of a diet without fibres. Faecal weight and caecal pH were also evaluated. According to the Hb depletion–repletion model, twenty-two male weaned Wistar rats were fed the AIN93-G diet without Fe until Fe-deficiency anaemia was induced with Hb < 70 g/l. The anaemic rats were divided into two groups: (1) fibre mixture group – fed 100 g of fibre mixture/kg of diet (soya polysaccharide, inulin, resistant starch, Arabic gum, fructo-oligossaccharide and cellulose) (n 11); (2) control group – fed without fibres (n 11). All diets had 157 mg of ferric citrate (30 mg of elemental Fe) added to lead to recovery from anaemia. Fe intestinal absorption was measured by Hb repletion efficiency (HRE) and apparent Fe intestinal absorption. The HRE was 44·8 (sd 9·5) % in the fibre mixture group and 43·0 (sd 9·5) % in the control group (P = 0·664). The apparent Fe absorption was 46·2 (sd 16·5) and 47·2 (sd 10·2) % (P = 0·861) in the fibre mixture and control groups, respectively. The faecal weight median was 6·17 g in the fibre mixture group and 2·11 g in the control group (P < 0·001). The caecal pH was in the same order: 6·11 (sd 0·59) and 7·07 (sd 0·34) (P < 0·001). Both the groups consumed similar quantities of diet, and growth was similar in both the groups. The fibre mixture had no influence either on growth or on Fe intestinal absorption in rats recovering from anaemia. This mixture favoured an increase in faecal weight and a decrease in caecal pH.
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Chao HC, Lai MW, Kong MS, Chen SY, Chen CC, Chiu CH. Cutoff volume of dietary fiber to ameliorate constipation in children. J Pediatr 2008; 153:45-9. [PMID: 18571534 DOI: 10.1016/j.jpeds.2007.12.044] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2007] [Revised: 11/19/2007] [Accepted: 12/18/2007] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To evaluate the proper ingested volume of dietary fiber for relieving constipation in children. STUDY DESIGN During a 3-year period, we prospectively evaluated the correlation of intake volume of dietary fiber with improvement of constipation in children. Patients were categorized into younger (3-7 years) and older (8-14 years) children. The evaluation period lasted 12 weeks. A good improvement was defined as the child exhibiting at least 60% relief of the constipation symptoms during the observation period. Freedom from constipation was observed during the last 4 weeks. RESULTS The study population consisted of 422 patients (213 younger, 209 older), with a mean age of 7.89 +/- 4.71 years. Baseline daily dietary fiber intake of the younger and older groups was 5.97 +/- 2.35 g and 9.83 +/- 3.51 g, respectively. 227 cases (53.8 %) showed improvement of constipation, and 49.1 % of the patients had relief of constipation. Greater intake of dietary fiber was positively associated with good improvement of constipation in both groups (P = .002, and P < .001). Cutoff volumes of daily dietary fiber intake in the relief of constipation were 10 g in the younger group and 14.5 g in the older group. CONCLUSION The cutoff of dietary fiber intake needed to relieve constipation increased with age, achievable in a 12-week intervention.
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Affiliation(s)
- Hsun-Chin Chao
- Division of Gastroenterology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
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Abstract
Constipation and encopresis (fecal soiling) are common childhood disorders that may lead to significant functional impairment. The etiology and course of constipation and encopresis are increasingly conceptualized from a broad biopsychosocial perspective, and therefore a holistic approach to assessment and treatment is indicated. Many children experience symptoms of chronic constipation and/or encopresis that are only partially responsive to conventional medical therapy. Complementary/alternative therapies can often help in the treatment of constipation/encopresis and are well accepted by patients and families.
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Affiliation(s)
- Timothy P Culbert
- Integrative Medicine Program, Children's Hospitals and Clinics of Minnesota, 2525 Chicago Avenue South, Minneapolis, MN 55404, USA.
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A method for determination of soluble dietary fiber in methylcellulose and hydroxypropyl methylcellulose food gums. J Food Compost Anal 2007. [DOI: 10.1016/j.jfca.2006.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
Constipation is an unpleasant and distressing symptom that many palliative care patients may experience, often having a profound effect on their quality of life. The many management options available reflect the multifactorial nature of constipation. The article explores the complexity of constipation in palliative care and highlights the challenge of managing opioid-induced constipation. Advances in the pharmacological and non-pharmacological management of constipation are reviewed and discussed in the light of relevant research. Further discussion includes definitions, incidence and causes of constipation in palliative care.
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Affiliation(s)
- Gaye Kyle
- Thames Valley University, Slough SL1 1YG, UK.
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Nyman M. Fermentation and bulking capacity of indigestible carbohydrates: the case of inulin and oligofructose. Br J Nutr 2007. [DOI: 10.1079/bjn/2002533] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The bulking index (i.e. the increase in faecal fresh weight in gram per gram indigestible carbohydrate ingested) with oligofructose and inulin is similar to that produced with other easily fermented fibres such as pectins and gums. Most studies in man have been performed at a level of 15 g/d and more investigations on lower intakes are needed to appoint the least intake for an effect. Concerning short-chain fatty acids (SCFA) most studies have been using oligofructose and points at an increased butyric acid formation in the caecum of rats. In one study on rats with inulin high caecal proportions of propionic acid were obtained. As inulin has a higher molecular weight than oligofructose it might be speculated if this could be a reason to the different SCFA-profile formed. No effects on faecal concentrations of SCFA in humans have been revealed with inulin and oligofructose, which neither is expected as most of the SCFA formed during the fermentation already has been absorbed or utilized by the colonic mucosa.
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de Cássia Freitas K, Amancio OMS, Ferreira Novo N, Fagundes-Neto U, de Morais MB. Partially hydrolyzed guar gum increases intestinal absorption of iron in growing rats with iron deficiency anemia. Clin Nutr 2006; 25:851-8. [PMID: 16678310 DOI: 10.1016/j.clnu.2006.02.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2005] [Revised: 02/23/2006] [Accepted: 02/26/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the effect of partially hydrolyzed guar gum (PHGG) dietary fiber towards intestinal iron absorption, for dietary intake and on the growth of rats with iron deficiency anemia in comparison to those fed on a diet with cellulose and without dietary fiber. MATERIALS AND METHODS Male Wistar rats (n=24) weaned at 21 days were fed with AIN93-G diet without iron for 2 weeks in order to induce iron deficiency anemia. At 36 days old, the anemic rats were divided into three groups: (1) PHGG group-100g of PHGG per kg of diet; (2) Cellulose group-100g of cellulose per kg of diet; (3) Control group-diet without dietary fiber. All the diets had 25mg of elemental iron/kg of diet added to lead to recovery from iron deficiency anemia. RESULTS The final hemoglobin values in g/dl, for the PHGG group, the cellulose group and the control group were, respectively: 11.3+/-1.2, 8.6+/-0.7 and 8.1+/-0.9 (P<0.001). The levels of hepatic iron, in mug/g of dry tissue, in the same order, were: 322.2+/-66.6, 217.2+/-59.1 and 203.7+/-42.4 (P<0.001). Apparent iron intestinal absorption was, respectively: 67.5+/-8.9%, 35.4+/-15.3% and 31.3+/-24.9% (P<0.001). The three groups consumed similar quantities of diet. The changes in weight and in body length were similar in the three groups studied. CONCLUSION PHGG led to greater intestinal absorption of iron, regeneration of hemoglobin and hepatic levels of iron than diet with cellulose and diet control.
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Affiliation(s)
- Karine de Cássia Freitas
- Pediatric Gastroenterology Department, Paulista School of Medicine (UNIFESP-EPM), Federal University of Sao Paulo, Rua Pedro de Toledo, 441, Sao Paulo-SP, CEP 04039-031, Brazil
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Gasbarrini G, Candelli M, Graziosetto RG, Coccheri S, Di Iorio F, Nappi G. Evaluation of thermal water in patients with functional dyspepsia and irritable bowel syndrome accompanying constipation. World J Gastroenterol 2006; 12:2556-62. [PMID: 16688801 PMCID: PMC4087988 DOI: 10.3748/wjg.v12.i16.2556] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the efficacy of water supplementation treatment in patients with functional dyspepsia or irritable bowe syndrome (IBS) accompanying predominant constipation.
METHODS: A total of 3 872 patients with functional dyspepsia and 3 609 patients with irritable bowel syndrome were enrolled in the study by 18 Italina thermal centres. Patients underwent a first cycle of thermal therapy for 21 d. A year later patients were re-evaluated at the same centre and received another cycle of thermal therapy. A questionnare to collect personal data on social and
occupational status, family and pathological case history, life style, clinical records, utilisation of welfare and health structure and devices was administered to each patient at basal time and one year after each thermal treatment. Sixty patients with functional dyspepsia and 20 with IBS and 80 healthy controls received an evaluation of gastric output and oro-cecal transit time by breath test analysis. Breath test was performed at basal time and after water supplementaton therapies. Gastrointestinal symptoms were evaluated at the same time points. Breath samples were analyzed with a mass spectometer and a gascromatograph. Results were expressed as T1/2 and T-lag for octanoic acid breath test and as oro-cecal transit time for lactulose breath test.
RESULTS: A significant reduction of prevalence of symptoms was observed at the end of the first and second cycles of thermal therapy in dyspeptic and IBS patients. The analysis of variance showed a real and persistant improvement of symptoms in all patients. After water supplementation for 3 wk a reduction of gastric output was observed in 49 (87.5%) of 56 dyspeptic patients. Both T1/2 and T-lag were significantly reduced after the therapy compared to basal values [91 ± 12 (T1/2) and 53 ± 11 (T-lag), Tables 1 and 2] with results of octanoic acid breath test similar to healthy subjects. After water supplementation for 3 wk oro-cecal transit time was shorter than that at the beginning of the study.
CONCLUSION: Mineral water supplementation treatment for functional dyspepsia or conspipation accompanying IBS can improve gastric acid output and intestinal transit time.
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Abstract
Chronic constipation is defined as a symptom-based disorder based on the presence for at least 3 months in the last year of unsatisfactory defecation characterized by infrequent stools, difficult stool passage, or both. On the other hand, the presence of clinically important abdominal discomfort or pain associated with constipation defines irritable bowel syndrome (IBS) with constipation. Intake of dietary fibre and bulking agents (psyllium) may be effective in alleviating chronic constipation in patients without slow colonic transit or disordered constipation. On the other hand, fibre may improve stool consistency in patients with IBS with constipation, but it is considered to be not effective in improving abdominal pain, distension or bloating. Probiotics may be effective in relieving constipation; however, the effect of lactic acid bacteria ingestion may be dependent on the bacterial strain used and the population being studied. Lactulose, which is a substrate for lactic acid bacteria (prebiotic), is effective to treat patients with chronic constipation.
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Affiliation(s)
- Fernando Fernández-Bañares
- Department of Gastroenterology, Hospital Universitari Mutua Terrassa, Plaza Dr Robert 5, 08221 Terrassa, Barcelona, Spain.
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38
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Fibre effects on intestinal functions (diarrhoea, constipation and irritable bowel syndrome). ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.clnu.2004.09.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Tungland B, Meyer D. Nondigestible Oligo- and Polysaccharides (Dietary Fiber): Their Physiology and Role in Human Health and Food. Compr Rev Food Sci Food Saf 2002; 1:90-109. [DOI: 10.1111/j.1541-4337.2002.tb00009.x] [Citation(s) in RCA: 271] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Menteş BB, Görgül A, Tatlicioğlu E, Ayoğlu F, Unal S. Efficacy of calcium dobesilate in treating acute attacks of hemorrhoidal disease. Dis Colon Rectum 2001; 44:1489-95. [PMID: 11598479 DOI: 10.1007/bf02234604] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE A randomized, double-blind, controlled study was conducted to investigate the efficacy of oral calcium dobesilate therapy in treating acute attacks of internal hemorrhoids. METHODS Twenty-nine well-documented adult patients with first- or second-degree internal hemorrhoids were treated with calcium dobesilate for two weeks, while16 patients received only a high-fiber diet to serve as control. Both symptoms and anoscopic inflammation were scored on a scale from 0 to 2 before (T0) and two weeks after treatment (T2). RESULTS A success rate of 86.21 percent with cessation of bleeding plus lack of severe anitis anoscopically at two weeks were achieved with calcium dobesilate. The pretreatment symptom score of 2 fell significantly to 0.45 +/- 0.13, and the pretreatment anitis score of 1.69 +/- 0.09 fell to 0.55 +/- 0.12 at T2 (P = 0.0001 for both comparisons). The symptom and anoscopic inflammation scores obtained with calcium dobesilate treatment were also significantly better than those with diet only (P = 0.0017 and P = 0.0013, respectively). CONCLUSION Together with recommendations about diet and bowel discipline, oral calcium dobesilate treatment provides an efficient, fast, and safe symptomatic relief from acute symptoms of hemorrhoidal disease. This symptomatic healing is associated with a significant improvement in the anoscopically observed inflammation.
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Affiliation(s)
- B B Menteş
- Public Health, Gazi University Medical School, Ankara, Turkey
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Silk DB, Walters ER, Duncan HD, Green CJ. The effect of a polymeric enteral formula supplemented with a mixture of six fibres on normal human bowel function and colonic motility. Clin Nutr 2001; 20:49-58. [PMID: 11161544 DOI: 10.1054/clnu.2000.0359] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND AIMS Fibres with varying fermentability may improve bowel function during enteral feeding. Two studies in healthy volunteers aimed to 1) investigate effects of Nutrison Multi Fibre (NMF) on gastrointestinal function, and 2) compare effects of NMF administered orally and nasogastrically on distal colonic motor activity. METHODS (1) Ten subjects were randomly assigned to 3x7 days self-selected diet (SSD), 2 litres Nutrison Standard (NS), or 2 l NMF. Objective and subjective indices were measured. (2) Two groups (n=6) received 2x250 ml boluses of NMF 2 hourly either nasogastrically or orally. Distal colonic motility was measured for 8 h (3 pre/5 post) first bolus. RESULTS Whole gut transit time was prolonged during NS (P<0.05) compared with SSD or NMF. Stool wet weight was higher during SSD (P<0.05) than during NS or NMF. Bowel frequencies were comparable. NMF was well tolerated. 2. Colonic activity index was maintained after oral administration with no associated diarrhoea. Activity index decreased after nasogastric bolus (P<0.05), but recovered to higher than fasting levels (P<0.05). 5 subjects had watery stools. CONCLUSIONS Oral NMF is well tolerated, normalises whole gut transit time and maintains colonic motility. Recovery of colonic activity after nasogastric bolus suggests a putative protective effect of NMF over a longer period of feeding.
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Affiliation(s)
- D B Silk
- Department of Gastroenterology and Nutrition, Central Middlesex Hospital, London, UK
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D'Argenio G, Mazzacca G. Short-chain fatty acid in the human colon. Relation to inflammatory bowel diseases and colon cancer. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2000; 472:149-58. [PMID: 10736623 DOI: 10.1007/978-1-4757-3230-6_13] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Short chain fatty acids (SCFAs) are the end products of anaerobic bacteria break down of carbohydrates in the large bowel. This process, namely fermentation, is an important function of the large bowel; SCFAs, mainly acetate, propionate and butyrate account for approximately 80% of the colonic anion concentration and are produced in nearly constant molar ratio 60:25:15. Among their various properties, SCFAs are readily absorbed by intestinal mucosa, are relatively high in caloric content, are metabolized by colonocytes and epatocytes, stimulate sodium and water absorption in the colon and are trophic to the intestinal mucosa. While the fermentative production of SCFAs has been acknowledged as a principal mechanism of intestinal digestion in ruminants, the interest in the effects of SCFAs production on the human organism has been raising in the last ten years. SCFAs are of major importance in understanding the physiological function of dietary fibers and their possible role in intestinal neoplasia. SCFAs production and absorption are closely related to the nourishment of colonic mucosa, its production from dietary carbohydrates is a mechanism whereby considerable amounts of calories can be produced in short-bowel patients with remaining colonic function and kept on an appropriate dietary regimen. SCFAs enemas or oral probiotics are a new and promising treatment for ulcerative colitis. The effects have been attributed to the oxidation of SCFAs in the colonocytes and to the ability of butyrate to induce enzymes (i.e. transglutaminase) promoting mucosal restitution. Evidence is mounting regarding the effects of butyrate on various cell functions the significance of which needs further considerations. Up until now, attention has been related especially to cancer prophylaxis and treatment. This article briefly reviews the role of SCFAs, particularly butyrate, in intestinal mucosal growth and potential clinical applications in inflammatory and neoplastic processes of the large bowel.
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Affiliation(s)
- G D'Argenio
- Gastrointestinal Unit, School of Medicine, Federico II University, Naples, Italy
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Staiano A, Simeone D, Del Giudice E, Miele E, Tozzi A, Toraldo C. Effect of the dietary fiber glucomannan on chronic constipation in neurologically impaired children. J Pediatr 2000; 136:41-5. [PMID: 10636972 DOI: 10.1016/s0022-3476(00)90047-7] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Inadequate dietary fiber intake is a widely accepted explanation for chronic constipation in children with severe brain damage. The aim of our study was to evaluate the efficacy of glucomannan, a soluble fiber, as a treatment for chronic constipation in these children. STUDY DESIGN Twenty children with severe brain damage and chronic constipation were randomly assigned to double-blind treatment with either glucomannan (n = 10) or placebo (n = 10) for 12 weeks. Stool habits, total and segmental gastrointestinal transit times, and anorectal motility were evaluated in all children before and after the treatment period. RESULTS Glucomannan significantly increased (P <.01) stool frequency, whereas the effect of placebo was not significant. Laxative or suppository use was significantly reduced (P <.01) by glucomannan but was not affected by placebo. Clinical scores of stool consistency were significantly improved and episodes of painful defecation per week were significantly reduced by glucomannan (P <.01) but not by placebo. However, neither glucomannan nor placebo had a measurable effect on total and segmental transit times. CONCLUSIONS In neurologically impaired children, glucomannan improves stool frequency but has no effect on colonic motility.
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Affiliation(s)
- A Staiano
- Department of Pediatrics, University Federico II, Naples, Italy
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Wong PW, Kadakia S. How to deal with chronic constipation. A stepwise method of establishing and treating the source of the problem. Postgrad Med 1999; 106:199-200, 203-4, 207-10. [PMID: 10576011 DOI: 10.3810/pgm.1999.11.777] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Chronic constipation is a common medical complaint encountered often in a primary care setting. Most patients can be treated successfully with simple measures, including education, bowel habit training, increased fluid and fiber intake, and use of laxatives. Chronic constipation is usually considered idiopathic, but secondary causes should be excluded. In about 1% of patients with severe, intractable constipation, further diagnostic testing (e.g., endoscopy, colonic transit study) is needed. Patients with colonic inertia can be treated with judicious use of laxatives, but surgery may be necessary in a few cases. Patients with outlet inertia should be referred for biofeedback treatment.
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Affiliation(s)
- P W Wong
- Gastroenterology Service, Brooke Army Medical Center, San Antonio, Texas 78234, USA.
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Roma E, Adamidis D, Nikolara R, Constantopoulos A, Messaritakis J. Diet and chronic constipation in children: the role of fiber. J Pediatr Gastroenterol Nutr 1999; 28:169-74. [PMID: 9932850 DOI: 10.1097/00005176-199902000-00015] [Citation(s) in RCA: 113] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Chronic constipation is one of the most common disorders in Western countries and despite numerous clinical, pathophysiologic, and epidemiologic studies its cause is still unclear. Several hypotheses have been proposed and according to experimental studies and clinical observation, fiber intake could play a role in its pathogenesis. The purpose of this case-control study was to examine the possible correlation of idiopathic chronic constipation in children and dietary intake, particularly fiber intake. METHODS A randomized sample of children (291 children with constipation and 1602 controls) aged 2 to 14 years was taken from three of the 52 counties of Greece. Stratification was performed on the basis of urban, rural, or suburban location and socioeconomic status. The nutritional data were obtained from a 3-day dietary record and a dietary history. Statistical analysis was performed with multivariate tests, multivariate analysis of variance, discriminant analysis, and chi-square analysis according to the characteristics of the correlated variables. RESULTS Constipated children had a lower caloric and nutrient intake (p < 0.001), lower body weight/height (p < 0.001), and higher prevalence of reported anorexia (p < 0.001). Discriminant analysis indicated that dietary fiber alone was independently negatively correlated with chronic constipation, despite the age and the age of onset of constipation. Relative risk also had a negative correlation with fiber intake (p < 0.001). Of the main fiber fractions only cellulose and pentose were independently correlated with chronic constipation. CONCLUSIONS Lack of fiber may play an important role in the etiology of chronic idiopathic constipation in children.
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Affiliation(s)
- E Roma
- First Department of Paediatrics, Athens University, Greece
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Aichbichler BW, Wenzl HH, Santa Ana CA, Porter JL, Schiller LR, Fordtran JS. A comparison of stool characteristics from normal and constipated people. Dig Dis Sci 1998; 43:2353-62. [PMID: 9824119 DOI: 10.1023/a:1026699525487] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In people with constipation, it is not known if decreased frequency of defecation is associated with abnormalities in the weight or in the consistency of stools or if the weight or the consistency of stools correlates with the severity of various discomforts associated with bowel movements. In neither normal nor constipated subjects has the consistency of stools been carefully correlated with their relative contents of water and solids. Our aim was to gain insight into these questions. Twenty subjects with idiopathic chronic constipation and 20 age- and sex-matched control subjects were recruited by advertisement. Stools were collected for one week. After each bowel movement, the subject's perception of various discomforts associated with the bowel movement were recorded. The stools were then analyzed. The results and conclusions were as follows: (1) Stool weight per bowel movement was similar in the two groups but stool weight per week was markedly reduced in constipated subjects. (2) Reduced stool weight per week in constipated subjects was due to a nearly proportional reduction in stool water and stool solids output. (3) Using data from both groups, there was a curvilinear correlation between percent insoluble stool solids and stool hardness, as measured by a texture analyzer; hardness increased only slightly as percent insoluble solids increased between 7 and 20%, but hardness increased dramatically when percent insoluble solids exceeded 25%. (4) Only 6% of stools from constipated subjects (2 of 34) had abnormally high values for percent stool solids and physical hardness. (5) In subjects with constipation, the severity of various discomforts associated with bowel movements (such as straining) correlated poorly with the weight or the hardness of stool that was produced by the bowel movement.
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Affiliation(s)
- B W Aichbichler
- Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas 75246, USA
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Macrae FA, Kilias D, Selbie L, Abbott M, Sharpe K, Young GP. Effect of cereal fibre source and processing on rectal epithelial cell proliferation. Gut 1997; 41:239-44. [PMID: 9301505 PMCID: PMC1891462 DOI: 10.1136/gut.41.2.239] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Low fat and wheat bran interventions significantly reduced the growth of small to large adenomas and modestly suppressed rectal epithelial cell proliferation in the Australian Polyp Prevention Project. AIM To study the effect of unprocessed wheat bran, unprocessed oat bran and processed wheat bran (Kellogg's All Bran) on rectal epithelial cell proliferation. PATIENTS Twenty subjects with recent adenomas and a high fat background diet were recruited. METHODS Rectal biopsy specimens were taken at entry and at the end of three six-week periods of oat bran (64 g/day), wheat bran (25 g/day) and All Bran (38 g/day), all in association with a diet < 25% energy as fat, in a randomised cross-over trial. Each of the bran supplements had a total of 11 g dietary fibre. The biopsy specimens were fixed in methacarn and stained immunohistochemically for presence of the proliferating cell nuclear antigen (PCNA). The kinetics used to measure proliferation were labelling index, whole distribution of labelled cells, and labelled cells in the top two-fifths of crypts using analysis of variance. RESULTS There were no significant differences in mean labelling indexes between the four diets or in the percentage of labelled cells in the top two-fifths (p = 0.59), but activity in the top two-fifths of crypts was lowest with wheat bran. The mean (SD) labelling indexes were 2.23 (0.11)% for control, 2.13 (0.08)% for wheat bran, 2.19 (0.09)% for oat bran, and 2.12 (0.08)% for All Bran. The proportion in the top two-fifths of the crypts was 2.6 (0.6)% for control, 2.15 (0.5)% for wheat bran, 3.3 (0.9)% for oat bran, and 3.1 (0.9)% for All Bran. On analysis of whole distribution, there was no significant overall effect of diets but there was a difference between subjects. Analysis including total fibre intake also did not identify effects on proliferation. CONCLUSION In this study of high risk subjects with initial high fat diets, dietary fibre in association with a low fat diet had no effect on rectal epithelial cell proliferation, although wheat bran had the greatest effect on percentage of labelled cells in the top two-fifths of crypts.
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Affiliation(s)
- F A Macrae
- Department of Gastroenterology, Royal Melbourne Hospital, Parkville, Victoria, Australia
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Abstract
Dietary guidance recommends consumption of whole grains to reduce the risk of chronic diseases including cancer and cardiovascular disease. Epidemiologic studies support the belief that whole grains are protective against cancers, especially gastrointestinal cancers such as gastric and colonic, and cardiovascular disease. Components in whole grains that may be protective are diverse and include compounds that affect the gut environment, i.e., dietary fiber, resistant starch, and other undigestible compounds in whole grains, compounds that function as antioxidants such as trace minerals and phenolic compounds, and compounds that are phytoestrogens with potential hormonal effects. Many of the protective compounds in whole grains are also in fruits and vegetables, but some plant compounds are more concentrated in whole grains, such as phenolic compounds including ferulic and caffeic acid. Other potential mechanistic effects of whole grains include binding of carcinogens and modulation of glycemic index. Clearly, the range of protective substances in whole grains is impressive, and advice to consume additional whole grains is justifiable.
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Affiliation(s)
- J Slavin
- Department of Food Science and Nutrition, University of Minnesota, St. Paul 55108, USA.
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Roberfroid MB. Functional effects of food components and the gastrointestinal system: chicory fructooligosaccharides. Nutr Rev 1996; 54:S38-42. [PMID: 9110574 DOI: 10.1111/j.1753-4887.1996.tb03817.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Functional food science, as recently proposed by ILSI Europe, opens new perspectives in nutrition and food sciences. The systematic investigation of the interactions between food components or food ingredients and genomic, biochemical, cellular, or physiological functions is a unique way to improve both our knowledge and the role of nutrition in maintaining good health and in preventing disease. However, such basic knowledge is insufficient to justify claims, unless it is confirmed through relevant nutrition studies aimed at demonstrating the same effect and its positive consequences in humans. In the first stage, this demonstration will in most cases justify functional (physiological) claims (e.g., bifidogenic effect for fructooligosaccharides, bulking effect for nondigestible carbohydrates, protection against oxidative stress for antioxidants) with no reference to any health benefit. A true health claim will require, in most cases, additional studies involving large populations and long-term trials. It is anticipated that the better we understand the mechanism of interactions between food components and specific biological functions, the more we will be able to demonstrate functional effects, and the easier it will be to accumulate convincing evidence in favor of health promotion or disease prevention. Because of both its direct contact with eaten foods and the diversity of its functions, the GI system is a potential target for many functional effects. Until now, only a limited number of these effects have been investigated so as to justify functional claims. Improvement of glucose absorption (leading to physiological glycemia and insulinemia), modulation of GI transit time, fecal bulking, acidification of colonic content, and control of cholesterol bioavailability are all recognized effects of dietary fiber. Balanced colonic microflora and immunostimulation are attributed to the consumption of probiotics. Prebiotics selectively modify the colonic microbiota and modulate hepatic lipogenesis. According to the ILSI Europe strategy for the development of functional foods, all these effects are of interest. Their support by sound scientific arguments will be a necessary condition for their implementation in food science and nutrition for the benefit of human health.
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Affiliation(s)
- M B Roberfroid
- Université Catholique de Louvain, Department of Pharmaceutical Sciences, Brussels, Belgium
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Abstract
The purpose of this article is to present an overview of pediatric constipation. Discussion of the definition from a medical and nursing point of view is included. Intestinal pathophysiology as well as etiological theories of pediatric constipation are reviewed. Current research to date and clinical treatment and experience in the area are presented. A rationale for further nursing research in this area is described.
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